This week I was talking to a group of physician interns about food choices for diabetes and was trying to explain the value of a low carbohydrate program. During the discussion one of the students interrupted to advise the group that eating less carbohydrates means more fat and that will lead to diabetes, obesity and cholesterol from increased consumption. This led to a discussion about the consumption of carbs and the different types of carbs that are available. Regardless of how much we spoke he was adamant about this.
In light of his misunderstanding this week we have a great article that shows that diets high in carbohydrates boost the concentration of blood glucose and triglycerides which can become problematic at high concentration when they circulate in the blood. In addition a further look into this idea shows that often the things that we think are good are not. A recent study published in Clinical Investigation showed that consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids, and decreases insulin sensitivity in overweight/obese humans.
This really comes into play when we think of how we are yanking soda machines out of schools and replacing them with juice machines. These "healthy drinks" are not really any better as a quick comparison on the website CalorieKing.com shows that 8 ounces of Cola has 27 grams of carbs, while 8 ounces of Apple or grape juice has 28 and 39 grams of carbs respectively. Maybe if more clinicians were open to looking at newer notions we might just be able to make a dent in the metabolic syndrome epidemic.
Dave Joffe, Editor-in-chief