Why You Should Eat Carbohydrates
New research suggests eating the right kind benefits women in midlife and beyond.
Carbohydrates are probably the most misunderstood of all macronutrients. They’re unfairly blamed for weight gain, especially during perimenopause, and often banished from the diet. But that’s a mistake. There are plenty of reasons to include carbohydrates, and a recent JAMA Network Open study suggests how foolish it is for midlife women to carve out them out.
What Are Carbohydrates?
Carbohydrates are the body’s primary source of energy because they’re easily digested to glucose, the energy that cells require in a steady supply.
With the exception of milk, carbohydrates are found only in plant foods. Carbohydrates are classified as simple sugars or as complex carbohydrates, a group that includes starch and fiber.
Sugars are the most basic carbohydrate form. Sugars are either monosaccharides with one sugar unit, or disaccharides, with two sugar units that the body digests quickly. Simple sugars are often referred to as refined or “low-quality” carbs.
Simple sugars are abundant in foods such as honey, maple syrup, baked goods, candy, and ice cream, and sugars are added to packaged products including ketchup, flavored yogurt, and granola bars. Refined grains, including chips, pretzels, and white bread also pack simple sugars. Fruit and milk contain naturally occurring simple sugars (lactose is the carbohydrate in milk).
Complex carbohydrates, such as starch, are composed of multiple sugar units and take longer to digest than simple sugars. Complex carbohydrates, which also includes fiber, are called “high-quality” carbohydrates. Whole grain breads and cereals, vegetables, lentils, and legumes (beans), are examples of foods with starch and fiber. The body can’t digest fiber, but the beneficial bacteria in the gut ferment it to support gut health and overall wellbeing.
Lean more about fiber here.
Carbohydrates and Weight Control
Weight gain happens when you eat more calories than your body uses. Except for fiber, carbs provide four calories per gram (one gram of protein also has four calories and a gram of fat has nine). Fiber adds very little to your calorie intake, but the body manages to absorb some of its energy.
It’s possible to eat carbohydrates and still lose or maintain weight. A 2022 Cochrane Database of Systemic Reviews found no difference in weight loss when people with overweight and obesity consumed a weight loss eating plan that was either a low‐carbohydrate or a balanced‐carbohydrate diet. In the same year, a study published in the European Journal of Clinical Nutrition concluded that a high-carbohydrate, low-fat diet was just as effective for weight loss as a low-carbohydrate, high-fat diet.
Carbohydrates, Glucose Spikes, and Diabetes
The body converts the simple sugars and starch you eat to glucose, the form of carbohydrate that cells use to satisfy energy needs. During digestion, the pancreas releases insulin, a hormone that helps lower levels of glucose in the blood by getting it into the cells.
Elevated blood glucose levels are a normal reaction to eating. Unless you have prediabetes or diabetes, you don’t need to give much thought to glucose spikes as a health issue. Consuming simple carbohydrates, such as candy, causes blood glucose to spike higher than complex carbohydrates, such as whole grain cereal. However, it’s unlikely that a high-carbohydrate diet contributes to type 2 diabetes risk unless it has excess calories that cause overweight or obesity. Having overweight or obesity is a risk factor for developing type 2 diabetes.
As estrogen levels fall during the transition to menopause, some women may become less responsive to insulin, resulting in a condition called insulin resistance (IR). A diagnosis of insulin resistance is considered serious because it can lead to prediabetes and type 2 diabetes. However, having overweight or obesity is also a risk for IR, and lower estrogen levels are not always the culprit.
People with prediabetes and diabetes may need to limit some carbohydrate as well as fat and protein from to better control their weight and blood glucose levels, but they don’t need to avoid carbohydrates. In fact, the American Diabetes Association Standards of Medical Care in Diabetes recommend that people with diabetes follow a balanced eating pattern that minimizes added sugars, such as table sugar, honey, and maple syrup, and includes dairy products, whole grains, and fruit.
While we’re on the topic of fruit, please ignore influencers who suggest fruit has negative health effects because it contains sugar. Fruit may contain natural simple sugars, but it also supplies vitamins, minerals, phytonutrients, and fiber. A 2022 European Journal of Nutrition study found that eating fruit can help prevent type 2 diabetes in people with normal blood glucose levels.
Why You Shouldn’t Skimp on Carbohydrates
A shortage of carbohydrate in your midlife eating plan can backfire in several ways.
• It forces the body to use protein for energy, which takes it away from its main job of building and repairing muscle tissue and providing the raw materials to produce hormones, enzymes, neurotransmitters, and all the other compounds that keep you alive and at peak function.
• Restricting your favorite carbohydrate-rich foods like bread, pasta, and rice can lead to binging because you feel deprived.
• It can aggravate “brain fog” and tank energy levels. The brain prefers glucose as its energy source, and you may feel lethargic which could cause you to eat more, exercise less, or both.
• It’s difficult to include the suggested amount of fiber, vitamins, and minerals on a very low-carbohydrate diet. Including carb-rich foods with fiber, such as fruit, vegetables, beans, lentils, and whole grains as part of a balanced eating plan helps you get the nutrients you need and aids in weight control.
Read more about fiber and weight control here.
Eating Carbohydrates Supports Healthy Aging
The JAMA Network Open article examined the association between carbohydrate intake and healthy aging in more than 47,000 women who were less than 60 years old at the beginning of the study. At the end of the 32-year follow-up period, the women were ages 70 to 93 years.
The study defined healthy aging as living to age 70 without having developed at least one chronic disease, such as type 2 diabetes, heart attack, or cancer (except for nonmelanoma skin cancer), and eight other conditions. Healthy aging also meant no impairment in memory or physical function, and being in good mental health.
The study found that total carbohydrate intake and high-quality carbohydrate intake were more likely to result in mental and physical wellbeing later in life. High-quality carbohydrate and fiber intake during midlife was associated with 31% and 17% greater odds of healthy aging in women. However, refined carbohydrates, considered to be low-quality, were linked with 13% lower odds of healthy aging, independent of Body Mass Index.
The researchers didn’t consider how high-quality carbohydrates benefited health in this study. However, they did find that greater total carbohydrate intake corresponded to more fiber and other high-quality carbohydrates in the diet, which may help explain the favorable associations with healthy aging.
The results of the JAMA Open Network study are in line with another 2016 observational study published in The Journals of Gerontology: Series A that found dietary fiber, including from fruit and grains, was associated with healthy aging in men and women. A 2024 Frontiers in Nutrition review notes that fiber helps prevent and manage conditions such as type 2 diabetes, obesity, and chronic inflammation. A higher dietary fiber intake is associated with decreased levels of chronic markers of inflammation in the blood that may negatively affect metabolic pathways related to aging.
How to Get the Carbohydrates You Need
How much carbohydrate should you eat? A 2018 Lancet Public Health observational study found that both high- and low-carbohydrate diets were linked to an increased death rate during a 25-year study period. The researchers concluded the sweet spot for carbohydrate intake was about 50-55% of total calories. In the same study, lower-carbohydrate eating plans with protein and fat from plant sources and foods with high-quality carbohydrate and fiber, such as vegetables, nuts, nut butters, and whole grain breads, were linked to a lower death rate, suggesting that this approach is also beneficial to wellbeing.
You can tally the carbohydrate you eat on a variety of tracking devices, but it’s not necessary. Choose to include most of your carbohydrates from nutritious foods with high-quality carbohydrates. Foods rich in added sugars, such as sugary soft drinks, cookies, and chips typically offer little more than calories, so limit them. Though fruit and plain milk contain naturally occurring simple sugars, they are not on the list of foods to avoid because they’re nutrient-rich.
Depending on your calorie intake, including five to six servings of grains, at least five servings of fruits and vegetables (combined) daily and plant proteins such as beans and lentils will help you to get the carbohydrate you require.
If you need more information about what constitutes a serving size for each food group, visit MyPlate.gov or check out the lists provided in the book I wrote with Hillary Wright, MEd, RDN, The Menopause Diet Plan, A Natural Guide to Hormones, Health, and Happiness. The book also contains balanced sample meal plans for three different calorie levels that contain about 50% carbohydrate.
EXCELLENT summary. Women are really putting their lean mass (mostly muscle) and overall health at risk by equating all carbs as “bad” and over restricting them. Great point about needing carbs for fuel to spare protein from being burned as a calorie source. Oversimplification by influencers is confusing a lot of women!
Important topic!