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Discover the ‘Good’ and ‘Bad’ of Carbohydrate

Written by: Ms. Yong Lai Mee, President of MDES

Carbohydrate is the main source of nutrient required by the body to generate energy in the body. It works like a ‘fuel’ giving us the ‘Ohm’ to stay energetic. There are 3 (three) types of carbohydrates namely simple carbohydrate or sugar, complex carbohydrate or starches and fiber. Diagram 1 shows different types of carbohydrates and examples of food.

Diagram 1: Types of carbohydrate1

Key Takeaway:

Carbohydrate  is the main source of nutrient required by the body to generate energy in the body.
Glycemic Index (GI) & Diabetes Management 2

During digestion process, carbohydrates are broken down into single unit of glucose unit that enable it to enter our blood stream and result in the rise of blood glucose level (Diagram 2). The rate of how quickly carbohydrate in food raises the blood glucose is termed as Glycemic Index (GI). Understanding GI of foods can help us in controlling diabetes along with carbohydrate counting.

Key Takeaway:

Understanding GI of foods can help us in controlling diabetes along with carbohydrate counting.

GI scale is classified into 3 categories: Low GI, Moderate GI, and High GI. Low GI is rating from 0 to 55, Moderate GI from 56 to 69 and High GI from 70 to 100. The Low GI food often called the ‘Good’ carbohydrate because it raises blood glucose slowly and High GI food often called the ‘Bad’ carbohydrates because as it raises blood glucose quickly.

Diagram 2: Summary of Carbohydrate, Glycemic Index and Diabetes Control2,4,6

In people with diabetes, the body is less effective in coping with spike of blood glucose level. As such, they are encouraged to consume carbohydrates with low GI. However, in the event of low blood glucose (hypoglycaemia), high GI carbohydrates like sugar/glucose (GI=100) is the best choice of carbohydrate.

In short, choose low to medium GI carbohydrates for daily meal, reserve high GI carbohydrates for treating low blood glucose.

Diagram 3: Examples of carbohydrates and Glycemic Index3

Key Takeaway:

Food with lower GI is highly recommended for daily consumption, while can use high GI food for treating low blood glucose but avoid in daily consumption especially for diabetic.
Choosing Carbohydrate for Daily Requirement

Daily requirement of carbohydrate differs from person to person depending on age, gender, and health status. In general, it is recommended that 45-65% of daily calories requirement is consist of carbohydrate. For people with diabetes, it is advised to have daily carbohydrate intake with Low to Medium GI such as oats, brown rice wholegrain bread, wheat pasta, and brans. Peanuts and almonds are also good source of low GI with high fiber and healthy fat.

Try to avoid foods that have a lot of added sugar.  Eating too much added sugar increases your blood sugar and can make you gain weight. Refer to nutritional facts label for carbohydrate, fiber, sugar, and GI value. There are plenty of delicious recipe that fulfill the diet requirement for diabetes patient.

Key Takeaway:

Diabetic is advised to have daily meal that include low GI with high fiber food & healthy fat.
Ketogenic Diet or Very Low Carbohydrate Diet 5

Ketogenic and low carbohydrate diet are popular diet for diabetes and weight lost management. A research study in 2008 categorized daily carbohydrate intake as follow:

  • Moderate carbohydrate
  • Low carbohydrate
  • Very-low carbohydrate
  • :
  • :
  • :
  • 130 to 225g of carbohydrate
  • under 130g of carbohydrate
  • under 30g of carbohydrate

Taking ketogenic or very low carbohydrate diet will force the body to breakdown body fat to generate glucose, but long-term usage may affect health. It is important to consult your doctor before you start a low-carbohydrate or ketogenic diet as certain medications can cause hypoglycaemia or increase the risk of diabetic ketoacidosis.

Key Takeaway:

Long-term usage of ketogenic or very low carbohydrate diet may affect health. Diabetic should consult your doctor before start.

Carbohydrate is important for people with or without diabetes. There are no ‘Good’ or ‘Bad’ carbohydrates, most of the carbohydrates are beneficial. The key to eating carbohydrate right is by having good knowledge about carbohydrates to achieve your health goal. Eat healthily by prioritize low to medium GI along with the appropriate amount for daily meals and reserve the high GI carbohydrate for treating low blood glucose.

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1 Types of Carbohydrates | ADA. (n.d.). American Diabetes Association. Retrieved June 28, 2021, from https://www.diabetes.org/healthy-living/recipes-nutrition/understanding-carbs/types-carbohydrates

2 Carbohydrates and the glycaemic index. (n.d.). Better Health Channel. Retrieved June 28, 2021, from https://www.betterhealth.vic.gov.au/health/HealthyLiving/carbohydrates-and-the-glycaemic-index

3 Glycemic index and diabetes. (n.d.). Medline Plus. Retrieved June 28, 2021, from https://medlineplus.gov/ency/patientinstructions/000941.html

4 Carbohydrates. (n.d.). Medline Plus. Retrieved June 28, 2021, from https://medlineplus.gov/carbohydrates.html

5 Low Carbs. (2019, January 15). Diabetes.Co.Uk. https://www.diabetes.co.uk/diet/low-carb-diabetes-diet.html

6 Accurso, A., Bernstein, R. K., Dahlqvist, A., Draznin, B., Feinman, R. D., Fine, E. J., Gleed, A., Jacobs, D. B., Larson, G., Lustig, R. H., Manninen, A. H., McFarlane, S. I., Morrison, K., Nielsen, J., Ravnskov, U., Roth, K. S., Silvestre, R., Sowers, J. R., Sundberg, R., . . . Vernon, M. C. (2008). Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal. Dietary Carbohydrate Restriction in Type 2 Diabetes Mellitus and Metabolic Syndrome: Time for a Critical Appraisal, 5(1), 1. https://doi.org/10.1186/1743-7075-5-9