The Science and Politics of Nutrition Series - Dietary Carbohydrates: Role of Quality and Quantity in Chronic Disease
Posted:
2019-07-31
Overview
The British Medical Journal (BMJ) launched a series of open-access, peer-reviewed articles under the title, Food for Thought - The Science and Politics of Nutrition. The series covers a variety of controversial nutrition topics where there are uncertainties in the evidence and debate among experts. The articles aim to bring together a wide range of viewpoints and to discuss the areas of consensus and uncertainty as well as how to move forward with research, policy and guidelines for practitioners.
This featured article in the series provides background information on the role of carbohydrate consumption in human development, the relation between carbohydrate types (chain length, glycemic index and load, fibre and resistant starch, added and free sugar and composite quality indices) and health outcomes, and a narrative overview of how carbohydrates containing foods (grains, potatoes, legumes and fruit) affect health (reviewing salivary amylase) (1). The article is not a systematic review, so needs to be considered a narrative review, in which the authors’ opinions are considered.
Key Messages
The key messages in the article:
- “Human populations have thrived on diets with widely varying carbohydrate content
- Carbohydrate quality has a major influence on risk for numerous chronic diseases
- Replacing processed carbohydrates with unprocessed carbohydrates or healthy fats would greatly benefit public health
- The benefit of replacing fructose containing sugars with other processed carbohydrates is unclear
- People with severe insulin resistance or diabetes may benefit from reduction of total carbohydrate intake” (1).
Additional PEN Content
Upcoming PEN Content
Are diets higher in total dietary fibre (including whole grains, cereals, vegetable, fruit, and legume fibre) recommended to decrease the risk of cardiovascular disease (CVD)?
This practice question is based on a high quality systematic review:
Reynolds A, Mann J, Cummings J, Winter N, Mete E, Te Morenga L. Carbohydrate quality and human health: a series of systematic reviews and meta-analyses. Lancet. 2019 Feb 2;393(10170):434-45. doi: 10.1016/S0140-6736(18)31809-9. Epub 2019 Jan 10. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/30638909
References
- Ludwig DS, Hu FB, Tappy L, Brand-Miller J. Dietary carbohydrates: role of quality and quantity in chronic disease. BMJ. 2018 Jun 13;361:k2340. doi: 10.1136/bmj.k2340. Citation available from: https://www.ncbi.nlm.nih.gov/pubmed/29898880