Chris G. Koutures, MD, FAAP Pediatric and sports medicine specialist

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Comprehensive blend of general pediatric and sport medicine care with an individualized approach that enhances the health and knowledge of patients and their families



Proud physician:
USA Volleyball Mens/Womens National Teams
CS Fullerton Intercollegiate Athletics
Chapman University Dance Department
Orange Lutheran High School

Co-Author of Acclaimed Textbook

Pediatric Sports Medicine: Essentials for Office Evaluation

Orange County Physician Of Excellence, 2015 and 2016


If you read traditional sports nutrition guides, you will often find the following recommended distribution and amounts of carbohydrates, proteins, and fats:

  • Carbohydrates
    • Should be the majority (50-60%) of daily calories
    • Best sources are complex carbohydrates
      • Higher fiber multi-grain breads, pastas, and cereals
    •  Less emphasis on simple, higher sugar-based sources
      • Snack/dessert products, juices
    • Good pre-event sources, especially in higher amounts before endurance events (Carbo Loading)
  • Proteins
  • Fats
    • Maximum of 30% of daily calories
      • Majority from unsaturated food sources
        • Nuts, fish, plant oils
      • Smaller amounts from animal-based sources
        • Meat and dairy products

However, there are now eloquent voices in the sports nutrition communities who are teaching a more low carbohydrate, higher protein and fat diet. I will ask you to review this podcast featuring the prominent exercise and sports medicine science expert Dr. Timothy Noakes.

Proponents of the low carbohydrate diet focus on the concept of carbohydrate intolerance where excessive carbohydrate intake (especially of processed foods) contribute to higher rates of snacking with subsequent increased risk of diabetes and overweight obesity.

Who is or might be at risk for carbohydrate intolerance?

  • Anyone who is gaining weight on a high carbohydrate diet
  • Family or personal history of diabetes 

What foods must be reduced/avoided?

  • Carbohydrate-laden processed foods
  • Breads, rice, pastas, oatmeal, grains
  • High amounts of high-fructose fruits
  • Juices, sodas, sports drinks,
  • Crackers, chips, pretzels, cookies
  • Potatoes and other starches

One would increase meats/poultry/fish and nut sources along with vegetables and dairy products. Concerned about the increase in cholesterol? Those who support the low carb/high fat and protein diet will argue that lowering blood sugar amounts is more beneficial to heart health and outweighs the risk of higher cholesterol amounts.

If interested in a low carb diet, what are recommendations to put it into place?

  • Please discuss with your medical professional before starting, especially if you have diabetes or any other health issues
  • Do you totally avoid carbohydrates?
    • Not recommended- rather reduce daily intake, perhaps from the usual American diet intakes of 300+ grams of carbohydrate/day to maybe 100-150 grams of carbohydrate a day
  • Start reading labels- use the Carbohydrate gram amount (not percentage numbers) to guide you
  • When starting, reduce eating outside the home to control content of food choices
  • Monitor weight, hunger, and energy levels in the first few weeks

I post this to encourage thoughtful consideration about the on-going debate of appropriate carbohydrate intake and how each individual can best adjust their intake to optimize long-term health and athletic performance.