Can I Increase My Carb Intake?

Ask Theresa is a weekly advice column by Theresa Link. A Virta Health Coach since 2015 and a loyal follower of the ketogenic lifestyle, Theresa is a Registered Dietitian who is an expert in living a metabolically-healthy life. 

In today’s column, Theresa empowers you to think about your carb intake and what you need to make your lifestyle sustainable. With some experimentation, you can discover your own personal carbohydrate sweet spot.

❓Question:

Theresa,

I’ve been really low carb (30 grams) for over 3 months now, and I am really thrilled with my progress. My ketones average 0.9, I’ve lost 20 pounds, I’ve lowered my fasting sugars from 180 to 105 and I’m off metformin! I’m embarrassed to admit it, but I really do miss apples, baked potatoes, and on occasion, rice. Am I able to allow for more of these old favorites? I’m nervous to try because I don’t want to backslide. I also feel like I should have more discipline!

Sincerely,
Aching for an Apple‍

👩🏻‍💻 Theresa:‍

Dear Aching,

You have no reason to feel shame about craving foods you love, like apples, potatoes, and rice. These foods are delicious, but the issue is that too many carbs can worsen insulin resistance and type 2 diabetes. Missing these foods doesn’t mean you lack discipline. Virta is a lifestyle change, not a diet, and it allows for flexibility and trial and error. Ultimately, it’s about your preferences, goals, lifestyle, and what you can reasonably sustain. So if you’re considering increasing your carbs, there are two ways to think about it:

1. Your personal carb tolerance
2. Your personal carb target

What’s the difference? Read on.

Personal Carb Tolerance

Carbohydrate tolerance is the amount of carbs you can consume while maintaining metabolic health, namely lowering glucose, losing weight, and reducing medications. It’s influenced by factors such as the presence and duration of type 2 diabetes, medications, insulin resistance, physical activity, lifestyle factors like stress and sleep, and genetics. Everyone's carb tolerance is unique due to their individual health history.

You've successfully lost weight, lowered your fasting glucose to normal levels, and maintained excellent ketones on 30 grams of carbs daily. Great work! But you’re craving an apple, which has around 20 grams of carbs (or 35-40 grams for the softball-sized ones). If you're ready, it's time to experiment.

Try eating half of a medium-sized apple (about 10 grams of carbs). Track your glucose, ketones, and weight. If your biomarkers stay within your goal range after a week or so, increase by another 10 grams. Continue this until your progress slows or regresses, indicating you’ve found your carb limit. Scale back slightly, keep experimenting, and you'll find your personal carb tolerance—your "sweet spot."

‍Personal Carb Target

Determining the carb target that works for you is different than establishing your carb tolerance. Do you enjoy the benefits of low-carb living but want some higher-carb foods like fruit, starchy veggies, or beans? If so, moderately increasing your carbs may suit you. 

Be prepared for some trade-offs. Your progress may slow, stop, or regress if you increase too much. In some cases you might also need to restart diabetes medications, but the dose determines the poison here. The more carbs you consume, the more likely these regressions become. It’s important to stay in close contact with your coach and provider to modify your plan accordingly. Cutting back on carbs benefits all of us, whether it’s starches like bread and rice or added sugar. The key to lifelong adoption of this is to figure out the amount of carbohydrate that matches your individual goals, preferences, and lifestyle. Work with your coach to figure out a plan that works for you.