Carbs—to Eat Or Not To Eat With CKD Management?

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Marika Wamback, BSc. R.D.
Registered Dietitian |

Carbs—to Eat Or Not To Eat

Carbs—to Eat Or Not To Eat With CKD Management?

The carbohydrate seems to be the most controversial macronutrient.  So many questions surround the topic of Carbs—to Eat Or Not To Eat, only eat certain amounts, only eat net carbs, only eat certain carbs at certain ages, are carbs fattening?, and the list goes on.  The ‘claims’ are both confusing and frustrating. Let’s start with some basics to clarify. 

Definition of a Carbohydrate

Carbohydrates are a macronutrient (meaning they are needed in large amounts in the body) and are the body’s main source of energy.   Approximately 50% of our diet should be from carbohydrates. When digested, they are converted into their simplest and smallest form-glucose.   Why? Because the energy from carbohydrates needs to be transported throughout the body to all of the organ systems. In order to do that, they must be small enough to be carried on the red blood cell through the blood vessels.  If this didn’t happen, we’d all have lumps of food moving under our skin (not very attractive!) nor would our nutrients be fully absorbed (we’d be lumpy and malnourished!).  

Carbs Affect the Brain

The organ that requires the most energy from glucose is the brain.  It uses 20% of the body’s glucose supply and it requires a minimum of 130 grams of carbohydrates daily (approximately 500 calories).  Carbohydrates also provide fuel to our muscles, and helps the muscles retain fluid. This is important for the muscles to work properly otherwise every time we moved or exercised, we’d get dehydrated.  

So, why does society have such a negative message about carbs?  Are carbs fattening or bad for you? No, they’re not. Excess amounts of ANYTHING causes weight gain.  An amount of food equal to or greater than 3500 kcal causes a weight gain of 1 lb or more. It can be easy to overdo carbohydrate intake, particularly, simple carbohydrates, because they are readily available in large portions.  Why do we need chips, chocolate, slushies, candies just to get gas for the car?

Carb Management

To manage carbohydrate intake, choose complex carbohydrates that have fibre (>3 grams) and minimal or no added sugars (<10 grams) per serving.  Fibre slows digestion, as it is indigestible, so it takes the body longer to digest complex carbohydrates. This helps slow the digestion of carbohydrates and absorption of glucose.  Great sources of complex carbohydrates are whole grains, fruits, vegetables, legumes, beans, and corn. Limit your portion of complex carbs to ¼ of your plate per meal. Most people need about 6 servings per day or more, but this is individual.  A portion size is handful of crackers (not the whole box), 1 slice of whole grain bread, ½ cup cooked pasta or 1 whole medium sized fruit. A plateful of pasta with garlic bread is too many carbs-your whole day’s worth and likely more!

Portion size of carbs is the size of your fist

Simple Carbs

Simple carbohydrates such as doughnuts, candies, cookies, white flour items, pop, chips are all non-nutritive carbohydrates.  They provide no nutritional value. Sugar is the fastest absorbing carbohydrate because it is rapidly digested during digestion.  It will leave you feeling hungry faster due to quick digestion and no fibre content. It is easier to eat larger portions (more calories = more weight gain) since simple carbohydrates don’t fill you up as much as complex carbohydrates.

With CKD management, watching portion size for carbohydrates (and all other foods in your renal diet) is essential for energy, hydration, phosphorus and potassium targets, blood sugar management (for diabetics) and weight management to help you feel your best with your CKD.

Carbohydrates are not the enemy.  The right amount of complex carbohydrates are necessary for good health and for CKD management. Choose your carbs wisely, watch your portions, and enjoy your food!  


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