Perspective: Defining Carbohydrate Quality for Human Health and Environmental Sustainability

Abstract

Plant foods are universally promoted for their links to improved human health, yet carbohydrate-containing foods are often maligned based on isolated, reductionist methods that fail to assess carbohydrate foods as a matrix of nutrients and food components. Currently accepted positive carbohydrate quality indices include plant food, whole-grain content, and dietary fiber, while negative health outcomes are linked to high intakes of added sugar and high glycemic index. More recently, negative health aspects have been linked to ultra-processed foods, which are often high in carbohydrates. Yet, carbohydrate staples such as grains and dairy products are both enriched and fortified, resulting in these carbohydrate foods containing important nutrients of concern such as dietary fiber, potassium, vitamin D, and calcium. This Perspective analyzes carbohydrate metrics used in dietary guidance and labeling and finds limitations in accepted indices included in standardized quality carbohydrate definitions and also proposes additional indices to benefit both human and environmental health. As nutrition recommendations shift away from a single-nutrient focus to a more holistic dietary pattern approach that is flexible and adaptable for each individual, it is necessary to determine the quality components that make up these patterns. This review concludes that current approaches that demonize staple carbohydrate foods do little to promote the recommended patterns of foods known to improve health status and reduce disease risk.

Perspective: Does Glycemic Index Matter for Weight Loss and Obesity Prevention? Examination of the Evidence on “Fast” Compared with “Slow” Carbs

“…We contend that GI is an imprecise measure of the glycemic response of a food when applied to foods in a meal, and that the GI assigned to foods from an FFQ may differ significantly from actual GI. Nutrient density, dietary fiber and whole-grain content of carbohydrates, and percentage of added sugar, are more important qualities ( 17 , 18 , 78 ). Further, a focus on staple carbohydrate foods and the positive nutrients they contribute to diet quality as compared with the detractor nutrients associated with indulgent foods is important in characterizing the quality of carbohydrates.…”

A New Carbohydrate Food Quality Scoring System to Reflect Dietary Guidelines: An Expert Panel Report

“…Fiber and free sugar content of CFs are commonly used nutrient-based metrics for assessing carbohydrate quality [ 4 , 15 ]. This analysis is built on earlier models of CF quality that were based on 10% cutoffs by weight for sugar and fiber and which had been used to assess diet quality in relation to cardiovascular disease risk [ 16 , 17 ].…”

Dietary Fats, Human Nutrition and the Environment: Balance and Sustainability

“…Dietary guidance around the world has evolved into desirable dietary patterns. Recommendations now support food practices, such as the Mediterranean diet, which are often high in dietary fat, but include other recommended foods, such as vegetables, fruits, legumes, and whole grains ( 20 ). These dietary patterns have implications beyond cardiovascular disease with new emphasis on brain health, gut health, and weight management.…”