String of Pearls

By Peter Galvin, MD

Lately, carbohydrates, or carbs, have gotten a bad rap – but not all carbs deserve it. What makes a carb healthy? It’s not the number of grams on the label, but rather it’s how the carb behaves in your body. Carbohydrates are chains that your body has to break apart, similar to a string of pearls. Digestion is how your body clips those chains into smaller molecules that your cells can use. The more processed a carb is – whether by a factory, knife, or blender – the faster it’s absorbed. And that speed changes how your body reacts. Health isn’t always about what kind of food you eat, but rather it’s how hard your body has to work to process it, and how long that takes. Several factors shape carb response, including fiber content, the carb’s processing, food combinations, and your activity level. Understanding how these factors affect digestion and blood sugar can help you make more informed and personalized choices.

In addition to protein and fat, carbohydrates are one of three macronutrients. The term “macro” means that your body needs them in large amounts to function properly. Carbs are the body’s primary and most readily available source of energy. They are classified based on their chemical structure and how many sugar units they contain. There are three main types: simple carbs, complex carbs, and fiber. Simple carbs are like short strands of one or two pearls that your body can snap apart easily. Complex carbs are longer strands of 10 or more pearls, which takes more time and effort to digest. Fiber looks like a complex carb, but with a twist. The “pearls” are linked in a way that your body can’t break, making them unabsorbable. So, fiber passes through your digestive system mostly intact, playing a crucial role in digestive health, blood sugar regulation, and satiety.

In general, the harder a carb is to break down, the more metabolic benefit it can offer. Digestion isn’t just about what you eat, but how much chewing, cooking, and processing the food has undergone before it hits your bloodstream. Carbohydrates technically are not necessary for human survival but eliminating them completely will cause an issue with gut health. No carbs mean a lack of micronutrients and vitamins plus fiber. Fiber feeds gut microbes that produce vitamins B and K. Carbs are not fattening, but it’s all the processing and what we’re doing to them that makes them so. In the 1990s, when carb consumption was high, obesity rates were lower. Processing carbs is a key factor. Added sugars and refined grains are linked to weight gain. The more a carb is refined, the faster its sugar gets into your bloodstream. Think instant oatmeal vs. 30-minute oatmeal.

When shopping, stick to whole, minimally processed foods and whole grains, for example brown rice and whole wheat bread. A good rule of thumb is that the longer the list of ingredients is, the worse it is for you. Eat fruit too. Yes, fruit has carbs and that single pearl, fructose, but eating fruit with fats like nuts or yogurt will slow down its absorption.

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