The carbohydrate controversy - Healthy Lifestyle - Brief Article

For years, it was a given that the most heart-healthy diet was low in fat and high in carbohydrates: fruits, vegetables, legumes, grains and other starches. But lately, experts have qualified the high-carb part, saying that overloading on carbohydrates can make you fat--and actually up your risk of heart disease. What now?

So far, many scientists who help set dietary guidelines are holding fast: Carbohydrates, they contend, should still make up the largest share--55 to 60 percent--of our daily calories.

But, there is some alarm about both the quantity and quality of the carbs in our diet. Eat too many, especially too many of the wrong kind, and you may, indeed, be courting heart disease.

Quantity

As to amount, the bottom line is simple: calories. Carbs have plenty of them, yet we tend to dismiss this. "Often, when we cut back on fat, we feel we can eat much larger portions of carbohydrates," says Amy Soccoccia, R.D., a dietician at the WakeMed Heart Hospital in Raleigh, N.C. Not true. Any excess calories we eat--whether from a cream sauce or starchy pasta--is stored as excess fat. And excess body fat makes us more susceptible to heart disease.

Quality

Recent research suggests that the kinds of carbs we eat matter as much as the amounts. "We know that there are good and bad fats," says Simin Liu, M.D., director of nutrition research and assistant professor of medicine at Harvard Medical School. "Similarly, we now know that there are good and bad carbohydrates."

This is not an entirely new concept. Dietary guidelines have long urged eating more complex carbs, such as whole grains, over simple ones, such as sugary foods. But Liu believes that a better measure of a carbohydrate's worth is the glycemic index, a point-system that rates a food on how quickly it sends insulin and blood sugar (glucose) soaring. Carbs with a high glycemic index raise blood sugar and insulin rapidly; those with a low index boost it more slowly, which is healthier.

In the last two years, Liu and his colleagues have linked high-carb diets with a high glycemic index to an increased risk of heart disease--especially in overweight women (recent studies are only following women). They're now looking at whether carbohydrates with a high glycemic index also boost blood pressure and body fat. Though the work is ongoing and somewhat controversial, many experts are listening.

Does this mean we all have to start carrying a glycemic index chart in our back pockets? Not according to Liu, who believes that there are just two basic ideas we need to remember.

* First, carbohydrates, such as potatoes, white bread, white rice and other refined or highly starchy foods register highest on the glycemic index. So eat these sparingly. Opt for their whole-grain counterparts instead, like whole-wheat bread and brown rice.

* Second, rely on fruits, legumes and vegetables for the greater part of your carbohydrate intake. Although the glycemic numbers among fruits and vegetables vary, most are at the lower end of the scale.

Hardly anyone--including those who dismiss the idea that we need to be aware of a carb's glycemic index--would argue with this healthy diet regimen. Fruits, vegetables and whole grains simply supply more vitamins, minerals, phytochemicals and fiber than either their refined or super-starchy starchy counterparts. That alone will help you guard your heart.

At-A-Glance Guide to Heart-Smart Carbs

Eat abundantly          Eat moderately        Eat sparingly

Fruits and vegetables   Whole wheat pasta     Cookies, cakes and candy

Lentils                 Brown rice            Refined bread, bagels,
                                              pastas, grains

Dry beans               Wild rice             White rice

Air-popped popcorn      Whole grain breads    Potatoes

                        Whole grain cereals   Potato chips and
                                              similar highly processed
                                              carbs

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