In my last article I drew attention to the fact that our dietary patterns are fuelling the fire of ill health in our population. The next step for me is to start to unpack this, highlight some key areas where this is occurring, and give some pointers as to how we can address this problem. The first part of this picture is blood sugar balance, and awareness of the carbohydrate content of our diet.
Over the last 50 years, the macronutrient composition of our diet has changed drastically. In the 60’s, 70’s and 80’s we were all told that saturated fat was the devil and to avoid it at all costs. We were told to cut out meat and cheese, etc., and instead build our diet around starchy foods and heart healthy oils (more on saturated fat and oils next time). This lead to a diet that was higher in starchy carbohydrates than is good for us. Let’s just use this example to illustrate how we took this on board.
How normal is it for people to have a bowl of cereal and a slice of toast for breakfast, a sandwich and packet of crisps for lunch, then potatoes or pasta for dinner? Pretty normal, nothing weird, right? None of these foods are “bad”, and I don’t like demonising individual foods, BUT consuming these foods in such high volumes on a consistent basis starts to cause metabolic chaos.
Carbohydrate metabolism explained
When we eat starchy foods, particularly refined ones that have had much of their fibre removed, our body can liberate the sugars that they contain pretty easily. This causes our blood sugar to rise rapidly. The body responds by releasing the hormone insulin, which binds to insulin receptors on the surface of our cells. This causes the opening of glucose transporters that allows glucose into our cells for use as energy. All well and good. Blood sugar spikes cause this response, and the problem is solved. The issue, however, is that many of us are consuming a diet that is constantly forcing our blood sugar up. This pattern of eating causes serious problems. Firstly, the process described above has a cut-off point. Our cells can only take in so much sugar in one sitting. They get full. When this happens, if our blood sugar is still high, it has to be dealt with as it is highly damaging. The next thing that happens is the excess sugar is shuttled to the liver. Here it is converted into a fatty substance called triacylglycerol aka triglycerides (these may have shown up in your blood tests before). This is basically a way for your body to store this additional energy. The triglycerides are sent for storage in your adipose tissue - and it becomes belly fat!
The path to disease
Triglycerides are sent to fat cells via our circulatory system, meaning that the they travel in the blood. Whilst here they are extremely susceptible to oxidation. If this occurs, it results in damage to the endothelium (the thin metabolically active skin that lines blood vessels). When this damage occurs, a whole cascade of events take place in response, that cause the formation of a plaque within the vessel wall (more on this soon). This event signals the beginning of heart disease. If this pattern of eating high glycaemic foods continues, then of course all of the above continues, but things also take another nasty turn. Because our body is pumping out insulin consistently, our insulin receptors soon start to ‘ignore’ insulin. We become insulin resistant, making it harder to clear blood sugar. When this first happens our body tried to deal with the problem by secreting more insulin, which worked for a while. Eventually insulin receptors really dig their heels in and resist insulin's message. At this point we are teetering on the edge of type 2 diabetes. As insulin’s signal isn't getting through, blood sugar remains dangerously high, which eventually causes toxicity to many tissues, including the beta cells in the pancreas. At this point, we have type 2 diabetes.
You can see that something as simple as the type and amounts of carbohydrates that we consume can have a massive influence on our susceptibility to disease, as well as influence its management.
Get carb smart
So what do we do about this? Simple. Follow these 2 steps to make a huge impact on your health:
Firstly, reduce your carbohydrate portion sizes at every given opportunity. If you are a pasta lover, fine, just reduce your normal portion size by half. Make up the volume again with non-starchy vegetables and protein. You like a sandwich? Ok, try an open sandwich instead.
Also, think about which type of carbohydrates you consume. Ditch the white at all costs. White bread, white rice, white pasta, etc. Swap them all for the brown variety. Brown or wholegrain varieties of these foods have a great deal more fibre in them. This means that they are digested slower and the sugar bound up within the fibre is liberated much more slowly. This drip feeds sugar into the blood, letting out small manageable amounts at a time.
Think about meal composition
The second part of the picture is the way in which our meals are composed. When planning your meals, think to yourself ‘where is my protein?’. Make sure you have a good quality source of protein at each meal. This could be meat, fish, poultry, tofu, eggs, nuts, seeds, nut butters etc. Think scrambled eggs on toast, chicken with brown rice and vegetables... the list goes on. Composing a meal like this will further slow down the digestion of the meal and slow down gastric emptying. This reduces the rate at which blood sugar rises even more drastically.