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Ask Dr. Gourmet



My husband has been diagnosed as being pre-diabetic. What amount of carbs should he eat per day? I know that carbs are bad for him, but as they are in most foods, it's hard to be totaly carb free. Also, we both eat a lot of fresh fruits and veggies, so what about the sugars they contain?

Dr. Gourmet Says...

I am sorry for your husband's new diagnosis. For many the issue of having "pre-diabetes" or "insulin intolerance" is one that can be controlled through making changes in diet and exercise. In a lot of cases weight is a major factor and losing weight is key.

First and foremost, carbohydrates are not bad.

The issue is that most folks today eat far too many calories and end up eating a lot of carbohydrates. Often this is in the form of low quality carbs like the simple sugars in soda, candy, etc.. The key is for your husband to eat high quality calories no matter whether those calories come from carbohydrates, protein or fats.

For instance, both Coca Cola and oatmeal are full of carbohydrates. The Coke contains 35 grams of carbs all in the form of simple sugar. That's about 150 calories that is drunk and used pretty quickly by the body and has been shown in research to not satisfy hunger well. In many cases folks drink that extra 35 grams of carbohydrates along with a meal and it is simply added calories that they don't need.

On the other hand, a half cup of dry oatmeal has about 25 grams of carbohydrate. This is a large serving and even with a teaspoon of sugar on top (4 grams carbs) this is not many more calories than the soda. It is, however, satisfying and really good for you. There's 4 grams of fiber, 5 grams of protein and tons of vitamins and minerals. We know that in the case of diabetics eating oatmeal and other high fiber (good quality carbohydrate) foods actually helps to lower blood sugar.

The key to eating healthy and keeping your husband from being diabetic is to eat great quality calories including great quality carbohydrates. Get rid of the junk food, processed snacks, sodas and fill the house with whole grains, beans, fruits and nuts.

There is a lot of controversy about the optimum number of carbohydrates. There is certainly evidence now that low-carb diets will help with weight loss but most folks can't sustain that lifestyle for very long. In general looking to get about 50 - 55% of calories from carbs is a realistic goal for most folks. The math is pretty easy because a gram of carbs contains 4 calories. So for a 1,600 calorie diet that would be about 220 grams per day

(1600 * 0.55)/4 = 220

Weight loss is key for most of those with pre-diabetes and a good place to begin learning about a healthy diet is to look at the Mediterranean Diet information on the Dr. Gourmet web site:

http://www.drgourmet.com/mediterraneandiet/index.shtml

The meal planning software makes use of these diet principles and can help create a healthy diet plan for you and your husband:

http://www.drgourmet.com/user/login.php

Good luck to you and your husband.

Timothy S. Harlan, M.D.
Dr. Gourmet