have our bodies metabolize what we eat and turn it into the fuel that our body needs to function,” and carbohydrates are the primary way of doing that.
But the popularity of low-carb diets has demonized carbs for some people.
If you aren’t eating enough carbs, your body can make blood sugar from stored fat through a process called ketosis. “Keto” diets seek to trigger fat-burning by restricting intake of not only added sugars and alcohol but also grains, fruits and legumes (such as beans and peas).
Odegaard says that discussing the value of such low-carb diets is tricky because there is no standard definition for them. “There’s still lots of questions to be answered,” he says. But in April, an American Heart Association scientific statement evaluated 10 popular dietary patterns and ranked the “very low carbohydrate” category as the least aligned with AHA guidance for heart-healthy eating.
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“Most evidence – the vast majority of evidence” points to consuming foods such as beans, fruits, vegetables and whole grains “as something that’s probably pretty good for you,” Odegaard shares.
Federal dietary guidelines suggest that in a healthy adult dietary pattern, 45 percent to 65 percent of calories should come from carbohydrates.
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Carbs and diabetes
The parameters are different for people with Type 2 diabetes, which Odegaard describes as “a disease of carbohydrate metabolism.”
In a healthy person, when blood glucose levels rise, the pancreas releases insulin to help cells absorb the sugar. With Type 2 diabetes, the body either can’t make enough insulin or can’t properly use what it makes. So, balancing carbs with activity can be an important part of life with diabetes.
A study published in 2019 in the Journal of the American Heart Association showed that while Mediterranean-style and other diets that emphasize fruits, vegetables, nuts and legumes lowered the risk of heart disease in older women with diabetes, “paleo”-style diets that reduced carbs by restricting grains, legumes and dairy did not.
“In people with Type 2 diabetes, the proportion of your overall dietary pattern that’s carbohydrates is something you may need to pay attention to,” says Odegaard, a senior author of that study. “But that’s something for someone to discuss with their care provider team and figure out what works for them.”
Overall, Odegaard says, the root of carb confusion is the desire for people to find “one single thing” that they can avoid in order to have a healthy diet. With carbs, he says, that can be short-sighted.
This is why Odegaard encourages people to think about where their carbs come from more than how many they consume. “I think it’s just a matter of what you emphasize within a very broad range of carbohydrate-based foods,” he shares. Whole grains, legumes and fresh or frozen whole fruits and vegetables are great even though they have carbs. Carb-heavy cakes, cookies and sodas can be occasional treats, at most.
Gardner, who is also a nutrition scientist at the Stanford Prevention Research Center, says the goal should be to “get rid of as many of those low-quality/simple carbs as possible.” Replace some of them with healthy carbs and others with sources of high-quality unsaturated fat, such as nuts, seeds, fatty fish, avocados and olive oil.
People can adapt to what optimizes their health and what’s enjoyable, Odegaard concludes. “You can have a very healthful diet with a large proportion of your energy intake via carbohydrates, and you can have relatively healthful diet with lower carbohydrate intake.”
By American Heart Association