Koolhydraatarme voeding wordt al langer gehypet, maar nu lijkt het erop dat er steeds meer bewijs komt dat het ook helpt voor de aanpak van diabetes, hormonen en insuline resistentie. Daarnaast lijkt het ook te werken voor de behandeling van overgewicht, maar hoe worden de claims onderbouwd en welke gradaties van koolhydraatbeperking worden er voorgesteld? Is koolhydraten beperken voldoende?

“Ik gebruik het regelmatig in mijn praktijk”


Waarom koolhydraten beperken?
In de praktijk betekent dit dat er minder zetmeelrijke prodcuten zoals brood en andere graanproducten en minder suikers aangeraden worden. Vier van deze punten kunnen ook gebruikt worden als reden om bij overgewicht eerder een koolhydraatbeperking te adviseren dan een vetbeperking, namelijk:
1. Bij toename van de obesitasepidemie blijkt dat de koolhydraatinname ook is toegenomen, in tegenstelling tot de vetinname,
2. Koolhydraatbeperking leidt tot een groter gewichtsverlies dan vetbeperking,
3. De dieettrouw bij een koolhydraatbeperkt dieet is doorgaans groter dan bij andere typen diëten,
4. Het vervangen van koolhydraten door eiwit leidt tot meer gewichtsverlies en een betere lichaamssamenstelling en een hogere ruststofwisseling.

Minder koolhydraten, meer eiwitten?
Het argument van de toegenomen koolhydraatinname is gebaseerd op gegevens van Amerikaans onderzoek. Wanneer er meer koolhydraten worden ingenomen neemt ook de insulineproductie toe. Dit kan leiden tot een toename van vetopslag.

Bij een koolhydraatbeperkt dieet/ voeding wordt er van uitgegaan dat deze voeding een grotere verzadigingswaarde heeft, doordat er geen beperkingen gelden voor de inname van eiwit en vetten. Met name de eiwitinname zorgt voor een grotere verzadiging. Door verminderde hongergevoelens is het dan ook gemakkelijker om zo’n dieet vol te houden.
Het extra eiwit leidt ook tot een hogere verbranding en een betere lichaamssamenstelling, door de extra toevoer van eiwit.
De effecten van de koolhydraatbeperking zijn dus niet alleen aan het verminderen van de hoeveelheid koolhydraten toe te schrijven maar door een totale verschuiving in de onderlinge verhouding van de macronutriënten. Er komt steeds meer bewijs voor een belangrijke rol voor eiwit bij gewichtsverlies en het handhaven van een gezond gewicht en een ideale lichaamssamenstelling.

Verschillende classificaties voor een koolhydraatbeperking
1. Zeer streng koolhydraatbeperkt dieet:  20-50 g koolhydraten/dag of een koolhydraatgehalte van minder dan 10 energieprocent kcal/dag. Dit dieet wordt ook wel aangeduid als ketogeen.
2. Streng koolhydraatbeperkt dieet: 130g koolhydraten/dag of een koolhydraatgehalte lager dan 26 energieprocent.
3. Koolhydraatbeperkt dieet: De koolhydraten leveren 26-45 procent van de dagelijkse energie-inname.
4. Dieet met een hoog koolhydraatgehalte: meer dan 45% van de energie wordt door koolhydraten geleverd.



Werken met verschillende fasen van koolhydraatbeperking
Het zeer streng koolhydraatbeperkte dieet kan in de startfase voor een betere regulering van de glucosestofwisseling bij diabetes worden ingezet. Bij overgewicht draagt het bij aan gewichtsverlies.
In de tweede fase kan de strenge koolhydraatbeperking worden ingezet zodat de gewichtsafname meer geleidelijk verloopt. In deze periode kan worden gezocht naar het evenwicht tussen de koolhydraatinname en het gewicht.
Het dieet waarbij de koolhydraatinname tussen de 26 en 45 energieprocent bedraagt kan worden gebruikt om het gewicht na het afvallen te behouden.

Voor een normale voeding dient de koolhydraatinname maximaal 40-45 energieprocent te bedragen. Dat was namelijk ook het gehalte aan koolhydraten in de voeding voordat de obesitasepidemie ontstond.
Maar het kan nog beter.

Minder “lege energie”
Uit cijfers van de voedselconsumptiepeiling die in de periode van 2007-2010 is uitgevoerd blijkt echter dat het koolhydraatgehalte in de gemiddelde dagvoeding van de Nederlander voor 43% van de energieleverantie zorgt. Echter er is sprake van een hoge inname (20 energieprocent!) van enkel- en tweevoudige suikers in het dieet. De Wereldgezondheidsorganisatie (WHO) pleit ervoor om een bovengrens van 5 energieprocent voor de mono- en disachariden te adviseren. Low carb betekent voor de consument: minder frisdrank, snoep en zoetwaren.
Als er nieuwe richtlijnen voor de inname van koolhydraten worden geformuleerd moeten ook de richtlijnen voor vetten en eiwitten worden aangepast.

Richtlijnen voor meer eiwit in je voeding
Bovenstaande onderzoeken laten zien dat de gunstige effecten van de koolhydraatbeperking ook het gevolg kunnen zijn van een hogere inname van eiwitten. De huidige richtlijn voor “gewone” voeding gaat nog altijd uit van 0,8 g eiwit per kg lichaamsgewicht.
-Voor  sporters is dit niet voldoende,
-Ouderen hebben ook een hogere eiwitbehoefte voor het behouden van spierweefsel.

“Het lijkt erop dat naar boven bijstellen van de adviezen voor eiwitinname voor gunstige gezondheidseffecten kan zorgen”


Voor vragen hierover, neem gerust vrijblijvend contact op!

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