The Difference Between Naughty Carbohydrates and Totally-Okay Ones

Carbs are not the enemy! They can actually be really good for you if you are smart about it

These days, there’s a lot of talk about no-carb diets, low-carb diets, cutting carbs and so on, but all carbs are not the same. The only thing this kind of talk reveals is a lot of confusion about foods classified as carbohydrates. There is a big difference between intact carbohydrates on the one hand, with an intact fiber matrix, the way nature intended, and stripped carbohydrates on the other hand, in which the fiber matrix has been removed by one or more industrial processes.

What Are Stripped Carbs?

Just to be clear, there are four major sources of stripped carbs: sugar cane, wheat, rice and corn. These food products are stripped of their fiber to produce sugar, white flour, white rice, cornstarch and corn syrup. All are relative newcomers to the table. Corn syrup entered the food supply in large quantities in the 20th century, white rice in the 19th century, white flour in the 18th century, and sugar in the 16th and 17th centuries. While it is true that small quantities of sugar were produced in geographically small areas around the world prior to that, the sugar industry did not explode in size and scope until just a few centuries ago, relatively recently from the perspective of humankind. None of these products existed as part of the human food supply prior to the past several hundred years.

Incidentally, besides sugar cane, dates and beets are two other raw material sources of sugar. As found in nature, both are fiber-rich nutrition powerhouses. As found in sugar bowls, not so much.

How Do Stripped Carbs Impact Our Health?

In the early part of the 20th century, the large-scale substitution of refined white flour for whole-grain meal resulted in an epidemic of anemia and B vitamin deficiencies, and so the U.S. Congress mandated that iron and vitamins B1 (thiamine), B2 (riboflavin) and B3 (niacin) be added to the new product. To this day, it is still referred to as “enriched” flour, the new name by which it then became known. Of course, no “enrichment” would have been required had the whole grain not been stripped of its essential nutrients in the first place. But there was still more to come. Folate replacement, termed “fortification,” was initiated in the 1990s once a causal link was established between folate deficiency and a class of congenital neural tube birth defects, of which spina bifida is the most well-known. “Fortify” comes from the Latin fortis, meaning strong.

When you see “enriched” white flour advertised as “refined” flour, you might ask yourself, as I did, what is it about flour that makes it “refined”? I thought refinement was for Victorian ladies. I turned to the dictionary for a definition of the word “refined” and discovered that to “refine” means to remove coarse impurities. Oh, I get it. Removing the bran and the germ makes the grain look cleaner and last longer. If the bran and germ are coarse impurities, then the flour is “refined.” But they’re not, and it isn’t.

Rice, too, has a story. In Southeast Asia in the 1800s, a newly developed milling process stripped the husks from kernels of rice, and thereby precipitated an epidemic of beriberi, an excruciatingly painful joint disease caused by a deficiency of thiamine. Thousands died. “Polished” white rice might look nice, but the thiamine was in the husks that had been removed at the mill.

And then there’s corn. A recent review in the journal Nutrients* examined the introduction of corn syrup to the Western diet in the latter half of the 20th century. The data show that the subsequent dramatic increase in sugar consumption has played a major contributing role in the explosive increase, over the past 50 years, in the numbers of obese and diabetic individuals within our borders.

Corn syrup is used so heavily in the processed food industry that it is virtually impossible to avoid. The first ingredient in many brands of ketchup, barbecue sauce and other condiments, it is also the sweetener of choice in most soda pop, salad dressing, jam and jelly, ice cream, candy, “nutrition” and “breakfast” bars, and baked items, such as breads, muffins, doughnuts, cookies, pies, cakes, crackers, and breakfast cereal.

So, what can you do right now? Avoid stripped carbs to the best of your ability, even if the improvement is relatively minor. Small changes can sometimes make a big difference. If you can make the time, cook your own meals. Pack your lunch. Try salsa or mustard instead of ketchup. Eat more fresh produce; fruits and vegetables are nutritious, intact carbs. The more fruits and vegetables you eat instead of muffins and cookies, the better you will look and feel. Beans and whole grains are also intact carbohydrates.

Roxanne Sukol, MD, M.S. is Medical Director of the Cleveland Clinic Wellness Enterprise. Dr. Sukol cares about what you eat! She has written and lectured extensively on the subject of diabetes and obesity prevention, and is committed to teaching people how to tell the difference between real food and manufactured calories.

Dr. Sukol tells you how to prevent and reverse diabetes in this 4-part series.

*Simopoulos, A. Dietary Omega-3 Fatty Acid Deficiency and High Fructose Intake in the Development of Metabolic Syndrome, Brain Metabolic Abnormalities, and Non-Alcoholic Fatty Liver Disease Nutrients 2013, 5, pp. 2901-2923.

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