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Carbophobia is real—here’s why it matters

Healthy carbohydrates are good for the body and provide essential vitamins, minerals, and antioxidants. Yet there’s a persistent fear and guilt associated with carbohydrates of any kind. In my practice as a dietitian, it’s not uncommon for me to hear from patients that they’ve “been bad” because they ate a slice of bread or a piece of fruit. Vilifying carbohydrates as a whole can keep people from achieving a balanced diet and a positive mindset around food. One of the rewarding things about my role at Vancouver Clinic is that I get to help individuals learn how to enjoy high-quality carbs as part of a balanced diet.

How carbs got a bad reputation

People didn’t always see carbohydrates as a problem. For a long time, the government advised that fat was the macronutrient to avoid. Companies responded by replacing the fat in our food with sugars. Then, the Atkins diet introduced the public to the idea of low-carb eating. Similar diets followed, including South Beach, Keto, and Paleo. While very few people I talk to actually follow these diets, many of them have adopted their restrictive perspective, resulting in carbophobia.

The concern with these diets is that they promote the idea that all carbohydrates are equal. Twinkies and apples, while both carbohydrates, do not belong in the same conversation. Removing healthy whole grains, legumes, and fruit is unnecessary, unhealthy, and makes these diets rarely sustainable. On the other hand, people should curb sugar (candy and soda) and refined starches (baked goods and white flour). When individuals find success with carb-limiting diets, it’s typically because they are cutting out these nutritionally poor choices.

What carbohydrates bring to the table

I have several reasons for encouraging my patients to include quality carbohydrates in their diets. Whole grains, legumes, and fruits are excellent sources of fiber, which is found exclusively in plants. Fiber improves our digestion, helping to prevent both constipation and diarrhea. Fiber also helps to prevent colon cancer, aid weight loss, regulate blood sugars, and lower cholesterol. According to the Harvard-based Nurses’ Health Study, women who ate two to three servings of whole-grain products each day were 30 percent less likely to have a heart attack or die from heart disease over a 10-year period than women who ate less than one serving per week.

Most people are deficient in fiber. The average person eats only 16 grams per day, but the recommended intake is 25 to 30 grams per day.

In addition to fiber, whole grains contain minerals including zinc, iron, and B vitamins. These help strengthen the immune system, repair damaged tissues, and create energy for the body. Fruits are high in antioxidants, including vitamin C, which prevents cell damage and reduces heart disease risk.

What fruits, grains to shop for

Anyone can increase the amount of high-quality carbohydrates in their diet by being thoughtful about what goes into their grocery cart. Good guidelines include:

  • Picking whole grains: Oatmeal, quinoa, and brown rice are wholesome options.
  • Looking for 100 percent whole-wheat bread: The nutrition facts label is regulated by law. Check it to make sure refined wheat isn’t sneaking in.
  • Choosing whole fruit: Fruit juice is all the sugar of fruit with none of the beneficial plant fiber.
  • Eating local: The Northwest is a mecca for delicious apples, cherries, and berries of all kinds. Selecting fresh, sweet, and in-season foods helps satisfy the taste buds.

Where carbs fit in a balanced meal

Balanced portions, including reasonable servings of carbohydrates, help people feel satisfied. Filling half of one’s plate with veggies, a quarter with protein, and the final quarter with a whole grain is a good goal. For example, aim for a large salad, a smaller serving of spaghetti, and a few meatballs. When people start with healthy ingredients and a good variety, there’s little need to count grams of carbohydrates. Instead, they can eat intuitively and enjoy their food.

Who should eat carbs

Patients with a prediabetes or diabetes diagnosis may be particularly concerned about raising their blood sugar by eating carbohydrates. Both of these conditions require nutrition and lifestyle changes, ongoing monitoring, and sometimes medications to control blood sugar and prevent complications. However, for most patients, high-quality carbohydrates are still recommended.

Whole grains and fruit improve the body’s ability to manage the amount of sugar in the blood stream. They also help people maintain a healthy weight, which is strongly linked to successfully managing these conditions.

Individuals with diabetes are encouraged to pair healthy carbohydrates with a protein or fat to help prevent sugar spikes. For example, eating whole-grain toast with sliced avocado, or an apple with peanut butter or cheese. For fruit, berries, oranges, and plums are excellent, high-fiber options. Eat them with cottage cheese or Greek yogurt. Any individual can follow these recommendations to keep their blood sugar steady and feel satisfied after a meal or snack.

When to talk to a clinician

If you have questions about introducing more carbohydrates into your diet or how to eat given your unique body and medical conditions, be sure to talk to your dietitian or medical provider. Carbohydrates have significant health benefits and can be enjoyed guilt-free.

Kenneth Hermansen is a registered dietitian and certified diabetes care and education specialist at Vancouver Clinic. He believes that a healthy diet is within reach for everyone and that eating well can be affordable, sustainable, and delicious.