Meatballs & Spaghetti (Low-Carb)

Every decade has its nutritional bogeyman, and for the last 10 years, it’s been carbohydrates, which are being widely blamed for the “epidemics” of weight gain, diabetes, cardiovascular disease, cancer, non-alcoholic liver disease, and dementia.

As with most things in life, it’s not that simple. Sure, certain types of carbohydrate may be associated with an increased risk of certain diseases, but a lot depends on the type of carb-rich food you eat, how much you consume, and what you’re eating alongside it. Not to mention non-nutritional factors like physical activity, sleep, and stress, all of which can influence how our bodies process carbs.

Whole or minimally processed carb-rich foods like fruits, vegetables, grains, and legumes contain fiber, vitamins, and minerals that are essential to good health. They help you feel full, have a modest impact on your blood glucose (which is why they’re called “low-glycemic”) and thus provide a steady source of energy, and make up a large proportion of the time-honored Mediterranean diet. Oh — and they’re delicious!

Refined carbohydrates, on the other hand, don’t contain much in the way of fiber and nutrients; they tend to be “high-glycemic,” potentially causing sharp increases — followed by rapid drops — in blood glucose, which can cause feelings of fatigue, brain fog, and hunger pangs. The most appropriate amount and type of carbohydrate varies from one person to another, depending on age, health status, activity level, muscle mass, hormone status, and other factors.

Pasta is somewhere in between these extremes: while it consists of white flour and thus qualifies as a refined food, it is a single-ingredient food that has been enjoyed for thousands of years around the world and has a moderate glycemic impact.

It isn’t terribly nutritious: it contains no fat and only around 8 g protein per serving (low-quality protein at that, lacking essential amino acids like lysine, threonine, and methionine). In fact, pasta is mostly starch. That’s why a plate of pasta eaten on its own or with a smidge of marinara sauce isn’t very filling (and could spike your blood sugar), whereas pasta served with a nutritious sauce containing fat, protein, and fiber can fill you up for hours. The nutrients are in the sauce; the pasta is just the “bit of fun on the side.”

If you have elevated blood sugar or some other manifestation of metabolic syndrome (which includes (pre)diabetes, triglycerides over 100 mg/dL, HDL cholesterol under 40 mg/dL, fasting glucose over 99 mg/dL, hypertension, and an elevated triglyceride-glucose index), your doctor may have told you to stop eating refined carbs, including pasta.

But since everybody, including my metabolically challenged clients, loves pasta, and because I want to help people eat the foods they love, I wanted to come up with a way for us to enjoy it without blowing our blood sugar & insulin out of the water. All it takes is a few minor tweaks:

• Stick to the serving size recommended on the package
• Accompany pasta with the “Awesome Foursome:” protein, fat, fiber and acidity
• Where possible, use less-glycemic, higher-fiber pasta (whole-wheat pasta or pasta made from — or enriched with — legumes)
• Cook the pasta al dente 

Let’s take a closer look at these four factors.

Serving size

Did you know that a recommended serving size of pasta is 2 oz (dry), providing about 38-42 g carbohydrate? Thus, a typical one-pound pack of pasta should, theoretically, feed eight fully-grown adults. But let’s be honest — when did you last feed eight people with one box of pasta? More likely the box yielded three or four servings maximum — which could easily translate to 80-100 g carb per serving.

If you’re used to eating large servings of pasta, the 2-oz recommended serving — which equals about 1 cup (cooked) (a typical serving in Italy) — may seem puny. To reassure your brain that you’re not about to starve, you could make a small amount of pasta look like a bigger serving by arranging it as shown here:

I cook & drain the pasta, toss it in a little olive oil or pesto (as here), serve it on the plate, and create a well at the center into which I ladle the sauce. Once I’ve filled up the well, my brain thinks it’s a big plate of pasta, but my pancreas, which secretes the glucose-regulating hormone insulin in response to rising glucose levels, doesn’t need to work as hard as usual to regulate my blood sugar.

Awesome Foursome

Once you’ve dialed in your pasta portion size, bring in the “Awesome Foursome:” protein, fat, fiber, and acidity.

Combining refined carbohydrates with these four food components slows down the speed at which the stomach empties and, thus, the rate at which the carbohydrate in the pasta is converted into glucose. So instead of a sharp spike in glucose, you might experience only a mild elevation, as well as longer-lasting satiety. (Not surprisingly, protein, fiber, and olive oil have been found to trigger the production of the satiety hormone GLP-1 in the gut.)

Less-glycemic, higher-fiber pasta

Recent years have seen the emergence of a wide range of “low-carb” pasta. These are typically made of alternative flour sources such as beans, chickpeas, or vegetables that are high in dietary fibers (which are indigestible and don’t affect blood sugars); some are gluten-free. Because they are made with legumes, some types of low-carb pasta contain more protein and/or fiber. If you’re not used to eating much fiber, consuming large amounts of legume-based pasta can lead to digestive discomfort like gas & bloating. So if you try these, start with a small serving and see how your body reacts.

Trust Italian pasta giant Barilla to come up with two novel types of pasta that contain more protein and fiber, and slightly less carbohydrate than conventional pasta: Protein+ (wheat pasta enhanced with legume fibers & protein), and Chickpea & Lentil Pasta (made purely from chickpeas or lentils, and gluten-free). The Protin+ pasta tastes exactly like regular wheat pasta, whereas the lentil & chickpea pastas have a pleasantly nutty taste and cook to al dente perfection (whereas many other legume-based pastas I have cooked went from crunchy to soggy in a matter of seconds. Which brings us to…

Cooking pasta al dente

Pasta cooked “al dente” means pasta that has been cooked so that it is still firm to the bite, but not hard or crunchy. The term “al dente” is an Italian phrase that means “to the tooth.”

When wheat pasta is cooked to an ideal al dente texture, it has a lower glycemic impact than when it is cooked until soft. (A food’s glycemic load, or GL, reflects its impact on blood glucose: the higher the GL, the more sharply your glucose and insulin levels are likely to rise.) According to the International Tables of Glycemic Index and Glycemic Load Values, spaghetti cooked for 5 minutes (al dente) has a medium GL of 15, whereas spaghetti cooked for 20 minutes has a high GL of 23 — the former would barely affect your glucose level, whereas the latter could lead to a significant increase.

Cooking pasta al dente also requires us to chew more than when we’re slurping down soft-cooked noodles. Chewing stimulates the receptors that stimulate feelings of satiety, reducing our sense of hunger that leads to eating more. What’s more, mastication is the first stage of digestion. Breaking food into smaller pieces makes it mix better with saliva, which is essential for the metabolism and easier to digest.

So there you have it: you can have your pasta and eat it, too. Buon Appetito!

P.S.: I taught this dish under time pressure at a webinar, which is why I used ready-made meatballs, tomato sauce, and pesto. Of course, it’s perfectly fine to make your own meatballs and sauce if you prefer. Since most of my clients struggle to find time to cook, however, I wanted to show you the fastest possible way of getting a tasty, nutritious meal on the table that’s nutritionally very similar to one you might have made from scratch. As I recover from a lifetime of crippling perfectionism, I regularly allow myself to use tasty, good-quality ready-made foods — so far without any adverse consequences! 🙂