Many of the world’s prevalent chronic diseases are preventable in some way. The Center for Disease Control (CDC) says most chronic conditions, such as diabetes and heart disease, can be prevented through healthy lifestyle habits.
For example, many people have prediabetes, a condition where blood sugars are slightly elevated but not high enough to be considered diabetes.
Having prediabetes is a significant risk factor for eventually developing type 2 diabetes. Per the CDC, up to 30% of people with prediabetes will develop type 2 diabetes within five years of their prediabetes diagnosis. If prediabetes is caught early on, it can help reduce the likelihood of turning into full-blown type 2 diabetes.
Ways to help reduce the likelihood of developing a chronic disease include:
- Eating a healthy diet, such as following the Plate Method for guidance
- Getting 150 minutes of moderate to vigorous physical activity per week
- Not smoking
- Limiting alcohol intake
- Getting regular age-appropriate screenings, such as mammograms, colonoscopies, etc.
- Getting enough sleep
- Knowing your family history – this may lead to earlier screenings to catch a disease early on when it’s more treatable
Many people would like to eat healthily, but it can be overwhelming to know what a healthy diet looks like. This is especially challenging when new diets are becoming popular all the time.
What are refined carbs?
One of the most-talked-about (and debated!) aspects regarding healthy diets are carbohydrates. Carbohydrates are a type of macronutrient the body uses for energy. The food groups containing carbohydrates include fruit, vegetables, grains, and dairy products like milk and yogurt.
There are three components to the carbohydrate group: sugars (such as fruit), starch (such as “starchy” vegetables like potatoes, beans/legumes, and grains), and fiber, which is found in plant-based foods. Of all of these, fiber is the only carbohydrate not to raise blood sugar because the body can’t absorb it. As a result, high-fiber foods tend to raise blood sugar less than low-fiber foods.
Carbohydrates are broken down into glucose molecules, or blood sugar, during digestion. Blood sugar levels rise after consuming carbohydrates, which is why people with (and at risk for developing) diabetes are encouraged to eat various foods and be mindful of their carbohydrate portions, as eating a carbohydrate-heavy diet can lead to elevated blood sugars.
Carbohydrates have the biggest impact on blood sugar levels than protein and fat, the other two macronutrients. This is why there is such a focus on carbohydrates when it comes to managing blood sugar levels.
People also focus on carbs because eating carbs triggers the release of insulin, which can increase the amount of fat stored in the body. When there is too much insulin produced, insulin resistance can form, increasing the risk of diabetes and weight gain.
Refined carbohydrates, or refined carbs, have been stripped of some of their nutrients during processing and aren’t in their natural form. Another type of refined carbohydrate is added sugars. Both of these types of carbohydrates are also referred to as “simple carbs/sugars.” When sugar is more simple, the body doesn’t have to work as hard to break it down for absorption, which means it raises blood sugar more quickly than a more complex carbohydrate.
Examples of simple/refined carbohydrates include:
- White bread
- Products made with white/enriched flour
- White rice
- Pastries, muffins, and other sweetbreads
- Sweets and desserts like pie, ice cream, etc.
Another way to spot refined sugars is to look at the ingredient label of a product. It is likely a more refined or simple carb lacking some nutrients and fiber if it has added sugar. Some of the names for added sugar include:
- Agave nectar
- Barbados sugar
- Barley malt
- Beet sugar
- Blackstrap molasses
- Brown rice syrup
- Brown sugar
- Buttered syrup
- Cane juice crystals
- Cane sugar
- Carob syrup
- Castor sugar
- Confectioner’s sugar
- Corn syrup
- Corn syrup solids
- Crystalline fructose
- Date sugar
- Demerara sugar
- Diastatic malt
- Ethyl maltol
- Evaporated cane juice
- Florida crystals
- Fruit juice
- Fruit juice concentrate
- Glucose solids
- Golden sugar
- Golden syrup
- Grape sugar
- High-fructose corn syrup
- Icing sugar
- Invert sugar
- Malt syrup
- Maple syrup
- Muscovado sugar
- Organic raw sugar
- Raw sugar
- Refiner’s syrup
- Rice syrup
- Sorghum syrup
- Turbinado sugar
- Yellow sugar
Refined grains are a type of refined carb. Grains naturally have three parts:
- The hard outer layer is called the bran, which includes fiber and some minerals.
- The core is called the germ, which includes healthy fats as well as vitamins and minerals.
- The endosperm, which is the middle layer containing mostly carbs and a small amount of protein.
When grains are refined, they are stripped of the bran and germ, leaving a low-fiber, lower-nutrient grain. These grains are often enriched with the vitamins and minerals lost during the refining process, so many refined grains have the ingredient “enriched flour” as the main ingredient.
Refined grains are also very low in fiber since the part of the grain highest in fiber is removed during processing. As a result, refined grains are higher in simple, low-fiber carbohydrates, raising blood sugar levels more than complex, high-fiber carbs.
How do refined carbs affect your health?
A diet high in refined carbohydrates tends to cause higher blood sugar and triglyceride (blood fat) levels. It has been associated with an increased risk of developing diabetes, cardiovascular disease (heart disease), stroke, and hypertension (high blood pressure).
Some of the risks of high blood sugar include:
- Cardiovascular disease
- Nerve damage (neuropathy)
- Kidney damage (diabetic nephropathy) or kidney failure
- Damage to the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness
- Clouding of the usually clear lens of your eye (cataract)
- Feet problems caused by damaged nerves or poor blood flow can lead to serious skin infections, ulcerations, and in some severe cases, amputation
- Bone and joint problems
- Teeth and gum infections
Some of the risks of high triglycerides include:
- Thickening of the arteries, which can lead to a heart attack or stroke
- Inflammation of the pancreas
How to avoid refined carbs
A great way to avoid refined carbs is to focus on eating foods in their most whole, natural form. The more a food is processed, the fewer nutrients it can contain. For example, an apple is the least processed and contains nutrients and fiber.
Applesauce is more processed and reduces the fiber content of the apple significantly. It’s not to say that no-sugar-added applesauce is unhealthy, but an apple is better for blood sugar levels and heart health due to its fiber content.
When choosing grains, it’s best to opt for 100% whole grains. These products will usually bear a stamp from the Whole Grains Council, and the ingredients will have the word “whole” in them – enriched flour and wheat flour aren’t whole grains. Multigrain doesn’t always mean whole grain either – it can be a mix of whole grains and refined grains.
When it comes to avoiding refined and added sugars, it’s helpful to look at the line for “added sugars.” The American Heart Association recommends that women don’t consume more than 6 teaspoons (24 grams) of added sugar per day and men keep their added sugar intake below 9 teaspoons (36 grams) per day. It can be helpful to keep an added sugar log for a week or so to get an idea of your baseline added sugar intake so you know where you might be able to stand cutting back on added sugar.
While some foods don’t have added sugar, they can still be very high in sugar – a good example is 100% fruit juice. Even though it’s natural sugar, it’s much more sugar than you’d get from eating a piece of the whole fruit. For this reason, it’s good to be mindful of how much sugar you’re consuming in the form of drinks, as sugary liquids raise blood sugar much more quickly than solid food containing sugar.
Refined carbs vs. complex carbs
Complex carbs are healthier because they are in their more natural state and haven’t been stripped of fiber and other beneficial nutrients. Complex carbs still impact blood sugar levels but tend to cause less glucose spike than refined carbs.
Complex carbs are made up of starches and dietary fiber, which are more complex molecules the body has to work to break down into glucose. The more work it is for the molecules to be broken down, the slower blood sugar levels tend to rise, which is the reason for the term “complex.”
High-fiber complex carbs include:
- Whole grain products
- Whole fresh fruit (not canned or juice)
- Whole vegetables
Complex carbs are often referred to as “good carbs” and refined carbs as “bad carbs.” However, both can be included in an overall healthy diet – it’s more important to focus on how often someone is including complex carbohydrates in their diet vs. refined carbs. It’s possible to eat a mostly whole foods diet and include a refined carb here and there without sacrificing health!
Choosing the right carbs
A good way to check-in and see if you’re eating the most nutritious carbs is to determine if the carbs are in their most natural, whole form without added sugars. If they’re not, then you may be eating more refined carbs and sugar than is optimal for good health.
The Mediterranean Diet has been ranked as the #1 diet for many years and is a prime example of a diet rich in complex carbs and low in refined carbs.
A Mediterranean diet is a style of eating that focuses on plant-based foods. It’s based on foods that people eat in countries such as Greece and Italy, but isn’t limited to those countries.
The Mediterranean diet isn’t as much of a diet as it is a lifestyle. Unlike many fad diets, there aren’t foods that are considered not allowed, nor are there any types of point system, measuring, etc. Because of this, it tends to be easier to adopt long-term, so it is more effective at providing health benefits.
The Mediterranean diet emphasizes plant-based foods as the backbone of the diet. Fruits, vegetables, whole grains, legumes, nuts, and seeds are abundant in this style of eating, as are healthy plant-based fats such as olive oil and avocados. Meat, dairy, processed foods, and refined sugar are avoided, and the emphasis is put on whole foods. While sugary drinks are avoided, moderate amounts of alcohol such as red wine are included, but of course, this is entirely optional.
The different types of foods in a Mediterranean-style diet include:
- Vegetables: Tomatoes, broccoli, kale, spinach, onions, cauliflower, carrots, Brussels sprouts, cucumbers, etc.
- Fruits: Apples, bananas, oranges, pears, strawberries, grapes, dates, figs, melons, peaches, etc.
- Nuts and seeds: Almonds, walnuts, macadamia nuts, hazelnuts, cashews, sunflower seeds, pumpkin seeds, etc.
- Legumes: Beans, peas, lentils, pulses, peanuts, chickpeas, etc.
- Tubers: Potatoes, sweet potatoes, turnips, yams, etc.
- Whole grains: Whole oats, brown rice, rye, barley, corn, buckwheat, whole wheat, whole-grain bread, and pasta.
- Fish and seafood: Salmon, sardines, trout, tuna, mackerel, shrimp, oysters, clams, crab, mussels, etc.
- Poultry: Chicken, duck, turkey, etc.
- Eggs: Chicken, quail, and duck eggs.
- Dairy: Cheese, yogurt, Greek yogurt, etc.
- Herbs and spices: Garlic, basil, mint, rosemary, sage, nutmeg, cinnamon, pepper, etc.
- Healthy Fats: Extra virgin olive oil, olives, avocados, and avocado oil.
Foods not eaten on a Mediterranean diet include:
- Added sugar: Soda, candies, ice cream, table sugar, etc.
- Refined grains: White bread, pasta made with refined wheat, etc.
- Refined oils: Soybean oil, canola oil, cottonseed oil, and others.
- Processed meat: Processed sausages, deli meats, hot dogs, etc.
- Highly processed food: Packaged foods with a long list of ingredients, such as breakfast cereal
This type of eating style has been linked with a reduced incidence of diabetes, heart disease, and overall mortality rate. However, simply focusing on high-fiber foods without refined ingredients such as enriched flour and added sugars can still benefit without following a Mediterranean diet.
Carbohydrates are the sugars, starches, and fiber found in plant-based foods. They are found in fruits, vegetables, legumes, grains, and dairy products like milk and yogurt.
Refined carbs are those that have been stripped of some of their nutrients through processing or have sugars added to them. Diets high in refined carbs have been linked with health problems like diabetes and heart disease.
Healthy carbohydrates are those in their more natural and whole forms, such as whole grains, whole fruits and vegetables, and legumes. Diets rich in complex carbs, like a Mediterranean diet, are associated with improved health outcomes and lower rates of diabetes and heart disease.