Is one carbohydrate truly better than another? With multiple media messages circulating about sugar, complex carbohydrates, fiber, low carb diets, and how sugar and bad carbs are making us fat and insulin resistant, it is hard to know the real truth behind carbohydrates. When I first decided to address this topic, I thought the answer would be simple if I relied solely on conventional wisdom. However, after much research and thought, the road that leads to the answer is anything but simple.


To even begin this discussion you must first have a good understanding of what carbohydrates actually are. Many people tell me, "I have been cutting my carbs to lose weight" but in fact they are cutting out breads, rice and pasta and eating plenty of milk, vegetables and fruit, unaware that those items also contain carbohydrates.

So, what does the carbohydrate group include? Below is a rough breakdown of the carbohydrate group:

  • Starch such as bread, pasta, rice, cereal grains and starchy vegetables such as potatoes (white and sweet), beans and peas
  • Fruit and fruit juices
  • Non-starchy vegetables and vegetable juices such as spinach, carrots, tomatoes, onions, and eggplant
  • Milk and milk-type products such as milk, yogurt, pudding, soy milk and rice milk
  • Sweets and other carbohydrates including a variety of items with added sugars including baked goods, regular soft drinks, syrups, jellies, and even some condiments such as barbecue sauce, salad dressings and ketchup

With that being said, what is recommended by National Academies Institute of Medicine is that adults, to prevent chronic disease, should consume 45% to 65% of their calories from carbohydrates, 20% to 35% from fat, and 10% to 35% from protein.

With approximately half of your diet containing, carbohydrates it is no wonder that carbohydrates are a hot topic at the forefront of discussions concerning weight control, development of diabetes, heart disease and even cancer.

The Claims:

People have been studying carbohydrates in all of its forms for the past century. This is by no means a new topic in the medical community. But why is there so much confusion in the media? Some say sugar is bad to eat, some say otherwise, some recommend diets high in complex carbohydrates, and some recommend cutting carbs completely. We are receiving mixed messages as consumers from media entities, diet book authors, and even some nutrition experts.

So, let's examine the claims. The first claim that is very popular is that eating foods high in added sugars makes us fat. Sugar is composed of sucrose, which is a disaccharide made up of two monosaccharides: glucose and fructose. Another sweetener on the market is high fructose corn syrup, often used in regular soft drinks. The claim that sugar makes us fat is that when sugar enters our bloodstream it causes our blood sugar to rise, which coincidentally happens when we eat any carbohydrate. In both cases the pancreas produces insulin to bring our blood sugar down. However, this claim states there is a difference when eating added sugars versus natural sugar found in fruit and milk. When eating added sugar the pancreas produces more insulin than it does when exposed to natural sugar, which in turn causes our bodies to deposit excess fat. Thus, this school of thought claims eating added sugar makes us fat.

Another similar claim is that eating sugar gives us diabetes. Conventional wisdom has taught me that sugar does not give people diabetes; excess calorie consumption, meal skipping, and obesity are more likely predictors of developing diabetes than sugar consumption. Nonetheless, there is a convincing claim that sugar gives us diabetes through biochemistry, not simply over-consumption of calories from sugar-sweetened foods due to high palatability. This claim states that sugar, but most specifically fructose, is metabolized by the liver and converted into fat, specifically the saturated fatty acid, palmitate. This saturated fat raises our LDL cholesterol and accumulates in the liver causing a condition known as fatty liver, which leads to insulin resistance and metabolic syndrome. Being insulin resistant and having metabolic syndrome are common precursors to developing type 2 diabetes.

While the evidence is not 100 percent convincing for nutrition experts to start recommending eliminating sugar from the diet, limiting added sugars is definitely on the radar. The USDA recommends that we get no more than 6% to 10% of our total calories from added sugar. That's about nine teaspoons a day for most of us.

So, what's the bottom line? Is cutting carbs and added sugar the answer to weight control? Is cutting sugar the cure to the diabetes epidemic? The answers, for now, are not crystal clear, but if you follow these simple steps you should be able to stay healthy.

How to Spot a Good Carb:

The latest trend in carbohydrates is separating the good from the bad. The good being high fiber complex carbohydrates that take longer to digest and that do not cause blood sugar peaks and valleys. The bad being refined carbohydrates and foods made with any added sugars or refined grains that cause sharp peaks and valleys in blood sugar levels.

Here is an easy breakdown of both categories:

Good carbs include:

  • 100% whole grain or whole wheat bread, pasta, cereal, and crackers
  • Beans and lentils
  • Starchy vegetables such as acorn squash, sweet potatoes, and green peas
  • Any non-starchy vegetables such as: carrots, broccoli, spinach, bell peppers, cucumbers, green beans and cauliflower
  • Whole fruit (not juice) and dried fruit in moderation. Fruit is naturally high in fructose but when eating the fresh or dried form in moderation it also contains fiber, which blunts the rise of your blood sugar.
  • Low-fat or fat-free milk and yogurt. Milk and yogurt are high in lactose, also a natural sugar, but milk and yogurt, in particular Greek yogurt, are also high in protein, which does the same thing as fiber: blunt the rise of your blood sugar.

Bad carbs include:

  • Sugary baked items such as cakes, cookies, brownies, and any other sugar-rich dessert.
  • Any refined flour or "white" bread, rice or pasta products. These are often listed on the ingredient label as "enriched wheat" ingredients.
  • Sugar-sweetened or high fructose corn syrup sweetened soft drinks, juices, and other beverages
  • Any added sugar, whether refined, in the raw, or in the form of honey, jelly, syrups or sugar sweetened condiments.

With many products it is hard to tell by the Nutrition Facts label whether the food is sweet from natural sugar or from added sugar. The best way to determine this is to check the ingredient label. See if ingredients such as high fructose corn syrup, white sugar, cane sugar, or brown sugar are listed in the ingredients. If they are listed within the top three or four ingredients, then it is a high "added sugar" product, and is considered a bad carb.

More confusion also arises with grains that masquerade as a good carb but also contain some bad carbs. The best example of this is "made with whole grains" breads, pasta and cracker products. Typically, these products contain some whole grains or whole wheat but also contain refined or enriched wheat flour, which is considered a bad carb. If you check your ingredients and the front of the label for 100% whole grain or 100% whole-wheat ingredients, you can be sure you are eating a good carb.

The Consensus:

While aspects of carbohydrate consumption may still be up for debate in the scientific community, we can all agree that high fiber, complex carbohydrates have multiple health benefits including preventing the development of diabetes, heart disease and cancer.

Happiness is one of the crucial elements to success with weight management and many of the bad carbs listed bring people enjoyment and pleasure. Most people would be unhappy skipping out on a piece of their favorite cake on their birthday. This is why the mantra for most dietitians is, "Everything in moderation." However, this phrase is often abused and used as an excuse to overeat or eat unhealthy foods frequently. So, if you visit my office, I will quantify what "moderation" actually means in terms of carbohydrates so you can confidently live your life free of carb-confusion.

Rebecca M. Lee, RD, LDN, is the registered and licensed dietitian/nutritionist at East Jefferson General Hospital's Wellness Center. Lee specializes in adult weight management, chronic disease prevention and sports nutrition. To schedule an appointment with Lee, call: (504) 849-6801, (504) 849-6868 or e-mail: