The Skinny on Carbohydrates: What They Are and Why We Need Them

For too many Americans, carbohydrates -- or carbs -- have become something to avoid in the daily diet. But as nutrition experts know, carbohydrate is an essential macronutrient that provides fuel for the brain and muscles and contains the fiber needed for proper gut function. Moreover, many foods primarily composed of carbohydrates have been demonstrated through numerous scientific studies to lower the risk for certain cancers, stroke, heart disease and high blood pressure. In addition, these foods play an important role in the control body of weight, especially when combined with exercise, which is why the leading medical and nutrition authorities recommend weight loss programs that are rich in foods containing carbohydrate, such as from whole grains, fruits, vegetables and low-fat dairy products. What exactly are carbohydrates, where are they found and why do our bodies need them? The following provides a layman's explanation of this essential macronutrient and its role in the functioning of the body and in improved health. What Are Carbohydrates? Carbohydrates are in a wide variety of foods and are one of the three major macronutrients that supply the body with energy, fat and protein being the others. But unlike fat and protein, carbohydrates are efficiently converted into glucose, which is used directly by the muscles and brain. That is why the Institute of Medicine (IOM), part of the National Academy of Sciences, recently issued a recommendation that children and adults get a minimum of 130 grams of carbohydrate a day to maintain maximum brain function.1 This amount is more than six times more than what the initial phase of the Atkins Diet allows (20 grams of carbohydrate a day). Besides being the most easily accessible energy source for muscles and organs of the body, carbohydrates play an important role in the construction and maintenance of the body's tissues, organs and cells, including nerve cells. At the same time, carbohydrates are found in a wide range of foods that bring a variety of other important nutrients to the diet, such as vitamins and minerals, phytochemicals, antioxidants and dietary fiber. A diet high in these nutrients has been associated with a lower risk for certain cancers, cardiovascular disease and stroke, and diabetes, among other medical conditions. Carbohydrates are grouped into two main categories: 1) simple carbohydrates, which contain simple sugars, such as glucose and fructose, found in fruits, berries, some vegetables, table sugar and honey; and 2) complex carbohydrates, found in many plantbased foods, whole grains and low-fat dairy products. For optimal health, nutrition and public health authorities recommend consuming a wide range of carbohydrate-containing foods with an emphasis on fruits, vegetables, whole grains and low-fat dairy products. For both weight control and good health, experts advise caution in over consuming processed foods where sugar is added, such as soft drinks, pastries and other sweets. Carbohydrates and Improved Health

There have been major advances in the understanding of how carbohydrates influence nutrition and promote better health. Of special significance is the role that carbohydrates play in gut function, disease prevention and body weight regulation. Because many carbohydrates contain dietary fiber, one of the most important benefits of eating carbohydrates is the health effects associated with consuming fiber-rich foods. Commonly called roughage, fiber is an indigestible complex carbohydrate found in plants and has no calories because the body cannot absorb it. Fiber-containing carbohydrates come in two forms -- water-insoluble and water-soluble -- based on their physical characteristics and effects on the body. Each form functions differently and provides different health benefits. Although most consumers just associate fiber with preventing constipation, a high fiber diet has been linked with a lower risk of heart disease in a large number of studies that have followed people for many years. In a Harvard study of more than 40,000 male health professionals, researchers found that a high fiber intake reduced the risk of coronary heart disease by 40 percent, compared to a low fiber intake.2 Fiber has also been linked with a reduced risk of diabetes, diverticular disease and may be protective against colon cancer.3 Moreover, fibers called cellulose and hemicelluloses take up space in the GI tract without yielding calories, promoting the feeling of fullness, which is helpful to those watching their weight. Carbohydrates prevent disease in other ways besides being the sole source of fiber. Packaged along with fiber in fruits and vegetables -- which are primarily carbohydrates -they are rich in antioxidants and contain a number of phytochemicals that have been linked to a lower risk of certain cancers, stroke, heart disease and high blood pressure.4 Based on an extensive review of more than 4,500 research studies around the world, in 1997, the American Institute for Cancer Research (AICR) and the World Cancer Research Fund issued the expert report, Food, Nutrition and the Prevention of Cancer: a global perspective, which concluded that "a simple change, such as eating the recommended five servings of fruit and vegetables each day, could by itself reduce cancer rates more than 20 percent."5 According to the research conducted to date, carotenoids and other antioxidants and various phytochemicals that are packaged in carbohydrate-containing foods are key players in reducing cancer risk and more likely, it is the combination of these compounds that confer protection. Besides protecting against cancer, researchers have also found that diets rich in fruits and vegetables can lower the risk of heart disease and stroke. One large Harvard study of both men and women found that those who ate eight or more servings of fruits and vegetables a day had a 20 percent lower risk of heart disease than those who ate fewer than three servings daily.6 Another Harvard study of nearly 80,000 women and 40,000 men found that people who ate five servings of fruits and vegetables a day had a 30 percent lower risk of ischemic stroke, the most common type of stroke.7 The other important health benefit associated with carbohydrates is regulating body weight, an area of research that seems to have gotten lost in the low-carb craze. According to the

recent report from the World Health Organization (WHO) and the Food and Agriculture Organization of the United Nations, Carbohydrates in Human Nutrition, people eating a diet high in fruits, vegetables, whole grains and low-fat dairy products are less likely to accumulate body fat than those following a low-carbohydrate, high fat diet.8 The WHO report lists three possible reasons:

High carbohydrate diets have lower energy density than their counterparts, meaning that carbohydrates have less calories weight for weight than fat; Studies have found that both in the form of starch and sugars, carbohydrates aid satiety, which leads people to eat less; Research also shows that very little dietary carbohydrate is converted to body fat mainly because it is a less efficient process for the body. Instead, most carbohydrates are burnt for fuel while the fiber in carbohydrate foods is not digested at all.

How Much Do We Need? Recognizing the many health benefits associated with carbohydrates -- and especially diets rich in fruits, vegetables, whole grains and low-fat dairy foods -- the Dietary Reference Intakes Report issued by the Institute of Medicine in 2002 recommended that Americans get the majority of their calories a day from carbohydrates.9 Specifically, the IOM report states that:

Adults should get 45 percent to 65 percent of their calories from carbohydrates, 20 percent to 35 percent from fat, and 10 percent to 25 percent from protein. The minimum amount of carbohydrate that children and adults need for proper brain function is 130 grams a day. Added sugars should comprise no more than 25 percent of total calories consumed. The IOM report was designed for normal weight individuals; overweight people need far less. For adults 50 years and younger, the recommended total intake for dietary fiber is 38 grams for men and 25 grams for women. For those over 50, it is 30 grams and 21 grams respectively.

Summing It Up For maintaining good health and weight control, nutrition and public health authorities agree that the bulk of a persons calories should come from carbohydrates and especially, from fruits, vegetables, whole grains and low-fat dairy products. Of equal importance, experts stress the importance of variety so that people will have access to all the essential nutrients and fiber available through carbohydrate-containing foods. ###