'Motivated' podcast: 'Not all carbs are evil'

Carbs often get a bad reputation. Here's what endocrinologist Dr. Rekha Kumar and nutritionist Maya Feller want you to know about balancing carbs and a healthy lifestyle.
22:43 | 07/31/17

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Transcript for 'Motivated' podcast: 'Not all carbs are evil'
Today we're talking about all things carves we're gonna clear up some carved confusion. And turn it to say that past three times. And turn right two fantastic guest actor Rica Kumar with real Cornell medical center new York presbyterian is at the full name. It's it again it as a lot to remember. Article are going to be here you're an endocrinologist. And my friend my Feller and fabulous nutritionists and all things through and nutrition so as a bottom of this carb confusion cramped. Somersaults talk about. The perception because the perception is if you're trying to lose weight if you travesty in shaping it is you call arms as possible a lot of people believe in this low carb philosophy. My is that. The secret to staying fit. That's not at all the secret to sink it's you're absolutely right so many people believe that they have to take the cards out of their diet completely. He and actually do need some carbohydrates the question the type of carbohydrate. If you're paring it and the portions I think you're having you know you can't take it all out is it your pairing him when he and Humana. So when I'm working with folks I like to say you know I you can have that piece of bread with a fat or pro teen and that's gonna slow that carbohydrates helped to keep them seeks heated. So they're not looking for food shortly there after. But especially as we age can you really be eating you know bagel for -- fans indeed take the breadbasket of dinner can you live like that is that realistic. I thinks. It's easy because it's what's excess of all. But I think people likely will gain weight and develop blood trigger problems as time goes on if that's the only thing they're eating and and that pattern. So the way we handle carbohydrates changes. As we progress through life so we've become. More resistant to the hormone insulin our blood sugar spikes more easily so maybe you could eat a bagel when you're eighteen but. Potentially not at 35. Changes that are taking place in the bodies we ate and he. Added. Yes Jack so father time was very mean. If you get older everything start that fact. So in order for us probably maintain the same when he. You know 25 and 55 and seven overtime we probably eat lax who eat less exercise more. And the reason for that is our metabolism slows down as we lose muscle and accurately so. The thing it determines how. Quickly you burn calories lower and how faster metabolism is at rest lean muscle and if you don't do anything to maintain your lean muscle. It naturally. Declines over time. That's one of the changes with age eight is muscle decline. The other is that. For other reasons you become more resistant to hormone insulin. And carbohydrates as well. See pictures spikes more quickly. As women go through men eyes and estrogen levels fall their levels of growth hormone and trust us to change. Can you handle nutrients different. Q do you have to scale back on the cards that little has your aging jets to mean your. I agree I think you have to scale back of it on calories and carbohydrates. Eat wheat is Atkinson a I think son. Natural increase in ideally it's acceptable if you start out at a low body later normal life neatly. The thing and our environment is that it's it's excessive for carbohydrates her. Easily accessible sat in Cary so all of these changes are very stature it. Says something typically should lead to mild changes over life really. You know lead to obesity and each where you to Allen's medical problems. So then you you can find a way to work it into your diet but when we're talking about what that means he say a palm sized serving of carbohydrates. But back to basics what does that mean is that vegetables is that a palm sized serving of fruit. Or are we talking about start she grains and pasta bread that kind of thing. Right so. To get specific I would say that we're looking at a palm sized serving of either greens. Beans or starchy vegetables and justice you know tease that out the starchy vegetables are your peas here the Tito's your windows watched. Also some of that pumpkins and things like that. Those are the starchy vegetables so when left to you have a lunch. You have a piece of dark leafy greens that I think go for too harmful for it that way and then you're gonna have something like keep watching corn. So then you're gonna split your time in half and you're gonna have half a parking lot and half a pop corn. And then I'm gonna say OK let's look for your protein. What if your vegetarian now it's gonna get really complicated right. But that's fine we're just gonna say increase the non starchy vegetables to three harmful and leave that Keiwan and corn as that one pop. So I talk about the Quito die because he you just said look the lawyer serving the carts or breakfast from the rest they're left with just fat protein and that's not realistic what a lot of people aren't our doing acute. Very popular and that is essentially just fat and protein. So we just story on this on Good Morning America a while back and I was Inglis sounds lot like Atkins it is a lot like Atkins but with a smaller percentage of protein. He really eating like seventy to 75% fat. And about 10% a year died from cars why is that a bad thing. So that I was originally formulated for people who have epilepsy and that is actually a model of care that requires you know medical supervision and a question of whether or not need to take additional supplements. So when people are engaging in that he'd botanic diet. Four we lost the research says we don't know how long they should or should not be on it could actually says some months which could be two months or three months. We know that there will be rapidly last yes they're changing the macro nutrient around having a very high fat diet. Low carbohydrate elope routine spraying. So yes they're losing weight but is it sustainable in the long run we also don't know for someone who does not have apple -- see there's not sufficient research to say what is the long term the fact. With regard there how how. So I mean but we hear a lot of effect of food pyramid changes over time right ethnic look different when I was a kid than it does today and it probably the different in twenty years. The realms going up army hearing if that was bad that was bad that was bad when he get a lot of bread and pasta embrace. And now it seems like that's shifting a little bit so aware argue with that now. If my career if you think a lot has shifted since the ninety's since. Kind of low fat high carb craze. And I think it has a lot to do it then diabetes and obesity epidemic and a lot of people I think not a scientist showing that high sugar. Hi added sugar high card plus high fat diet. Likely contributed T obesity epidemic. On the flip side of that is that we do need carbohydrates as our fundamental source of energy and our brain relies on glucose which. Is the breakdown product of carbohydrates. So there's. Likely some healthy type and amount of carbohydrates that we should be consuming for long term weight control. But when you look at studies of very low carbohydrate diets in Quito Janet diets. We're short term weight losses is gut. And it looks better than low fat diets calorie restricted diets. Part of the reason for that is yes you're changing macro nutrient content you know composition but you're also losing a lot of water when you. Essentially stop eating carbohydrates and rely on burning fat as fuel which is what the key agenda diet is. You deplete your like agent stores in your muscling your liver act. So like Janice how we store carbohydrates so normally when we're not eating and our Fletcher or drops we can use our glide kitchen stores and our muscle and our liver. When we use up like teaching and we lose a lot of water and so when you. Going to keep it botanic Dieter a very low carbohydrate diet that initial rapid weight loss. This is a lot of like engine and has a lot of water waited isn't necessarily. So would you look at long term weight loss. We're very low carbohydrate diets and Peter Jennings diets might not necessarily eat better. Do we know doing any answer. You know. If it could be right we just don't know well the research hasn't been I think right now it looks essentially. Equivocal if you you know look at all of it in that analyses and kind of cool data of long term you know you look six months out low carb looks better and at low fat. But at the twelve month marked. They look pretty simple. But there's this issue with cars is really interesting article near times recently about being a carve a holly and the idea that once you eat a little bit. It has a reaction your body that makes you just want to gorge yourself and that as far as I know it's not a prom a lot of people have with bats right nobody wants to drink olive oil and it had just a little bit. He can we talk about that property of car because people have that experience you try to have one bite and you just can't stop right why. So it's really interesting I think it's probably two things. I think it's partially related to this vicious cycle of insulin resistance and we all have varying. Levels are degrees of insulin sensitivity or insulin resistance. I'm in our environment we tend to its insulin resistance because we're not very active we have less muscle we eat a lot of processed carbohydrates. And so what happens as our blood sugar goes up. Our insulin goes up. In overtime we don't respond as well tinsel and C need more and more insulin taken current news hour to get the same and what happens is that your body. Your functioning at a higher insulin level your bodies looking for carbohydrates. To use a year essentially craving and so it's almost like eating sugar carbohydrates could stimulate cravings for more shepherd carbohydrates. Sets that the insulin side of the story. So then what do you do what's the answer if eating is if eating it is gonna make you crave more of it and you're trying to be reasonable in your portion size. How do you gets a cash trying to do you. After work with people to actually read frame that diet and that relationship to the karma hike it and that's when I see he can't OK let's look at. The quantity of carbohydrate that you're having how regularly it's coming interior by the and whether or not you're pairing it with something. Right because if someone to eating high levels of carbohydrate and they continue to have that craving and get into that cycle they're gonna want warm more or more and more. So the question is how do we educate them to understand that some of this is creeping and some of this is your body you know kind of telling you that it wants more. Anti abstinence means you can't and Margaret it's it's an. Yes if it was and from all carbohydrate that we are ads using can't get down to nothing but you couldn't get it off from saint fruits and vegetables. So. What about the idea abstinence for some people is that a Smart strategy where you're just not eating things that are gonna trigger the desire for more cocker. I think it really depends on the person right and if you look at like the theories of cognitive behavioral therapy you know you work with people kind of to meet them where they are right. And you have to kind of take into consideration their whole life right what's happening. In their dignity their work their family before you say look I'm gonna takeaways this trigger food from you because that might be even more of a trader. So it's like you want to work with the patient and fair OK well can we reduce it gaming can we change it can we do with substitution can week. Look at something else rather than completely taking away and for some people abstinence is absolutely fantastic but then the question is is it sustainable. And there's the option of using Madison so now at least pet. Identified you know potentially to hormone mariner transmitter pathways are saying insulin is an issue dope immediate opening rewards pathway might be an issue. And our practice we do use Madison's. To treat these things to treat cravings to treat insulin resistance. So when behavioral intervention on its own isn't sufficient there's the option of using Mattison to what kind of medicines are using. So we can use in medicine Matt Foreman which is act FDA approved for the treatment of type two diabetes. It is an insulin sensitize are so it treats insulin resistance which were saying is the underlying cause of these cravings. And so it's considered off label use but we do prescribe met for meant to treat carbohydrate cravings and kind of sugar addictions and it helps with weight management. It helps with weight management I helps people adhere to low carbohydrate diets. Because it over time lowers the insulin level so that desire to eat carves. Back can be last and if you pair Matt Foreman with a lower carbohydrate diet patients can you better. Now let's say you gonna low carb diet you know you do it you get to a place where your happy with the way he went transition to something a little more sustainable is your body now more sensitive to cards once you eat that don't that are you now and am just in three pounds just gonna hop onto your hips. Our patients say that and and I don't think it's necessarily three counts of fat that's hopping onto your hats I think it's that water you're storing I think if your. Keep it Janica very low card for weeks and weeks and then you kind of splurge you might notice this in this rapid increase in weight and I think part of that is due to the waterway pitcher starring. So what's. You know a lot of this for Tagamet seems it's it's more for people on the extreme right's abstinence must give I'm not going to do that. Taking a prescription medicine to treat Europeans most people don't that's necessary for them so let's talk about everyone in the middle right what's practical for most people and sustainable and as and I keep us from me happy enough to crank. So the first question is in harm's in the morning after it is this debate between you know every car after six or you get them out of the way early in the mornings and the rest of the day to burn off. When are you supposed to eat your cars with the optimal time. So from my perspective. And this anecdotal there is no optimal time to eat carts I've read studies that say you know people do better. Eating cards in the afternoon I read studies that say people do better having their carts in the morning I read the always think there's an individualized approach right. Meeting that person where they are and they really really think we have to encourage people to pay attention to their portion size as well as the type of carbohydrate. We know in this country that people have this propensity toward eating tons of added sugar. We were eating wheat too much at picture Nijinsky used to having expect everything to be sweet. Six likely itself we can even get people in the morning to move away from a sugar flavored oatmeal to eight clean oatmeal. Where they add a small amount of fruit the more party starting on the right foot. And Simpson do you think there's any wisdom to the idea panic a car cut off time. Some some a lot of people say like after 6 PM after 7 PM because then it's mean you're sleeping your body does a process that right I mean is there any science to support that. I think it's very person dependent and what their medical conditions might be where someone with. You know diabetes it is a big question of our population now we probably wouldn't suggest not eating carts in the second half the day they're Pletcher could drop overnight. So I think it depends on what a person or patient is doing. And our practice such as focused on weight control we tend to emphasize more protein earlier in the day it's protein leads to more fullness. And yeah we emphasize locally scenic index diet so their version of a low carbohydrate diet but they're not know carved they're not Peter Jennings they're not. You know we're not telling them to abstain from carbohydrates but it's something in between and I think he eating the right carbohydrates not added sugars not high fructose corn. But that would have the right car when it the healthiest are guessing it's not the fatal no definitely not that they the health and hang out too bad. The healthiest carved from my perspective and of course you know this does not take into consideration any kind of medical condition. It's really coming from a plan B supports right I love not starchy vegetables I think everyone can eat probably two or three more servings per day. I its goodness it's just directing that I. I am another type of carbohydrate that they really in to a different people are. I'm refined our ethnic coming from hold credence horse this. I ultimately like starchy vegetables as the car I'd take that lets see someone does not want to have right we'll than anything. Go for a starchy vegetable or illegal break because those habitats are they're going to be filled with fiber. And they tend to last a little bit longer in comparison to refined copper. Carves likely that this is -- something in here people doing it and be extremely low carb for a couple of days and then have a couple of days where it made. Boost their carb intake the idea being that then your body doesn't panic it isn't panic at the prospect of not having enough car herbs is there are signs I'm. I think it's it's almost considered like a version of interment fasting where. You know maybe two or three days a week here more restrictive and any other days here. More balanced and I think that the issue there's just adherence some people find it. Easier to to do something more restrictive for just a few days a week and that's more managed office and so I think it depends on the person. We thing. I I would have to agree they really do think it depends on the person and I always think it's a question of the clear threat to if you're able to kind of cycle and then the they Wear your off this cycle is when that it's moderate as a post excessive that he. I think that could be something that could work for some. Or talk about the idea of it carves triggering. Carb cravings. So a lot of it will reduce their cards in order to stay in place were they know feel that they're not having those greetings. But we talk about those diets people say in his all the time it's unsustainable man why. It's unsustainable because it's extremes and every time you swing that pendulum from one extreme to the other you're not actually listening to your internal hunger to tidy Kuester constantly over right I mean you're going from feast to famine to feast to famine it's really hard to kind of leave in that. Why Italy and as opposed to seeing let me find some balanced on the medal and then really get to know your body. Listen to all I've had enough I feel full oldest is very sweet right this is saying half none have some have none have so it it's a lot to manage. But in terms of kind of read redefining. What is an acceptable amount of cards you know when people a sudden people for this story that we get on Quito and telling me and him like 9% of their diet on carved that sounds crazy. But should we be redefining. The percentage of our diet that's coming from that right now it's what what are the recommendations for them daily percentage from cart. It's it's very it's also I think it goes back kind of like an energy balance state as. And even calories of are you. You know burning more than you're taking an ar is that equal and I don't think it's the same for every person I think in elite athlete will need more carbohydrates. Then added. Someone completely sedentary and I think. It's gonna probably vary by age it's gonna vary by lifestyle. And there's probably not a set percentage or. Amount of calories that necessarily should come from carbohydrate. I absolutely agree with that 100% and I think that that's one of the biggest challenges we have in this country right now. So people are looking for those magic numbers while living in this fast food nation and you know the typical western diet is riddled with. The worst type of cards the worst type of saturated fat and the worst type of added sugar. And so when he stated someone you really have to get to know you that's when you need to go see your doctor go meet with your dietitian T have a sit down and figure out what is your arm where should you be. I love the idea of being individualized something about the via stress in in and I'm sure that we see over and over again it in your work I don't believe and one side's until it's as I think. Never have spent every one. I'm should you be eating carves a free work out. Is that the best fuel the free exercise it depends on if you're in the league athlete if how hard your training is going to be me to my carb loading the for a spin class that's not effective. The three pancakes the oh yeah yeah. Keller. In Daly tell my patient I think we have to think about the hatred that promotes meet in its weight dean where we. And as well as an athlete like deliberately perform them in lieu of Brett. Should she is that the food group you should be going to mean should you be trying to get them cracker or. Or is it does not matter but the here in the communicative and. I also think it depends on where you're working out in your day right so is it in the morning is that the mid day would like what he eaten before are you going in and fasting state I mean for people that come to see me who are just the regular working out people you know. Five times a weaker for it lasts maybe they're gonna wanna have like a little bit of empathy and a half a banana with a little bit of peanut butter not too much fat don't wanna give them GI upset. Something like that. Right and I love that you you keep doing which is that you're eager educated on this is your field we took a card you're talking about cars like he's at a banana when I think my car I think about hasn't passed an oatmeal and more red. But it the world is a much bigger than that. Absolutely and some of them are really fun and friendly and and healthy right and that eagerly are evil right. Exactly right you know what I wish I could stand from the rooftops and yell out not call carts are evil we just have to figure out there right ones. I think is going to be or promotion of group. Is now that the final not all cars are evil. Oh absolutely yeah I knew I wouldn't say you have to cut out I'll cover right it's from it and that are all are equal it that threat so. 100 calories from a tone that is different then. You know 100 calories from. A sweet to see it don't always wondered about that because I again I grew up in a world where it was calories in calories out it's a numbers game. So why isn't a hundred calories and done it equals 100 palaces. A hundred calories of secret haters gonna give you vitamin a year can get fiber your candidate pat potassium hundred calories from Madonna is gonna give he added sugar refined carbohydrates. Where they have put the vitamins and minerals back into self pride and give you a surgeon insulin make you sleepy. And then potentially have cravings within. An hour to be affecting your body and different are so you wanna go for the non evil. Cars. That is our thought of the day that today are evil garden it's a car. Thank you both for joining as of the topic I think a lot of people have questioned publicly answered some of them.

This transcript has been automatically generated and may not be 100% accurate.

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