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Low-carb is not for diabetics

Tribune Media Services

DEAR MAYO CLINIC: I have type 2 diabetes and am constantly looking for low-carbohydrate foods, which has meant avoiding pasta. However, there is a certain brand of pasta that claims it has a "unique pasta recipe and fewer carbohydrates get absorbed in your system." The claim is that only five of the 42 carbohydrates are digestible. Can this be true?

It could be true. This claim comes from the manufacturer and hasn’t been the subject of published research. Here’s some background to help you make choices about pastas and carbohydrates in your diet:

First, you don’t need to avoid carbohydrates. A low-carbohydrate diet is not routinely recommended for people with diabetes.

The American Dietetic Association and the American Diabetes Association recommend that about 50 percent of the calories consumed should be from carbohydrates, with the largest amount from high-fiber, whole-grain carbohydrates.

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The U.S. Recommended Daily Allowance for carbohydrates is 130 grams.

This allows you to eat foods with carbohydrates, including pasta, potatoes, bread, fruits, milk and yogurt, and in small portions, sweets, sugars and desserts.

It’s important to know how many carbohydrates you are eating.

More than any other nutrient, carbohydrates affect the blood sugar the quickest and the most.

For people with diabetes, it’s important to keep blood sugar levels as constant as possible — from meal to meal and from day to day — to avoid health complications.

In recent years, "low-carb" pastas have been showing up on grocery store shelves. Some are higher in fiber, such as the whole-grain pastas. Fiber is a carbohydrate that isn’t digested. On the product label, it’s included in the total carbohydrate count, but fiber doesn’t boost blood sugar levels. That’s why whole-grain pastas have less effect on blood glucose levels than traditional pastas.

Other pastas labeled "low-carb" may have a higher percentage of protein than typical pastas. Protein has much less impact on the blood glucose level than carbohydrates.

Your question probably refers to a specific brand of pasta that suggests that the starch granule is "protected" or "resistant" from digestion in the stomach and small intestine, where glucose absorption occurs. Information isn’t available on how this pasta "protects" starch from digestion; if proved true, this would be a first in pasta products.

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There’s no harm in trying any low-carbohydrate pasta. Check how the product affects your blood sugar level. Some reports indicate that people who are insulin resistant, meaning they require large doses of insulin, may see a higher-than-expected rise in blood sugar levels after eating some low-carbohydrate pastas. Adding a tomato sauce also may result in larger blood glucose increases, as the acid in the sauce may cause the "protected" starch to be digested in the small intestine. Other people with diabetes may find that low-carbohydrate pastas are a good way to satisfy cravings for pasta without alarming jumps in blood glucose levels. — Carol Willett and June Lee-Cahoon, Nutrition, Mayo Clinic, Rochester.

E-mail a question to medicaledge@mayo.edu or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207.

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