Carbs, Protein and Fat: How much?

buffet-variations-1321243“What percentage of my diet should be carbs? What about fat? and how much protein do I need?” I get this question all the time and usually give the same answer: do you really want to think about that every day?  The point is, even as a dietitian who is somewhat good in math I would never want to calculate these figures on a daily basis. Even using an app. But many people are confused about this, they hear things at the gym, their marathon running friends are carb loading, or maybe they saw a magazine headline at the grocery store check out. Not to mention goals of losing weight, which usually are part of the motivation to find the best combo of macronutrients that could be the magic answer.

As far as recommendations that would provide a “balanced” diet here is the general guide:

Carbs: 45-65%          Fat: 20-35%               Protein: 10-35%

Many are surprised that our diets should be at least half carbohydrates, with all the low carb diets out there, it may not make sense. Remember, everyone is different and it is important to consider your own health history, metabolism and body. There are some patients I have worked with who respond differently to carbohydrates (such as those with PCOS or polycystic ovarian syndrome) and balancing carbs with protein is important to prevent increases in insulin. And for the average person who wants to maintain a certain level of blood glucose, including protein in a meal definitely helps. It is more about balance and less about avoidance or restricting.

But what if you really did want to figure out what percentage of your diet is protein for example? I do know people who eat a lot of protein thinking it will help them build muscle (just yesterday at lunch a young twenty-something year old teacher had two bunless cheeseburgers on his plate….nothing else). You first would need to know the total amount of calories you ate in a day (nothing I would ever recommend doing, but just to demonstrate how ridiculous and irritating it would be), let’s use 2000 calories as an example.Then 10% of this would be 200 calories. That means 200 calories as a minimum should come from protein. Since protein has 4 calories per gram, that means 200 divided by 4 is 50. So the answer is 50 grams of protein is 10 percent of calories from protein in a 2000 calorie diet. An ounce of meat has 7 grams of protein, so 7 ounces of meat would just about meet the 50 grams. But protein also comes from other foods, even cereals and grains, dairy, beans, nuts and pasta have some protein. See why it would not be too fun to try to figure out? Even for one day, pretty irritating. So what should you do if you want to eat a healthy balanced diet?

I did do a brief review of the research regarding macronutrients and health as well as weight. To put it simply, I could not find any new breaking news regarding macronutrients and weight. Low glycemic index diets do not result in more weight loss as far as current research (that means low carb). The one macronutrient mentioned as affecting both health and weight was fiber. There were several studies that suggested a high fiber diet was beneficial for both health and weight. This means more fruits, veggies and whole grains. Now that is not exactly a newsflash, but does reinforce a “health” approach to eating verses a “weight loss” approach or trying to limit a certain food group. That is why the government came up with the simple “My Plate” illustrating half the plate as “colors”, or fruits and vegetables, a quarter of the plate whole grains and a quarter of the plate protein food, as well as dairy on the side. The message I like to send is variety, not restriction. I don’t think it is “dieting” to try to add more fruits and vegetables to your meals. If you throw strawberries in your salad or an apple in your lunch bag, it makes sense because you enjoy them. This kind of move toward healthier eating does not seem stressful to me. It does not take too much thinking (too much thinking about eating is not health promoting, and tends to add stress which is NOT good for health). If you don’t take the My Plate idea too far (you don’t have to have the perfect plate every meal), then it is a good general and simple guide.

If you are interested in more specifics regarding dietary recommendations, see Dietary Reference Intakes however please keep in mind we all have different needs, and not everyone eats or needs exactly the same amount of a nutrient. These are general recommendations.

The Academy of Nutrition and Dietetics also has a position paper (2002) on the topic called Total Diet Approach. Although it mentions the outdated Food Pyramid it also describes a way of eating where “all foods can fit” and again, stresses the importance of focusing on health without trying to be perfect. If you like a food, any food, you need to fit it in. It is the average intake of nutrients over an entire week for instance that matters. So even if you eat twinkies for all three meals one day, it does not matter….over time.

Bottom line: keep it simple. Learn from listening to your own body. Good old boring common sense…….





Carbohydrates: Good or Bad?

carbsLow carb dieting is nothing new. Back in the 80’s Dr. Atkin’s brought this extreme way of eating to the limelight with his famous book “Dr. Atkin’s Diet Revolution” and then again in 2009 with his “new” version. As with most fad diet books, this was no magic answer and the nation’s obsession with weight and dieting continued. Not to get into the boring details, but this high fat high protein low carbohydrate diet mostly caused people to lose water weight (which is what happens with carbohydrate restriction). So while the scale may go down temporarily, the end result is time wasted yet again on another fad diet! Or worse, some serious health consequences.

Carbs fell off the radar as the villain for quite awhile until the “gluten free” craze began. Don’t get me wrong, there are definitely people who need to eliminate gluten from their diets either because they have celiac disease or another autoimmune disorder where avoiding gluten may be helpful (although celiacs definitely need to avoid gluten at all costs, it is not yet conclusive whether avoiding gluten is helpful in other autoimmune disorders but some health care providers often recommend it). Some people may have an intolerance to gluten, which may be less serious than celiac disease (where serious intestinal damage eventually results from eating gluten over time). With an intolerance, discomfort may result which may vary from person to person from mild to more severe. In this case, avoiding it to feel better is worth it.

So besides needing to avoid gluten for medical reasons, are there any other reasons to avoid carbohydrates?

No. We NEED the high carbohydrate foods for many reasons:

1. Healthy high carb foods such as whole grains provide fiber which keeps our digestive system running smoothly.

2. Fruits and vegetables contain carbohydrates (fruits typically more than veggies) and they also provide us with vitamins, fiber and phytochemicals which may help fight cancer.

3. Dairy foods such as yogurt and milk have some carbs and they provide us with protein (especially for vegetarians who don’t eat meat), calcium and vitamin D.

4. Carbohydrates give us energy and and help maintain our glycogen stores (this is your muscle’s source of energy, so when you want to go do something, such as run or play or dance, you aren’t going to move too fast without enough carbs in your diet).

5. Some high carbohydrate foods are just plain yummy and a part of many celebrations (think birthday cake). It is important to participate in the fun things in life, as mental health and happiness are equally important as physical health.

BUT a highly refined, low fiber, high carbohydrate diet devoid of protein brings a whole different set of problems, and this may be why people still focus on it. We are talking extremes here (unfortunately, I have seen these extremes but typically in people with sensory issues, such as children or teens with autism, or extreme picky eating). What happens when a person’s diet is almost exclusively carbohydrates? Unfortunately, those at risk include:

1. People with sensory issues such as those who can’t tolerate certain textures or tastes

2. Children who were typical picky eaters when they were toddlers, whose parents resorted to catering to them (for instance, made Ramen noodles every single day because Johnny would not touch anything else). Johnny never is exposed to new tastes (such as vegetables and meats) and consequently grows up to be an adult living on Ramen noodles!

3. Vegans or vegetarians who are not educated on how to obtain a balanced diet

4. People who simply can’t afford to purchase the food that is healthy for them

5. People who eat what they were brought up to eat

There may be more however these are the categories I have personally encountered. So what are the consequences of living on mostly high carbohydrates?

1. Carbohydrates trigger the release of insulin (a good thing to maintain a normal blood sugar). However, when the pancreas is overstimulated it eventually stops working normally, This may lead to elevated blood glucose and even “prediabetes” as well as abnormal weight gain.

2. On a high carbohydrate diet devoid of protein, your appetite will not be satisfied. You will end up having to snack all day (which is irritating! and your high carb snacks never really satisfy you).

3. You will be missing out on many important nutrients. Most of the patients I see who are extremely imbalanced in their eating (eating mostly high carbohydrate and refined foods) tend to consume inadequate protein (leading to poor immunity, hair loss, fatigue, etc), inadequate iron, no fiber (leading to constipation and digestive issues), and other vitamin and mineral deficiencies.

4. Living a normal life is really hard when you can’t eat a variety of foods. Many of the teenagers I have seen who only eat Ramen noodles and chips really start to struggle in social situations.

So the answer to the question “are carbohydrates good or bad?” is not that simple. They are both good (when consumed with a balanced diet) and bad (when they are all you consume).

My advice: include whole grains and other fun carbs (such as your favorite cookies when you crave them!) but also keep trying a variety of fruits, veggies, dairy foods and protein sources. I have heard many a dietitian say “it takes 20 tries to know if you like a food”. The more exposures, the better. So don’t give up……take a bite!