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Simple Carbohydrates, The Ingredient That is Getting Away With Killing People Unnoticed
I have been thinking a lot lately about the silent killer habits that I talk to my physical therapy patients about. A lot of these are escaping our attention. I have had patients who are doctors that had to quit their jobs due to side effects of insulin resistant type II diabetes. People who are thin and who are way more intelligent than me are making these mistakes.
Processed grains and added sugars are everywhere. Companies are getting away with making simple carbohydrates look like complex ones. Companies like Kroger's, McDonald's and Subway sell breads that are called multigrain but that are refined flours. People still think that being thin means being healthy. The current generation of young people is the first who will not outlive their parents. We have to down vote this type of behavior by voting for healthier options with our dollars. It's the burden of living in a free democratic society.
Complacency Kills 
My friend who went to both Iraq wars said that his company motto was, "Complacency Kills". I like the way they made it their motto to cultivate a mindfulness of this. I think the sugar problem is one that has to be handled this way. If you think about it, sugar being in everything is like guerilla warfare. Cheap common items are becoming bombs waiting to go off hidden in plain site, not unlike terrorist IED's.
A Review of Simple Verses Complex Carbohydrates
Part of being complacent is trusting our memory too much. As a physical therapy assistant I have to take a certain amount of continuing education courses every two years. Although this can be a pain I know why it is required because I often have to look up random things I don't encounter regularly. I also know that communicating with my teammates and family is important. Last week my teammate caught a mistake I was about to make but because I called to review the case I was able to prevent it. These things need to be a bigger part of our daily dialogue.
Carbohydrates come in many forms but can mainly be broken down into simple and complex carbohydrates. Our body needs sugars do do vital functions. The problem is that too much at any given time is analogous to trying to lift an object that is simply too heavy for our back. Our pancreas has to release insulin and glucagon to constantly keep our blood sugar at a healthy level. It is like our backs, eventually we all wear our back out to some degree and have back pain. 
Knowing when and how to lift is a subtle art that is difficult to master.
When you look at the ingredients of any grain containing product you should look for it to say simply, whole grain rice, wheat or whatever. Don't be fooled by Enriched, refined whole grain wheat 
. When it says those words it means it has been processed, the fiber has been removed and it is now a simpler carbohydrate. A good tool to know how fast a carbohydrate converts to blood glucose is called the glycemic index.
The Glycemic Index
The glycemic index is good to know because a lot of the time it is difficult to know which foods are going to be easier on your pancreas. White rice 
, for example is a high glycemic index food with most types having a glycemic index of over 70. Our doctor told me that I have to watch this with my wife because she has lots of Asian patients who are thin but are diabetic because of white rice. It has a higher glycemic index than white sugar. As technology improves and becomes cheaper we need to reference and monitor this more.
Hopefully smartwatches will be able to non-invasively tell us our blood sugar at any given time as with heart rate in the near future. In the mean time you can look at charts online when you are unsure about a food. Harvard has a nice chart with a lot of common foods here.
Yesterday, my wife and I went to the Body Worlds Exhibit at the Museum of Health in Houston. Go to this museum if you are ever in Houston! Afterwards, Mod asked me what my favorite thing was at the exhibit. I thought it was too simple but honestly the video on how sugar is killing us was what came to mind. It seems a shame after all the beautiful plasticized human bodies, money and effort because the video is free on youtube. Here it is, I love this video, the girls sweet voice and the message 
. There were two kiddos sitting on the floor watching the video and it made me happy.
Simple Carbohydrate Substitutes
At one of my recent continuing education courses we were talking about what are good options. I brought up agave nectar, which has been touted as a lower glycemic index option. A classmate said that it has too much fructose making it a simple carbohydrate. I brought up stevia which is made from a plant and has little to no calories but all the sweetness. She said it's too synthetic and or processed. I am still using stevia for now though until there is strong evidence against it.
Her thought was that natural honey is the logical choice. I'm not sure I agree because it seems like such a simple carbohydrate although it does have a GI, glycemic index of 55. Remember 55 and below is considered low glycemic. The important thing I think is that we are keeping the dialogue going. Not just with ourselves but with our families, friends and definitely the companies who would have us die for their profit. I like skeptics of all carbohydrates such a paleo diet people who think grain based diets in and of themselves are bad. I am not a paleo person but I'm interested for that piece of strong evidence that might convert me. The main thing is keeping the conversation going in an objective way.
Blogging in itself has been a way for me to make researching important information more fun. It stimulates conversation and is a platform that makes more more relevant than I am just out in the world at large. Let me know what thoughts you have when reading this in the comments below. If you know of any tools or websites I'm interested in those too! As a final note, here is a USA today article with more information on how sugar is killing you.
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Juan says
I really enjoyed the article Adam. With all the articles, videos and documentaries online about the detrimental effects of sugar, people still underestimate the effects of sugar. Obviously sugar can be addicting, but I also believe people think that "simply cutting back on sugar" is too simple of an advice to be true and effective. The video that accompanies this post is really well done. I'm going to show it to my son as well. Thanks again.
Adam Shed says
Thanks Juan! I agree, we can't go in depth enough to make sure we are safe on this one. Any ideas how I could have gone deeper than the "simply cutting back on sugar" more? I thought the glycemic index bit was kind of helpful. I want to get a blood sugar monitor and figure out how to use it in the future. I bought one once but had a hell of a time getting good readings. I don't bleed easily. There has to be a better way.
Pat says
Grain, whole or processed, will cause inflammation in your body and ultimately leaky gut syndrome. This society is infatuated with sugar, grains and fiber; which are making us sicker and sicker. Go to any gastroenterogist's office, and you'll be amazed how full the office is at any time on any day. Grains and fiber does not lower cholesterol or keep your bowels regular. This myth is making us sicker, and cereal companies richer. Eat wholesome, organic meals at home (grass fed meats, pastured raised chicken, wild caught fish, organic veggies and limited fruits), and health will flow through you. I'm a physical therapist who believes strongly in nutrition, and this is what I tell all my patients to release their chronic inflammations.
Adam Shed says
I've been hearing this a lot too. People are saying it's the gluten that we are not made to handle. So you think the main problem is the inflammation it causes? I like the idea, I'm thinking fruits and proteins would be better too but I must be addicted because I love my grains. I want more evidence against whole grains still but I won't be surprised if this is true. Humans didn't eat grains naturally, I get that.
Adam Shed says
Come to think of it we were just talking about leaky gut at my last CEU. Do you live in Houston? Was that you? Hehehehe
Donna says
See http://www.drmcdougall.com
Plenty on how sugar hurts the body, as well as how a plant-based diet saves lives.