Dr Mosley: Carbs aren’t the en­emy, but do ditch pasta

The Scottish Mail on Sunday - - Health -

IT MAY be a new year, but it seems the same old ar­gu­ments are still rag­ing about carbs.

‘Blow to low-carb di­ets’, ran some head­lines last week, in the wake of a World Health Or­gan­i­sa­tion-backed study that found peo­ple who eat the most whole­grain bread, grains and pulses – foods rich in fi­bre, and also car­bo­hy­drate – have the low­est risk of heart dis­ease, stroke and bowel can­cer.

The study’s au­thor, Pro­fes­sor Jim Mann of the Uni­ver­sity of Otago in New Zealand, also hit out at ‘fash­ion­able’ low-carb di­ets, pop­u­larised by celebri­ties.

The find­ings come af­ter a re­port in Au­gust which suggested that those who stick to very low-carb di­ets, mainly of meat and an­i­mal fats – such as the keto, or ke­to­genic diet, and Atkins diet – die four years younger, on av­er­age, than those who eat even large amounts of carbs. Mod­er­ate in­take, how­ever, was linked with the best longevity.

But the sup­port­ers of low-carb eat­ing can point at an­other huge study called Pure, pub­lished in 2017, which looked at the di­etary habits of more than 135,000 peo­ple in 18 coun­tries, which con­cluded that ‘high car­bo­hy­drate in­take was as­so­ci­ated with a higher risk of to­tal mor­tal­ity.’

In other words, lots of carbs are bad. So where does the truth lie?

FIRST… A LES­SON IN CHEM­ISTRY

CARBS, mostly, come in three forms in the av­er­age diet.

First there are sug­ars, made up of sin­gle mol­e­cules of glu­cose, fruc­tose and su­crose. Ta­ble sugar, for in­stance, is typ­i­cally 50 per cent glu­cose, 50 per cent su­crose. Maple syrup is a mix of su­crose, with some glu­cose and fruc­tose, and wa­ter. And so on.

Then there are starchy foods, which in­clude bread and po­ta­toes, but also rice, pasta and break­fast ce­re­als.

These starchy foods are made up of long chains of glu­cose mol­e­cules that get bro­ken down in our guts and re­leased as glu­cose into our blood.

Depend­ing on how highly pro­cessed they are, these foods ei­ther con­tain a lot of healthy fi­bre, or not much.

Then there are fruits, veg­eta­bles and pulses – like lentils – which con­tain vary­ing amounts of carbs, but also con­tain fi­bre.

Fi­bre is ac­tu­ally a form of car­bo­hy­drate which our bod­ies can’t di­gest, but which is great for feed­ing the mi­cro­biome, the two to three pounds of mi­crobes that live in the gut and which are so im­por­tant for the im­mune sys­tem and over­all health.

Ever since the agri­cul­tural rev­o­lu­tion thou­sands of years ago, carbs have formed the ba­sis of most peo­ple’s di­ets. Fruits, veg­eta­bles and starchy foods are cheap and fill­ing, and an im­me­di­ate source of en­ergy. These sorts of carbs made the modern world pos­si­ble.

And yet, obe­sity has spi­ralled over the past few decades. To­day, about 26 per cent of adults are obese – of a weight that raises the risk of a range of health prob­lems, in­clud­ing di­a­betes, heart dis­ease and some can­cers. That’s risen from 15 per cent in 1993. More wor­ry­ingly, one in ten five-year-olds is now obese.

So, what has changed? Well, there is no sin­gle sci­en­tific an­swer. How­ever, many peo­ple ar­gue that we eat more in gen­eral – snack­ing, for in­stance, is a very modern phe­nom­e­non – and par­tic­u­larly con­sume more sug­ary foods.

Pub­lic Health Eng­land’s Na­tional Diet and Nu­tri­tion Sur­vey sug­gests that Bri­tons, on av­er­age, eat more than three times the rec­om­mended 30g a day of ‘free’ sug­ars – that’s sugar added to foods, or found in syrups and fruit juices, and so eas­ily ab­sorbed and laid down as fat.

It is also eas­ier to live a more seden­tary life than it was for gen­er­a­tions be­fore us. The real ar­gu­ment rages around foods like white rice, pasta and po­ta­toes.

These foods don’t con­tain a lot of nu­tri­ents, and lit­tle fi­bre, but they do have a lot of starch. Stud­ies have found that eat­ing a stan­dard por­tion of white rice, po­ta­toes or spaghetti has a sim­i­lar ef­fect on blood sugar lev­els as eat­ing seven to ten tea­spoons of sugar.

So, what does this all mean? Well, not all carbs are equal.

And while a diet con­sist­ing of mod­er­ate lev­els of fi­brous whole­grains and pulses will be ben­e­fi­cial, a diet rich in re­fined starchy carbs won’t be.

WHAT ABOUT LOW-CARB WEIGHT-LOSS PLANS?

WHEN it comes to short-term weight loss, there have been a num­ber of stud­ies show­ing that cut­ting down on all carbs is an ef­fec­tive way to shed the pounds. But, when the low-carb di­eters in these stud­ies are fol­lowed up years later, most have re­gained the weight they had lost.

The same goes for low-fat di­eters who eat lots of re­fined carbs. But those who eat a bal­anced, Mediter­ranean-style diet lose weight and keep it off, ac­cord­ing to re­search. They also ben­e­fit from lower ‘bad’ choles­terol and blood sugar lev­els.

So what’s in this kind of diet? Not much in the way of pizza, pasta, rice or po­ta­toes, but lots of olive oil, nuts – also a good source of fi­bre – oily fish, and veg­eta­bles, and plenty of whole grains, beans and lentils, which are also high in carbs, al­beit ‘healthy’ ones.

Given the choice be­tween a very low-carb, a low-fat or a Mediter­ranean diet, par­tic­u­larly when it comes to long-term ben­e­fits, I think the sci­en­tific ev­i­dence is over­whelm­ingly in favour of the lat­ter.

If you want to lose weight fast, or get your blood sug­ars un­der bet­ter con­trol, then your best ap­proach may be to start off with a low-calo­rie, low-carb Med-style diet un­til you have achieved your goals, then add in more grains and fi­bre for the long-term ben­e­fits this will bring to your mi­cro­biome, and there­fore to you.

You’ll find more in­for­ma­tion and menus at the­fast800.com.

TASTY: But starch in a pasta por­tion has the same ef­fect on the body as ten tea­spoons of sugar

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