Carb Quality

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Here at Diabetes Flashpoints, we’ve covered the debate surrounding low-carb diets for people with diabetes. For people who choose to follow a very-low-carbohydrate diet, this is usually where the topic of carbohydrates ends. But for the majority of people with diabetes who do consume substantial amounts of carbohydrate, the question remains: Which carbs are the best ones to eat?

Some people with diabetes find the glycemic index to be a useful guide in predicting whether a given food will lead to a spike in their blood glucose level. But the glycemic index has limits as a tool for deciding whether or not to consume a particular food. Oranges, for example, have by most measures a higher glycemic index than cooked pasta — but it is unlikely that a person will eat enough oranges to disrupt blood glucose levels the way that a spaghetti dinner might. Furthermore, a single high-glycemic-index item might be combined in a meal with other foods rich in fiber or fat, leading to a much slower rise in blood glucose than if it were eaten alone. So the glycemic index is not the only relevant characteristic of a carbohydrate-rich food.

A recent article in the Chicago Tribune examines the concept of good and bad carbs, noting that there is widespread disagreement about certain foods and food categories. According to the article, while almost all dietary experts agree that highly processed and high-sugar foods are bad, items such as white potatoes and pasta elicit controversy (potatoes have a high glycemic index but also a high nutrient content, while pasta is refined but has a relatively low glycemic index). Even whole grains are a matter of debate: Some proponents of particular diets recommend eating them only in structurally whole forms (such as bulgur wheat rather than whole-wheat bread, or steel-cut oats rather than Cheerios). And some diet advocates insist that it’s better to avoid grains altogether — a position common to all variations of the Paleolithic diet, as well as some other non-mainstream diets.

What do you think — is the list of good and bad carbs in the Tribune article a useful guide? Which forms of carbohydrate do you try to incorporate into your diet, and which do you try to avoid? Have you tried following a Paleolithic or a low-carb diet? Do you find certain diets or rules about carbohydrates to be impractical or incompatible with your lifestyle, even if they might support good health? Leave a comment below!

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