Should you eat pasta? Sure, with caveats

A new study has put the health — or at least weight — benefits of pasta in the headlines. That study, published in the British Medical Journal, is a meta-analysis of prior studies examining the effects of pasta consumption on weight, and related measures of body composition. All of these intervention trials examined pasta in the context of low-glycemic dietary patterns.

As the authors detail in the discussion of their paper, pasta, itself, is a low-glycemic food. This is in part due to the varieties of wheat used, and in part due to the extrusion process intrinsic to pasta production. While there are health advantages to whole grain as compared to refined grain pasta, even standard (refined) pasta is low-glycemic, and higher in nutrients as compared to other applications of the same ingredients in products such as bread.

Overall, the inclusion of pasta in low-glycemic diets was associated with moderately greater weight loss, and general improvement in measures of body composition. The clearest implication of this is not that eating pasta without restraint will cause weight loss, but that weight consciousness is not a reason to avoid pasta as part of a sensible diet. The findings of the new metaanalysis align with prior research, including subgroup analysis suggesting that weight outcomes were better for pasta in the context of high-carbohydrate than high-protein diets.

Personally, I eat pasta routinely, mostly because I love it. I eat whole grain pasta preferentially. I probably did this at first for health benefit, but that was many years ago. I do it now because I prefer it. When it comes to taste buds, familiarity breeds not contempt, but preference.

Pasta figures famously in some variants of the traditional Mediterranean diet, which in turn figure among the diets practiced by the longest-lived, most vital populations known. As diverse studies continue to highlight the health benefits of traditional Mediterranean dietary patterns, enthusiasm for them among experts in nutrition is predictably strong and widespread.

My conclusion about the new meta-analysis is that the exact benefits of pasta may be hard to isolate. But arguments against it because it is a “carbohydrate” are misguided, and misleading.

As fate would have it, my wife and I are just back from leading a culinary tour through Sicily. We ate a fair amount of excellent pasta, as the Sicilians tend to do. Despite their annoying penchant for smoking, Sicilians are known for healthy aging, and enjoy generally better health and greater life expectancy than we do in the U.S.

So, should you eat pasta? The addition of whole grain pasta is apt to enhance the quality of modern diets, often deficient in whole grains and the fiber it provides. It depends in part on what you eat with it. There is, obviously, a big nutritional difference between pasta fagiola (a traditional, vegan dish of pasta and beans; we experienced it in Sicily with fava beans in particular) or pasta prima vera (pasta with a mix of vegetables), and fettuccine Alfredo (a dish of fettuccine pasta, cheese, and butter).

And, of course, it depends on the always important but routinely neglected “instead of what?” question. I suppose somebody, somewhere might be choosing between whole grain pasta and, say, whole grain couscous or bulgur wheat. Acknowledging the potential glycemic advantages of pasta, this is basically a lateral move. Somebody somewhere might eat more pasta, fewer hot dogs, and would certainly be trading up. Pasta in lieu of vegetables, beans, legumes, or highly nutritious grains such as quinoa would make little sense.

And, as ever, dose matters. Wholesome, real, simple, minimally processed, mostly plant foods are required to make up a wholesome, healthful diet. But so, too, is balance and sense in the overall assembly. The right place and proportions for pasta in an ideal diet are conveyed nicely by variants on the Mediterranean diet theme that have stood the test of time.

If you need any help getting past the “carbs will be the death of you” argument, we might turn to the Sicilians, who as noted, eat pasta routinely. Even despite their smoking, they live longer, leaner, and generally healthier than we do. Feel free to dine accordingly.