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The Prediabetes Nutritionist

The Best Carbohydrates for Midlife Women with Prediabetes

The Best Carbohydrates for Midlife Women with Prediabetes

Midlife women: that carbohydrates have the highest impact on your blood glucose does not mean you must avoid them because you have prediabetes. However, the type you choose, how much and how often you eat them determines how well you manage your blood glucose.

In this blog post, we will discuss carbohydrates and the best types to choose if you want to reverse prediabetes.

What are Carbohydrates?


Carbohydrates, protein, and fat are the three macronutrients in the human diet (Holesh et al., 2023). Carbohydrates include sugars, starches, and fibre.

Sugars and starches are the body’s primary sources of energy. Fiber, on the other hand, does not provide nutrients but has unique health benefits.

All carbohydrates comprise three elements: carbon, hydrogen, and oxygen. These elements are combined to form single sugar units.

Simple carbohydrates typically contain one or a few units of sugar. Complex carbohydrates, such as starches and fibre, are made up of chains of these sugar units (Holesh et al., 2023).

Sugars (Simple Carbohydrates)

simple carbohydrates


When someone mentions sugar, the first thing that comes to mind is table sugar. However, sugar can take many forms, both naturally occurring and added. Regardless of the form, all sugars provide the same number of calories per gram.

In scientific terms, sugars are grouped based on the number of sugar units they contain. “Mono” refers to one unit, “di” means two units, “oligo” means three to ten units, and “poly” means ten or more units. The word “saccharide” means sugar.

Monosaccharides consist of a single sugar unit. Glucose, fructose, and galactose are examples of monosaccharides.

Glucose is the main form of sugar that circulates in the blood and is used for energy by the body’s cells. Fructose is naturally occurring in fruit, root vegetables, and honey. Galactose, which is less sweet than glucose, is found in milk as part of lactose (Clemente-Suarez et al., 2022).

Disaccharides consist of two sugar units or monosaccharides. Lactose comprises glucose and galactose and is naturally found in milk.

Maltose is made of two glucose units and forms when starch breaks down. Sucrose is made of glucose and fructose, commonly known as table sugar. It can be found in many fruits, some vegetables, and grains (Clemente-Suarez et al., 2022).

Starches and fibre (Complex Carbohydrates)

Complex carbohydrates


Polysaccharides are complex carbohydrates that consist of numerous sugar units. They can form chains containing hundreds or thousands of sugar units and are found in starches and fibre (Holesh et al., 2023; Clemente-Suarez et al., 2022).

Examples of foods containing starches are beans, peas, rice, oats, bulgur wheat, quinoa, potatoes, and vegetables.

Fibre contains non-digestible polysaccharides that encourage healthy bacterial growth in the colon and act as a bulking agent.

The main components of fibre are cellulose, hemicellulose, and pectin. Wholegrains, fruits and vegetables, such as brown rice, oranges, broccoli and legumes, are rich in fibre. (Clemente-Suarez et al., 2022).

Carbohydrates are Your Body’s Main Energy Source

Carbohydrates are your body's main energy source


Carbohydrates are essential for providing energy for various bodily functions such as walking, breathing, and thinking.

Glucose is the primary energy source that carbohydrates provide and is the only energy source that your red blood cells use (McMahon et al., 2021).

Although glucose is the preferred energy source for the brain, it can also run on ketones produced when fat breaks down (Mergenthaler et al., 2013; Poff et al., 2021).

When you consume carbohydrates, your body breaks them down into glucose, which causes a rise in blood glucose levels.

When the blood glucose levels go above average or usual, the pancreas releases insulin to move glucose into cells for energy.

However, depending on how much is eaten, the body doesn’t always utilise all the glucose for energy. Insulin instructs the liver and muscles to store the excess glucose as glycogen for later use. If the glycogen stores are full, the body converts the excess glucose into body fat (Holesh et al., 2023).

All Carbohydrates Don’t Affect Your Blood Glucose Equally

All carbohydrates don't affect your blood glucose equally


Not all carbohydrates have the same effect on our blood glucose levels. Some types of carbohydrates raise the blood glucose levels more than others. To rate carbohydrate-containing foods based on their effects on blood glucose, we use the glycemic index (GI) tool.

This tool measures how high the blood glucose levels rise and for how long after consuming a particular carbohydrate-containing food. Depending on their characteristics, some foods enter the bloodstream faster, others more slowly because they take longer to digest.

The glycemic index (GI) rates food on a scale from 1 to 100, with 55 or lower considered low, 56 to 69 medium, and 70 or higher high.

Foods with a high GI cause a greater increase in blood glucose levels than those with a low GI (Atkinson et al., 2021; Holesh et al., 2023).

In general, non-starchy vegetables, most fruits, beans, and peas tend to have low GIs. For example, ½ cups of black beans have a GI of 30, and a medium apple has a GI of 38.

Foods such as steel-cut oatmeal and oat bran, basmati rice (58) and pasta have a medium GI. On the other hand, white bread (made from refined flour), breakfast cereals and sweets tend to have a high GI.

Some varieties of white bread have a GI of 88, instant mashed potato has a GI of 92, cornflakes have a GI of 105 and white Jasmine rice has a GI of 116.

It is worth noting that some lower-calorie, nutrient-rich foods may have a higher GI than expected. For instance, ½ cup of carrots have a high GI of 92, and 2 cups of watermelon have a GI of 72.

However, we will delve deeper into the concept of GI in a future post.

The Best Carbohydrates to Choose for Prediabetes

The best carbohydrates to choose for prediabetes in midlife


Prediabetes refers to a condition where your blood glucose levels are higher than normal but not high enough to be classified as diabetes. In prediabetes, your body does not respond to insulin correctly, leading to increased glucose levels in your bloodstream.

For individuals with prediabetes, consuming whole-processed carbohydrates is the best option (Holesh et al., 2023). Fruits, non-starchy vegetables and whole grains are excellent sources of these carbohydrates and are rich in essential nutrients such as vitamins, minerals, and fibre.

Additionally, they generally have a low glycemic index, which means they do not cause a sudden increase in blood sugar levels. Besides stabilising blood glucose, the fibre in low-GI carbohydrates helps to reduce LDL cholesterol levels, which are often elevated in people with prediabetes.

Fruits like apples, bananas, and berries contain natural carbohydrates. They are packed with essential vitamins, minerals and antioxidants such as beta-carotene and vitamin C.

Non-starchy vegetables such as spinach, broccoli, and cauliflower are also great sources of carbohydrates. They are high in fibre and offer numerous essential nutrients like folate, potassium, and magnesium, which support digestion and overall health.

Whole grains like quinoa, brown rice, and whole wheat bread are other excellent sources of carbohydrates. These foods are high in fibre and provide a range of essential nutrients that support digestion, heart health, and overall well-being.

They also have a lower glycemic index than refined grains, which means they don’t cause a rapid increase in blood sugar levels.

However, limiting the consumption of carbohydrates like fizzy drinks, fruit-flavoured drinks, sweets, grain-based desserts, and pastries is crucial.

These foods are high in added sugars and fats and lack essential nutrients. Consuming them frequently and excessively can cause rapid increases in blood sugar levels, which may lead to health issues such as diabetes, obesity, and heart disease.

Portion Control is Key


Remember, although unprocessed carbohydrates are the best type, watching how much you eat is still important. Consuming large amounts of unprocessed carbohydrates, particularly fruits and starchy carbohydrates, can still cause weight gain and high blood glucose levels.

The amount of carbohydrates you need daily depends on several factors, including your age, body composition, and activity levels.

The Institute of Medicine (IOM) suggests that carbohydrates should make up 45 to 65% of your total daily calorie intake, which equates to 202 to 270 grams of carbohydrates per day, providing 810 to 1080 calories in an 1800-calorie-a-day eating plan.

If calorie counting isn’t your thing, aim for roughly ¼ to ⅓ of carbohydrates on your plate. Remember to spread your carbohydrates evenly throughout the day. For more information, check out the post “An Easier Way to Manage Your Portions.”

It’s also best to pair carbohydrates with foods rich in protein and fat. This slows the digestion of carbohydrates and encourages glucose to enter your bloodstream more slowly, which keeps you feeling fuller for longer and stabilises your blood glucose levels.

In summary


Carbohydrates are a type of nutrient that includes sugars, starches, and fibre. They are a vital source of energy for the body. Carbohydrates have the highest impact on blood glucose levels, so choosing and eating carbohydrates wisely is crucial.

Consume unprocessed carbohydrates such as whole grains, starchy carbohydrates, fruits, and vegetables if you have prediabetes.

These carbohydrates are ideal because they are nutrient-dense, digest slowly, and do not cause significant spikes in blood sugar levels.

But don’t forget to practice portion control; it is still essential, even when consuming healthy carbohydrates, because excess can cause rapid blood sugar rises and weight gain.

These small changes can improve your health and reduce your risk of developing type 2 diabetes. What will you change today?


REFERENCES
1. Holesh, J.E., Aslam, S., & Martin, A. (2023) Physiology, carbohydrates. Available: https://ncbi.nlm.nih.gov/books/NBK459280/ Last accessed: 04 January 2024

2. Clemente-Suárez, V. J., Mielgo-Ayuso, J., Martín-Rodríguez, A., Ramos-Campo, D. J., Redondo-Flórez, L., & Tornero-Aguilera, J. F. (2022). The Burden of Carbohydrates in Health and Disease. Nutrients, 14(18). https://doi.org/10.3390/nu14183809

3. Atkinson, F.S., Brand-Miller, J.C., Foster-Powell, K., Buyken, A.E., & Goletzke, J. (2021) International tables of glycaemic index and glycaemic load values 2021: a systematic review. The American Journal of Clinical Nutrition, https://doi.org/10.1093/ajcn/nqab233

4. McMahon, T. J., Darrow, C. C., Hoehn, B. A., & Zhu, H. (2021). Generation and Export of Red Blood Cell ATP in Health and Disease. Frontiers in Physiology, 12. https://doi.org/10.3389/fphys.2021.754638

5. Mergenthaler, P., Lindauer, U., Dienel, G. A., & Meisel, A. (2013). Sugar for the brain: The role of glucose in physiological and pathological brain function. Trends in Neurosciences, 36(10), 587. https://doi.org/10.1016/j.tins.2013.07.001

6/ Poff, A. M., Moss, S., & Soliven, M. (2021). Ketone Supplementation: Meeting the Needs of the Brain in an Energy Crisis. Frontiers in Nutrition, 8. https://doi.org/10.3389/fnut.2021.783659

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