LIKE AN EASY MIDDLE CHILD, carbohydrates were once overlooked. Fats got most of the attention and fruits and vegetables the praise. That changed with the emergence and incredible popularity of the Atkins, South Beach, and other low-carb diets. Almost overnight, carbohydrates plummeted from being the “go to” foods for healthy eating and weight loss to culinary creeps.As is the case with so many popular fads, the case against carbs began with a kernel of good science that has since been lost in hype and in the tragic generalization that all carbohydrates are the same.
In most parts of the world, carbohydrates provide the lion’s share of calories. They contribute more toward weight maintenance or weight gain than any other nutrient. By wielding control over blood sugar, they have a critical inﬂuence on the development of diabetes, one of the fastest- growing chronic diseases in the United States and around the world. Last, but certainly not least, the type of carbohydrate in your diet may be as important as the type of fat in the development of heart disease, or protection against it, something largely ignored in the popular media.
In fact, eating the right type of carbohydrate—meaning grains that are as intact and unprocessed as possible— stands right next to maintaining your weight and choosing the right kind of fat in the foundation of a healthy diet.
Until the low-carb diet returned from oblivion a few years ago, the prevailing attitude was that all so-called complex carbohydrates are good, or at least benign, compared with fats. This idea came from rather simplistic looks at diet and disease in China and other developing countries. In general,
the Chinese eat mostly carbohydrates, with a sprinkling of protein and fat. They also have very low rates of heart disease. Putting one and one together, some dietary experts concluded that the low rates of heart disease in China were the result of the high-carbohydrate, low-fat diet and transplanted that idea to the West. The “carbohydrates are good” message has been a key part of the recommendations from the American Heart Association, American Cancer Society, and World Health Organization. It has also traditionally formed the base of the USDA’s dietary recommendation.
Like many transplants, though, this one isn’t doing so well on foreign soil. Even as we tried to cut back on fat and ate more carbohydrates, we got fatter as a nation. The steady decline in rates of death due to heart disease that occurred during the 1970s and early 1980s has slowed. And the percentage of adult Americans with diabetes has almost tripled over the last 20 years. This tough-to-manage disease now aﬀects an estimated 18 million Americans. Around the world, the number of adults with diabetes is expected to jump from 135 million in 1995 to 300 million by 2025.
THE WRONG TYPES OF CARBOHYDRATES DO MORE HARM THAN GOOD
Why isn’t a higher-carbohydrate diet paying oﬀ for us the same way it appears to for the Chinese? On average, the Chinese weigh less and are much more physically active than we are. Weight and exercise matter—high-carbohydrate diets have diﬀerent eﬀects on lean, active people than they do on overweight, sedentary people. So simply eating a high-carbohydrate diet doesn’t oﬀer blanket protection against heart disease, cancer, and diabetes, something the Chinese are also learning. In Beijing, for example, there has been a 400 percent increase in diabetes over the last few years as desk jobs replace manual labor and carbohydrate intake remains high.
The other big problem is that little attention has been paid to the types of carbohydrates we eat. A diet high in reﬁned carbohydrates that are quickly digested and absorbed can have damaging consequences. These include higher levels of blood sugar, insulin, and triglycerides, and lower levels of HDL (good) cholesterol. In other words, more cardiovascular disease and diabetes. In the Healthy Eating Pyramid, reﬁned carbohydrates are in the “Use Sparingly” category, meaning you will do yourself a favor by expanding your diet to include intact, whole-grain carbohydrates at most meals.
Carbohydrates from grains, fruits, and vegetables can give you a good share of your daily calories. For optimal health, though, it is important to rely on carbohydrates from whole grains, things like whole-wheat bread, brown rice, whole-grain pasta, and other possibly unfamiliar grains like kasha, quinoa, whole oats, and bulgur. Not only will these foods help protect you against a range of chronic diseases, they can also expand the palette of tastes, textures, and colors you can use to please your palate.
learn more: Building a Better Pyramid
NOT JUST SIMPLE VS. COMPLEX
Carbohydrates have traditionally been divided into two categories: simple and complex. Simple carbohydrates have been portrayed as the bad boys of nutrition, while complex carbohydrates are regarded as the golden children. This is a gross oversimpliﬁcation. Not all simple carbohydrates are bad, and not all complex carbohydrates are good. Later in this chapter I will describe two far more useful ways of categorizing carbohydrates: by their eﬀect on blood sugar (the glycemic index) and by whether they come from reﬁned or whole grains.
learn more: Fats in the Bloodstream
Simple carbohydrates are sugars. The simplest simple carbohydrates are glucose (sometimes called dextrose), fructose (also called fruit sugar), and galactose (a part of milk sugar). Table sugar is sucrose, which is made by joining a molecule of glucose with one of fructose. Milk contains lactose, which is made by joining a molecule of glucose with one of galactose. Simple carbohydrates provide us with energy and little else.
Complex carbohydrates are more … well, complex. In essence, they are long chains of linked sugars. Although there are many types of complex carbohydrates in our food, the main one is starch, a long chain of glucose molecules. The human digestive system can break down complex carbohydrates like starch into their component sugars. Others are quite indigestible and pass largely unchanged through the stomach and the intestines. These indigestible carbohydrates, called ﬁber, are an important part of our diet.
WHY CARBOHYDRATES MATTER
In the average American diet, carbohydrates contribute about half of all calories. And a staggering half of these “carbohydrate calories” come from just eight sources:
• soft drinks, sodas, and fruit-ﬂavored drinks;
• cake, sweet rolls, doughnuts, and pastries;
• potato chips, corn chips, and popcorn;
• bread, rolls, buns, English muﬃns, and bagels;
• beer and;
• French fries and frozen potatoes.