On July 17, 2023, the World Health Organization (WHO) released an important dietary guideline that sheds light on the quality of carbohydrates we consume. This guideline focuses on key aspects of carbohydrate consumption that have been carefully studied and discussed by experts from various countries, such as the United States, the United Kingdom, Canada, Europe, China, and New Zealand. These insights have been gathered from thorough analyses of recent systematic reviews and meta-analyses, all of which are rooted in solid evidence-based guidelines for carbohydrate intake.
It’s important to highlight that the WHO report solely emphasizes the quality of carbohydrates, without delving into specific proportions or quantities. The recommendations presented in this report hold significant weight and are based on rigorous research.
Key Recommendations of WHO Carb Guidelines
Let’s now delve into the core recommendations highlighted in this report:
A central and pervasive theme throughout the carbohydrate guideline revolves around a single term: “dietary fiber”!
WHO highlights the immense importance of dietary fiber. Increasing the consumption of foods rich in fiber within our carbohydrate choices is pivotal for improving a range of “non-communicable diseases,” including chronic conditions and cancer. This dietary strategy also plays a role in lowering the overall risk of mortality.
The WHO carbohydrate guideline draws extensively from recent research, mainly relying on prospective observational studies. It strongly recommends focusing on primary carbohydrate sources from four food groups (whole grains, vegetables, fruits, and legumes) and emphasizes a minimum daily intake of 400g of fruits and vegetables.
The four groups of carbs recommended by WHO share a key feature: they are rich sources of dietary fiber. This fiber comes in various forms, including insoluble fiber from leafy greens, viscous soluble fiber from whole grains (like oats), and soluble fiber from fruits, which can be either viscous or non-viscous and fermentable. Carbohydrates with dietary fiber contribute to better health, while those without lack proven health benefits.
WHO’s carbohydrate guideline doesn’t highlight starchy vegetables or tubers like potatoes as healthy choices; the focus remains on dietary fiber. Starchy vegetables offer more fiber than white rice, white bread, and refined pasta, yet pale in comparison to whole grains such as brown rice, whole-grain pasta, and whole wheat bread. While limiting starchy vegetables aligns with both WHO and mainstream American nutrition views, it’s an initial step. Reducing low-fiber white rice is wise, but note that starchy foods, while nutrient-rich, lack fiber. Only whole grains, legumes, vegetables, and fruits are optimal carbohydrate sources.
Don’t Solely Rely on Glycemic Index/Load
A key aspect involves Glycemic Index (GI) and Glycemic Load (GL). People managing diabetes focus on postprandial glycemic control, valuing low GI and GL foods to stabilize blood sugar and improve metabolic conditions.
The WHO report explores GI and GL’s impact. Unlike fiber, observational evidence for their health benefits, including reducing all-cause mortality, lacks consistency. Unlike fiber, GI and GL haven’t definitively shown cardiovascular disease mitigation. Hence, prioritizing GI or GL alone for carb choices isn’t advised.
Many high-fiber whole grains, veggies, and legumes also boast low GI and GL. Yet, solely concentrating on GI and GL can mislead. Foods with high fructose may have low GI/GL. White rice or bread’s high GI may have low GL when eaten sparingly, but their fiber deficiency remains.
Foods like instant oatmeal, with higher GI and GL due to over-processing, may appear less healthy than rolled or steel-cut oats. However, they remain nutritious with nearly 20g fiber per 100g carbs, aligning with WHO guidelines. For ideal results, opt for high-fiber, low-GI steel-cut oats.
How Much is Enough
How much fiber is optimal? WHO advises 25g daily, favoring whole foods over supplements. Though 40g offers more benefits, it’s challenging for most. Thus, the pragmatic guideline sets a 25g target, grounded in evidence and real-world feasibility.
For veggies and fruits, aim for 400g daily, as suggested. Research shows 800g yields greater health gains, yet due to practical constraints, the guideline settles on 400g, still delivering positive effects.
WHO’s carbohydrate guideline prioritizes carbohydrate quality, not just quantity or ratios. Though it once recommended 40%-70% caloric intake from carbs, similar to the U.S. DGA, the emphasis is on high-fiber whole grains, veggies, and legumes. 70% carbs are healthful with this approach. Below 40% lacks fiber, raising disease risk. This embodies WHO’s stance.
Summary
In the timely July 2023 report, WHO emphasizes carb quality, grounded in recent research.
Four groups of high fiber carbs are recommended: Whole grains, vegetables, fruits and legumes.
Aim for 25g of fiber from whole food and 400g of vegetables and fruits to improve health
