Carbohydrate isn’t always a dirty word when it comes to eating healthy

by Kathy Swanwick for The Times Herald Record

Up until a few years ago, Dr. Alan Schaffer had the bad — although delicious — habit of grabbing a pint of Ben and Jerry’s Chocolate Fudge Brownie ice cream before settling onto the couch at home to watch a ballgame on TV.
“It was 1,000 calories, all fat and sugar,” he said.
Ironically, as the medical bariatrician at Goshen Medical Associates, Schaffer has the job to help his patients lose weight — and keep it off. He knew it was time to better manage his own, so three-and-a-half years ago he started on a weight-reduction program.

‘It was a revelation’
Schaffer began paying more attention to his food, consuming more lean meats, fruits, a wide variety of vegetables and whole grains. Instead of the ice cream at night, he’d reach for an apple. Rather than drink an eight-ounce glass of orange juice in the morning — with maybe 24 grams of sugar — he’d eat an orange, better for him because of the fiber.

Schaffer lost 40 pounds, has kept the weight off and said he feels 10 years younger. And, along the way, he discovered that the types of foods he consumes affect his overall mood as well.
“I’m eating better,” he said. “It really was a revelation. It’s about knowing myself and knowing that when I eat a lot of carbohydrates I get out of control. The nurses in my office noticed that I was nicer. It mellowed me, smoothed out my mood.”

Schaffer’s improved food intake falls in line with the principles of current diets such as the Zone, which take into account the glycemic index (GI) and glycemic load (GL) of the foods we eat.

If you start eating like this now, perhaps your annual New Year’s resolutions will become about maintaining your weight, overall good health and enjoying your food — not just about the sometimes-elusive and frustrating goal of weight loss.

What is the glycemic index?
Minding your GI and GL are tools to help establish healthier eating patterns, experts say.
“Glycemic index,” said Schaffer, “is a measure of how fast a particular carbohydrate will increase one’s blood sugar. Sugar has an index of 100. This is important because high-glycemic-index foods will cause insulin levels to spike higher, resulting in the development of hypoglycemia (low blood sugar), but more importantly, buildup of fat. Insulin promotes production of fat and inhibits its breakdown.”

GI, according to the Mayo Clinic, was originally devised as a way to help diabetics control their blood sugar levels. Foods with a glycemic index of 55 or less are considered low; those with indices of more than 70 are considered high.

Glycemic load, said Schaffer, “is the amount of carbohydrate an individual takes in, say, in one day. Or the amount of carbohydrate in a particular food.”

Insulin surges increase appetite
“People have been using these concepts for a very long time,” said Kristine Bihun, a clinical diabetes educator at the Stanley S. Dunkelman. M.D., Diabetes Treatment Center at Orange Regional Medical Center in the Town of Wallkill.

“Pick healthy foods that are less processed, with less effect on blood sugar and less effect on insulin production. As a result, your body will release less insulin in response.”
Those insulin surges, she said, will cause you to want to eat again quickly.

Go to, Bihun suggested, for information on how to put together a nutritious meal. For example, one-half of your dinner plate should be filled with vegetables, the other half divided into grains and protein.

And use common sense, she urged, when choosing foods based on their GI and GL.

“It’s not that straightforward,” said Bihun. “People think they can sit with a list of foods and pick what they will eat. But not all foods have a GI. It works (only) to a certain degree.”

Coping with carbs
“If you have an array of high glycemic carbs, pick and choose,” said Fran Sussman, owner of Fran Sussman Holistic Services, in Chester. “Presented with bread, pasta, alcohol and dessert, pick the one you want most, and skip the others for that meal. Having all will definitely raise your blood sugar precipitously; having one, in the context of a meal, will probably not.”

It’s important, said Sussman, who has 20 years of training in food sensitivity, for people to often cook at home instead of constantly eating out or having TV dinners or prepared foods. Roast a chicken on the weekend, she suggested, for protein for your lunch for a few days. Or make meals ahead in a slow cooker.

She advises her clients to eat three daily meals made up of four parts: lean protein, starch, nonstarchy carbs — such as a salad made up of richly colored vegetables — and a little bit of healthy fat, such as avocado, nuts, seeds, coconut and walnut oil.

“The impact of carbohydrates on your blood sugar can always be moderated by combining them with protein and fat, and by increasing fiber,” said Sussman. “Some acids, like vinegar and lemon juice, help a little, too, so don’t skip the salad dressing.”

Check the dressing, though, to be sure it’s free of a lot of additives.

Finding a balance

Warwick resident Kim Sumner-Mayer first sought Sussman’s help a few years ago when she was suffering from postpartum depression, weight gain and “brain fog.” Following a consultation, Sussman told Sumner-Mayer that she was probably gluten intolerant.
“So I took all of the gluten out of my diet,” said Sumner-Mayer, 43, and a family therapist. “I instantly felt better.”

Several months ago, though, she called on Sussman again for guidance; she wanted to “tweak” her diet a bit as she hadn’t yet entirely dropped all the weight.

This time, they concentrated on the types of carbohydrates she was consuming, as well as when and how much she was eating.

“I didn’t realize I was so sensitive to carbs and sugar,” said Sumner-Mayer, who said her diet is now gluten-free and nearly sugar-free. “It’s made a big difference.”

In the past few months, she said, she’s been getting most of her carbohydrates from vegetables such as squash, carrots, broccoli, cauliflower and zucchini.
“And I love sweet potatoes,” she said. “They’re so nutritional.”

But she doesn’t entirely deprive herself and has pancakes with her family on weekends.
“I’m not extremist about it,” said Sumner-Mayer, who noted that she gets regular exercise and now weighs less than she did before she had her first child. “I’m trying to find a balance. I cut way back on baked goods and sweets. My carb cravings went away. I don’t want brownies or chocolate as much. The less I have, the less I want.

“Forty-three years of eating and I’m now just finding this out about myself,” she added.

Local nutritional experts suggest the following sample meals to help keep your blood-sugar levels even throughout the day.

Remember to check with your doctor about what is the best food plan for you before beginning any program.

Fran Sussman, owner of Fran Sussman Holistic Services in Chester, suggests having two eggs, a starchy vegetable such as cooked carrots and a piece of whole grain toasted bread with a little dairy butter “from pasture-fed cows” or almond butter. Add a mango or some berries, but avoid traditional, sugary breakfast foods.
“If you have cereal and a banana for breakfast,” said Sussman, “you’re basically having candy for breakfast.”

Make a sandwich on multigrain bread with lean meat, lettuce, tomato and mustard, said Kristine Bihun, a clinical diabetes educator at Orange Regional Medical Center. “Mustard has no calories,” she said. “Be careful of real mayonnaise, which is high in fat.”
You might also have a salad with high-quality sliced turkey, grilled chicken, tuna or salmon with a light dressing.

Chicken, fish or lean beef with broccoli and a salad with oil and vinegar is a healthy, low-glycemic meal, said Alan Schaffer, M.D., of Goshen Medical Associates. Be sure to grill the chicken and steam the broccoli. No croutons in the salad. You can substitute other vegetables for the broccoli, but be aware that peas, carrots, onions, Brussels sprouts and potatoes are high in starch, with higher glycemic indexes.

After-dinner or late-night snack
Grab an apple, Schaffer suggested, instead of ice cream or cookies. It’ll satisfy your craving for something sweet, and add some fiber to your diet at the same time.
-Kathy Swanwick

1. Pile ’em high: Fill half your plate with vegetables or salad.

2. Be wise with your potatoes: Pair one or two baby new potatoes with a small ear of corn, or make a white bean and potato mash. Or try sweet potatoes, yams or taro – steamed, roasted or mashed.

3. Go grainy: Choose a really grainy bread, sourdough bread, pumpernickel or bread made from legumes.

4. Smart carbs: Refined breakfast cereals will spike your blood glucose and insulin levels. Replace them with smart carbs such as natural muesli or traditional (not instant) oatmeal.

5. Look for low: Try low-GI rice, serve your pasta al dente, and choose intact grains such as barley, buckwheat, bulgar and quinoa. Opt for lower GI starchy vegetables.

6. Love those legumes: Get into the habit of eating legumes such as beans, lentils and chickpeas, and have them at least three times a week.

7. Develop the art of combining: Mix some high-GI carbs with some low – lentils with rice, rice with beans and chili, tabouli tucked into pita bread, baked beans on toast.

8. Have lean protein with every meal: Go with lean meat, skinless chicken, fish and seafood, eggs, milk, yogurt or cheese. Or eat legumes and tofu if you’re vegetarian.

9. Tickle your taste buds: Try vinaigrette (using vinegar or lemon juice with a dash of extra virgin olive oil) with salads, yogurt with cereal, lemon juice on vegetables such as asparagus or sourdough bread. These foods contain acids that slow stomach emptying and lower your blood glucose response to the carbs in the meal.

10. Keep track of your snacks: Go low-GI when snacking, with fresh fruit, dried fruit or fruit and nut mix; low-fat milk and yogurt. Limit high-GI refined flour products such as cookies, cakes and pastries – regardless of their fat and sugar content. And watch portion sizes of low-GI foods; too much will increase your glycemic load.

Source: Glycemic Index Foundation

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