Carbohydrates: Evil or Essential?

Any athlete who is concerned about their performance has questioned, if not thoroughly investigated, whether they should eat more carbs or less carbs to improve their fitness. Actually, with the current trend towards low-carb diets and a Paleo-lifestyle, and considering the world pandemic of obesity, you may be a conscientious-carb-counter. This topic is much more involved than just cutting carbs and going gluten-free with hopes of improved health and athletic performance.

There are important questions to be explored here. In regards to training, when is the best time to eat carbs – before, during, or after exercise? What type of carbs should you consume – sugary stuff like pure sucrose or honey, or do you go with complex carbs such as pasta and potatoes? And of course – how many carbs should you be eating? Ultimately the amount, type, and timing of carbohydrates doesn’t come down to who the NY Times asked for an interview and is now making headlines as a superior diet or performance enhancement, but what works for you with respect to your health, fitness level, activity level, and how you perform with any given food.

Fuel Your Athletic Body

Our bodies primarily run off of carbohydrates (glucose) and fat for energy. Though fat is the preferred fuel source in most instances, (unless you’re sprinting, for example), most people are actually burning more sugar (glucose) for fuel even when they train aerobically. Many are burning more than ideal glucose to get them through their daily tasks even if that includes sitting at desk most of their day. Relying on sugar as a primary fuel source results in a host of health and performance problems, both mental and physical.

You need to burn sugar at certain times – it’s essential for health and to some extent, athletic performance. For the most part you’re always using a combination of fat and sugar for energy. Less glucose isn’t always better, but you want to spare your sugar reserves and rely on them only when necessary. In other words, you want to use fat for fuel as much and as long as you can so the glucose is there when you need it – perhaps for a longer duration workout, a race, high intensity training, or just to keep you from being stupid. Yeah, that’s right – adequate glucose getting to your brain will keep you from being stupid. When your glucose levels are depleted, (you’re close to or have already hit the wall  or “bonked”), your brain will be starved of its preferred fuel source, so you won’t think straight, and maybe you’ll just be a moody pain in the ass. This is why so many athletes participating in endurance events, (which I define as at least roughly one hour duration – but hey, that’s just me), especially ultras or Ironman events, often don’t stick to their race plan in regards to eating, drinking, and pacing. When glucose levels in the blood drop the body is focusing on the muscles, including the heart, rather than the brain.

Insulin, Stress Hormones, and Blood Sugar

Let’s learn a bit of biochemistry relative to the subject as well as you – a hopefully efficient, or soon-to-be efficient – athlete.

Simply put, when you eat something that contains sugar, whether that’s fruit, bread, or something sweet, your body releases a hormone called insulin from your pancreas. This insulin causes your liver and muscles to take in glucose from the blood. If your liver and muscles don’t need to store this sugar, then the insulin will assist in delivering the sugar to your adipose tissue, so you store it as fat.

Hormones never work alone in the body; it’s never that simple. Although there are many complex biochemical pathways involved, one other to understand is the role of our major stress hormone, cortisol, with respect to insulin. When blood sugar goes up, (you just ate some carbs), insulin goes up, which helps bring blood sugar back down. But when you need more blood sugar your body often does so at the expense of cortisol, which is released from the adrenal glands. Glucagon from the pancreas also plays a part here to help elevate blood sugar, but for athletes who are training hard and for the average person under often considerable daily stress, they’re constantly in a tug-of-war between their pancreas (releasing insulin) and their adrenal glands (releasing cortisol), to stabilize their blood sugar.

We need insulin to survive; it’s not a bad hormone as many have made it out to be. But most people make too much, too often, and then their body stops paying attention to the high levels. The receptors that deal with the insulin eventually get tired of dealing with the hormone, and like the fable “The Boy Who Cried Wolf”, these receptors stop paying attention to the high insulin levels. This is what is called insulin resistance. With insulin resistance the body has lost its sensitivity to insulin; it’s not paying attention to it as well as it once did. So now the body has to make more and more of the hormone to achieve what it once only needed a little bit of to accomplish the job. It’s inefficient, and linked to pretty much all inflammatory diseases and a host of health problems from obesity to cardiovascular disease to cancer. Aside from diagnosable health problems, insulin resistance will give you a slew of other problems such as a low sex drive, premature aging, poor mental and physical concentration, and overall not feeling as good as you should be feeling.

When your body stores this glucose (sugar) it does so in the form of glycogen and it stores this glycogen in your liver and muscles. If it’s in the muscles, as most of it is, then it is going to be used by those muscles for energy. The liver will convert its stored glycogen to glucose to keep your blood sugar stable, (or as stable as possible), to use for energy and metabolic processes, as well as for your brain to function efficiently (hopefully).

The process of converting stored glycogen to glucose is called glycogenolysis (breaking down glycogen). Again, it’s not a bad thing to pull from the stores, as long as you don’t do it too much and deplete your stored sugar. This process though is promoted primarily by epinephrine, (adrenaline), which is one of the stress hormones secreted by your adrenal glands in response to stress. This is why when you’re under stress you make stress hormones and your body burns more sugar – it’s the preferred pathway to get your body out of trouble – that “fight or flight” system.

The average 150 lb endurance athlete can store roughly 400-450 grams of glycogen. This stored sugar is divided up between the liver (100-125g) and the muscles (300-350g), for when it is needed. When you need to pull from those stored glycogen levels depends on your exercise intensity, your exercise duration, and your overall health and fitness. It’s not a cut-and-dry number, and isn’t necessarily always dependent on your current heart rate you are training or racing at. Though heart rate can often be one of your best measurements of exercise intensity, you still may be burning more glucose than what is appropriate even if you feel you are training aerobically. Yeah, this is why some people don’t make gains when they train easy – their body is still burning too much glucose.

If your body is running too low in blood glucose and glycogen, then it body will want to make some. So it calls on a different part of your adrenal glands to secrete another stress hormone, this time cortisol, to help make glucose from another source. This process is called gluconeogenesis and occurs in the liver too. But this time the body is making sugar (-genesis) and most often it is doing so from amino acids, which are coming from protein, which is often coming from breaking down valuable muscle tissue. No, that’s not a good thing.

Even if you’re burning mostly fat during training, after some time you will be pulling protein for fuel. Many say this occurs around three hours in a well conditioned athlete, and therefore for those not so well conditioned, it will occur much sooner.

Aside from breaking down muscle tissue and not using fat for energy, those stress hormones which are created to help provided the “necessary” glucose levels will wreak havoc on your health over time. Obviously, chronic stress is not a good thing. So if you’re always training hard and depleting your tanks, perhaps literally, then you’re a great candidate for illness, injury, and a variety of health problems.

In the future I will discuss how to train your body to burn fat as fuel, not just when you’re actually training, but the entire day.

Dr. Stephen Gangemi "Sock Doc"

I'm a board-certified chiropractic physician and clinical nutritionist with a passion for true natural health care. I implement dietary & nutritional therapies, exercise & movement practices, and lifestyle changes along with manual therapy techniques to help the body heal and prevent illness and injuries.