July 2021
Jacqui Lewis - BHSc Nutritional and Dietetic Medicine

Pros and Cons - Calorie vs Carbs Counting

Keeping the balance of energy consumption vs energy output sounds like simple maths.
I’m sure we have all heard before that "weight loss is as simple as making sure calories out exceeds calories in". 

If it were as straightforward as that - why do we have an obesity epidemic on our hands, and why is it seemingly impossible for some people to lose weight and keep it off?

So there must be more at work than just maths, right?

Now I’m going to put it here that I am not overly a fan of counting anything regarding food, weight and overall health. However, I am always keen to encourage a balanced approach to food. I hope that we can all get to a point where our relationship with ourselves and food is strong enough that you can:

  • Eat when you're hungry
  • Eat the rainbow
  • Protein first
  • Remove processed foods
  • Exercise enough
  • Have a strong sense of what works for YOU

However, sleeve gastrectomy and gastric bypass patients' post-surgery diets need to be quite prescriptive, especially at the beginning of your WLS journey. This approach ensures you are getting the nutrition you need, balancing energy to ensure you continue to lose the weight - and that the weight loss is fat tissue - not muscle tissue.
So we do need to monitor things well in this situation.

Tracking calories, carb counting, and protein goals act as a solid guide to good health. Because WLS Patients have a smaller stomach, macronutrients such as Carbs, Proteins and Fats need to be balanced to maintain health, reduce blood sugar levels, and keep you on track toward your goal weight.

So what is the difference between counting calories and counting carbs, and is one better than the other overall? 

Suppose you choose to count calories to manage your body weight. In that case, you are looking for a deficit of 3500 calories to create a total loss of 450 grams. So roughly reducing your food intake each day by 500 should equate to a loss of 450 grams a week.

On the other hand, carb counting is a measure of grams of carbohydrates consumed in your meals and snacks. Generally, being conscious of high carb foods and reducing them enough to equate to weight loss is the key. Taking in lower carb foods and eating more complex carbs than simple carbs will ideally lead to weight loss. 

Like calorie counting, carb counting is where you would set a daily goal/limit for carbs and watch that the foods you eat throughout the day do not take you over that limit. So if you feel 45% of your calories should come from carbs, your equation would look like this: If you eat 1800 calories per day, you could derive 810 calories from carbs - or about 202.5 grams of carbs per day. You would then portion these out in your meals and snacks. 

Each method has its pros and cons. Both need a keen eye for detail - which is why we also encourage "intuitive eating" as your journey progresses, so you are not back into the "dieting mentality" of restricting calories or carbs to lose weight.

Pros of Calorie Counting:

  • You can easily read a nutritional label and get an idea of how much of your allotment will be used in that particular meal.
  • A low-calorie diet can benefit health conditions associated with bariatric surgery patients, like high blood pressure and heart disease.

Cons of Calorie Counting:

  • Calorie counting doesn't take into account your nutritional needs, only your intake of calories.
  • Cutting calories to an unhealthy level (usually less than 1,200 to 1,500 calories per day) can be a harmful way to lose weight - and may even end in a stall or a struggle to lose fat stores.

Pros of Carbohydrate Counting:

  • This approach can be beneficial for those who must watch their carbohydrate intake, like people with diabetes.
  • You can easily read a nutritional label and get a number to count toward your daily intake to prevent weight gain.

Cons of Carbohydrate Counting:

  • Not all foods contain carbohydrates.
    For example, a porterhouse steak doesn't have carbohydrates but is very high in fat and calories.

Watching carbohydrates alone doesn't guarantee a healthy diet over the long term.
Portion control is a considerable part of carbohydrate counting. 

Those who choose to count carbohydrates to prevent weight gain will often memorise certain portions. For example, the following foods typically have about 15 grams of carbohydrates:

  • One slice of bread (whole grain)
  • One small piece of fruit, such as an apple or orange
  • 1/2 cup fresh fruit
  • 1/2 cup starchy vegetables, such as cooked corn, peas, lima beans, or mashed potatoes
  • 1/3 cup pasta
  • 1/3 cup rice

The idea of eating a balanced, varied, and whole food diet is a good choice. How you go about that is a personal choice and should be guided by your professional team. 

They know how to get you closer to your goal in a healthy fashion and shortcut any stalls or regains by working out where the balance is out.

If you choose a low-calorie diet - just be sure you are also thinking about "nutrients." 

We all know a glass of wine has as many calories as a banana. Still, one will bring you closer to health than the other. So you need to discern that a calorie is not always "just a calorie". It can be loaded with negative offsets. If you choose carb counting, you'll still be distracted with counting and calculating the percentage of your daily intake that carbs make up. So it's a matter of working out what works for you for this time and tracking the results on your body weight, energy levels, cognition and overall health. 

Alongside your chosen method, I encourage the use of portion control plates and bowls and develop your "listening skills". So you can get to know what your body needs at any given time. Work with a professional on this if it doesn't come naturally. You can aim to really develop the feeling around food and its role in fuelling the body and make it less about rewards and distraction or emotion.

BN Multi is here to support you in reaching your SMART goals with weight loss surgery meal planners and books, portion control plates, weight loss surgery supplements, and more.

Jacqui Lewis
BHSc Nutritional and Dietetic Medicine

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