Reshma Shah, M.D., MPH, is a practicing pediatrician affiliated with Stanford University School of Medicine, who gave an excellent presentation at the annual International Plant-Based Nutrition Conference in September. This is the first in a series of columns based on her book “Nourish, The Definitive Plant-Based Nutrition Guide for Families,” co-authored by well-known registered dietitian Brenda Davis.

“Nourish” cites acknowledgments from many national and international health organizations that plant-based, whole food nutrition is appropriate for people of all ages. The following is one example: “It is the position of the Academy of Nutrition and Dietetics that appropriately planned vegetarian, including vegan, diets are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. These diets are appropriate for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, adolescence, older adulthood, and for athletes.”

Today’s column will discuss carbohydrates, one of the three macronutrients, the other two being protein and fat. Macro means large, so macronutrients are nutrients we need a lot of, and they are also large enough that we can see them.

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While fat and protein are found in all animal and plant foods, carbohydrates are found primarily in plants (dairy products contain some carbs). Carbohydrates vary from simple sugars to starches to complex molecules that make up fiber. Carbohydrates are the main source of energy for the body. Fat and protein can serve as energy sources in certain situations, but are “back up fuels.” In particular, carbs are the preferred source of energy for the brain, red blood cells and nervous system.

Shah and Davis note that carbohydrate-rich whole food helps control blood sugar, insulin, cholesterol and triglyceride levels. Fiber and resistant starch (starch that resists digestion) feed the trillions of bacteria in our gut microbiome. A large meta-analysis in 2018 showed that people eating the fewest carbohydrates experienced a 32% increase in all-cause mortality.

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In Western societies such as ours, most kids (and adults) eat too many processed carbs and not enough whole (aka complex or unrefined) carbs. “Nourish” explains that “refined carbohydrates are carbohydrate-rich foods that have been stripped of most of their beneficial components by food processing techniques before we eat them.” They promote obesity, elevate triglycerides, increase blood pressure, lead to pre-diabetes and diabetes, increase risk of certain cancers, contribute to gastrointestinal disturbances and cause inflammation and oxidative stress, fatty liver disease and cavities.

Furthermore, food companies add addictive sugar, salt and fat (in the form of oil) to processed food. Examples of these problem foods are cookies; cake; soda; fruit juices (basically flavored sugar water); white rice; white pasta; white bread and bagels; doughnuts; pastries; most crackers (including those marketed for toddlers); and almost all cereals that come in a box, especially those marketed for kids (do you want to give your child dessert for breakfast?). Before you buy carbohydrate-based food for your family, check the food label for serving size; sodium per serving (safe amount for adults < 1500 mg. per day; less for children), sugar per serving (4 grams is a teaspoon); added oil; and the carbohydrate:fiber ratio (multiply the fiber number by 5, and if the result is greater than the number for total carbs the product has lots of fiber and whole grains). Food companies try to fool you, and if the label says “made with whole grains” or “contains whole grains,” the product is mainly processed grains.

“Nourish” notes that eating a variety of whole grains is important, but recommends the following grains in particular: 1) colorful grains and starchy vegetables such as black barley, red or black quinoa or rice, orange or purple sweet potatoes, and winter squash; 2) nutrient-dense whole grains such as amaranth, buckwheat, oats, quinoa, teff and wheat; and 3) peas and corn.

Whole grains can be eaten for breakfast in the form of oatmeal for example (steel cut or oat groats are the least processed), added to soups and salads, added to stir-fry, or eaten for dinner, such as sweet potatoes and squash.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email gfeinsinger@comcast.net.