The C’s

C stands for Carbohydrate.

Most of the food we consume is in the form of carbohydrates. These include the starches and sugars that we eat every day, all the bread, pasta, rice, potatoes, candies, cakes, cookies and sweets. Many Americans have never eaten less fat than they do today and yet they have never been fatter. This is in part due to the fact that we eat far too many carbohydrates.

What is even more important is the fact that there is often a large amount of fat consumed with the carbohydrates. This is because carbohydrates do not typically have much taste and, like other vegetables, they are low in sodium. So what do we do with them? We salt them and we spread fat over them. Even worse we dip them in boiling fat like French-fries and chips. This makes carbohydrates a big problem today. They are a major source of our health issues.

Believe it or not, our bodies cannot store very many carbohydrates. We really can’t store more than we can use in a day. Just think about what the athletes do the night before a marathon race: they eat large amounts of carbohydrates (pasta, rice, etc.) in order to have enough energy for the race the next day. Why do they do this? Because our bodies cannot store more carbohydrate than the energy required for about one day.

The carbohydrate we can store is maintained in our livers in the form of a chemical called glycogen, which is designed to be rapidly converted into sugar. The liver is not capable of storing more than a small amount of glycogen. What happens to the extra carbohydrate we consume? You guessed it; it is converted into fat! So we don’t accomplish anything when we eat low fat diet foods that are mostly carbohydrate if we are consuming more than we can burn as energy the next day. It just becomes fat anyway. This is why “C” is the last and in many ways, the most important letter in PVC. We need to decrease the amount of carbohydrate we consume or we will never lose the weight.

What does our body do with carbohydrates? It burns them as energy. That’s the only thing we can do with carbohydrates. They are energy food, that’s it. How much carbohydrate should you eat in a day? The answer is how much energy will you need and how much stored energy do you already have in your fat stores. This is the only place we are going to discuss grams. Luckily, most foods today have a clear indication of their carbohydrate content on the nutritional label (see Let’s Look at Labels). Ideally, you shouldn’t eat more carbohydrate in a day than you will burn as energy in that day. For the average American this comes down to about 250 grams per day. If you want to lose weight, you must eat less than that. If you want to lose more rapidly, decrease the total carbohydrate you eat in a day down to near 100 grams. I usually tell my overweight patients to limit their carbohydrate intake to 100 grams per day and the carbohydrates you get from your green vegetables are free.

All carbohydrates are not bad though. In fact, they are some of the healthiest foods we eat! The best source of carbohydrate is fruit for several reasons:

  • The sugar in fruit is easily digested and absorbed
  • Vitamins are abundant in fruits
  • Healthy fiber is contained in the pulp
  • Antioxidants in the colorful skins protect you from heart disease and cancer

Therefore the best carbohydrates are those that come from fruit.

PVC Point

Eat colorful fruit and vegetables. The color usually means that there are high levels of antioxidants which help you avoid cancer and heart disease.

No free lunch!

As with all other food groups, there are good fruits and there are those that you should limit. The table below summarizes the grams of sugar for every 100 grams of fruit by the type of fruit.


Obviously dates really stand out for their sugar content. If we remove dates from the list, you will see the others that you should be careful of are bananas, lychees and grapes.


I can’t tell you how many people start their days with a banana. They think they are doing themselves good by having potassium. Instead they are starting the day with sugar (see It’s All in the Timing). Again, there is no free lunch here. These grams of carbohydrate come out of your total for the day. Fruit is the healthiest form of carbohydrate though because of all the other beneficial components like vitamins and antioxidants. We just have to be selective about what fruit we eat.

One Potato, Two Potato

If you love potatoes, you may be wondering about sweet potatoes as a substitution for white potatoes. There is a modest nutritional advantage to choosing the sweet potato, because it has a significant difference in soluble fiber and beta-carotene content. They still should be looked at as a carbohydrate and not a vegetable.

Glycemic Index: The PVC View

While we are speaking of carbohydrates, now is a great time to share a few facts (and myths) about the “Glycemic Index.” The theory behind the Glycemic Index (also known as Glycemic Load) is that all carbohydrate-containing foods can be ranked by how quickly they elevate blood sugar. The theory states that the more rapid rise in blood sugar following consumption of these foods is harmful to health and may contribute to heart disease, diabetes, cancer and obesity. One popular diet book even goes so far as to promote the Glycemic Index as the “key” to lifelong health! I’m here to tell you this is not completely true.

The main problem is the lack of standardization of methods for determining a food’s Glycemic Index. Methods vary, results are inconsistent and the amounts of food tested are unlikely to be what is usually consumed. For instance, when the Glycemic Index first became popular in the early 1980s, carrots were listed as one of the highest and so the recommendation was to avoid eating carrots. The amount of carrots tested was close to 1 ½ pounds! It’s unlikely that any of us would eat 1 ½ pounds of carrots in one sitting! Also, foods are tested without any other foods, and we all know that we rarely eat just one type of food at a meal. Finally, by adding a little fat to food, there is a dramatic decrease in the Glycemic Index. This would seem to be a good thing if you followed Glycemic Index alone, yet we all know it’s not.

What is the bottom line for the Glycemic Index? It remains an UNPROVEN theory. The many other strategies we’ve outlined in the PVC diet, such as focusing on a plant based diet, are proven to be effective in promoting health.

Nutrition Facts

As I said above, fortunately most food items you buy today will have nutrition facts printed on the packaging. This will list the number of grams of carbohydrate. The first thing you should do is to look at the number of servings per container and the size of a serving. This is very important (see Let’s Look at Labels). Then count the total grams of carbohydrate per container by multiplying the grams of carbohydrate per serving by the number of servings per container. You will be amazed at how many grams of carbohydrate you consume in a day. Remember, carbohydrates are dense and contain about 4 calories for every gram of their weight. This really adds up.

Carbohydrate Drinks

Do you drink most of your carbohydrates? Many Americans do! One of the major sources of excess carbohydrates today is in what we drink. The average soft drink has over 40 grams of carbohydrate which translates to almost 200 calories of pure sugar. That’s 10 teaspoons of sugar! This doesn’t just pertain to carbonated beverages. Anything that is sweetened is likely to contain the same load of calories. Sport drinks are an excellent example. Fruit drinks often are no better. It’s amazing how many people consume most of their calories from their drinks! As a result, the City of New York has put a ban on large sweetened drinks.

Take a look at the chart below. It graphically depicts the number of teaspoons of sugar found in various drinks such as soda, juice and sports drinks. Now think about literally putting that much sugar into your mouth at one time. Yuck.


An additional issue is the fact that most soft drinks in the U.S. are sweetened with high fructose corn syrup. There is a lot of debate today as to whether high fructose corn syrup is more dangerous to us than regular sugar. There are some who believe that it’s responsible for the rising diabetes problem. I’m not going to comment on this as there is much debate on this topic, but will only emphasize that whether you’re consuming regular cane sugar or high fructose corn syrup, the calories are the same.

The bottom line with carbohydrates is that they are only used for energy that is needed on the day that they are consumed. If you eat more carbohydrate than you can burn in a day then the excess is converted into fat. It’s as simple as that. If you want to lose weight, you have to decrease your carbohydrate intake below what you are burning as energy.


Eat no more than a palm-sized piece of protein in an entire day from an animal that either swam or flew when it was alive.

Calories from protein are still calories and are therefore not “free” calories.

Beware the fat and carbohydrate content of protein sources.

Make sure half the circumference of your plate is filled with green vegetables—they can be consumed with almost no restriction! Cook them in a healthy manner though.

Our bodies cannot store more carbohydrates than the energy required for about one day— the excess just turns to fat. If you are significantly overweight, you should consume no more than 100 grams of carbohydrates per day.

That’s it! Not a difficult diet to remember or to stick to. There is no better time to get started than today.