BF Basics: Carb Confusion (Part Four)

Carbs and Fiber: YOU do the math...



You ever notice we WLS folk have NO problem talking about poo? Seriously. It’s an acceptable topic of conversation no matter where you are or what you are doing. So long as you are talking to other post-ops that is. It can (and has been) even discussed around the dinner table.

Why are we so obsessed with poo? Mainly because it is sort of a luxury to be “regular” post-op. I am proud to say that I am and I credit that mainly to the fact that I make sure to get adequate fiber every day.

Dietary Fiber
This is the term you’ll see on food packages. But what is Fiber? Again, we turn to our friends at Wikipedia:

“Dietary fiber or Dietary fibre or sometimes roughage is the indigestible portion of plant foods having two main components:

• soluble (prebiotic, viscous) fiber that is readily fermented in the colon into gases and physiologically active byproducts, and
•  insoluble fiber that is metabolically inert, absorbing water throughout the digestive system and easing defecation.”

Here’s what’s important to you. Dietary fiber is found in carbohydrates. Since our bodies cannot digest dietary fiber, it cannot be turned into glucose or glycogen or converted into fat.

Because of all this, there is a piece of terminology that I am sure you all are familiar with: net carbs. When looking at a food label, you’ll see the total amount of carbohydrates. Then, under that, there’s the amount of fiber, sugar, etc. The net carbs are the total number of carbohydrates grams minus the total number of dietary fiber grams. So if a food has 20g of total carbohydrates and 2g of dietary fiber, the net carbs would be 18g of carbohydrates.

The American Dietary Association recommends we get at least 25g of fiber every day. Why? Look at bullet point #2 above. Fiber absorbs water in the digestive system and sort of “scrubs out” the intestines, carrying out waste (poo). You like to poo? Eat your fiber!

Now, in order to get your fiber you have to take in carbohydrates, this goes without saying. The trick, then, is choosing the right foods to get a good balance of carbohydrates and other nutrients. Fresh fruits and veggies (when you are cleared for them) are obviously a good choice. And there are many grain products that give good fiber (100% whole wheat bread, quinoa, etc.). Beans are also an excellent source of fiber (hence the popular school rhyme. You know the one…”Beans, beans…good for the heart. The more you eat the more you…” well you get the point.)

Fiber Supplements


Because of the reduced amount of food we can eat post-op, it might be necessary for some of us to use fiber supplements (much in the way that we use protein supplements) to get some of our fiber. I just want to highlight that there’s nothing wrong with that (or nothing that I could find wrong with it). Fiber supplements tend to be low calorie and if they have any more carbs than the fiber they give, it’s usually very little.

Having said that, as you get further out from surgery, the other benefits of fiber (satiety and regulation of blood sugar) may prompt you to find more ways to get fiber from your food.
I’ve said it several times before but it bears repeating: you cannot get fiber without consuming carbohydrates. You NEED fiber for several purposes (some that I’ve outlined and others that I have not). Therefore, it stands to reason that you HAVE to eat some carbohydrates (and preferably ones that are good sources of fiber) in order to maintain the proper intake of…fiber!

The food industry and whole grain products

Food companies are notorious for trying to confuse us with packaging. There are some phrases that are meant to make you think you are getting a lot of fiber when may not be.

For instance, when a package says “5g of whole grains per serving.” That isn’t the same as fiber. That 5g of whole grains might only have 2g of fiber. While it’s great that the product is made with whole grains, you really do need to check the nutrition label to get a complete picture of what you are eating.

Also beware of bread packaging. Some loaves of bread will simply say “wheat bread” while some say “100% whole wheat.” Some might even say “enriched wheat bread.” These have very distinct meanings and those meanings do impact you.

So what does this all mean and how can you tell what you’re getting?

If you see a package that simply says “wheat bread” or “enriched wheat bread,” go straight to the nutrition information and look at the ingredients list. If whole wheat flour is not listed, what you probably have is white bread with some wheat germ added for the lovely brown color.

If a package says 100% whole wheat bread, you are probably getting bread that really was made with whole wheat flour, but it’s good to check the label just to make sure.

This is a lot of information, we know. But it’s important! So about fiber, here’s the breakdown of what you should know:

• Dietary fiber can only be found in carbohydrates, therefore you have to eat carbohydrates to get them
• Our bodies can’t digest fiber and can’t convert them into glucose or glycogen or fat for energy storage
• Our bodies CAN use dietary fiber to clean out our digestive systems and for excretion (poo-ing)
• Because dietary fiber can’t be digested, the amount of dietary fiber in food does not count toward the net amount of carbohydrates in the food we eat
• The American Dietary Association recommends healthy people get at least 25g of fiber a day for good health
• Vegetables, whole grains and beans are all excellent sources of fiber
• Beware the packaging on bread products that say whole wheat. Always look at the ingredients to make sure that whole wheat flour is used.

 Part Three: A Time for Every Carb

BF Top 5: Most Beneficial Cereals

Ok, so we’ve tackled oatmeal and we’ve talked about pasta. We still have several more starchy carbs to get through this week. Stay tuned through the end of this week to hear my thoughts on (and a few good recipes pertaining to) bread and rice.

Today, however, let’s return to breakfast for a moment and talk about cereal.

Cereal is one of those things that perplexes many post-ops, old and new alike. First, let’s get the most frequently asked question out of the way. Yes, technically eating cereal with milk is eating and drinking together. Whether you do it, of course, is up to you, but the dynamics of the pouch don’t change just because the pairing of cereal and milk are customary and fundamental to our way of thinking of the food.

As such, I don’t eat cereal with milk. I rarely eat it by itself as an intended meal or snack. That’s mostly owing to my commitment to eat carbs with protein. But one really good opportunity we have with cereal is that a good cereal — a nutritionally balanced cereal that has low sugar (and no added sugar), not too many calories and a realistic portion size — can have a lot of benefits. Food companies pack lots of great nutrients into cereal and they can give you a LOT of fiber.

Whether you eat it as a meal or as a yogurt topper, for breakfast or for dinner, here are my top 5 picks of cereal brands you should check out.

Kay’s Naturals Protein Cereal



If you haven’t heard of Kay’s Naturals in general, you need to get informed! This wonderful company makes tasty snacks that work for OUR plan. It’s not a bariatric targeted company, but they seem to get that people want whole grain, high protein, low calorie and even gluten-free snacks. We Americans love our snack foods! Kay’s makes three flavored cereals. I’ve only tasted one – the apple cinnamon. It tasted like a less-sweet version of apple cinnamon Cheerios. They also make French Vanilla and Honey Almond. The only thing I do NOT like about Kay’s Naturals is that their serving sizes can be wonky. The bags are 1.5 oz. and the serving size is 1 oz. I mean, who are they kidding? I’m going to eat the other half ounce! But even when you factor in the other half serving, it’s not a bad choice at all!

(You knew I was going to do list this) Fiber One

Now I am partial to the Original and it’s the only kind I eat, but it is noteworthy that they make other kinds of Fiber One that also give you a good portion of your daily value of fiber. But you just can’t beat the stats on the original! I use it to top yogurt, on my cottage cheese, as breading for all sorts of things, even as crust for my protein cheesecake. This versatile little cereal packs 57% of my daily value of Fiber and gives me the crunch I like!

Kashi Go Lean!

7 whole grains, on a mission. That’s Kashi’s tagline (which, as a communicator, I should say is genius). When Kashi first started selling cereal it was sort of strange. It was too chewy and tasted sort of like corrugated cardboard. But they were smart. They listened to their customers and they made it better. Now Kashi has a variety of cereals (hot and cold) that are both tasty and beneficial. I am partial to Go Lean! Crunch myself. That cereal + Greek Yogurt + a little Splenda + a few pumps of sugar-free hazelnut syrup = BIG Love!

Nutritious Living Hi-Lo Cereal

I actually tasted a sample of this a friend gave me and that day ordered a box for myself. It is vanilla-almond flavored and puts in me in the mind of Cinnamon Toast Crunch (texturally speaking) meets Honey Bunches of Oats (Flavor wise). Like many healthier cereals, the sweetness is a lot lighter than your standard commercial brand. That’s ok with me because I tend to put cereal on things that I sweeten like cottage cheese and Greek yogurt.

Splurge: Chocolate Cheerios

Ok, ok so I may take some flack for this one but here is my pitch. I love chocolate Cheerios. I, like many women in the U.S., am occasionally (read: monthly) afflicted by an insatiable desire for chocolate. Now, on my plan a few squares of good, dark chocolate is a perfectly acceptable indulgence, but during these…periods of time…my cravings for chocolate go beyond the “one serving every now and again” realm. Chocolate Cheerios are a great way to satisfy the choco-monster while still getting whole grains and limiting my caloric intake. For those who can truly moderate this type of thing (and that’s a personal decision…if you can’t moderate cereal do not go and buy this and then blame me for noshing out on it…) it’s a very sensible swap if you can’t make some chocolate work in your day.

BF Basics: Carb Confusion (Part three)

A Time for Every Carb...



Let me tell you a little story about one of my first post-op experiences in the gym. I was on the treadmill. I was walking fast (or fast for me at the time). There was wind in my hair, sweat on my face and then all of a sudden…the room got very, very dim and started spinning. I felt like someone had stuck a spigot in my back and drained all my energy.

Thankfully, I gripped the handles of the treadmill and pulled the emergency stop plug (if this ever happens to you PLEASE do the same!). I was cold. I was shaky. I was tired. I was carb deprived.

This was in the midst of my “all carbs are evil” post-op phase (it’s really a phase…seriously!) and I hadn’t given my body the fuel it needed for sustained activity. So it gave out on me. Traitor!

The Glucose/Glycogen Factor
OBLIGATORY DISCLAIMER: this is an extremely simplified account of how your body uses carbs. For more in-depth information, I suggest independent research!

For all the non-chemists in the house...this would be the chemical structure of a glucose molecule.

Carbs are important for a variety of reasons, but especially if you are planning to get active. They provide your body with the energy you need to get going and stay going through your workout.

When the body stores carbs as an energy source, it does so by first converting it into glucose, or blood sugar. Glucose is an extremely simple sugar that’s easy to burn, making it a good source of energy for your body in a pinch.

If there is “left over” glucose that your body doesn’t need, it first stores it in your muscles and liver as a molecule called glycogen. Now when your body doesn’t need all that energy to maintain your activity levels, it turns it into body fat for longer-term storage.

But when you DO need it – mainly when you are doing exercise that sustains your heart rate an elevated level for a prolonged period of time – your body will use both glucose and glycogen to get you through. But your body only has a limited supply of the stuff readily available so when that runs out and your body is still burning calories at an elevated rate (true fact, your body continues to burn many calories even after you stop exercising), your body must turn to burning fat.

Anecdotally, I can say that I can feel when my glycogen stores run out. I can feel a temporary dip in my energy level, a feeling of weakness, maybe a little light-headedness. Then your body gets into gear and you recover. This critical moment is the point where many weight loss gurus tell you to “dig deep and find something within you to keep you going.” It is my most sincere hope that that something ends up being my Buddha belly. Just sayin…

So what does this all mean to you?



This means that if you plan to take on exercise, you should not endeavor to cut all carbs out of your life. You shouldn’t even endeavor to cut all simpler carbs out of your life.

Many exercise experts advise that before a strenuous workout, you should have a snack made up of carbohydrates and some protein. They advise against eating a lot of fiber before a workout, however (we’ll talk about fiber tomorrow). That leaves you at the simpler end of the carb continuum. Now why is that? Well, the body can’t access more complex carbs as quickly and the energy it takes your body to burn more complex carbs diverts energy you need to…you know…not DIE on the treadmill.

Now, just because you work out does NOT mean you have an open license to eat potato chips before you go to the gym. But having some yogurt with fruit in it (especially a no-sugar added and lowfat variety) is not a terrible thing. My personal favorite pre-workout snack is a banana with some peanut butter (surprise, surprise). Especially when I am doing strength training that gives me the carbs, fat and protein I need to get through the whole thing (we’ll talk about how fat factors into the equation in our next series).

...And a time for whole grains & more complex carbs

There is also a time for whole grains & more complex carbs (like vegetables), although you already knew that. It's a good idea to eat whole grains, along with some protein for snacks. Why? For newbies, the hunger is sometimes completely absent but for us "veterans" hunger between meals can be an issue. To stave it off (and prevent dips in blood sugar and other types of glorious post-op metabolism wonkiness), a good complex carb with some protein can help. Roasted soy beans are good as are fruit with yogurt or peanut butter (although note that peanut butter is primarily a source of fat with high protein content so...moderation!).

And as I said before, complex carbs contain fiber, which keeps you regular. Regularity is a blessing after surgery. I'm sure you'll all agree.

One important thing to note is that the recommended daily intake of fiber is about 25g a day for women, 30g a day for men. In order to get that much fiber you HAVE to take in a decent amount of carbs. Because our bodies can't absorb fiber, they don't count in our net carb count for the day. Simply put, there is no way to fiber but through carbs. And trust me when I say you WANT to get an adequate amount of fiber.

So…in summary, there is a time for every carb because:

• The body converts carbs into glucose that can be burned quickly for energy
• Excess glucose gets turned into glycogen that is stored in the muscles but your body can still use it if it needs it
• Excess glycogen is stored as fat. Your body burns fat when you sustain your heart rate long enough to go through your stores of glycogen
• It’s good to have a healthy carb/protein snack (not refined carbs no matter how healthy they claim to be) before a workout
• More complex carbs can keep you sated and keep your blood sugar levels sustained for longer periods of time, making them an ideal part of a good snack
• More complex carbs contain fiber, which is essential in staying regular

<< Part two: Simple vs. Complex Carbs: why it's not that simple...

BF Basics: Carb Confusion (Part two)

Simple vs. Complex: Why it's not that simple...

Most sources will tell you that there are two different kinds of carbohydrates — simple and complex. I don’t like that explanation, mainly because it sets us up with an “either/or” method of thinking that has led to some characterizing carbs as “good” (complex) versus “bad” (simple). Folks, it’s just not that black and white.

Instead let’s imagine all the carbohydrates in the world standing in straight line. One extreme end of that line would be simplest of carbs, the other would be the most complex. All carbs fall somewhere on that line. Some are more complex or simple than others. Make sense? Lovely! Moving on…

Refined Carbs

Like I said yesterday, somewhere along the way, carbs got a bad reputation. I personally blame MTV (kidding). Hence, you’ll hear a lot of people talk about “good” and “bad” carbs. I'm not generally a fan of deeming any food good or bad. It’s just food. Some choices are more beneficial than others. All have their rightful place in a well-balanced eating plan.

But, within that, there is a distinction of carbs that I think we can all agree are less beneficial than others and should be consumed in extreme moderation. That would be “refined carbs.”

Refined carbs are carbohydrates that have been largely stripped of their fiber and nutrients. They are easy to identify because they are mostly “white” carbs (yep…it’s a white thing…). White bread, white pasta, potato chips, refined sugar (the white kind that comes in the bag…yep…that’s the one). Most refined carbs have a non-refined counterpart: whole wheat bread and pasta, whole grain chips, raw sugar, etc.

I call out refined carbs for two reasons. First, because if we were going to label any carb “bad” (and I wouldn’t, but still...) they would be it. They give you a lot of calories, with packaged foods they are often prepared using less than stellar methods (frying in trans fats, with a boatload of sodium, etc.) and in return they give you very little nutrition. And because your body can easily convert refined carbs to blood sugar (see below), you get a big spike followed by an even bigger crash.

Think of refined carbs like that ex-boyfriend or girlfriend you were once so ga-ga about...they seemed like the best thing ever...but in reality they were are just no good for you! The post-op WLS patient should only consume refined carbs in extreme (meaning not very often at all) moderation.

Whole Grains and Other Complex Carbs

Increasingly, you’ll see the term “whole grain” on food packaging. But what is it?

This is one of those instances where what it sounds like is basically what it is. A whole grain utilizes all parts of the grain (the whole grain), including the bran (the hull), endosperm and wheat germ. These all have nutritional benefits. The bran is fibrous and helps keep us regular. Whole grains also contain essential nutrients that are either largely absent in their refined counterparts or, because of the removal of the other parts of the grain, our bodies (our bodies meaning any human body) don't absorb those nutrients effectively.

How the Body uses Carbs: a basic primer

Carbs are rated from the simplest of the simple to the most complex of the complex based on how fast your body can convert them into energy. The simplest carbohydrates can be quickly converted and can enter your blood system very fast, causing your blood sugar level to rise and then eventually fall again. More complex carbohydrates (ones that contain fiber, which we’ll talk about Thursday) take longer to break down and thus keep your blood sugar at a sustained level for a longer period of time.

What does this all mean to you? Well the simplest sugars will give you quick energy but when your blood sugar level quickly falls, your body will crave more carbs to get that level up again (hence the adage, “carbs beget carbs”). More complex carbs take longer to burn and don’t cause that same reaction.

Also, when we aren’t using the energy from carbohydrates, our body converts them fat and stores it. The simpler the carb, the easier it is for the body to convert the carb to fat. Now if we want to demonize anything in this process, let’s demonize body fat. Body fat is the ENEMY. We don’t want it! We don’t need it! BOOOOOO!!! HISSSSSSS!!! (That felt good.)

The Inevitable Caveat

Even with simpler carbs, the body will treat different kinds differtly. Your body doesn’t see a banana (a very simple carb among fruits) the same way it sees a piece of white bread or a snack cake.

Believe it or not, there is a use for natural simpler carbs in the body. And I'm going to tell you what that use is…tomorrow! (Red Herring! How dare she!)

So, in summary, here’s what you need to know about the simplicity and complexity of carbs:

• Try not to think of carbs as “simple vs. complex” but rather on a scale from the most simple to the most complex
• Refined carbs are foods like white bread and pasta, white sugar and some types of snack foods like potato chips and cakes
• Refined carbs should only be consumed in extreme moderation
• Simpler carbs are easiest for your body to convert to both energy and fat and they cause a rapid rise in your blood sugar level, followed by a quick lowering (or crash)
• Complex carbs give your body energy but raise your blood sugar more slowly and steadily
• The body reacts differently to natural, simpler carbs like fruits and vegetables than it does to refined carbs

Stay tuned tomorrow to learn how a banana can actually be your friend!

<< Part one: What the Hell is a Carb Anyway?

Mexican Spaghetti featuring "Skinny Spaghetti"



RECAP: Along with the Carb Confusion series, I'm highlighting recipes and reviews of so-called "better for you starchy carbs." So yesterday we tackled breakfast with the wonderful world of oatmeal.

Today let’s discuss pasta.

I should warn you and say that, in general, I am not a fan.

And there’s no need to suggest your favorite post-op noodles. I’ve tried them all – Dreamfields, Tofu Shirataki, spelt noodles, soy noodles and every other kind of noodle you can think of.

Except the noodle I am about to review. Skinni Spaghetti by Dixie Carb Counters. My friend Pam sent it to me and for months it sat in the back of the pantry, untouched (the divas aren’t that big on noodles either). But the other day I made a sauce that actually made me want a noodle. Usually in these situations, I default to my zucchini noodles but this recipe needed something thinner. So I looked to the noodles my good friend sent me.

First, the sauce recipe. This was a serendipitous moment for me. It happened purely by accident. I am a big fan of using both lean meat and Italian sausage in spaghetti sauce and I usually have Italian sausage in my freezer. When I went to make my sauce, I found I did not! But I did have some…chorizo. So the wheels in my brain got to turning. This was the result.

Nik’s Mexican Spaghetti Sauce



1 lb. lean ground turkey (you could do beef…I don’t because me and beef have beef with each other)
1 log (about 8 oz.) of Mexican-style chorizo sausage (I used the kind from Aldi)
1 cup of diced onions and green peppers (I used the frozen bagged kind)
1 tbsp minced garlic
1 jar of your favorite spaghetti sauce
1 tsp chili powder
¼ tsp ground cumin
¼ tsp ground coriander
1/8 tsp cayenne pepper (optional if you like the heat..we do)
2 tbsp Neufchatel cheese (1/3 less fat cream cheese), softened

Directions:
In a pan sprayed with non-stick, sautee onions and peppers until softened. Add garlic and sautee for an additional 3 minutes or so.

Add ground turkey and chorizo to the pan and brown through. Drain mixture of excess fat and return to pan.

Add spaghetti sauce and stir until fully incorporated. Add spices and simmer about 10 minutes on low heat.

Add cream cheese to sauce and allow it to melt, stirring to fully incorporate it.

The reaction from the divas? “This tastes kind of like chili, but kind of like spaghetti sauce. It’s good. But my mouth is confused.”

That situation might be worrisome to some, but to me the bottom line was this: clean bowls. End of story.

Now back to the pasta. I only made a portion of the skinny spaghetti for myself and opted to give the girls whole wheat spaghetti.

The "skinni" stuff has pretty good stats. For 2 oz. of spaghetti (which is way more than I'd actually try to eat) is 143 calories, 3g fat, 14g carbs, 11g fiber and 26g protein (holy spaghetti, Batman!). That was not necessarily a proclamation of joy peeps. That fact alone raises a LOT of red flags from a flavor perspective.

So anyway, the package says very clearly to add the pasta to boiling water and cook for 2-3 minutes and warns "do not overcook." Well, there's an ominous premonition if I've ever read one. But I carried on.



After cooking it for two minutes, it was still not what I'd call al dente, so I decided to let it go another two minutes. After THAT two minutes it still hadn't softened that much and so I accepted that this was the inevitable caveat of this food item and ladled it out into a bowl.

For the sake of this review, I tried a tiny noodle by itself. I can't exactly describe the texture, but it is not "of the noodle variety." It's more like a noodle shaped cracker. VERY starchy. When photographing it, it looks like your standard noodle, but sadly it is not. The noodles were also noticeably absent of that slickness that freshly cooked noodles have. In fact, they were downright dry right out of the pot! (despite the fact that I did add oil to the cooking water)

If you look closely...it sort of looks like fake food...or spaghetti that has been out a while. It only actually sat for a minute or two in this pic. Notice how the cheese is all melty? It's hot...but DRY!!!

I could tell I would not be able to eat much of this as my pouch grumbled at just that noodle. But I decided to pack half the two ounce portion (who was I kidding making that much?) with my lunch. But first I tossed it in a bit of olive oil to try to preserve any moisture that might be present.

At lunch I warmed this up with a wet paper towel over my bowl (more moisture preservation) and that helped a little...but not much. I did manage the whole portion (to see if it bothered my tummy...surprisingly it did not). In the end, the texture kind of bugged and while I could eat it...I probably will not...ever again...

So it all boils down to this...if I were inclined to eat pasta (which I am not), I'd probably go with a good whole wheat variety (or Pam's beloved Dreamfields) and eat a responsible portion of it. This stuff? Is probably going to continue to sit in my pantry and a thousand years from now archaelogists will find it and use it as an artifact from the low carb movement.

Verdict: Diva says DECLINE!

Skip the pasta, make the sauce, top with cheese and have at it!