Episode Overview

Carbohydrates are one of the most misunderstood topics in nutrition, especially after a breast cancer diagnosis.

In this episode, Laura continues her Nutrition Myths and Truths series by breaking down what carbohydrates actually are, how different bodies respond to them, and why context matters more than rules.

This conversation is not about what you should eat or what you should avoid. It is about understanding how carbohydrates interact with metabolism, inflammation, gut health, genetics, and lab markers so you can make informed, confident decisions.

If you missed the first episode in this series on red meat and how to interpret nutrition research, you may want to listen to that first for foundational context.

In this episode, you will learn:

• What carbohydrates are and why vegetables and fruits are carbohydrates

• The difference between simple and complex carbohydrates beyond labels

• Why refined carbohydrates can impact inflammation even when blood sugar looks normal

• What science actually says about carbohydrates and cancer risk

• Why a nutrient itself is rarely the problem and metabolic response matters more

• How genetics influence carbohydrate response and why two people can react differently

• Why fasting glucose alone does not tell the full story

• How insulin, HbA1c, triglycerides, and inflammation markers fit into the picture

• Why carbohydrates play a role in triglyceride levels

• Whether grains are nutritionally necessary

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Read the full transcript:

0:00
You're listening to better than before breast cancer with the breast cancer recovery coach, I'm your host, Laura Lummer. I'm a certified life coach, and I'm a breast cancer thriver. In this podcast, I will give you the skills and the insights and the tools to move past the emotional and physical trauma of a breast cancer diagnosis if you're looking for a way to create a life that's even better than before breast cancer, you've come to the right place. Let's get started.

0:33
Hey, friends, welcome to episode 449

0:36
of better than before breast cancer. I'm your host, Laura Lummer, and this is our second installment in my nutrition myth and Truth series, where we are slowing things down and we are looking at what nutrition science is really telling us, without food, without rules, without telling you what to eat, and without headlines that are taken out of context and blown out of proportion. So if you missed the first episode in this series. I focus on talking about red meat and, more importantly, on how to understand scientific studies and what they can tell us and what they can't. So if you've ever found yourself feeling confused or conflicted by nutrition advice and who hasn't, or if you've ever felt overwhelmed by big bold claims and headlines and who hasn't I really encourage you to go back and listen to that one. It does set an important foundation for how we're approaching this entire series. So today we're going to talk about everybody's favorite carbohydrates, and I'm not going to talk about what you should eat, and I'm not going to talk about what you shouldn't eat. We're going to talk about what carbohydrates are, what research actually says about them, and how to think about them through a metabolic lens, instead of a right or wrong, good or bad moral lens. So let's start with what carbohydrates are. So at their most basic level, carbohydrates are sugars, starches and fibers found in plants when we eat them, most are broken down into glucose, which we also refer to as blood sugar, and which the body can use for energy. So where the confusion usually starts is right here, because when we talk about carbohydrates, we often talk about them as if they behave one way in the body and they don't. And even more importantly, we often talk about them as if that food itself is the problem. It's a bad food. But biology is way more complex than that, and so are carbohydrates. So I'm sure you are familiar with the terms simple carbohydrate or complex carbohydrate. Simple carbohydrates are smaller sugar molecules that are digested quickly and raise the blood sugar rapidly. These are the things like sugar candy, sweetened beverages, refined flours and grains. Complex carbohydrates are longer chains of glucose and they take longer to digest. These include vegetables, legumes, whole or minimally processed grains. And this is where I want to stop and make a point very clear, vegetables, fruits and legumes, are carbohydrates, and I want to make that very clear because some people don't associate them with carbohydrates. In fact, I was having a lunch with someone one time, and we were eating some vegetables, and she was telling me how she doesn't eat any carbohydrates. And I said, Well, we're eating carbohydrates right now. And she says, Well, no, we're eating vegetables, okay, but there's three macronutrient categories. We've got proteins, fats and carbohydrates. We don't have two additional being vegetables and fruits. Vegetables are carbohydrates. Many people, when they hear the word carbs, just think, only bread, cookies, chips, popcorn and pasta, but those are just one category of carbohydrate foods, which are the really ultra processed and refined ones. But carbohydrates absolutely include leafy greens, root vegetables, beans, lentils, squash berries, fruit and all of these foods provide fiber, minerals and compounds like phytonutrients that support gut health, immune function and metabolic stability. So for many people, these types of carbohydrates. Complex carbohydrates make up the most nourishing and supportive part of their carbohydrate intake. And so it matters, because when people say they're cutting carbs, we don't want to be unintentionally reducing foods that support digestion, blood sugar regulation and overall metabolic health. So it's important we understand what we're talking about, and it's also worth clearing up at this point, a misconception, I think, a very common misconception, about ketogenic diets. So a ketogenic diet is often, most often, portrayed as something that's just bacon, butter and cheese, but a well constructed ketogenic. Or low carbohydrate diet typically includes a very high intake of non starchy vegetables, because those vegetables provide that fabulous fiber, phytonutrients and the bulk that supports gut health and helps regulate inflammation. So the goal is never. The absence of plants is the management of glucose and insulin through thoughtful food choices. So we'll go much deeper into ketosis and ketogenic diets in a future episode in this series, because that topic, I think, on its own, really deserves to have a full conversation. But the issue here is really about, what kind of carbohydrate are you consuming? Is it simple? Is it complex? Is it processed? How much fiber does it contain? What are you eating it with? Because food combining matters, and how is your body responding to it? This is super important. How is your body responding to it? And this is where we have to widen the conversation, and we have to take it beyond blood sugar alone, because someone can have normal fasting glucose and still experience inflammation, gut disruption or immune system stress from a diet high in refined carbohydrates. Refined carbohydrates can shift your gut bacteria in ways that promote inflammatory signaling, even when your glucose numbers look good on paper. So blood sugar is important. We're going to talk a little bit more about that, but it's not the whole story. Okay, let's talk a little bit. Let's touch on carbohydrates and cancer. So this is where things very often get oversimplified. It isn't that a specific nutrient, like a carbohydrate, causes or prevents cancer, because in a cancer preventative type of diet, what do we say? Be plant forward. A lot of times people say, Be plant based, meaning only plants. I'm not a fan of that, but plant forward means you're eating carbohydrates. So cancer biology is not simple by any means, and what matters is what a nutrient does in your body, what does it trigger metabolically, and what the downstream effects are over time, not does this food cause cancer? Right? Why would it cause cancer? Are you telling me that eating a ding dong causes cancer? Well, eating a ding dong does something inside of my body, and the reaction in my body is what increases my risk for disease. So for example, does the food raise insulin repeatedly? Does a food increase inflammatory signaling? Does the food alter your immune function? Does it stress your liver? Does it disrupt gut integrity and give you leaky gut? So those are all mechanisms that really matter so much more than what we talk about, just calories in, calories out, or carbohydrate, fat, or whatever we've got to think on a deeper level on how our body works and how we can care for it. So just the presence of a food in its isolation is way oversimplifying something. So when researchers look at carbohydrate intake and cancer outcomes, especially breast cancer, most of the data we have comes from observational studies. So I talked in depth about the type of studies and what we can gain from studies in the first episode of this series. But observational studies, Cliff Notes version is that these are studies that follow large groups of people over time and look for patterns between what they eat and health outcomes. And observational studies cannot prove cause and effect, but they are useful for identifying trends and what people eat in an observational study is not controlled by the people doing the study, so there's lots of room for error. So a big, well known, famous study, which involved a huge cohort was the Nurses Health Study, and other studies similar to that, that have followed large groups of people for long periods of time have consistently shown that diets higher in fiber and high quality carbohydrates. What are high quality carbohydrates? Again, vegetables are associated with better metabolic health and lower risk of chronic disease. Now, on the other hand, studies looking at breast cancer survivors have found that higher intake of refined carbohydrates and sugar sweetened beverages after diagnosis is associated with poorer outcomes and higher mortality, meaning a higher death rate. So what's also important is what these studies do not show. Okay, there are no large, long term randomized control trials in humans proving that total carbohydrate intake alone causes or prevents. Breast cancer, lots of big studies and lots of randomly controlled or gold standard studies are done in rats and mice, but doing them in humans is incredibly difficult to conduct over the kind of time frames that cancer requires and over the type of control it requires to see what humans are eating. So what we have instead are patterns. We have mechanisms. We have metabolic clues, and those clues consistently point us back to metabolic health, inflammation and insulin signaling, not to carbohydrates, just as a villain on their own, but what happens when you consume the food so two people can eat the same carbohydrate containing food and have completely different responses. One person may see very stable blood sugar. Another may see sharp spikes and crashes, big spikes and dips in even if blood sugar looks beautiful in one person. That does not mean that the food is metabolically neutral for them. So I want to give you a personal example that just happened recently that kind of tells the perfect story here. I As you know, as I talk about on this podcast, I test my blood a lot. I wear CGM a continuous glucose monitor that's always monitoring my blood sugar, because I want to see how my body reacts to food, stress, sleep, and, yes, your blood sugar reacts to all of those things. So I look at my labs at least once a month, if not every three weeks. I have a friend we did some labs and some genetic workup on her just recently, and she has a sweet tooth. I have a sweet tooth too, but I no longer indulge that sweet tooth. I miss it, but she does right? She allows herself to eat sugar, and she's like, I love sugar, and I eat it on a regular basis. So I get her labs, and all of her blood sugar markers are beautiful. Envious I had blood sugar envy because it takes me so much work to get even close. I don't even think my I don't even have to think I have never had my insulin and HBA 1c and fasting glucose as low as hers, even on my strictest fasting and just being really good, having great adherence to my program. So that says something about the way her body works. But it doesn't mean, hey, you can eat sugar. It's a free for all. Because why we were looking at this was because she's struggling with some really impactful, inflammatory issues. Okay and so, highly refined carbohydrates and excess sugar, even if your body, if you're lucky enough to have one of those bodies that can regulate its glucose, it still is increasing inflammatory signaling. It still can stress the immune system. It still can alter gut bacteria, raise triglycerides and burden your liver. So we don't want to just look at blood sugar. We want to ask ourselves, did my glucose spike? That's what I learned from my CGM. We want to ask, what is this doing inside my body over time? And this is why genetics matter in this conversation, right? Genetics come into this picture because the body's response to carbohydrates is definitely influenced by many things, but one of them is genetics. So I talk about them as SNPs, single nucleotide polymorphism. So snip, SNP, and the snip is simply a small variation in a single building block of your DNA. So think of it like a little spelling difference in a very large instruction manual, a little typo. It does not determine your fate. It does not say this will happen to you for sure, but it does and can influence how efficiently certain processes in your body work. So there are many snips related to carbohydrate metabolism and insulin signaling and glucose regulation, but I want to talk to you about just five of them today. This is not an all inclusive list, but these are some of the more commonly discussed snips in nutrition genomics. So one of these snips is called TCF 7l, two. This gene plays a role in how insulin is released in response to carbohydrates. Certain variants make insulin release less effective, so it affects the pancreas, and the pancreas is ability to make insulin, and if that gene is expressing itself, it can increase the risk of glucose dysregulation. There's a gene called IRS one, this helps insulin communicate with your cells so glucose knocks on the door, insulin knocks on the door. The cells respond. Are they going to take it in? What are they going to do with it? How are they going to work with it? And some variants of this, IRS one, make it harder for cells to respond properly to insulin and. That contributes more to the possibility, not for sure, the possibility of insulin resistance. There's PPA, RG. This gene influences how fat cells respond to insulin and how glucose is stored. So certain variants of this gene can affect how well the body handles carbohydrate intake and how it's stored. There's a gene called Amy one. It determines how much salivary amylase that so digestion starts in the mouth. Our mouth is the beginning of the digestive tract. This gene determines how much salivary amylase you produce, which starts the breakdown of carbohydrate, right? Carbohydrate digestion starts in the mouth. Different macronutrients begin to get digested in different parts of our body. So this is why, when we take something that is fat soluble, or when we take a a water soluble vitamin, a lot of times, it's recommended to take a liposomal form, means it's wrapped in some kind of fat because we needed to get through the gut and into the small intestine where the fat really starts getting absorbed, so that the vitamin can get into our system. So fewer copies of this Amy one can mean that poorer starch digestion and larger glucose swings are something that the person with this snip might have a higher predisposition to. There's an Apo E gene, and while this gene is really often discussed in fat metabolism, it also affects inflammation and glucose handling, so different variants influence how the body responds metabolically to carbohydrate intake. And again, these SNPs don't dictate what you should eat, but if you know what you have, they help explain why different bodies respond differently. Now, they don't tell the whole story. Again, they say what we're predisposed to if they're expressing themselves. So when you think about diabetes, we think about out of control, blood sugar regulation. What do we think about people who are overweight? But have you ever met someone who looks like they're a very healthy weight, even a slender person with type two diabetes I have, and so what this says is that this person genetically, they're not really predisposed to a lot of weight gain, but the other processes that their diet is triggering in their body are creating this insulin resistance, right? So we don't always have to look overweight. It's definitely something that we see more often, because having high levels of body fat absolutely is tied to inflammation and insulin resistance and constant high levels of glucose and constant triggering of insulin responses, right? So that's all tied together, but it's not an absolute. So this is why labs are important, and why looking at your labs through a metabolic lens, not a diagnostic one, matters, right? Because diagnostic labs are looking at ranges of blood that may tell a doctor that you may need some kind of medication for something, or may indicate to a doctor that something's off and there may be some onset of disease. When we're looking from a metabolic lens, it's not to be diagnostic as far as diseases are concerned. Is to ask ourselves, what is the blood saying? What is your body telling you? Do we see high inflammatory markers? Do we see an imbalance here somewhere that could be supported by good nutrition. So many people only ever see their fasting glucose on a standard blood panel. So when you see your blood panel, you see glucose. That's a snapshot. It's where your blood sugar was at that day when you took your blood draw. And I always look at my clients at their fasting insulin and their HBA 1c among other markers, but definitely the fasting insulin and HBA 1c which, again, are big indicators of what's going on with insulin resistance, and that can give us an idea of what's going on with inflammation in the body, but we don't often see that on a blood test. So when we're looking at just our regular blood sugar on a blood test, it doesn't tell us how much insulin your body needed to keep up with that glucose, to keep it at the level that's at. It didn't tell us how stable your blood sugar has been throughout the day or through over time, and it doesn't tell us whether inflammation is building up. But markers, like the fasting insulin, the HBA, 1c they tell us a deeper story about glucose regulation, as I understand, they used to be a part of labs where they're not anymore. So this is where a tool like a continuous glucose monitor or even a glucose and ketone monitor can be incredibly helpful, because they can show us real time responses to food, stress, sleep and movement. All of these will affect our blood sugar, and so they take the guesswork out. This is something that Dr Neisha taught me, and that is a part of her whole educational platform, test assess. Don't guess, and the only way we can. Not guess about what's happening in our body is through testing, looking at data, when we pair data with labs, so genetic data and labs, we can start seeing patterns and stop assuming things. And a minute ago, I mentioned triglycerides. I don't know if you caught that, but I want to make another clarification here, many people associate triglycerides with dietary fat because it's part of a cholesterol panel, but carbohydrates play a major role here. So when you eat carbohydrates, especially refined ones, excess glucose that is not immediately used for energy is sent to the liver, and the liver will convert that glucose into triglycerides and release it into the bloodstream to go off for storage. So elevated triglycerides are often a sign of carbohydrate overload or poor glucose handling, not just fat intake, and that's why triglycerides, HDL, insulin, inflammatory markers together tell a much more complete story than any single number alone, than just looking at Oh, there was my glucose. It was under 100 My doctor says it's good. So I want to touch on another thing, another final point I want to make here is, let's talk about grains.

21:18
If you never ate another grain in your life, but your diet included vegetables, fruits, nuts, seeds, quality, proteins, you would not necessarily because of the food develop a nutrient deficiency. Grains are not essential nutrients. They're optional, and the nutrients found in grains can be obtained elsewhere in the diet, as long as your diet is well constructed. So when people talk about it, and which, I hear this all the time, if I say, you know, grain free, if we want to go grain free, oh my gosh, I don't want to cut out a whole category of food. Well, this category of food, grains literally cannot provide anything that these other categories that can be much more healthy to your system can provide for you. And so we don't necessarily just think about taking something out. But how much more could you add in? Because if you weren't consuming grains, which can really cause you to feel full very quickly, how much more vegetables could you eat and get a lot of fiber intake along with some really great things to help reduce inflammation in your body and support your gut health? So bottom line, carbohydrates are not inherently good or bad. What matters is how processed they are, how your body responds to them, what they trigger metabolically, what your labs and data show. And so this is about understanding your body, not following more dietary rules and restrictions, understanding the response your body has to food. And that's why I'm doing this series, I want you to understand what works well for you, and different things you can look at to help yourself understand if your body is responding optimally and if it's in the best possible metabolic state. All right, I love to hear your comments, so come and join my free community living well after breast cancer. I'll post the link here in the show notes, and you can also join just by going to my website, the breast cancer recovery coach. But if you really want to dig into more and understand your metabolic picture, your genetic blueprint, your labs and how your body's responding, come to my website. Check out my metabolic health coaching packages. You can find everything at the links here in the show notes, and then also on my website, the breast cancer recovery coach.com All right, friends, I will talk to you again soon, and until then, be good to yourself.

23:56
You've put your courage to the test, laid all your doubts to rest. Your mind is clearer than before. Your heart is full and wanting more. Your Future's at the door. Give it all you got

24:15
no hesitating. You've been waiting

24:17
all your life. You've been waiting all your life. This is your

24:26
moment. This is your moment.