Not low-carb, right-carb

Philip J. Goscienski, M.D.

August 2006

In all the media discussions about low carbohydrate diets most of the focus has been on issues such as the risks of high-fat diets, the difficulty of staying on the program and the economic woes of the Atkins Foundation.

Atkins-like diet programs, riding on Dr. Robert's coattails, offer modifications of the regimen. Some of them, such as the South Beach Diet that promotes heart-friendly fats, have some good elements but not one has much of a scientifically verified track record. The longest study that has been reported in any medical journal lasted only 12 months and average weight losses were anything but spectacular — a paltry 12 pounds in one year — and not all that weight consisted of fat, the supposed target.

Few reporters or news analysts have paid much attention to carbohydrate types. Without getting into the controversial issue of the Glycemic Index, we know that some carbs are good, some are not so good, and some are truly ugly.

Good carbs are abundant in fruits and vegetables and it doesn't matter if they are raw, parboiled or pickled. The human digestive system adapted to them remarkably well more than a million years ago. They should make up about half of our calorie intake. In spite of reams of studies confirming that a diet that is high in fruits and vegetables protects against heart disease and cancer, most Americans avoid them.

I risk offending farmers, breadmakers and the ladies that run bake sales when I state that grain products are not-so-good carbs. Before you rush to your e-mail artillery with me as your target, let me explain that from a purely biological point of view, cereal grains are not well suited to humans. That doesn't stop me from enjoying oatmeal for breakfast, a sandwich for lunch and an occasional pizza or pumpkin pie, but it's a compromise that we have been making for more than 10,000 years since early farmers learned how to use grains to make bread and beer, not necessarily in that order.

The human intestine cannot digest unprocessed grain, whether it's wheat, oats or barley. Try eating a couple of handfuls of wheat from the field and your gastrointestinal tract will remind you of it for days or weeks. Each kernel of grain must be heated and crushed in order to release the endosperm that is ultimately made into flour.

Most of us seem to tolerate cereals and baked goods fairly well. However, in every society in which farming replaced hunting and gathering, health has declined. There was always a drop in life expectancy and an increase in diseases of the teeth and bones, anemia, infectious diseases and infant mortality. Where grain-based foods are totally absent from the local cuisine there are fewer autoimmune diseases such as lupus and type 1 diabetes.

The truly ugly carbs are refined grains, primarily white flour. They are very late arrivals on the human scene but heavy contributors to the present-day epidemics of obesity and type 2 diabetes.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at