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On a dinner date at one of my favourite Italian restaurants, my friend looked at me aghast when I ordered a mushroom risotto and some garlic bread. Given that I was a medical doctor specializing in nutrition, he said, I should know better than to order a “carb" meal after sunset. He, of course, went on to order a “healthy" high-protein steak for himself.

photoWhile I was amused by his reaction, what he said did not come as a surprise. In fact, this bias against carbohydrate foods is something I hear all the time from patients at the clinic. Why do carbs get such a raw deal when it comes to weight management and overall health? And why are we being fed this incorrect dietary message?

I think it all started with the Atkins Diet—the pioneer of all things low-carb, this diet promised us that eating eggs, steak, and even butter in unlimited quantities would help us lose weight, while carbs like pasta, sugar, rice, bread or potatoes were the obesity culprits. It even claimed that fats are harmless. Since the Atkins plan had all of Hollywood endorsing it, it became a huge hit, and poor carbs were criminalized as the “edible enemy".

So here’s a guide to carbs—what they are, what they are needed for and what role they play in our body—so you can gauge for yourself if you need to be carb-phobic.

All the energy that the body uses comes from the food we eat and the fluids we drink.

These nutrients are predominantly broken into three classes: carbohydrates, fats and proteins.

Quite simply put, our body uses carbs to make smaller sugars (glucose, fructose, galactose), the fuel that gives you energy and helps keep everything going.

Your body can use glucose immediately if required (for example, if you are exercising) or store it in your liver and muscle tissues in the form of glycogen for later use. Once these glycogen stores are filled up, any extra gets stored as fat. When we don’t consume enough carbohydrate, protein is broken down to make glucose for energy. Since the primary role of protein is as a building block for muscles, bone, skin, hair and other tissues, relying on protein for energy limits the ability to build and maintain tissues. Additionally, this puts stress on the kidneys, which now have to work harder to eliminate the by-products of this protein breakdown.

Carbohydrates have other specific functions in the body, including fuelling the central nervous system and the brain.

Now that it’s clear why carbs are needed, let’s understand the different types of carbs, so you’re not misled by blanket pronouncements on the dangers of consuming them.

Simple vs complex

Carbohydrates are divided into simple and complex forms. Simple carbs or refined carbs are absorbed and converted to energy very quickly and provide a rapid source of energy. Simple carbohydrates include sugars such as fruit sugar (fructose), corn or grape sugar (dextrose or glucose), and simple table sugar (sucrose).

Refined grains are stripped of their outer bran coating and inner germ during the milling process, leaving only the endosperm. Carbs like white or polished rice, white bread and white pasta are made from such processed grains.

Complex carbohydrates, on the other hand, take longer to be digested and absorbed into the body. They also take longer to break down, and therefore provide energy at a slower rate than simple sugars. This is sustainable energy. Examples of complex carbs are wholegrain breads, brown rice, wholewheat pasta, and breakfast cereal like oats. In the wholegrain, the bran, germ and endosperm are all still present. The bran is a great source of fibre, the germ is a source of protein, vitamins and minerals, while the endosperm supplies most of the carbohydrates, mainly in the form of starch.

As you can tell, unrefined or wholegrain carbs provide far more nutrients than their refined counterparts, and because they release energy in a slow and sustained manner, they also keep you satiated and energetic for much longer. Wholegrains are rich in phytochemicals and antioxidants too, which help protect against heart disease, certain cancers, and diabetes.

Complex carbs also contain a healthy dose of
fibre. Fibre passes through the body undigested, and though it doesn’t provide nourishment, it is essential for the body’s healthy functioning. Fibre comes in two varieties: soluble fibre, which dissolves in water, and insoluble fibre, which doesn’t. Soluble fibre binds to fatty substances in the intestines and carries them out as waste, thus lowering levels of low-density lipoprotein (LDL, or bad cholesterol). It also helps regulate the body’s use of sugars, helping to keep hunger and blood sugar in check. Insoluble fibre helps push food through the intestinal tract, and helps prevent constipation.

While overeating carbs can cause obesity, the problem lies not in the carbs but in the act of eating more than you should, and this applies to protein and fats too. Carbs also get a bad reputation because of the things that are eaten with them. For example, potatoes themselves are not bad, but potatoes with a heavy dollop of fattening cream are another matter altogether. Similarly, wholewheat pasta in a tomato or pesto sauce with veggies and lean meat is great, but white pasta in a cheese sauce is asking for trouble.

Drastically reducing carbs, on the other hand, can do more harm than good. Sure, you may lose a few quick kilos, but will you keep them off? Very unlikely. Diets with drastically low carbs inevitably lead to overindulgence on junk food.

A good “healthy" diet, I believe, even if it is focused on weight loss, should always make you feel high on energy levels, which is not possible on a very low-carb diet. A balanced diet, according to the US food and drug administration, comprises 45-60% of your daily caloric requirement from carbs, 20% from proteins, and 15-20% fats.

Carb denial also leads to stress, irritation, even depression. Stress leads to increased cortisol levels, which boost appetite and lead to bingeing. Eating the right carbs, on the other hand, can help with mood, because it increases the level of the hormone serotonin, which is essential for mood and sleep regulation.

The good ones

Here is a list of foods that provide complex carbs

• Fruits and vegetables like bananas, pears, oranges, cherries, apples, onions, carrots, broccoli and green beans. These are all sources of complex carbs, and provide essential nutrients like vitamins and minerals.

• Wholewheat, multigrain or whole rye bread; wholewheat pasta, brown rice and ‘rotis’ are all great sources of complex carbs.

• Beans and legumes provide complex carbs as well as protein.

Vishakha Shivdasani is a Mumbai-based medical doctor with a fellowship in nutrition. She specializes in controlling diabetes, cholesterol and obesity.

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