Calories, carbs or fats: Which is worse your my health?

If you’re trying to eat healthier, you may have heard that cutting calories is the best course of action.

Or maybe you heard from your friend at work that cutting out all carbs and loading up on fats is the thing to do.

And yet, every time you see your doctor, she suggests lowering your fat intake to improve your cholesterol. So, which is the real culprit for bad health: total calories, carbs or fats?

Registered dietitian Priscilla Benavides, MS, LD, says “it depends.”

“The goal should be a well-balanced diet that provides enough, but not too much, of each nutrient that we need,” Benavides said.

“To start out, you may find it easiest to focus on just one part of your diet, which could be total calories, carbs or fats.

Which one you decide to focus on first depends on what health issue or goal that you’re trying to address.”

Whether you want to lower your blood sugar, improve your heart health or lose weight, Benavides breaks down which approach may contribute the most to your specific health concern.

For weight loss, focus on total calories

If you’re aiming to shed weight, Benavides says looking at your total caloric intake may have the biggest impact.

A calorie is a unit of energy that comes from three main sources: carbohydrates, proteins and fats. They are the fuel your body uses to function.

On the new food label, calories are the largest, boldest numbers listed near the top. Pay attention to portion sizes—one container will usually hold several portions.

How many calories you need depends on a number of individual factors, such as your weight, activity level, gender and age.

Your dietitian will plug these variables into a formula to calculate how many calories you need to consume each day.

If you don’t have a dietitian, Benavides suggests using the Body Weight Planner from the National Institutes of Health.

“For weight loss, the right number of calories should help you lose about one to two pounds per week,” Benavides said. “Small, gradual weight loss goals are more realistic and doable.”

She suggests tracking your weight on a schedule that works for you, such as once a week. Look at long-term trends, instead of daily fluctuations.

Some tips for slashing calories include cutting back on or eliminating sugary drinks, swapping whole milk for fat free or skim milk, trimming fat from meats before cooking, using less salad dressing and reducing portion sizes.

To lower blood sugar, count carbs

High blood sugar may be a sign of diabetes or prediabetes, which can lead to a slew of health problems.

If you have been told by a health care professional that your blood sugar levels are problematic—or that you have diabetes—changing your eating habits should be a major part of your prevention and management plan.

Benavides, who is a health educator with the Texas A&M Healthy South Texas Diabetes Education Program, recommends focusing on carbohydrates for blood sugar control.

“Carbohydrates are a source of sugar and affect your blood sugar more than protein or fat. Watching your carb intake can help manage the amount of sugar in your bloodstream,” she said.

“However, we need carbohydrate-containing foods for energy and even digestive health, so don’t cut them out completely.”

On a nutrition label, carbohydrates are found near the middle and are broken down by dietary fiber and total sugars.

The United States Department of Agriculture (USDA) recommends getting 45 to 65 percent of total calories from carbohydrates.

Here’s how to calculate how much you need: divide your recommended calorie intake by 45 or 65 percent. Divide that number by four because 1 gram of carbs provides four calories.

The total is how many grams of carbohydrates you should consume per day. Remember, this varies per person.

Evenly space these carbohydrate grams throughout the day with the same amount at each meal in order to maintain even blood sugar levels throughout the day.

The following is a sample calculation for someone who needs 2,000 calories a day:

2,000 calories x 0.45 = 900 calories from carbohydrates

900 ÷ 4 = 225 grams of carbohydrates per day

The types of carbohydrate-containing foods you consume is also important. Candy, cakes and other sweets provide sugar but not many other nutrients or fiber.

Aim to get the majority of your carbohydrates from whole grains, legumes, vegetables, fruits and milk.

“I don’t like to recommend eliminating things completely because I don’t want people to feel deprived,” Benavides said. “Enjoy bread, tortillas and the occasional desert, but do so reasonably.”

A few easy ways to cut carbs are swapping sweet drinks for water, switching from white bread to 100 percent whole-wheat and reducing portion sizes. Benavides recommends using the USDA MyPlate method, which says starchy foods should take up just a quarter of your plate.

For heart health, reduce fat

A single gram of fat provides nine calories, so lowering fat intake is an efficient way to cut down on total calories.

As you know by now, reducing overall calories is key for weight loss, but reducing fat, specifically, has other added benefits.

For starters, some fats may increase risk for heart disease. For those with diabetes, evidence suggests that a low-fat diet may help your cells more effectively absorb sugar (glucose) for energy.

“There are three types of fat,” Benavides said. “Saturated fat, which comes from animals, butter, tropical oils and cheese, is considered ‘bad’ because it raises potentially harmful cholesterol.

Unsaturated fat, on the other hand, comes from plants and their oils, seeds, nuts and fatty fish and lowers potentially harmful cholesterol.”

The third type of fat is called trans fats. Artificial trans fats can be found in fried foods like doughnuts, baked goods and stick margarines.

Trans fats can raise your bad (LDL) cholesterol and lower your good (HDL) cholesterol, which results in higher risk for cardiovascular disease.

For this reason, as of 2018, the U.S. Food and Drug Administration placed tight regulations on the use of trans fats, which has made them harder to come by.

Still, there are a few of these items lingering on shelves, so keep an eye out for products that contain hydrogenated or partially hydrogenated oils in the ingredients list, and avoid those altogether.

On a nutrition label, fats are listed after calories and are broken down by saturated and trans fats. If the percent of daily value for fat is 5 percent or less, it’s considered low. Anything 20 percent or higher is high.

The USDA recommends getting 20 to 35 percent of your total calories from fat. The calculation is much like the one above for carbohydrates, except instead of four, we divide by nine.

The following is an example for someone who eats 2,000 calories per day and wants to keep their fat intake on the low end:

2,000 calories x 0.2 = 400 calories from fat

400 ÷ 9 = 44 grams of fat per day

Some tips for reducing fat intake include using small amounts of vegetable oils in place of solid fats, trimming fat from meats before cooking, switching to low-fat milks and cheeses and loading up on non-starchy vegetables.

“I don’t want people to think of a particular food as ‘bad’ because that can cause feelings of guilt and really oversimplifies the complexity of nutrition science,” Benavides said.

“Rather, nutrients serve different purposes and have unique benefits. Therefore, focus on reasonable changes to your meals that will help you improve your health condition and meet your unique health goals.”

Written by Lindsey Hendrix from Texas A&M University.