Carbohydrate Foods and Health

Table of Contents

This page takes a close look at the importance of foods rich in carbohydrates and their relationship to health and chronic disease.

A widely repeated and misleading belief can be summarized as carbs are bad. The two images above show examples of very healthy foods which are also high in carbohydrate. Thus, generalizations like “carbs are bad” misses the mark and may even be dangerous.

Whole plant foods are essential in the human diet — providing vitamins, minerals, and antioxidants. And all their fiber and most of their calories are from carbohydrates. The U.S. epidemic of chronic disease is not solely about what we eat, but blood-sugar problems and the high insulin response — caused by the habitual consumption of refined carbohydrates — is central to this health catastrophe.

Nutrient and Carbohydrate-Rich Foods
By dry weight, vegetables range from around 50-percent to 90-percent carbohydrate; grains are 70-percent to 92-percent carbs. Nuts and seeds, much lower. Plants are our primary source for glucose, the normal fuel used by every cell in the human body.

At the Deli-Case: No Free Will

Art is one of my occasional coffee pals. This Viet Nam Vet, former industrial chemist, and science teacher, watches his blood-sugar like a hawk. A while back he wore a continuous glucose monitor. Art is on a permanent kick about there being “no free will,” and he’s on to something.

There is no “free will” near the deli-case, hot-case, or a donut shop. It’s a no-brainer why the high-calorie, crave-worthy choices are at the check-out counter. High turnover “merch” in high-traffic locations helps put the kid through college. Recreational, impulsive eating and human hormones are tied directly to the businesses balance sheet.

Art calls my research on nutrition and disease “your nutrition kick,” but he adopted my first suggestion: Instead of drinking OJ every morning, just try eating a whole orange.

Art’s continuous glucose monitor showed him how morning OJ produced a significantly higher blood sugar spike, compared to eating a whole orange.

Dopamine and serotonin are, respectively, in charge of our signals for reward and happiness. Both are neurotransmitters. For our recreational or reward-based eating, they “drive the bus,” so to speak — that is, eating based on the feeling: “I deserve this.” Serotonin has many important roles in the body, but has consistently been shown to be low in people who overeat[I]. Dopamine is involved in every addictive behavior.

Whether or not it’s food craving or food addiction, they communicate with the wallet, calories, and insufficient nutrition. At 7:50am, a high school student does the Grab n’ Go—rushing off to catch the bell to first period. In hand, I assume, is breakfast: a Red BS and a sweet-fat deli treat. The question is what is in control, not who.

[i]  What Does Serotonin Have to Do With Eating Disorders? Melinda Karth, Ph.D Psychology Today, May 29th, 2022

At the Deli-Case
The combination of sweet-and-fatty punches all the right buttons. Recreational or social eating is non-nutritive and often linked to brain hunger, not metabolic hunger.

Carbohydrate: Our Primary Fuel

Humans are omnivorous with marvelous food flexibility. I outline some cultural examples under the page Fats, Oils, and Health. Today, with the right fuel, manageable stress, good sleep, and physical activity, you might thrive 90 years or more. And there are exceptions; maybe Grandpa who smoked, drank, cheated and reached 90. There are always exceptions.

To accomplish one’s God-given optimal health-span, the body must acquire deep nutrition without becoming overweight. When we successfully fight disease and successive generation of cell stay healthy and operate well, so too will the person. That is the essence of optimal longevity. We all will die, but death is a result of disease, not “old age.”

Our long, long, ago ancestors never passed up good meat, be it fish, a gazelle, or a swarm of cicadas, but our closest living cousins, bonobos and chimps—in fact—eat mostly plant foods. Yes, chimps hunt other monkeys and cannibalism does occur, as it did with humans, but that’s not day-to-day.

Humans are not chimps or gorillas, but as a group, primates possess the jaws, teeth, long intestines, and metabolic physiology to eat plants and thrive. Unlike most mammals, humans and our closest cousins have color vision, presumably to select plant foods for ripeness. We acquire the vitamin-C that all animals need from plants. True carnivores like canine’s and cats make their own vitamin-C in abundance.

Choosing diverse whole plant foods has a strong scientific basis for life extension and disease prevention[i]. Most American’s seem unaware of those repeat findings. Perhaps, we’re just too busy eating for pleasure to notice.

[i] Benda Davis, RDN – Food Revolution Network

Health is Here!
Eating a variety of whole plant foods provides healthy carbohydrates, vitamins and minerals and disease-fighting antioxidants.

Fuhrman’s Equation
The equation is hypothetical, but summarizes the clinical philosophy of Joel Fuhrman, M.D. When we flood the body with high levels of whole-plant-derived minerals, vitamins, and antioxidants—and keep caloric intake low (very low fat)—the immune system works better and the body can more naturally clear-up chronic disease problems.

The levels of food satisfaction (satiety) allowed by avoiding the white flour, sugar, and highly-processed junk and instead focusing on un-refined whole plant foods can tip the balance. Of course, lifestyle modification also means: regular exercise, stress reduction and getting adequate sleep. 

High-Carb Disease Reversal

Joel Fuhrman, M.D. is a gifted family practice physician and lifestyle medicine author. Since the early 1990’s, Dr. Fuhrman has specialized in reversing chronic diseases and optimal health through plant-based nutrition. He has published numerous books. He offers two memorable summaries of healthy eating that express high-carbohydrate menus:

“Humans are a green plant-dependent species” and

 

“The salad is the main dish[i].”

He’s serious. His diet-based disease treatments includes: type-2 diabetes, obesity auto-immune diseases, lupus-like allergies and lupus. They all begin by treating the brain—the lack of knowledge about Real food. His calls his successful patients “nutritarians.”

Watch a short YouTube interview with Joel Fuhrman, M.D.: HERE.

[i] Eat to Live, 2004

When a body replaces the Standard American Diet (SAD) with nature’s true and faithful disease-fighters, good things happen: swapping-out the mocha-latte, Red BS, sub-sandwiches, sweet-fat deli-addiction, snack “food,” white bread, heat-and-eat pizza, crazy-expensive breakfast cereals, processed meat, and so forth. Whew!

Lifestyle medicine experts, nutritionists, and health coaches can help.  In addition to a food revolution, the practice of lowering stress and getting sufficient daily exercise and sleep means the body becomes a better disease-fighting machine.

It’s absolutely not a “fad diet;” rather, it’s the human diet. Importantly, “plant-forward” menus do not mean cutting out all animal products. Restricting — yes. Great reading by Joel Fuhrman: Eat to Live and The End of Diabetes. Near the bottom of the page Fats, Oils, and Health, you’ll meet two other disease-reversal experts: Dr. Caldwell Esselstyn and Dr. Dean Ornish.

Meat not the “main dish?” The notion “salad is the main dish,” is a philosophy as ancient as Hippocrates. The body resolves disease when we flood it with plant-based nutrients and cut calories at the same time (see Fuhrman’s Equation, above). Fasting has also been key to disease treatment for a very long time. The perfectly normal everyday-fast is one required for a healthy body and mind — between supper and breakfast, roughly 12-hours.

The Everyday Fast — ANCIENT!

  • After supper, brush your teeth and say aloud I’m done eating for today. Now see how that goes.
  • A daily period without eating of, say, 12-hours allows the body to cleanse and repair. Without a meal to digest, your body and brain bring down blood sugar and insulin and they clean-house. This daily “fast” boosts the immune system, lowers inflammation and helps prevent disease.

A 12-hour daily “fast,” of course, means skipping the recreational, late-night, extra meal. Because of the addictive nature of highly-caloric and highly-processed foods, that may be very difficult. And yet, no “specialized service” or doctor is required — no new moon-shot tech or new construction.

Health providers, coaches, and friends can help a person reconcile an unhealthy lifestyle with the body’s ancient design and wisdom. The term “disease” must include obesity, because — in about four-of-five cases — people carrying excess weight have an underlying metabolic health problem. They may suffer from the same blood sugar and insulin problem as someone who is type-2 diabetic. Restated, excess body-fat and type-2 diabetes are often different stages of the same metabolic problem.

Why discuss healing in a section about carbohydrates? 

  • Whole plant foods — high in carbohydrates — are high in disease-fighting antioxidants (most of which are themselves carbohydrates)

  • Diets rich in diverse whole-plant foods CAN provide sufficient and complete protein.

  • Diverse whole-plant nutrition is naturally low in fat, calories, is anti-inflammatory, and combats oxidative stress.

Carbs are Not “Bad”!

Pizza appears to be the single most reliable way to assemble a group of humans. Add beer or a sweetened beverage and you’ll further boost participation, but pizza by itself seems to work like magic. Clearly, the reward neurotransmitter, dopamine, likes whatever pizza—plain-cheesy, meaty, Hawaiian, vegetarian. Our natural response to pizza has a lot to do with refined white flour.

The National Institutes of Health recommend getting 45 to 65-percent of calories from carbohydrate-rich foods. Do they mean pizza? The World Health Organization’s recommend acquiring 55 to 75-percent of calories from carbs.

In the years following the Second World War, “western” scientists learned about the very long-lived Okinawans. They ate their traditional diet, getting about 85-percent of calories from plant-based carbohydrates, mostly nutrient-packed sweet potatoes. Seventh-Day Adventist adherents who are vegan—the longest-lived contemporary U.S. study-population—get 58% of calories from whole-plant carbohydrates.

Pizza, pretzels, hot-pockets, and U.S. D.A. School Lunch formulated with refined white flour is NOT what we’re talking about.

Whole Plant Carbohydrates, Not Pizza

To be diamond clear, white flour still contains most of its protein, fats, and has a slightly higher percentage of carbohydrate. Not a reason to celebrate. What the factory removed is soluble and insoluble fiber, vitamins, minerals and the disease-fighting antioxidants.

In sourcing carbohydrate calories, the health-science authorities (noted above) are referring to: whole grains, legumes, whole fruits, diverse vegetables, starchy tubers, nuts and seeds, herbs and spices—the plant foods I describe elsewhere as “Real”—not pizza, burger buns, donuts, muffins, or those regrettable white-flour dinner rolls. Below is an ominous statistic I return to repeatedly:

Nutrient-stripped white flour is at least 95% of all wheat consumed in the U.S.—and a  monstrous fraction of U.S. calories.

Whether it’s kale and celery, or sweet potatoes and rice, many of our faithful disease-fighting foods are HIGH in carbohydrate—most digestible and some not (insoluble fiber). The TABLE above right shows various foods and their macronutrient content. The percentage of carbohydrate in each is highlighted green.

The subject of fiber is discussed in a separate webpage under the Foods and Health menu — Fiber: the Epidemic of Absence.  Food habits built upon refined carbohydrate are very unhealthy. The over-consumption of finely milled flour is specifically discussed on the page Insulin and Metabolic Disease. Refined carbs reflect a major portion of a U.S.D.A.-approved school lunch.

Of course, milled wheat and corn have been staples for a long time. Until after the U.S. Civil War, when the newly invented steel roller-mill was harnessed to steam power, white flour was very expensive and Americans had limited access.

Northern Tlingit People and Refined Carbohydrate Foods

At the northern end of Southeast Alaska, white flour was introduced to the indigenous Tlingit people around 1881. Prospectors in what became Juneau, Alaska staked gold-claims in 1880, 90-miles south. Carrie Willard, wife to the first Presbyterian minister at the new wilderness outpost known as Haines Mission, described in her memoir how Pastor Willard traded with a Tlingit family flour, shot and powder. In exchange, Eugene Willard received an awesome fur coat.[i] The sepia-tone image (right) taken a few years later shows him modeling this possession, one he clearly prized.

[I] Among the Tlingits: Letters 1881 – 1883. Carrie M. Willard (1995)

 The “letters” of Carrie Willard’s help to date the early arrival of white flour and, we can assume, sugar within Tlingit aani (the Tlingit homeland). Irrespective of ethnic background, refined carbohydrate foods are a health-scourge: over morning coffee with friends; at the after-school pizza round-up; and at the Southeast Alaska State Fair where the most crowded “exhibit” is a non-stop eating fest called the food court.

For Alaska Natives and American Indians fry-bread may be viewed as a symbol of both unity and the trauma of western colonialism and dispossession. My fervent hope is that one day this symbol will be relegated to history books, instead of breakfast, lunch, or dinner. By God, it is hard it to eat just one! This compulsive, addictive affect of the SAD concoctions is summarized below:

  1. The starch in ultra-processed foods quickly becomes 100% glucose and is rapidly absorbed into the bloodstream.
  2. The higher is the blood-sugar spike, the higher will be the dopamine (addiction’s neurotransmitter) spike hitting the brain’s “reward” center leaving you seeking more.
  3.  Our brain and hormones evolved to assume an environment of caloric scarcity, so we keep eating more.

For more on this topic, including a discussion of insulin resistance and its relationship to the disruption of our hunger hormones leptin and ghrelin, see Insulin and Metabolic Disease.

The A, B, C’s of Sugar, Starch, and Fiber

Between about 1710 to 1999, North America’s per-person annual sugar consumption increased at least 35-fold: from roughly four-pounds to 150-pounds.  A final fifty-pound jump in annual consumption between 1980 to 1999 was spurred by the new U.S.D.A. dietary guidelines and high fructose corn sweetener being commodified around 1980.[i]

Our current average daily sugar consumption is now very roughly 17 to 19 teaspoons — about twice the U.S. Center for Disease Control’s (CDC) daily max recommendation for men and triple the max for women.

The CDC also says children age two and under should eat zero sugar; meaning, no fruit juice, honey, candy, sweetened crackers, or breakfast cereals. Many parents are unaware of the danger, others are simply overwhelmed by the sweet-fatty options at every check-out stand, etc.

The Big Three: Sucrose, Glucose, Fructose

The chronic disease pandemic impacting U.S. health is by no means all about sugar, but fully understanding the thing called “sugar” is central to understanding the chronic disease problem. Quite possibly, it’s not what you think.   

[i] Good Calories, Bad Calories by Gary Taubes

A–Sucrose: a double sugar

“Added sugar” means sucrose or its chemical equivalent. Sucrose is a disaccharide (double sugar) comprised of fructose and glucose in equal parts. Caloric sweeteners such as sucrose, table/brown sugar, molasses, high-fructose corn sweetener, honey, maple syrup, molasses, cane sugar, beet sugar are metabolically similar –comprised of roughly 50% glucose and 50% fructose. Let’s break down what that means.

B — Glucose

The simple sugar glucose can be metabolized by every cell, tissue and organ. For example, your brain burns glucose beautifully, consuming roughly 20-percent of your calories at rest. Blood cells and eyeballs can only burn glucose. The glucose molecule is also the fundamental building block of plant fiber and starch (described below). This offers a very powerful hint on the importance of carbohydrates for human nutrition.

Glucose has always been extremely common in the food portfolio of human-kind: the leaves, shoots, fruits, tubers, grains, vegetables, nuts, legumes, and so forth. Unquestionably, humans evolved the capacity to use lots of whole carbohydrate plant-foods, meaning lots of glucose. The modern highly-processed/packaged foods—what we see the wild-eyed child ripping open as they leave the store–are made with refined carbs.

To repeat for emphasis, ultra-fine, nutrient-stripped white-flour products still contain the protein and fat, but the fiber, vitamins, minerals and disease-fighting antioxidants were removed at the factory. The starch that remains goes straight to glucose in the small intestine.

Milling and refining any food, increases the speed with which it is metabolized; meaning, its ability to spike blood-sugar, insulin, and trigger our addiction neurotransmitter. No doubt, you’ve noticed how hard it is to eat just one. On the page Insulin and Metabolic Disease, I discuss how highly processed foods and high glucose spikes are linked to food addiction and hacked eating behavior.[i]

C–Fructose (Fruit-Sugar)

Whole fruit tastes amazing because of fructose is the sweetest caloric sweetener. Of course, fruit is packed with fiber, vitamins, and antioxidants. Fruit travels well. It’s a marvelous source of hydration and quick energy. Keep a few in your car or handbag, in addition to water, rather than the junk-old. These are the healthy sources of fructose. Consider allowing fruit to entirely replace the packaged snacks, juice-drinks, Red BS, and junk-ola.

Because of its abundance in “added sugar”—and our limited ability to metabolize it—fructose plays an important role in our chronic disease explosion. Avoiding the refined fructose in added sugar is a natural first step towards “healthy,” but it’s’ not easy.

Fructose is only metabolized in the liver. Health-science didn’t figure this out until the mid-1980’s–after the U.S.D.A. dietary guidelines cause the increase in sugar consumption. A few decades later, clinician-scientists like lab-researcher and med-school professor, Robert H. Lustig, M.D., began waving the proverbial red flag. He was publicly described its dangerous effect to the liver around 2010. Of course, alcohol (and excessive fat intake) will also fatten the liver.

The liver is THE WORST place for fat to accumulate, because it has hundreds of vital functions. The SECOND WORST type is visceral fat—meaning belly fat. A protruding belly is often connected to the liver fat that is now invested in close to HALF of U.S. adults.

Starch and Fiber — 101

Starch and fiber are carbohydrates assembled from the glucose molecule. Starch comes in two forms: straight-chain or bushy/branched-chain. The straight-chain form is less common, very health, and abundant in lentils and beans (legumes). Called amylose, this starch is slow to digest and therefore generates a lower rise in blood sugar: called “resistant starch.

The branched, bushy-chain variety is very common. Called amylopectin, it is abundant in tubers and grain. This starch is converted to glucose quickly and, therefore, generates a higher spike in blood-glucose. Rising insulin should faithfully follow rising glucose.

[i] Metabolical—pg. 167

AT RIGHT–representations of how glucose is organized in food:

  • Amylopectin and amylose: dietary starches
  • Glycogen: Your day-to-day reserve fuel stored in liver and muscle tissue
  • Insoluble fiber (Cellulose): Long chains/sheets of interconnected glucose molecules that pass with your stool
  • Soluble fiber* (not shown) Short fiber chains, roughly 3 – 10 glucose molecules in length that feed the microbiome

*Soluble fiber is extremely important to the health of the gut-lining and is beneficial to mental/behavioral health too. By and large, Americans eat for too little fiber — about three-fold less than what is recommended by the U.S.D.A. For the whole story on fiber, check out the page Fiber: The Epidemic of Absence.

Healthy Shopping with Kids

Teachers know the importance of class-time spent helping students grasp the value of why. What are some personal reasons why I’m supposed to learn this stuff? Knowing why is every bit as important as the study “content,” the what they are learning. It helps to motivate and improve the classroom vibe. Parenting about food and health is no different.

With two-thirds of grocery store products containing added sugar, deficient fiber, lacking disease-fighters—even more formulated with imbalanced inflammation-producing fats—a grocery store, deli, or coffee shop can be Hazardous Terrain  (metabolically speaking).

Before entering the store or deli, explain to the child—and to yourself—why we’re entering and what ya’ll will, and will not, be leaving with.

To be perfectly honest, for a food nerd like me, it’s a mini-heartbreak to notice a child leaving a store with hands full of processed, expensive, sweet-fat-emulsified SAD junk. There in-hand is the child’s future risk for weight gain, vascular disease and diabetes.

Given our current national statistics, a bootstrap estimate is that 30 to 40-percent of the students in an average U.S. public school will become type-2 diabetic and die early from its complications. Seventy years ago that number was a single-digit.

Is type-2 diabetes terminal? Hell no, but if it’s not reversed the risk of early death goes up. Most people with type-2 diabetes, who don’t actively reverse it, die from complication of vascular disease (heart disease, stroke, dementia, peripheral arterial disease, etc), with astronomical chronic medical/care expense. Seventy years ago that number was a single-digit. Amazingly SAD!

 Assuming you’ve talked to the kids about why and what, before entering the “Terrain,” everyone now take a few deep breathes. With your charges in hand, go directly to the produce section. There we find the original “sweet-treats.”

Grab a few to eat ASAP, a few more for later, and some for the pantry. With nature’s sweet disease-fighters in the basket, take another deep breath and smile! Now complete your foraging mission. Staying clear of the trigger areas–the sweet-fat, highly processed packaged and expensive junkola with long lists of ingredients–is not easy, but you’ve made a great start.

Carbs and Liver Fat

Non-Alcoholic Fatty Liver Disease (NAFLD) was not a thing before 1980. Back then, doctors saw the problem of a fatty liver as being almost entirely alcohol-related. Today, somewhere between 25-percent and 40-percent of U.S. adults possess stored liver fat, mostly NOT from alcohol, but from excessive refined carbohydrate consumption with fructose playing a significant role.[I] Recall that fructose is half of our sucrose — the “double sugar” that comprises our added sugar (described above).

Of course, all excessive calories can become fat, so over-consuming any of the macronutrients can contribute. Liver fat is now understood as a major underlying factor in our non-communicable chronic disease pandemic.

So, what’s wrong with a little liver fat? When fatty, the liver begins to fail at its job — “over “500 vital functions” according to Johns Hopkins Medical. For example, it can’t properly filter out toxins or excessive hormones (such as estrogen) and it processes less glucose. While every cell of the body can burn glucose, your liver is actually responsible for converting about one-quarter of all your glucose intake and 100% of the fructose. The problems of insulin resistance and the inability to control blood sugar are closely associated with liver fat.

Liver fat is now understood as a major underlying factor in our non-communicable chronic disease pandemic.

Sugar, refined carbs, fats/oils, and even protein — all calories in excess of need — can contribute to elevated triglycerides (fat in the blood) and oxidative stress. By no means does all fatty liver “show,” but visceral fat that builds up above the belt-line is commonly associated with fatty liver. Diminishing the body’s ability to process glucose (insulin resistance) is GROUND ZERO for our chronic disease pandemic. For a more complete description of “ground zero” see Insulin and Metabolic Disease.

[i] Metabolical—pg. 153

[ii] Defeating Diabetes—pg. 30

Garth Davis, M.D. is a Houston-based bariatric surgeon whose specialty was “treating” obesity and diabetes using procedures like gastric bypass surgery. He was making money hand over fist.

Then, Davis profoundly reversed his understanding of how best to treat obesity and he changed his medical practice. He was seeing the same people back at his clinic, every bit as sick as they were before, some far worse. Gastric bypass surgery hadn’t actually treated the disease, one of maladaptive human behavior and lifestyle!.

AT RIGHT–Dr. Davis beautifully explains the public’s misunderstanding of the causes of insulin resistance, diabetes and obesity. They have everything to do with chronically elevated blood-sugar, elevated triglycerides, and fat in the liver — the fat Dr. Robert Lustig describes as “the baddest guy in medicine.”

“So, we see that, popular belief to the contrary, the high blood sugars that define diabetes are not, in fact, the cause of diabetes. Rather, those high blood sugars are an after effect, a symptom… .

The problem is actually the fat and inflammation that is destroying the body’s ability of utilize sugar safely.”

Garth Davis, M.D. in Proteinaholic, Page 152

“Fat and inflammation that is destroying the body’s ability of utilize sugar safely”? That description is a long way from the public’s general understanding of someone’s problem with “blood sugar,” excess weight, or type-2 diabetes.

  • To paraphrase Dr. Davis, radical swings in blood-sugar and chronically triglycerides—fat in the blood—buggers up the body’s ability to manage blood-sugar, meaning insulin resistance.
  • Eliminating the refined carbs is indeed the first step to improving this disease-making condition, but all excessive and addictive SAD calories — the inflammatory added oil, carbs, and protein — are an American health crisis, not simply “sugar.”

Moreover, you can be metabolically sick and not be fat, but various estimates suggest that at least three-quarters of those with protruding bellies and apple-shaped torsos are metabolically sick. Liver fat and insulin receptors disabled by fat (insulin resistance) is the subject of the page Insulin and Metabolic Disease.

The human liver weighs around four pounds. It processes one-quarter of your glucose, ALL of your fructose and alcohol intake. The major dietary contributors to the U.S. liver fat epidemic are: sugar, refined carbs, and alcohol. The chronic stress is another environmental contributor leading to high-calorie-reward (addictive) eating and hacked hormones.

Research funded by the National Institutes of Health show that key markers of metabolic health improve after just ten days—once the metabolically sick person dumps the added sugar, pop, and fruit juice.