Carbs

[WendyB61]

Around how many carbs a day is it best to aim to eat ?

 

[Drummer]

Around how many carbs a day is it best to aim to eat ?

It all depends on what you can cope with - the best guide is a glucose tester, check after meals - two hours after starting to eat, and it soon becomes obvious what foods cause spikes.
At first checking before and after a meal and aiming for no more than a three whole number increase is a general rule of thumb, but after a while the premeal check isn't necessary, and then you only need to check afterwards if you are experimenting with something new.
People react differently to different foods - I can't cope with porridge or legumes but many can.
Once I saw under 8mmol/l after eating I stuck to the same meals and my numbers continued to reduce - presumably as my metabolism recovered.

 

[Leadinglights]

A good starting point is a suggested no more than 130g better divided fairly evenly between meals and taking into account drinks and snacks rather than a carb heavy meal but it very much depends on the individual what their body can tolerate at any one time.
The only way to tell that is by testing before you eat and after 2 hours and an increase of no more than 3mmol/l will suggest the meal is OK. But the obvious aim is to bring overall levels down so you would be aiming at 4-7mmol/l before meals and fasting/morning and no more than 8-8.5mmol/l 2 hours post meal.

 

[Burylancs]

Around how many carbs a day is it best to aim to eat ?

Well that’s always been a fraught question. The traditional, historic advice from the BDA ( now trading as ‘DiabetesUK’) was for T2s to lose weight, moderate carbs and increase exercise. It was never defined what moderating carbs meant, it was assumed a T2 was eating too many to start with.

There are two ways of assessing carbs in the diet - as a percentage of total calories or in absolute number of grams consumed. And there are two considerations to bear in mind. One gram of carbs has 4 calories, one gram of protein has 4 calories and one gram of fat has 9 calories. The second consideration is that the human brain on average needs the amount of glucose per day equivalent to that produced by 130 grams of carbohydrate. The easiest way of ensuring that the brain gets that amount of high octane fuel is by having at least 130g carbs per day.

One of the earliest influential attempts to describe healthy diets was by the great American Physiologist, Ancel Keys, in his book in 1959 called ‘Eat Well and Stay Well’. He added a further element in his 'Eat Well and Stay Well the Mediterranean Way' in 1973. Keys suggested 10-20% of calories from Protein, 20-30% from Fats including 25% from ‘Good Fats’, and carbs floating depending on how active you were. His suggestions were for the general population.Keys generally warned about too many carbs and made war on breakfast cereals for shooting up the bgs. But of course Ancel Keys main concern was to find diets that reduced the risk of cardio vascular disease.

The historic recommendations of both the BDA and the NHS followed that general pattern until quite recently. Between 45 and 60% of calories from carbs depending on level of activity and work done, 10 to 20% from Protein and 20 to 35% from Fats ( with the usual proviso on Good Fats). All that within the framework of 2500 calories a day for men and 2000 for women. If you followed that advice and reached diabetic targets all well and good if not you were to walk up through the quantity and quality of medication available until you reached your targets on that diet.

The recent cult diet, the Newcastle Diet, roughly follows that advice suggesting 60% of calories from carbs, 10-20 from Protein and 20 to 30% from Fat. The study the Newcastle Diet is based on used the Cambridge Diet which is an Ancel Keys-type diet dating from the 1960s. That being the case it has ended up with a traditional kind of balance that many would call ‘high carb’. It's a curious hybrid beast - a high carb diet within a low calorie framework.

Other low carb diets follow the route of talking about absolute levels of carb consumption in terms of grams of carbs instead of as %s of calories The Atkins Diet originally had very low levels of carbs but had to drastically revise its daily total up to 130g in 2012 following a Class Action in America by people who had their kidneys damaged by the Atkins Diet. But it’s a viable approach possibly in the short term. But as Bernstein reminded us - if it’s not Protein or Fat it must be Carbohydrate. That means there is always a possibility of hidden carbs in the diet we’re not seeing and missing from our calculations, weighing and label reading.

In the 1990s with the advent of analogue insulins and the Dafne Programme a technique called Carb Counting replaced ‘Exchanges’ in the world of Type 1 Diabetes. The same idea of Carb Counting seeped into the Type 2 world. But in Type 2 it was called Carb Awareness because Type 2s can’t count carbs and match it to a precise amount of insulin required. A good example of Carb Awareness came in one of the better education courses for Type 2s - ‘X-Pert Patient Type 2 Diabetes’. X-Pert Type 2 course defined a Carb Portion as 15g of carb for a Type 2, which would raise the bg by one point on average. X-Pert suggests between 8 and 15 of these Carb Portions per day depending on your work or level of activity. That’s between 120 and 225g of carb per day. Obviously most of the sedentary auld codgers on this group could get by on the 8 carb portions but road builders would need the full 15. The handbook for the X-Pert course gives a handy list of Carb Portions such as 2 small new potatoes as 1 CP or one slice of bread.

Overall I believe it is best for Type 2s to start thinking in terms of Carbohydrate Awareness and adopt the concept of Carb Portions of 15g of carb raising the bg by roughly 1 point. As a starting point. Because it's a long haul, a lifetime in fact with Good Control of Type 2 and meeting targets a continuous process not a static state to be achieved.
After that it’s going to be a question of finding an individual balance of Carb Portions to sustain good control and staying on target. And of course the question of 'how many carbs' can't be taken out of context and discussed in a void ; it's an integral part of general lifestyle and of who you are.

 

[Martin.A]

Around how many carbs a day is it best to aim to eat ?

I try and average no more than130g per day, which is generally considered to be the baseline for low carb. I'm sometimes over and sometimes under but it averages out over time. Some go lower, and some go a lot lower. There's no hard & fast rule - it's a choice we all make - but it has to be sustainable.