Updated: Mar 3
You've most certainly heard the phrase: "carbs are the enemy". I'm hoping the person who made that statement wasn't a registered dietitian or a medical doctor, although if they were, I’m guessing they sell lifestyle books or wellness programs. Turns out I was partly right. In fact, carbs have been vilified since the dawn of the low-carb diet. In the 1970's, Dr Robert Atkins, the father of the low-carb movement, published his Diet Revolution books, which went on to sell over 15 million copies. He encouraged people to cut out all carbs and focus mainly on foods that contained the two other macronutrients: protein and fat. No wonder this dietary pattern became so popular. People were told to eat bacon, cheese and fried chicken, and even though prestigious scientific journals called these dietary recommendations dangerous and irresponsible, the damage to carb's reputation was already done.
Macronutrients are required for survival. The word "macro" means big, or large, and we need macronutrients in large amounts to survive and reproduce. You've probably already guessed that micronutrients are required in smaller amounts for optimal health. There are three macronutrients, or “macros”: carbohydrates, also called carbs, protein and fat. Today, we'll talk about carbohydrates and we'll focus mostly on the intake of carbs and its relation to health and longevity.
Right off the bat, I got some interesting and constructive messages from people who had already read this article. Seems like people tend to take some claims quite literally, even when healthy doses of sarcasm are used. This is why I’ll add a disclaimer here! Even if I believe that most carbs can play a part of a healthy diet, I’m not encouraging uncontrolled diabetic to become fruitarians or to drink smoothies for breakfast, lunch and supper. Thanks for always remaining respectful in the comments section.
MACROS AND MARKETING
Macronutrient ratios are the main determinants of most of our modern dietary trends. The plant-based diet is a carb heavy dietary pattern, while the paleo diet is protein packed and the ketogenic diet focuses mainly on fat as its primary food source. Although each single macro is portrayed as the hero by the gurus that promote it, we have a ton of science showing us what really consists of a healthy ratio, or percentage, of all three macros. Most health organizations recommend macro ratios similar to this one, where the following percentages represent the calories per day obtained from each specific macro:
carbs should account for 45-65%
fat should account for 20-35% of daily calories
protein should account for 10-35%
Certain special populations in specific circumstances would stand to benefit from manipulating these ratios in order to fine tune them for their specific needs. For example, elite athletes specializing in long distance running might focus on a carb-heavy diet, while body builders might want to increase the amount of total calories obtained through protein. Whether you're a weekend warrior, or an elite athlete, you can check out my website plantbaseddrjules.com, where I detail how to personalize a macronutrient ratio to fit your needs. Just check out the For Athletes section here. Basically, what I'm trying to say is that we focus way too much on macro ratios, and not enough on the actual foods supplying those macros. The quality and source of these macros ends up being way more important than the amount. The concept of focusing on macros instead of actual food is called "food reductionism" or "nutritionism" and will be reviewed in detail in a future post. By focusing on specific macros or nutrients, food corps can use this to market their products as being more attractive than their competitors.
LET'S GET BACK TO CARBS
Although carbs have been vilified, looking objectively at the science quickly shows us that some of the longest living populations on the planet are mostly plant-based, with almost 85% or more of their calories coming directly from carbs. That's way more than the 45-65% of daily calories from carbs recommended by the WHO. Other populations that still make up some of the Blue Zones (check out my article on the longest living populations here) have macro ratios that include more than 50% of calories from fat. More proof that the food sources of these macros are the main determinants of health, much more than the actual ratio of carbs: protein: fat.
WHAT ARE CARBS ANYWAYS?
Carbs are made by plants, through a fascinating process, where energy from the sun combines with water from rain and carbon dioxyde from the air to form carbohydrates, through photosynthesis. Carbs can then be subdivided into simple carbs or complex carbs. Turns out that before making them the enemy, one must understand how the different types of carbs behave in very different ways.
Photosynthesis produces compounds called saccharides. Simple carbs are formed by one or two saccharides. Those containing a single saccharide are also called simple sugars, like glucose or fructose. Those containing two saccharides linked together are called disaccharides, and are also a type of simple sugar, like sucrose, lactose and maltose. Oligosaccharides contain 3 to 9 saccharides, and polysaccharides contain 10 or more saccharides linked together, like links on a chain. The polysaccharide group contains the starches (that store energy) and fiber (that gives structure).
WHY ARE CARBS IMPORTANT?
Carbs are vital for optimal health because they serve as the main fuel for our red blood cells, brain and nervous system. Although fat and protein can serve as energy backups, they are not an efficient fuel for many tissues. When we consume adequate calories from carbs, our body naturally spares protein so it can be used in other important health processes that I'll review in a separate article. What many fail to understand, is that carbs behave quite differently depending on the food source from which they come from.
So now you know that carbs can be "simple" if they contain 1 or 2 saccharides, or complex, if they contain more. The most important determinant of whether a carb is healthy or not is actually it's food source, and not its subtype.
There are unrefined, or unprocessed carbohydrates and refined ones. As previously described, the unprocessed carbohydrates can then be subdivided in either simple or complex, depending on the number of saccharides that are linked together. The most important thing to remember is this: it's not whether the carb is simple or complex that determines its health implications, but whether it's coming from refined sources or whole unprocessed foods. Let me give you an example, and I'll go into more detail later. Most people know that high fructose corn syrup is a sweetener made from corn. Food processors add this to anything from fast food items, to breakfast cereals, to canned soups and soft drinks. Foods containing added fructose from high-fructose corn syrup are among the unhealthiest of all the processed foods. The sad part is that I now have patients telling me that they avoid eating fruit since it contains fructose too! Where did we go wrong?
As stated earlier, the most important determinant of whether a carb will be unhealthy or not is if it's processed or not, or eaten in whole food form. Pepsi and apples both contain fructose, but the apple’s food matrix that’s surrounding the fructose, made up of fiber, polyphenols, antioxidants and other phytochemicals, is what gives this type of fructose its magic. The vast majority of carbs that are eaten are derived from the processing of plant foods, while a minuscule amount is actually eaten through their whole unprocessed form, a.k.a. real plants. Turns out that when we take healthy plants and extract their sugars, we remove pretty much all of what was important for human health.
FOOD PROCESSING IS MAKING US SICK
We take apples and make apple juice, ignoring the fact that fiber was trapping most of the vitamins, minerals, antioxidants and phytochemicals and that processing removes most of them. That's why their carbs are not behaving in the same way as when we are eating an actual apple. We take corn, because it's cheap and easy to grow, we make corn starch, then process it into high fructose corn syrup. This is then added to beverages, processed foods, cereals and baked goods. Corn is super healthy, whereas high fructose corn syrup is not, since it contains only sugars, with none of the nutrients previously present before processing. There are other examples of how we take perfectly healthy foods and process them into unrecognizable and nutrient-deficient versions of their former selves, all for convenience, cost and taste. We take whole wheat, grind it into a flour, refine and bleach it, removing the germ and the bran, which contains much of the nutritional fiber and vitamins and then use it to make bread, pasta, cookies, cakes, chips and muffins. White flour is almost 100% carbs with zero nutrition, while its whole unprocessed version, whole wheat, is a nutrition power house. People seem to be unaware that white bread is an ultra processed food, and that white pasta, white rice and all the foods we make out of them are too. In fact, they’re the main contributors to the ultra processed calories we get in our diet that contribute to the current obesity epidemic.
Trading health for shelf-life
It turns out that if you take a healthy food, like corn, and process it by removing everything it contains except its sugars, it makes it real bad for our health. Yet we still trade health for convenience and nutrition for shelf-life. Studies show that our kids are now eating more than 60% of their calories from processed foods, devoid of any nutrition and contributing to the obesity and chronic disease crisis. Carbs aren't the enemy, highly refined and processed carbs extracted from healthy whole foods are the enemy. They're associated with many negative health outcomes, such as obesity, diabetes, hypertension and dyslipidemia, just to name a few. In contrast, the Okinawan populations in Japan, before westernizing their diets, were consuming more than 85% of their calories from carbs, and were outliving everyone else on this planet, with rates of cancer and chronic diseases that were embarrassingly low compared to ours.
Food processing is used to prolong shelf life, to cut cost and to increase palatability, or taste. By hiding extra sugar, often in the form of table sugar, honey, high fructose corn syrup or other sweeteners, food processing makes the food much tastier. Food scientists are capable of finding the so-called “bliss point”, where the concentration and ratio of salt, sugar and fat makes the food irresistible. Mother Nature just can’t compete. Although the WHO recommends less than 12 teaspoons of sugar per day, they also include a conditional recommendation to consume less than 6 teaspoons of added sugars per day for optimal health. One teaspoon equals approximately 4 grams of sugar. The average American, or Canadian, consumes an average of 17 teaspoons of added sugar everyday, well above the recommended limit. That’s almost 70 grams of added sugar, when a healthier target should be less than 25 grams per day for an adult. If your child is eating a normal sized bowl of Lucky Charms for breakfast, they are likely getting more than 20 grams in a single meal.
Sugar itself isn't inherently good or bad. It's the main source of fuel for our body. But consuming excessive amounts will lead to excessive calorie consumption. Also, after gulping down a soda, apples don't taste like anything anymore. Now imagine that a typical soda contains over 40 grams of sugar, or 10 teaspoons. Your child eating those Lucky Charms every morning is likely getting between 5-7 teaspoons of added sugar. Not only are these food sources low in nutrients, they're high in calories and fiber depleted, leaving consumers nutrient deprived and hungry within a few hours.
THE CARB CONTROVERSY
So by now, you should be able to understand how carbs aren't the enemy if the foods that contain them are coming directly from the soil. Unfortunately, most carbs that people are eating these days are coming from processed foods instead of whole foods. We take plants, process them into white flours and high fructose corn syrup, then strip them of all the nutrients they contained. After removing the fiber, vitamins, minerals, antioxidants and phytochemicals they contained, we make pasta, bread and cereals out of them that we then feed to our children. The fact that we then label carbs as bad simply goes to show how the population is uneducated about nutrition and preventative health. We made a deal with the devil and exchanged wellness for convenience and many are paying the price with their health. When talking about carbs, it's important to distinguish between fruits and froot loops, or between corn and corn syrup. Turns out the source of our carbs is much more important than the amount.
MY CARB CONCLUSION
Instead of saying "I'm gonna cut down on carbs", I'd much rather hear "I'm gonna cut down on refined carbs". That's the scientifically correct way of doing it. Fruit won't make you fat, and beans, whole grains and legumes, which are mostly carbs, are associated with increased life expectancy. People would live longer if they ate more carbs, not less, the only condition being that these carbs come from real whole foods that grow in the ground, or from a plant. Carbs are nature's candy. They give sweetness to many foods, and by adding them to processed foods, they become highly palatable. Many will have a hard time when trying to decrease refined carbs too quickly. Our taste buds get dumbed down by the constant onslaught of high-carb containing foods. Here are my recommendations for those looking to decrease their intake of refined carbs in exchange for more carbs from whole food sources:
use healthier sweetener substitutes, like date sugar, date syrup or date caramel to spice up your treats. You can even make your own by downloading my free recipe eBook here!
make fruits and berries your dessert of choice.
retrain your taste buds by going very slowly. Your taste buds will slowly regain their sensitivity again within a few weeks. Berries and fruits will regain their intense sweetness very soon!
choose foods labeled "no added sugar".
dust off your blender and make fruit smoothies. We freeze them and make smoothie popsicles that my daughters love.
use whole grains instead of refined grains. Use brown rice instead of white rice, whole grain bread instead of white bread, whole wheat, quinoa or chickpea pasta instead of white pasta.
for many, the consumption of sugar sweetened beverages such as soda, fruit juices or gourmet coffees are a major contributor to overall carb intake. Switch to water infused with lemon. I personally enjoy putting some frozen fruit in my water to make it more interesting.
cook delicious meals at home. By cooking at home, you're naturally gonna decrease the amount of processed ingredients. If you're looking for easy plant-based recipes, you can download my free recipe eBook here!
In summary, carbs only become the enemy once they're extracted from whole plants and from the other beneficial compounds that plants contain, and then isolated to be used in their refined forms. Plant-predominant dietary patterns are carb loaded, yet are consumed by the longest living populations on the planet. When appropriately planned, a diversified whole food plant-based diet has been scientifically shown to improve health and reduce disease, even in the presence of animal products and refined foods. White flours and breads can be a part of a healthy diet. It's important to make space for flexibility when recommending dietary patterns, since compliance tends to be more challenging than accessing the required knowledge to eat healthfully.
Hopefully you now have a more nuanced view of what makes carbs good or bad. We can't simply lump them all in the same category. I'm definitely not trying to convince people to restrict all the foods that we have grown to love. My kids still consume Lucky Charms on special occasions and eat out at McDonald's here and there. The main issue with the modern day dietary pattern is that the vast majority of our everyday foods are coming from carb-heavy refined foods. Although they can co-exist harmoniously within a plant-based diet, the overwhelming majority of our calories should come from whole plants. So let's stop labeling carbs a good or bad, without specifying exactly the source of the ones we're talking about. That's really what will determine if they're healthy or not.
If you'd like to learn more about the different macronutrients that make up a healthy dietary pattern, check out the For Nerds section of my website by clicking here!
Check out my website plantbaseddrjules.com and look for the “How To” section in the menu. There, you’ll find tips and tricks that helped me on my journey towards a plant-predominant diet. Everything there is completely free, no catches!
Look for me on the socials, @plantbased_dr_jules on Instagram and go like my Facebook Page, Plant-based Dr. Jules. If you’re looking for some fitness motivation and are curious to see what a plant-based athlete can accomplish, follow me, @maritimeninja, on my fitness account on Instagram or check out my fitness group on Facebook, called Maritime Ninja Warrior.
Thanks so much for reading!
Plant-Based Dr. Jules 💚🌱
Plant-based Dr. Jules 💚🌱