According to the Scientific Report of the 2020 Dietary Guidelines Advisory Committee, diets high in low-quality carbohydrates (added sugar and highly refined carbohydrates) are of concern because they are generally associated with high triglycerides and low HDL-C, biomarkers associated with increased rates of CVDs.
As of 2015-2016, 42% of U.S. energy intake was from low-quality carbohydrates. Nutritional science suggests that it is important to reduce consumption of sugar-sweetened beverages, processed foods with added sugars and refined grain products
such as chips, crackers, cereals, and bakery desserts, including those that are often considered healthy such as white bread, white rice, and white potatoes.
Although the metabolic and health effects of consuming sugar have often been compared unfavorably with consumption of complex carbohydrates, according to Mozaffarian et al., “Among the most important new insights related to diet and cardiometabolic health is the growing evidence characterizing the importance of carbohydrate quality.” It seems that many other additional, but not fully understood, characteristics of complex carbohydrates are relevant in determining their health effects. These include fiber content, bran and germ content, glycemic index, glycemic load, the way they are metabolized by the liver and their structure. For
example, if carbohydrates are whole and unprocessed, minimally processed, highly refined, or liquid affects how they are metabolized by the body.
Mozaffarian et al. observed that because multiple characteristics appear to be relevant, health effects are unlikely to be replicated by simple extraction of individual factors (e.g., fiber) or nutrients and consumption of these as supplements or food
additives. And that “…consuming individual constituents as supplements, is unlikely to produce the same benefits as substituting whole-grain, higher-quality carbohydrates for refined, lower-quality carbohydrates.”
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