THE BLOG
06/30/2011 03:04 pm ET Updated Aug 30, 2011

Should You Rethink the Complex Carbs in Your Diet?

Take all the "white stuff" out of your diet. You've read it in popular magazines, heard it from your friends and even from the lips of Oprah, the long reigning queen of day time television. Taking away all things white from your diet -- bread, pasta, bakery items and sugar can be an excellent way of reducing empty calories from what you eat as well as losing weight.

There is little doubt that refined sugar and flour, for the most part, have been stripped of nutrients and fiber and are little more than a significant amount of complex carbohydrate starch. These complex starches are not only high in calories but can be quite troublesome for our bodies to metabolize. However, I believe that the white stuff is by no means the only grain-based, complex carbohydrates that can be eliminated to enhance weight loss, as well as help Americans reduce the risk of developing any number of potentially life-threatening health conditions.

A serious health condition, metabolic syndrome, occurs in approximately 20 to 30 percent of all industrialized populations. It is a growing medical condition that can be directly linked to diets high in complex carbohydrates and lifestyle behaviors. The symptoms of metabolic syndrome relate to elevated insulin levels and include high blood pressure, obesity, increase risk for Type 2 diabetes, increased risk of dementia, fatty liver and potential kidney damage.

In addition, many complex carbohydrates of grain derivatives have been linked to allergies, skin conditions, ear infections especially in children, fatigue, sleep problems and depression.

Given the risk for metabolic syndrome, it seems as though taking out the white stuff should be a positive preventive way to avoid metabolic syndrome and its accompanying symptoms. But there's more to addressing the issues of grain-based complex carbohydrate consumption than just removing the "white stuff".

As humans we do not possess the enzymes required to digest cellulose, the protective fiber found on the outside of all grains, which is why we have to mill flour -- to break down the cellulose that we cannot digest or gain nutritional benefit from. Cellulose-protected plant foods are edible only by ruminants -- double bellied animals which possess the enzyme system and digestive engineering to utilize grain foods as their dietary staple.

Thousands of years ago, when the continents divided and humans went from migrating, nomadic hunter-gatherers to stationary agriculture based tribes, we needed to identify a dependable food supply and grains became just that. We quickly learned however, that we needed to do something to the grain to be able to ingest it. Trying to chew on wheat or even rice without altering its structure in some way was impossible and resulted not only in sore tongues and lips, but upset digestive systems.

Milling of the cellulose-rich wheat, rye and corn grains produced flour which could easily be chewed and ingested, unlike the raw grains. Thus began our use of grains, which are sweet, versatile to cook and a dependable food source. Evolutionary problem solved. Or was it? Let's look at the positive side of making the switch. Simply switching from white to whole wheat bread can lower heart disease risk by 35 percent according to a 1994 Harvard Nurses study, which looked at 75,000 nurses who ate whole grains in place of white flour.

The two big differences between white bread and whole wheat bread are the processing and the amount of fiber the flour retains after processing. While there are three parts to a wheat berry which both are made from, white flour processing only uses the "endosperm," the starchy part of the berry. Whole wheat flour uses the bran outer layer which is the cellulose we cannot digest and the germ part as well. We've all heard of wheat germ, which contains the plants nutrient stores.

White bread has almost zero nutrient value unless it is enriched, while whole wheat flour is much higher in fiber and contains vitamins B6 and E, magnesium, zinc, folic acid and chromium. The bad news here is that generally the baking or cooking process destroys much of the vitamin content. However, some minerals -- and certainly the fiber -- can remain even after baking.

And the fiber is what matters most. Harvard studies on fiber show that this indigestible portion of grains, can lead to fewer heart attacks, decreased diverticular disease, Type 2 diabetes and constipation. It also provides fullness and hunger satiation, and aids bowel integrity. So then, why any concern about whole grains?

Whole grains still require the human body to secrete insulin in order to utilize the complex carbohydrate in whole grain products. And insulin is the main culprit in metabolic syndrome. If an individual replaces the same amount of white flour products with whole grain products he will enjoy increased nutrient benefits. However, if he has already developed a high insulin secretion due to the white flour products he has consumed, switching to whole grain products will not necessarily produce the results he hopes for.

In my more than 30 years of practicing nutrition, I have seen individuals -- with a wide span of conditions -- improve dramatically when all flour-based products were eliminated from their diets. I believe that some of us are not genetically or enzymatically built to ingest and handle the metabolism of grain foods.

While grains may not appear to cause health issues for some individuals, many of us gain weight and develop skin problems, sugar regulation issues, bowel problems, acne and other chronic concerns that I believe can be greatly improved or eliminated by removing all flour products from the diet. The reason is twofold: first, the gluten contained in grains and second, the insulin secretion required for metabolizing the carbohydrate starch.

When the Islets of Langerhans beta cells of our pancreas have enlarged over time to produce higher levels of insulin -- in order to accommodate the amount of complex carbohydrates we are eating -- they will continue to do so if complex carbohydrates continue to be ingested. This occurs even when a more nutrient rich alternative such as whole grains is consumed.

In my experience, many patients who remove or dramatically reduce flour and sugar products from their diet show improvements in health.

There is, however, a satisfying and delicious alternative to completely cutting out flour products that many are using with great success. This will be the subject of a follow-up blog post.

Selected Sources and Further Reading:
http://www.medicinenet.com/metabolic_syndrome/page2.htm
http://www.webmd.com/allergies/guide/wheat-allergy
http://www.channing.harvard.edu/nhs/
http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fiber-full-story/index.html