Follow nutritional trends long enough and every macronutrient will eventually be blamed for everything. Fat was the villain in the nineties. Then carbohydrates took the shift. Protein currently enjoys good PR — though it is only a matter of time before it gets its own documentary with dramatic music.
The problem with the sentence "carbohydrates make you fat" begins with the fact that carbohydrates are not one food.
Lentils are a carbohydrate. Oats are a carbohydrate. An apple, a potato, white bread, Coca-Cola, beans and a slice of cake all contain carbohydrates — but treating them as the same product simply because they share a macronutrient is nutritionally absurd.
Carbohydrates are one of the main sources of energy in the human diet. Glucose is an important fuel for a large number of tissues, and the body has sophisticated systems for storing and regulating it. The fact that we can survive on very few carbohydrates — thanks to gluconeogenesis and ketones — does not mean that eating them is a mistake. We can also survive without olive oil; that is not an argument against salad.
A far more useful distinction is the one that looks at the quality of carbohydrate sources.
Whole grains retain more fibre and grain components than refined ones. Legumes deliver carbohydrates together with protein, fibre and micronutrients. Whole fruit contains natural sugars, but also water, fibre and a large number of bioactive compounds. Vegetables offer an entire spectrum of different carbohydrates and fibres.
On the other side, sweetened drinks can deliver large amounts of sugar with very little satiety. Refined sweets combine sugar, starch and fat in a form that is very easy to overconsume. Both are carbohydrates, but the label has not helped us understand the difference.
Large epidemiological studies and meta-analyses are, for precisely this reason, far more consistently linking the quality of carbohydrates — particularly fibre intake and whole grain consumption — with health outcomes, rather than the idea that carbs as a category should be minimised as much as possible.
A large series of systematic reviews and meta-analyses published in The Lancet showed that higher fibre and whole grain intake are associated with lower risk of cardiovascular disease, type 2 diabetes, colorectal cancer and all-cause mortality. This does not prove that every slice of wholegrain bread is medicine — but it does seriously complicate the claim that carbohydrates as a group are the problem.
So what about insulin?
Yes, carbohydrates raise glucose and insulin more than fat does, and insulin plays a role in energy storage. From this arose the popular idea that insulin is the primary driver of obesity and that reducing carbohydrates enables fat loss independently of calories.
Controlled metabolic ward studies do not support such a simple version. When energy and protein are controlled, both low-carb and low-fat approaches can produce body fat loss. Hormones are part of energy metabolism, but they do not override energy balance.
This does not mean macronutrient distribution is unimportant. For some people, a low-carb approach can dramatically reduce appetite and ease control of intake. Athletes with high training volumes may have quite different needs. Someone with diabetes may need to think much more carefully about the quantity and timing of carbohydrates. Context, again, matters more than a slogan.
For everyday eating there is an even simpler way to look at things.
A bowl of porridge alone and a bowl of porridge with nuts, seeds, fruit and an additional protein source are not the same experience. Bread alone and bread with eggs, avocado and vegetables are not the same meal. Adding protein, fat and fibre changes satiety, texture, flavour and the rate of digestion.
At VERA, therefore, we do not try to build a carbohydrate-free menu. Oats, bread, fruit and other carbohydrate sources have a perfectly natural place in the food we want to eat. What interests us far more is what they come with — and how good the whole meal is.
The greatest irony of the war on carbohydrates is that the first casualties were usually the very foods that bring most people what they are lacking: fibre.
Perhaps the question should not be how few carbohydrates can I eat?
Better: where do my carbohydrates come from?
The answer — mostly from vegetables, fruit, legumes, oats and other minimally processed sources, with the occasional dessert because life is normal — is probably less exciting than a new diet.
But nutrition has an uncomfortable habit: the most useful answers are precisely the ones that are hardest to sell as a revolution.
Try it at VERA — specialty café and wellness bistro, Nikole Spasića 4, Stari Grad, Belgrade.
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