What We Get Wrong About Carbs - And How To Better Choose Yours

Can we stop blaming carbohydrates altogether — and figure out which ones are best for your health?

I mean, cutting carbs is everywhere.

Your neighbor is cutting sugar.

Another friend can't stop raving about her Carnivore diet that removes all carbs.

Gut health gurus on Instagram post about cutting all grains.

And there's the one where you cut out all carbs called "FODMAPs".

So you ask yourself:

Should I cut carbs?
Why does everyone say carbs are bad?
Could adjusting my carbs help my bloating, discomfort, poor energy, or unpredictable flare-ups?

I've done my fair share of experimentation with various low carb diets (Specific Carbohydrate, Ketogenic, Autoimmune Paleo), measured my ketones, and went grain free for months during a yearlong quest to calm my worst ever ulcerative colitis flare.

The answer was in between the extremes of eating too many carb-filled junk and restricting myself to less than 10 carb foods.

Because of these experiences, I realized how crucial it is to distinguish how carbs harm or help your body to find my own sweet spot.

In this newsletter, we’ll shatter the ‘carbs are evil’ myth and show you how to pick the right ones for your body.

What Are Carbs, Anyway?

Not all carbohydrates are created equal, but all of them are eventually turned into sugar and glucose by your body for energy production.

They include everything from a broccoli floret to a slice of bread.

Carbs are categorized in many overlapping ways, which can leave anyone scratching their head over what’s “good” or “bad.”

The 1,000 Ways to Categorize Carbs

When you slice and dice carbohydrates… you get many different (sometimes confusing) words to describe their various characteristics:

Simple, complex, and fiber

Simple carbohydrates (sugars) have shorter chains and tend to raise blood sugar quickly. Examples include table sugar (sucrose), fruit sugar (fructose), and milk sugar (lactose). Common sources are candy, soda, fruit juices, and sweetened dairy products.
Complex Carbohydrates (starches) are longer chains, generally slower to digest. Think whole grains like brown rice, oats, and barley; legumes such as beans, lentils, and chickpeas; and starchy vegetables like potatoes and corn. Processing (like refining grains into white flour) or certain cooking methods can still raise blood sugar faster.

Fiber is a form of carbohydrate the body can’t fully break down. It promotes satiety, helps regulate digestion, feeds your good gut microbes, and supports healthy blood sugar levels. You’ll find it in fruits (apples with skin, berries), vegetables (broccoli, leafy greens), legumes (lentils, peas), and whole grains (bran, bulgur).
Resistant Starch is a type of starch that resists digestion in the small intestine and passes to the colon, where it can act like a fiber, feeding beneficial gut bacteria. Green (slightly unripe) bananas, cooked-then-cooled potatoes or rice, certain legumes, and raw oats are common examples.

Naturally-occurring (whole foods like fruits, vegetables, and dairy) where they come bundled with fiber, vitamins, and minerals vs. Refined (white flour, white rice) where most of their fiber and nutrients are stripped away.

Natural sugars (fruit, dairy) vs. Added sugars (soda, cereal, cakes, cookies, many condiments, sauces and even bread and yogurt).

Fast vs. Slow Digesting (High vs. Low Glycemic)
- Some carbs (especially refined or sugary foods) can quickly raise blood sugar. Others (intact whole grains, legumes, high-fiber vegetables) release glucose more gradually.
High-fiber vs. Low-fiber
- Fiber is a form of carbohydrate that comes from plant cell walls that the human body cannot digest. It feeds your gut microbiota, supports food transport through your GI tract, increases nutrient absorption, and helps your body detoxify and eliminate unwanted compounds.
- High-fiber foods include oats, berries, beans, and cruciferous vegetables (like cauliflower, kale, Brussels sprouts).
- White pasta, white bread, and many highly processed snack foods contain little fiber, often leading to rapid blood sugar spikes and reduced satiety.
Prebiotic Foods
- A subset of fibers and resistant starches function as prebiotics, meaning they feed beneficial gut bacteria. Examples include onions, garlic, green bananas, cooked-and-cooled potatoes, and legumes.

Despite the many labels, you can start to see which carbs are more nourishing and which ones may be contributing to unwanted spikes in blood sugar, cravings, or digestive symptoms.

Why We Are Getting Carbs Wrong

Yes, you can survive without carbs, but that ignores the bigger picture: vitamins, minerals, fiber, and polyphenols.

The latest carb messaging out there is that they aren't essential.

You see, this photo below stereotypes carbs as bread.

It makes a good point, even if extreme.

Bread and refined carbs are the type of carb that is contributing to poor health outcomes.

You do not need them.

But to say that ALL carbs are non-essential is only partially true.

Yes, biochemically (taking a reductionist* approach and only considering glucose and energy metabolism), humans can survive without dietary carbs.

(*A reductionist approach to nutrition means focusing on parts of food rather than the whole food and its components.)

Your body can produce glucose (via gluconeogenesis) from other macronutrients (fat and protein) and ketones for energy.

The problem is that we are throwing the baby out with the bathwater, as the old expression goes.

Carbohydrates are not neatly packaged in food as only carbon, hydrogen, and oxygen.

They do not have a sole purpose of energy production.

Carbs, in whole foods, are coupled with other vitamins, minerals, polyphenols, and fiber - and usually other macronutrients like protein.

Research shows that these components positively impact metabolism, digestion, the gut microbiome, the immune system, and more.

It's these "other" food components that make many carbohydrate foods very much essential for human health.

Why We Eat The Wrong Kind

So if carbs can be valuable, why are we so unhealthy?

Because we’re eating the wrong kinds… as Dr. Hyman has truthfully pointed out.

As most human food consumption data will show.

We are not eating the recommended amounts of vegetables or fiber.

We are exceeding recommendations for refined grains.

This dietary pattern is what is called a "western" diet.

And this dietary pattern is rapidly expanding across the globe.

One reason is because it's the food that is put in front of you to eat.

It's your environment.

Processed food companies are tricking you with aisles of packaged food bringing you convenience slapped with labels claiming the food is a "healthy, whole grain" or "high in fiber.'

You're a busy mom, grabbing a “whole grain” cereal box for your kids, thinking it’s healthy but it’s loaded with sugar.

That's why it's no surprise to hear of a study reporting that over 70% of the 50,000 food products at Walmart, Target, and Whole Foods (large grocery stores in the United States) are ultra-processed.

And probably a lot of these are labeled healthy "whole grain" and "high fiber."

So, no, you're probably not eating the best kind of carbohydrate if your eating a "western" diet.

Which Carbs Are Sabotaging Your Health?

The real culprit of this "western" diet is the ultra-processed, low-fiber, low-nutrient, high-sugar carbs.

Think donuts, sugary cereals, cookies, white flour pastries, and super-sweet beverages.

All yummy treats.

Believe me, I love a good donut too, but not every day.

It's when half of your diet or more comes from these types of foods that your metabolism, gut, and immune system will eventually start to fail.

Do you ever notice how a ‘tiny cookie snack’ turns into half the box?

That’s no accident.

You aren't giving your cells what they need, nor your gut microbes for that matter.

You're likely to overeat because your cells will drive you to eat until they get what they need.

And to boot, these foods are engineered in labs by food scientists to make you want to eat more of them.

The special combination of sugar, fat, and salt make them irresistible.

They are highly addictive, devoid of nutrition, and linked to higher caloric intake and rates of obesity and chronic disease.

When you eat more of these, you are eating less whole, nutritious food.

And my own experience with these kinds of foods is that they can be comforting and very addictive.

Bread, cookies, breakfast cereal, doughnuts, sugary beverages, ice cream, french fries (chips), potato chips (crisps) are reported in research as most addictive.

These refined foods are increasingly everywhere.

And oftentimes made with food ingredients from crops (wheat, corn, soy) subsidized by governments so they seem cheap.

Bottom line: They make us sick if we eat too much of them. So eat less of them.

The Truth About "Healthful, Whole Grains"

Whole Grains are healthy, right?

Current Dietary Guidelines for Americans as well as other national nutrition guidelines tell you to prioritize whole grains, so they must be.

Not so fast.

The truth is, the "whole grains" you are being sold and think are healthy are not truly healthy.

Food companies are using their own form of reductionism to say that a highly-processed, nutrient-poor food item is "healthy" because it has one "healthy" ingredient in it.

First, let's be clear that a whole grain is:

In its natural state, with all three parts of the grain still intact (germ, endosperm, bran).
Are higher-fiber carbohydrates and retain their original vitamins, minerals, and polyphenols.
Think brown rice, quinoa, farro, barley, buckwheat, wheat berries.

Not this "whole grain" "and "high-fiber" breakfast cereal (which absolutely tastes amazing btw... look at that added sugar, no wonder!)

This is not the "healthy, whole grain" you or your kids should be eating every morning.

The problem is that you are told by many medical and nutritional authorities to:

Read an ingredient list
Look for products that list “whole grain” or “whole wheat” as the first ingredient as opposed to “enriched”
And that you will have made a healthy choice.

This is why "whole grain" has taken over your plate and is plastered on boxes of processed foods in your grocery store.

Yet, these foods are not intact whole grains that medical and nutritional authorities really want you to eat.

It's what food companies want you to eat.

So is the item labeled ‘Whole Wheat!’ in the grocery aisle actually good for you?

Taking a "whole grain" and pulverizing it into flour.
Then they add sugar and other appetizing ingredients to it so it tastes extra good and you want more of it.
Think the flour for bread and bakery items, cereal, pasta, and crackers.

Your body more quickly and easily digests these carbs, which likely means a higher glucose response, screwed up metabolism, and gut and immune dysfunction.

What Actually Matter When Choosing Carbs

Two big factors overshadow everything: fiber and overall nutrient density.

When you prioritize these two things, you will improve the impact of carbs on your blood glucose, feed your beneficial gut microbes, reduce the amount of added sugar, fat, salt, additives, preservatives, and artificial flavors (e.g. ingredients found in highly processed carb foods).

A better way to choose healthier carbs

Nutrition guidelines often make minimum requirements for food labeling.

For example, "high fiber" has to be at least 6 g of fiber per 100 g of food and "whole grain" 8 g of whole grain per serving.

But, better metrics you can use are:

Net carbs which are the total carbs in a food minus the fiber.
Fiber to Carb ratio
Nutrient density

If we go back to our "healthy" breakfast cereal, one serving has 51 grams of carbohydrates and 6 grams of fiber.

This makes the cereal "healthy" with a carb-to-fiber ratio of 8.5.

According to some, a ratio of 10 to 1 is "healthy".

However, this cut-off was arbitrary and created to enable a greater number of food products found in most US grocery stores labeled as "healthy."

(In someone's world, this makes more food "healthy" for you!)

A better way to choose healthy carbs is to eat more foods with a lower Carb to Fiber ratio such as foods below 5 instead of 10.

Here are some examples of some starchy vegetables and grains that are common pantry staples:

And below are some examples of some healthier non-starchy, legume, and fruit carb options.

The highest nutrient dense amongst carbohydrate rich foods in terms of their vitamin, mineral, and polyphenol content are whole vegetables.

Generally speaking, all of these will also have the best carb to fiber and net carb ratios.

So eat more vegetables:

Dark leafy greens like kale, collard greens, beet greens, mustard greens, spinach, romaine lettuce, bok choi, arugula
Other highly nutrient dense vegetables like capers, garlic, leeks, mushrooms, broccoli, red cabbage, brussel sprouts, beets, and pumpkin.

What You Need To Know About Carbs And Your Health

Because of this push toward the wrong kind of carbs, you might be choosing too many refined flours and sugars, and fueling your chronic health issues.

Could your bloating, discomfort, poor energy, unpredictable flare-ups have anything to do with your carb intake?

The answer is yes.

The type and amount of carbs you consume can shake things up in your body, influencing factors such as blood sugar levels, insulin sensitivity, digestion, gut microbiome balance, and immune system.

Blood Sugar Dysregulation & Insulin Resistance

Feeling a daily sugar crash?

It might be that starchy bagel breakfast lacking fiber.

Carbs are the macronutrient that causes the largest increase in your blood sugar.

Diets high in refined, rapidly digesting, simple, low-fiber carbohydrates (e.g., white bread, pastries, sugary beverages) tend to cause sharp spikes in blood sugar.

Chronic exposure to these spikes are taxing on your metabolism and can eventually lead to insulin resistance, a key driver of metabolic dysfunction, and a key underlying factor associated with gastrointestinal function, gut dysbiosis, hormone imbalance, and autoimmunity.

On the flip side, whole food vegetables, fruits, legumes, and intact whole grains release glucose more gradually, reducing the likelihood of blood sugar spikes as compared to refined carbohydrate options.

Understanding your individual response to different foods is important.

Digestion, Gut Microbiome Diversity, & Immune Function

Refined carbs are often low in dietary fiber and can reduce the variety of nutrients reaching the colon, where gut bacteria thrive.

Research shows that diets lacking in fibrous, whole-food carbohydrates can lead to reduced microbial diversity and beneficial bacterial strains, potentially altering digestive motility, weakening immune function, and increasing inflammation.

Fiber-rich carbs (especially those containing resistant starch and prebiotic fibers) feed beneficial gut bacteria, boosting microbial diversity.

A healthy microbiome is linked to better digestion, stronger immunity, and potential benefits in inflammatory and autoimmune conditions.

Hormone Regulation

In pregnancy, perimenopause, and menopause, natural hormone fluctuations may result in increased risk for dysregulated blood sugar and insulin resistance which could lead to gestational diabetes or more perimenopause/menopause severe symptoms like fatigue, mood swings, and hot flashes.

Being mindful of your quality and quantity of carbs and how your body reacts during these shifts can support you during this time.

Inflammatory & Autoimmune Conditions

Consuming lots of ultra-processed foods—often rich in refined carbs, additives, and unhealthy fats—can promote inflammatory pathways.

This is of concern for people with autoimmune disorders and certain digestive conditions, which may worsen when the gut environment is out of balance.

Eat More Of These Carbs

If you've read this far, you probably already know what I'm going to say.

Keeping your blood sugar balanced throughout your lifetime is one of the best things you can do for your health.

If you want to reduce your bloating, gas, or discomfort after eating carbs, have better energy, reduce autoimmune flare-ups, or even lose weight, you need to eat healthier carbs that balance your blood sugar, feed your good gut microbes, and provide micronutrients and polyphenols.

The following 2x2 table presents a menu of food options on the continuum of carbohydrate and fiber quantity.

(Note: In nature, foods do not usually contain only one type of macronutrient. The foods also contain other macronutrients.)

When you consider carbohydrates, you want to:

Eat MORE of Box 1
Eat SOME of Box 2
Eat LESS of Box 4

If you're a vegetarian or vegan, you aren't eating Box 3 and your major protein sources are in Box 1 and 2 because in nature carbohydrates are often packaged with protein.

Box 1: High in Fiber, Low in Carbohydrate

Leafy greens, cruciferous vegetables (broccoli, cauliflower), many non-starchy vegetables, and in some cases certain nuts and seeds.

Box 2: High in Fiber, High in Carbohydrate

Legumes (beans, lentils, chickpeas), intact whole grains (oats, barley, brown rice), starchy vegetables (potatoes, sweet potatoes), and most fruits (especially if they are fiber-rich).

Box 3: Low in Fiber, Low in Carbohydrate

Meat, fish, eggs, and dairy. Note: Dairy does have carbs (milk and yogurt are generally higher carb than cheese).

Box 4: Low in Fiber, High in Carbohydrate

White bread, refined/processed grains, pasta, muffins, bread, donuts, sugary drinks, fruit juice, candy, pastries, most fast food, many snack foods like crisps/chips.

Bottom line: Aim for more from Box 1 & 2, less from Box 4. Box 3 depends on your preference.

How Much Carbohydrate Is Too Much?

It depends on who you are and what kind of carbohydrate.

Do you have a chronic health condition like type 2 diabetes (non-insulin dependent), fatty liver disease, heart disease, PCOS, acne, an autoimmune condition?
Have you had a high blood sugar or insulin test result?
How old are you?
Are you an athlete or consistently doing strenuous activity?
How often and much do you eat refined, processed carbohydrates, fast or convenience food?

Per the Dietary Guidelines for Americans, it's healthy for me to consume between 200-300 grams of carbohydrate.

"Low-carb" can mean 50 grams or it can mean 150 grams per day depending on who you are.

When I tested posited for gestational diabetes during my second pregnancy, I was trying to choose lower carb foods as I monitored the types of carbs I ate alongside my glucose levels multiple times a day.

If I'm out cycling for 4-6 hours, I might need to consume 500 g of carbohydrate or more for the day.

It is always best to consult a healthcare professional or qualified nutrition professional for personalized guidance, particularly if managing chronic conditions or specific hormonal issues.

Low Carb Can Also Mean High Fiber

Still worried that going "low-carb" automatically means "low fiber?"

(It doesn't have to, and I'll show you some examples.)

I've read research and heard other health providers raise concern that having women drop grains causes a big drop in fiber intake.

And this is because the "western" dietary pattern fiber intake mostly comes from grains.

But this shouldn't be a reason to caution women against reducing their grain intake.

While it’s true many low-carb approaches restrict certain grains, legumes, or starchy vegetables, if you emphasize “Box 1” foods — like leafy greens, cruciferous veggies, certain nuts, and seeds — you can keep carbs under 50 g a day and still get a good amount of fiber to support gut health.

(Now the impact of the higher fat on the gut microbiome is another topic we can discuss more soon.)

For context, many guidelines suggest at least 25-30 grams of fiber daily for adult women.

Yet the average "western" diet often falls short at ~15 g (or less), which can lead to bloating, poor digestion, a starving gut microbiome, and metabolic issues.

Below, you’ll see two examples of how to strike a better balance.

Example 1: Around 50 g of total carbs and a full 26 g of fiber—more fiber than a standard western diet.

Example 2: Around 125 g of total carbs and 46 g of fiber - closer to how I might structure my day.

(P.S. Please remember that the one bowl of sugary breakfast cereal. It has 51 g of carb and 6 g of fiber as a comparison to these two examples!)

You can hit your fiber targets — even on a "low-carb" plan.

Feel free to try one of these templates or create your own to support your digestion and blood sugar balance, feed your beneficial gut bacteria, and get your fill of essential vitamins, minerals, and polyphenols.

The key is focusing on high-fiber, nutrient-dense foods rather than zeroing out all carbs.

5 Small Steps Toward Healthier Carbs

Wondered what to do next?

Here are some tiny actions you could take to make carbs work for you

1. Review The Types Of Carbs You're Eating

Scan your pantry—how many items are refined flour or sugary cereals? Spot any “whole grain” labels on foods that still pack added sugars, refined flour, and long ingredient lists.
Track your food intake for a few days looking at:
- Your intake of pasta, bread, cereal, pastries, chips, cookies, crackers, fruit juice, sweetened beverages, added sugars to tea or coffee
- Your total carbs and total fiber.

2. Know Your Numbers

Get screened for blood glucose dysregulation or insulin resistance. Anybody can have insulin resistance — even children, elite athletes, and people who are naturally thin.
Some tests that can help:
- Fasting blood glucose
- Fasting insulin
- Hemoglycated HbA1C - 3 month average blood glucose levels (although this won't show spikes in glucose)
- Fasting triglycerides (fat in the blood)
- HsCRP aka highly-sensitive C-reactive protein (a marker of inflammation)

3. Identify Your Specific Response To Foods

Know your individual blood sugar responses to specific foods you eat. This is especially important if you have borderline high or elevated levels on the tests above.
Glycemic variability (swings in blood glucose) is correlated to poorer biomarkers across the board, but this underlying dysfunction may not show up on a standard point-in-time test (e.g. fasting glucose). So lowering the extent of spikes and crashes is an important for your health.
You can check your individual carbohydrate compatibility and reduce glycemic variability by using a continuous glucose monitor (CGM) if this is available to you, or a simple glucose monitor accessible.
Each of us responds differently to foods depending on our metabolism, gut microbiome, sleep, exercise, and more so it is helpful to monitor your sleep, exercise, and food intake alongside your glucose levels.

4. Swap Refined Carbs

Choose lower carbohydrate density, lower carb to fiber ratio, and lower net carbohydrate (total carb - fiber = net carb).
Try to eat more non-starchy veg from Box 1 instead of Box 2 or 4.
Try an intact whole grain instead of a refined one (e.g. eat roasted sweet potato instead of white rice or fries, find a healthier bread option).
Look for an ingredient list with fewer items, minimal added sugar.
Try adding prebiotic fiber and polyphenol rich foods. (Get my polyphenols packed food list here.

5. Notice How You Feel

Pay attention to your energy, digestion, mood, or other symptoms as you make changes.

✨Final Thoughts

You don’t have to ban carbs to feel better; you just need a strategy for picking carbs that serve your health goals.

Once you understand the difference between real food and refined junk carbs - and what the carb you're eating comes with, you’re on your way to making carbs work for you, not against you.

By picking quality carbs, you can stabilize blood sugar, optimize your digestion, nourish your gut, and support immune function.

Thank you for reading, friend.

Until next time,

April

P.S. If you'd like professional help reviewing and tracking what you eat to make a more personalized plan, I'm here to help. Schedule a call here.