Study stresses quality of carbohydrates in weight management
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Key takeaways:
- Carbohydrates from refined grains and starchy vegetables were linked to weight gain.
- Carbohydrates from whole grains, fruit and nonstarchy vegetables were associated with less weight gain, and even weight loss.
A recent study underscored the importance of the quality of carbohydrates in long-term weight management — particularly in those with excessive body weight, researchers said.
For example, findings suggested that people should limit their intake of added sugar, sugar-sweetened beverages, refined grains and starchy vegetables and instead consume more whole grains, fruit and nonstarchy vegetables.
“The role of carbohydrate in weight gain and obesity remains controversial, and diets of varying macronutrient compositions, such as low fat, low carbohydrate, and high protein, are widely promoted,” Yi Wan, PhD, a postdoctoral fellow from the department of nutrition at the University of Harvard, and colleagues wrote in BMJ. “Because recent or current diet is likely most relevant for body weight, repeated assessments of diet and examination of dietary changes concurrent with body weight change may better characterize weight gain prevention strategies.”
The researchers examined links between food sources containing carbohydrates and weight changes every 4 years over a span of 24 years in a cohort of 136,432 adults aged 65 years and younger. The researchers also examined the effects of the intake of fiber, added sugars and natural sugars.
A 100 g per day increase in total carbohydrate intake was linked to a 0.2 kg increase in weight gain, whereas a 10 unit increase in glycemic index and a 100 unit increase in glycemic load resulted in 1.2 kg and 0.7 kg greater weight gain, respectively.
Weight gain was associated with 100 g per day increases in:
- starch (1.5 kg);
- added sugars (0.9 kg); and
- total glucose equivalents (1.5 kg).
The researchers found that weight loss resulted from increases of 10 g per day in fiber (–0.8 kg) and 100 g per day in natural sugars (–0.1 kg) and total fructose equivalents (–0.2 kg).
Meanwhile, greater weight gain occurred after a 100 g per day increase in carbohydrate intake from:
- refined grains (0.8 kg); and
- starchy vegetables (2.6 kg).
In contrast, weight loss was associated with a 100 g per day increase in carbohydrate intake from:
- whole grains (–0.4 kg);
- fruits (–1.6 kg); and
- nonstarchy vegetables (–3 kg).
The researchers noted the associations were stronger among participants with overweight or obesity at baseline and in women vs. men.
They suggested the possible reasons for the negative carbohydrate intake, glycemic index and glycemic load effects on weight change “include heightened responses to insulin and other hormonal changes that favor fat deposition.”
According to the University of Illinois at Urbana-Champaign, starchy vegetables can include potatoes, corn and acorns, whereas nonstarchy vegetables include carrots, green beans, mushrooms and broccoli.
Wan and colleagues explained the adverse impacts from starchy vegetables draws concerns over current recommendations from the Dietary Guidelines for Americans “to increase consumption of all types of vegetables, specifically including starchy vegetables.”
Still, “these findings support the potential importance of carbohydrate quality and source for long-term weight control,” they concluded.
References:
- University of Illinois at Urbana-Champaign. Starchy vs non-starchy vegetables. https://diabetes.extension.illinois.edu/food-and-diabetes/starchy-vs-non-starchy-vegetables. Accessed Oct. 12, 2023.
- Wan Y, et al. BMJ. 2023;doi:10.1136/bmj-2022-073939.
Perspective
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This study validates what we've known for a long time — that various types of carbohydrate intake absolutely influence weight gain over time. The strength of this study rests on the significant number of participants over 100,000 men and women and the length of time to which they were followed.
Clearly, this study demonstrates the changes in carbohydrate intake have a profound effect on weight, namely less starchy vegetables and nonrefined sugars and more fiber result in weight loss, and conversely, starchy vegetables, foods with higher glycemic index result in weight gain. This effect is by far more profound in middle age. The importance of this study is that it demonstrates that relatively minor changes in carbohydrate intake can affect our weight.
This study matters because right now we're dealing with the weight loss drug craze with Ozempic (semaglutide, Novo Nordisk) and other weight loss drugs being prescribed to millions of people each day. The cost of these weight loss medications is astronomically high.
This study sheds new light on dietary management of overweight and obesity and should be incorporated into treatment plans for every osteopathic physician in primary care or specialist who treats patients with chronic medical conditions such as diabetes or high blood pressure where obesity is the root cause or a contributing factor. Finally, this study reinforces the osteopathic philosophy of a holistic approach to health care with lifestyle management nutrition and healthy living being a critical part of disease prevention and management.
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