This past weekend, I spoke at the Texas Osteopathic Medical Association conference. As I prepared my speech, I suddenly realized that what we had been telling people for years about the apple was entirely rotten! These days, I recommend that my clients and patients eat not only carbohydrate (the apple) but also fat and protein (think pairing the apple with peanut butter) with every meal or snack. The reason: Blood Sugar Control!
The 2010 Dietary Guidelines recommendations (new ones arrive in 2015) focused on foods that Americans need to increase and decrease. The foods to increase include fruits, vegetables, whole grains (complex carbohydrates) and low-fat and non-fat dairy foods. The foods to decrease include both refined grains and added sugars (simple carbohydrates). The primary function of carbohydrate is to provide glucose particularly important for the brain and central nervous system. Glucose is the main fuel for these systems. After a meal, glucose is stored in the muscles and liver as glycogen for the body to utilize for energy between meals by breaking glycogen back down into the glucose components.
As people become overweight, glucose homeostasis can become disrupted and insulin resistance may develop. When a meal is consumed, the pancreas secretes insulin to facilitate transport of glucose into the cells. How high insulin levels surge determines whether the body stores glucose as fat or uses glucose immediately. In insulin resistant individuals, the body cells do not respond to insulin. The pancreas continues to secrete more insulin in an effort to achieve a response. Insulin resistance can exacerbate a tendency towards Type 2 diabetes and perpetuate overconsumption in response to surging insulin levels and a lack of transport of glucose into the cells. However, insulin resistance is not caused by carbohydrate consumption rather overweight and genetics. When a person loses weight, insulin resistance may resolve.
The current American diet tends to provide an excess of simple sugars and starchy foods generally leading to poor nutrition and storage of excess calories as fat. In addition, low intake of fiber can lead to disorders of the gastrointestinal system. Added sugars or simple sugars are found in candy, sugar-sweetened beverages and desserts and generally provide calories with little vitamins or minerals. Complex carbohydrates or starches are found in potatoes, breads, cereals and starchy vegetables such as corn. These complex carbohydrates provide vitamins and minerals as well as fiber. Refined grains tend to provide less fiber and nutrients and have become increasingly prevalent in the American diet.
Eating complex carbohydrate sources such as fruits, vegetables and whole grains as suggested by the 2010 Dietary Guidelines for Americans, provides people with vitamins, minerals and fiber currently lacking in the American diet. These complex carbohydrates must be broken down to be absorbed and move more slowly through the digestive track helping people to feel fuller longer but also moderating blood glucose levels. However, eating complex carbohydrate alone can be problematic in rising of blood glucose when eaten without protein or fat. This may result in a rebound need for further eating or snacking. Overall, maintenance of blood glucose homeostasis and gastrointestinal integrity from eating complex carbohydrates such as the apple can promote optimal health and well-being just balance that carbohydrate by adding some protein and fat.