If you have read the two previous articles in this series, you should now have a good overview of the importance of quality carbohydrates, proteins and fats in the diet. This next section discusses how to balance the intake of each macronutrient.

Balancing macronutrient intake is the key to optimizing day-to-day energy, mental clarity and long-term health. Everyone is an individual when it comes to balancing macronutrients. Some people can eat a high-carbohydrate diet with very few, if any, adverse health effects. For other individuals, a high-carbohydrate diet can result in an increased risk for developing cardiovascular disease, adult onset diabetes or exacerbating inflammatory conditions. For others, they may suffer from frequent or multiple injuries, or may just feel tired all the time.

Finding the right balance of carbohydrates, proteins and fats should be the first step when making changes to move from chronic health problems to optimal health.

The body can utilize carbohydrates, proteins and fats for energy. As a survival mechanism, the body has developed some very complex mechanisms by which the blood glucose level can be adequately maintained, even with extreme variations in the dietary intake of carbohydrates, protein and fat. Unfortunately, these mechanisms cannot compensate for the stresses put on the body by modern-day lifestyles. A conscious and proper balancing of macronutrient intake can provide the fine-tuned maintenance of blood glucose that is required for the optimal health, energy and concentration most individuals desire.

Maintaining an optimal blood glucose level for four to five hours between meals is accomplished by eating a combination of protein, carbohydrate and fat at each meal. The carbohydrates supply the initial energy, and the protein and fat supply the long-term energy. For example, food supplies energy to the body in the same way that wood supplies energy to a burning campfire. When an armload of dry kindling is put on a burning campfire, the kindling burns very quickly, and gives off lots of heat, or energy. Very soon, however, the fire burns down, and it no longer provides adequate heat. Carbohydrates are like the kindling; they supply very quick energy to the body, but that energy is soon depleted.

On the other hand, eating protein and fat are like putting a green log on a fire that is burning well; the log takes awhile to get going, and it only gives off a moderate amount of heat (energy), but it burns for a long time. The protein and fat are not as quick an energy source for the body, and supply only moderate amounts of energy, but it lasts much longer. Therefore, carbohydrates supply immediate energy following a meal, and protein and fat provide more sustaining energy.

How dietary carbohydrates are handled by the body also depends on the body's immediate requirements for glucose, and how well the individual's blood glucose balancing system is functioning. When a track-and-field athlete is competing in an event, the body is required to put out short bursts of intense energy periodically over several hours. In this case, a "sports drink" can supply an instant boost to the blood glucose level. The glucose from the blood is rapidly taken up by the muscle cell and converted to ATP (adenosine triphosphate), which fuels the muscle cell.

However, when the body is not involved in intense physical activity, the cells cannot use sugar from the blood that rapidly. Thus, without physical exertion, a high-sugar drink or snack (e.g., glass of juice, soda or candy bar) will cause a rapid rise in the blood glucose level.

Elevated blood glucose levels, for extended periods of time, cause damage to tissues. Therefore, once the blood glucose level rises beyond a certain point, the body must do whatever it can to reduce the blood glucose level. This requires the pancreatic hormone insulin. Insulin is released into the blood and stimulates the cells of the muscles and liver to take glucose out of the blood, thereby reducing the blood glucose level and reducing the chance of damage to tissues. The muscle cells and liver convert the glucose to a compound called glycogen. Manufacturing glycogen is the only way the body has of storing glucose. Unfortunately, the muscle cells and liver can only store small amounts of glycogen. Once all the glycogen stores are full, if the blood glucose level is still too high, the liver starts converting glucose to triglycerides. The triglycerides are released into the blood and are taken up by fat cells. This is how excess carbohydrates increase body fat and cause weight gain.

In some individuals when the blood glucose level rises very rapidly, such as after a glass of orange juice, a soda, a candy bar or even a banana, the body overreacts and releases an excessive amount of insulin. The amount of insulin is greater than that needed to bring the blood glucose back to normal, and the blood glucose drops below normal. It usually takes one to two hours after ingesting the high carbohydrate food or drink for the blood glucose level to drop too low.

As mentioned before, once the blood glucose drops too low, you feel tired, have poor concentration and, in some cases, become faint. This scenario is so common it has its own name-reactive hypoglycemia. The blood glucose drops in reaction to an ingestion of concentrated sugars from carbohydrate-rich foods. When you eat carbohydrates with protein and fat, the release of glucose into the blood from the carbohydrates is slowed, and there is less of a chance of reactive hypoglycemia. This is why it is very important for individuals with frequent hypoglycemia (i.e., low blood sugar) to have a balance of protein, carbohydrate and fat every time they eat.

Protein and fat also are necessary to stimulate a feeling of satisfaction, satiation or satiety after a meal. Protein and fat stimulate the release of CCK (cholecystokinin) by the small intestine. CCK is absorbed from the intestine into the blood, circulates to the brain, and there signals the brain that the food intake is sufficient. This stimulates the feeling of being satisfied by the meal. A meal of carbohydrates will not stimulate the release of CCK. With a carbohydrate-only meal, the stretch receptors in the stomach must be activated before you will feel satiated. By that time, the amount of carbohydrates eaten is well above the amount necessary to increase the blood glucose level. The excess carbohydrate is converted to fat and stored in fat cells, ultimately causing an increase in body fat and weight.

Determining Quantity Of Macronutrients
As mentioned in the first article, the daily protein requirement depends on the individual's lean body mass (i.e., muscle mass) and activity level. The exact requirement can be calculated by a good nutritionist using the individual's height, weight, waist measurement, and hips or wrist measurement (depending on the sex), along with the activity level.

On average, an adult female who exercises at least 30 minutes, three times per week, and is not overweight or underweight would need 50 to 80 grams of protein per day. The average adult male with the same exercise regiment, who also is not overweight, would need 80 to 120 grams of protein per day. Assuming three meals per day, this averages out to 16 to 24 grams of protein per meal for women, and 28 to 40 grams of protein for men. An underweight individual may require more protein, and an overweight individual usually requires less.

How many grams of protein are supplied by what quantity of which dietary protein? Beef, pork, lamb and poultry all contain approximately 8 grams of protein per ounce. Therefore, women would need to eat 2 to 3 ounces per meal of these protein sources, whereas men would need 31/2 to 5 ounces per meal. Fish and seafood supply 51/2 to 61/2 grams of protein per ounce. Therefore, a serving of fish or seafood would be 3 to 5 ounces for women and 51/2 to 7 ounces for men, depending on the specific protein source.

You don't need to buy a scale to weigh protein foods. When you buy a package of meat, poultry or fish, the total weight is printed on the package. There are 16 ounces in 1 pound. If a package weighs 11/2 pounds, or 24 ounces, and you need 5 ounces at a meal, you know that you can eat a little over one-fifth of the package per meal.

Dairy products and eggs contain a greater percentage of fat than do other animal proteins. One ounce of whole-fat hard cheese contains 6 to 8 grams of protein and 8 to 9 grams of fat. Nonhard cheese dairy products, such as milk, yogurt and cottage cheese, also contain carbohydrates.

One whole egg provides 6 grams of protein and 6 grams of fat. Half the protein, 3 grams, is in the egg white. The other 3 grams of protein is in the yolk, along with all 6 grams of fat. If all the dietary protein requirements were met by eating only dairy and eggs, then you would be consuming too much fat. Eating either low-fat dairy products or combining one or two whole eggs with additional egg whites will supply protein without the excess fat.

Now that you have an idea of the quantity of protein to eat, let's discuss carbohydrate intake. You want enough carbohydrate to maintain the blood glucose level, but you don't want too much or you will gain excess body fat and weight. Let's use the average exercising woman and man example again.

A good starting place for women is 21 to 48 grams of carbohydrate per meal; for men, 38 to 63 grams of carbohydrate per meal. Remember, carbohydrates can be either starchy and dense (e.g., rice, pasta, potato and corn), or they can be nonstarchy and light (e.g., salad, broccoli, green beans, peaches, plums).

A good combination is a small serving of dense carbohydrates and a large serving of light carbohydrates. For example, a good combination of light and dense carbohydrates would be a cup of broccoli, a large green salad and 2/3 cup of brown rice, or a cup of green beans, a large green salad and a medium sweet potato. Both examples supply 43 grams of carbohydrate.

If you eat too many carbohydrates at a meal, you may feel fatigued and have difficulty concentrating one to three hours after the meal. If you don't eat enough carbohydrates, you may feel hungry, irritable and edgy a few hours after the meal.

Since you now know why fats are so important, we need to discuss how much fat to have at each meal. In general, women need 6 to 12 grams of fat, and men need 12 to 16 grams of fat per meal. A tablespoon of most fats (e.g., butter, olive oil, mayonnaise) supply approximately 12 grams of fat. Low-fat salad dressing and mayonnaise tend to have 3 grams of fat per tablespoon. Therefore, when choosing lean sources of protein, most individuals need 1/2 to 11/4 teaspoon of some type of fat with each meal. If the meal has lots of rich ingredients (e.g., a cream sauce, cheese or eggs), then adding other fats to the meal is unnecessary.

Now, to bring it all together. For a woman, a balanced meal could be 3 ounces of chicken, 1 cup of broccoli, 2/3 cup of rice and a large salad, with 1 tablespoon of salad dressing. For a man, the same meal would have 5 ounces of chicken, 1 cup of broccoli, 1 cup of rice and a large salad, with 2 tablespoons of salad dressing.

In general, a meal must contain all three macronutrients--protein, carbohydrate and fat--and no one macronutrient in excess of need. Here are some guidelines to help fine-tune the intake of macronutrients:

• A feeling of hunger and fatigue two to three hours after a meal indicates that the meal contained too little protein and too many carbohydrates.
• A feeling of hunger and irritability or edginess two to three hours after a meal indicates that the meal probably contained insufficient carbohydrates.
• If always hungry less than four hours after a meal, but there is no fatigue or irritability, then there is insufficient fat in the meals.

 

Good nutrition is profoundly important to maintain our good health and support our healing capacity. However, few of us understand how to eat the appropriate foods in the right proportions. Even when we do, it can be very difficult to follow through and eat in a consistently healthy manner. Furthermore, for the average person, reliable nutritional information is hard to come by. Every season it seems someone comes out with a miracle diet to improve our health. We are often lost in a sea of information that we are ill equipped to fully understand and evaluate. I believe that understanding nutrition is a vital part of achieving and maintaining good health. Over the past 25 years, I have worked with a few physicians and clinical nutritionists who have consistently kept abreast of scientific research and progress in the field. These professionals have routinely integrated new nutritional findings into their work with clients. Inspired by their successes, I urged Joy Bicknell, clinical nutritionist, to prepare this series of articles for my column. Joy and I spent many hours discussing what to include in this series, and how to make it relevant to both the professional and to his or her clients. As you will see, nutritional processes range from the very simple to the profoundly complex. I have divided a large volume of complex material into what I hope are small digestible parts (no pun intended). I personally had to read many sections six or seven times to understand them myself. Yet my commitment to learn about this new and beneficial knowledge has positively influenced my own nutritional choices and my own work with clients. I hope this information will contribute to the decisions about your own nutrition as you, along with your clients, focus on achieving a healthier lifestyle. These articles will help you more fully understand that what we eat and drink play a major part in our health and healing capacity. There are specialists with extensive training and knowledge in this area of science. Naturopaths, clinical nutritionists, as well as some physicians, have dedicated a part of their career to gaining an in-depth understanding of nutrition. This prepares them with the knowledge needed to create an appropriate plan of action to address specific nutritional issues. The purpose of this series of articles is to explain how good nutrition can improve your client's ability to heal from pain and injury, as well as optimize his or her health. By publishing these articles, I am not suggesting that practitioners give nutritional advice to their clients. To do this appropriately requires many years of study and training. This information is offered as a resource for you and your clients as you grow in your awareness and understanding, and in the choices you make about your daily nutritional practices. Article 1: Nutritional Basics For Health (Winter 2002) The first article discussed why we eat the foods we do, the body's physiological need for food, the six types of nutrients our bodies need, the function of macronutrients and micronutrients, food quality, including organically grown foods and nutrient density, and the complex functions of carbohydrates and proteins in relation to health and healing. Article 2: The Vital Functions Of Fats (Spring 2002) This article explored, in detail, the many components and functions of fats, which are also known as lipids. Glycerides, phospholipids, sterols, fatty acids and cholesterol are all lipids. Together, these lipids provide "long-term" energy stores, help form and maintain cell walls, form the compound from which all sex hormones and many regulatory substances are produced, and help regulate blood pressure, blood clotting, inflammation and the immune response. Article 3: Balancing Macronutrients: Carbohydrates, Proteins And Fats (Summer 2002) This article looks at how to balance carbohydrates, proteins and fats in the diet, and explores ways of determining the appropriate quantity of macronutrients, the timing of meals and snacks for optimal benefit, and the importance of insulin metabolism, including health problems associated with chronic low blood sugar. Article 4: The Micronutrients: Vitamins And Minerals (Fall 2002) This article presents the functions of vitamins and minerals, and the important relationship between these micronutrients and macronutrients in the body. It looks at the challenges in obtaining optimal vitamins and minerals exclusively from the foods we eat. Article 5: The Importance Of Water (Winter 2003) The final article discusses the often unrecognized and tremendous importance of water to our bodies. It looks at how water, salt and protein work together to enhance health. It also discusses the importance of water quality and the choices available for water filters and purifiers.