Carbs Needed for lady 67. Dr says to watch the carbs

db56
db56 Posts: 31 Member
in Health and Weight Loss
My Dr. told me to really watch the carbs because my bloodwork showed 2 points away from the prediabetes level. I need to lose 20 pounds and I am confused as to carbs needed.

Replies

  • cmriverside
    cmriverside Posts: 34,454 Member
    edited March 2022
    Just plug in your Goals (for weight loss?) If you want you can change your macros (fat/protein/carbs) percentages but I would talk to a Dietician to get a good ratio for your condition.

    Carbs: to cut back on carbs, cut back on all sweets. Cut back on cereals, crackers, chips and sweetened yogurt if you use it. All grains are mostly carbs (oats, wheat, rice, corn.) Read labels! Cut back on ketchup, sweetened salad dressings or sauces. Limit fruit to two or three servings of WHOLE fruit daily. No juices or stuff like lemonade.

    Limit potatoes to one or two servings per day. One or two servings of grain-based foods like cereal, bread, rice, corn, or pasta.

    Then focus on adding vegetables to every meal. If you study your FOOD diary you can see which fruits and vegetables are highest carb and try to limit them. For instance, peas and carrots are fairly high carb, lettuce and cabbage aren't. If you pre-log you can adjust before you eat it.
  • spiriteagle99
    spiriteagle99 Posts: 3,748 Member
    Basically you want to limit carbs from sugary and highly processed foods. Eat whole grains not white ones. Increase your vegetables, and limit starches like potatoes and rice.
  • ahoy_m8
    ahoy_m8 Posts: 3,053 Member
    edited March 2022
    OP, specific to your question about "carbs needed" for most people:
    - 25g fiber (a type of carbohydrate)
    - 50g for brain activity (assuming a non-ketogenic diet)

    This is a very low number of carbs strictly needed compared the minimums needed of fat (0.35g/lb body weight) and protein (1g/kg lean mass up to 1g/lb lean mass if in a deficit or highly active). It's so low that it takes effort to eat lower than 50g daily. So most people will focus on getting minimum fiber, fat and protein and not worry at all about minimum carbs.

    As to how many carbs are optimal for you in your current situation, a medical professional trained in nutrition could dial that in better than strangers on the internet. That said, advice above about paying attention to the types of carbs seems reasonable:
    - less added sugar, refined plant products where fiber has been removed
    - more fiber, unrefined plant foods that naturally have fiber (and sugar, but not "added sugar")

    For most people, if you meet your daily minimums for fiber, fat and protein, there is no problem using your remaining calories on carbs, especially if they are predominantly of the unrefined high fiber type.

    Does that make sense?
  • Beautyofdreams
    Beautyofdreams Posts: 1,009 Member
    If you decide to increase fiber, do not increase fiber more than 5 grams per week. If you increase it too rapidly you can run into digestive problems like diarrhea or constipation.
  • cmriverside
    cmriverside Posts: 34,454 Member
    edited March 2022
    Beautyofdreams wrote: »
    If you decide to increase fiber, do not increase fiber more than 5 grams per week. If you increase it too rapidly you can run into digestive problems like diarrhea or constipation.

    What? That doesn't happen to me. I go from 25g to 50g of fiber sometimes over-night. Your experience might be a one-off.

    Five grams per week? Where did you come up with that number?
  • Beautyofdreams
    Beautyofdreams Posts: 1,009 Member
    From my registered dietician at the local hospital. Granted, I am missing 15 inches of small intestine, but considering the number of posts that appear from constipated people on the forums, I am not alone here.
  • cmriverside
    cmriverside Posts: 34,454 Member
    Beautyofdreams wrote: »
    From my registered dietician at the local hospital. Granted, I am missing 15 inches of small intestine, but considering the number of posts that appear from constipated people on the forums, I am not alone here.

    Constipation in relation to fiber is more about not enough fat or dehydration. Both fats and sufficient hydration are necessary to move food through the digestive process in a healthy manner.
  • Bridgie3
    Bridgie3 Posts: 139 Member
    db56 wrote: »
    My Dr. told me to really watch the carbs because my bloodwork showed 2 points away from the prediabetes level. I need to lose 20 pounds and I am confused as to carbs needed.

    To survive a human doesn't actually need to consume carbohydrates at all; all nutrition can actually be achieved by eating meat and fish and such. BUT. Where's the fun in that.

    And also: carbs are impossible to eliminate. Even cream has carbs. And any excess protein you eat is turned into carbs as it cannot be stored as protein. So you will get carbs no matter what you do.

    I would recommend putting 75g of carb a day in your macros and see how well you do on that. But when it comes to diabetes you're either getting better or you're getting worse. Insulin resistance doesn't sit still - you either knock it on the head, or it knocks you on the head.

    I spent my 5 yrs as a prediabetic not really taking it seriously. Till that used up its time limit and right on schedule I became diabetic. Now, - that's no fun. Exhaustion, nausea, tingling toes. I am attempting to stay around 20 grams of carb a day, but I wish I had been softer on myself sooner. Maybe I wouldn't be here.

    Now: when you talk to your doctor, get clarity around whether you can eat high carbs and lose weight and turn it around, or whether you eat low carb, lose weight because of the low carb (ie as a secondary effect) and turn it around due to the low carb. I've found my doctor says both and they need to pick one.

    They need to pick one thing they tout, because the science is new on diabetes and sugar, and some doctors will squish in 'old' understanding with the new, which undermines the new. eg they say to avoid saturated fats; this is a holdover to when cholesterol was bad. Now cholesterol is good, and only broken cholesterol is bad; but they still can't bring themselves to say 'sure, go ahead, eat natural fats'. They sort of mumble about 'good' fats and can't meet your eye.

    If you have chosen your calorie quantities in the MFP calculator, you then need to go and adjust your macros. Adjust the carb macro till its percentage of your daily calories shows as 75g or lower; and then adjust your protein macro percentage to identify the correct amount of protein, which I think is .8g per Kilo of body weight. The rest has to be fat. Ok? your last macro is fat, and it's the surplus once you have identified all of the items that will act as carbohydrates in your system.

    Try it for 3 mths, and then when you go in for your next Hb1ac you can see if you're improving or deteriorating.

    And I say this: try to eat only those foods which were available 300 yrs ago. This way you avoid margarine, which is the carbon monoxide of fats, you avoid seed oils and highly processed oils. Saturated fat is no longer the bad guy. EAting egg? the yolk is good for you now (full of healthy cholesterol) and the white is less wonderful so if you want to scramble five eggs, get rid of 3 whites.

    :D The world is upside down now.

    Did you know my nana wasn't allowed more than 3 eggs a week, nor to eat any shellfish, due to cholesterol? I remember in the 80s they discovered that eggs and shellfish weren't bad any more. "Oh how wonderful" she said. "Eggs and shellfish aren't bad for me any more. How wonderful."

    She died of dementia related cause: couldn't remember her last poo, kept taking laxatives. Died of a heart attack on the bathroom floor at 84. Statins most of her adult life, avoiding fats most of her adult life. Science is only what we know at the time. When we learn new stuff, sometimes the old stuff proves wrong.

    :)

  • AnnPT77
    AnnPT77 Posts: 34,598 Member
    Beautyofdreams wrote: »
    From my registered dietician at the local hospital. Granted, I am missing 15 inches of small intestine, but considering the number of posts that appear from constipated people on the forums, I am not alone here.


    I'm sure - like so many things - the exact effects are individual. My guess would be that if someone sometimes eats 25 grams of fiber per day, and sometimes 50, everything may be fine - if they're used to both levels semi-routinely, or maybe just because their body is tolerant.

    It's interesting that the RD recommended a 5g increase per week, presumably a rule of thumb.

    The reason I suggest people increase slowly, if their fiber intake has been persistently low, is based on posts like those you mention, but also specifically comes from participating in a "10 80g veggie/fruit servings daily" challenge here. I'm a big veggie/fruit eater routinely, so it was NBD for me, and for a few others for similar reasons. Maybe I'm misremembering, but this is what I recall from it:

    Some other people learned of the challenge some days before it started, began tweaking their eating to ramp up veggie intake gradually, just doing that as a practical matter to figure out how. A small number of people went from very few veggies/fruits, to the 800g daily, all at once. Among that group, some had . . . problems. Constipation, IIRC, usually resolved by increasing fat intake. A few people found themselves over-full, too, when still short of calorie and other nutrition goals, if I remember right.

    From other reading, I think other effects could be possible, too, from gut microbiome adaptation, which it seems can take up to a couple of weeks. I think this effect is behind the common story that eating beans inevitably causes flatulence (once the not-boiling of types that must be boiled, and improper cleaning of the dry beans, is out of the situation).

    I'm sure beans do cause flatulence, always, for some people, because some people are sensitive to some things. But my experience - as a person who eats lots of legumes - is that they don't cause any particular extra gas when I'm eating them regularly, in quantity.

    Gradual increase just seems reasonable to recommend, given those potential issues with a quick big increase. Honestly, IMO, a lot of people would be better off (health wise) if they ate more fiber-rich foods. Encouraging them to get there in ways that skirt problems seems like a good idea, likely to increase the odds of succeeding. Just my opinion, though.
  • GinLee61
    GinLee61 Posts: 1,226 Member
    edited March 2022
    I would strongly recommend that you ask your doctor to refer you to a registered dietician.

    That being said, my husband developed type 2 diabetes several years ago and his A1C was over 8%. His doctor sent him to a registered dietician and she developed an eating plan for him which limits his carbs to about 45 percent of his daily calories. Over time he's lost 30 pounds and has been able to bring his A1C down to 6.2% as of his most recent checkup. Note that he also takes Metformin.

    My sister is also type 2 diabetic. She is seeing a new doctor who recommended that she eat no more than 140G of carbs per day (30 or less carbs per meal and 20 or so for snacks 2x a day). She has been following this since October and has lost 20 pounds. As of a few weeks ago her A1C was down to 6.8%.

    There's a pretty decent blog post on MFP about carbs.
    https://blog.myfitnesspal.com/essential-guide-to-carbs/
  • sarah7591
    sarah7591 Posts: 415 Member
    Beautyofdreams wrote: »
    If you decide to increase fiber, do not increase fiber more than 5 grams per week. If you increase it too rapidly you can run into digestive problems like diarrhea or constipation.

    Could too much fiber cause constipation?
  • AnnPT77
    AnnPT77 Posts: 34,598 Member
    sarah7591 wrote: »
    Beautyofdreams wrote: »
    If you decide to increase fiber, do not increase fiber more than 5 grams per week. If you increase it too rapidly you can run into digestive problems like diarrhea or constipation.

    Could too much fiber cause constipation?

    Trust me, yes it can - especially in a context with too little dietary fat, or under-hydration, sometimes other factors as well.

    But "too much" is not some objective number, necessarily. As several of us are saying, for some people, working up gradually to a large fiber intake may be fine, when going from low to high in one jump may cause problems.

    But there may be some amount of fiber that's "too much" under any circumstances, for a specific individual.

    This is kind of a tangent to the OP, though: She's looking for advice on carb intake, because she's pre-diabetic. Ahoy_m8 bringing fiber in the first place was on point, because of the question being about needed carbs. Most mainstream registered dietitians would say we need fiber, which is carbohydrate, assuming there's no contraindicating disease in the picture.

    OP, apologies for having contributed to the digression into fiber issues, from your original question. You've gotten some good advice, in some of the posts above . . . including that suggestion to work with your medical team, maybe ask for a referral to a registered dietitian (RD) if you need help, maybe check out whether there are diabetes education classes in your area or online that you'd be eligible to take as a pre-diabetic, etc. Even some health insurers (US) or grocery chains or the like offer low-cost/free consults with an RD these days.

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