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Could butter be healthier than toast? Food dilemmas you need to know about

A new Lancet study says processed and refined carbohydrates — like those in polished rice, bread and pasta — are more deadly than the worst kind of fat.

columns Updated: Sep 03, 2017 12:16 IST
Sanchita Sharma
Sanchita Sharma
Hindustan Times
Refined carbs don’t exist in nature. By rule of the thumb, avoid powdery grains because the small particles that makes them easier to cook and digest also lead to sudden spikes in glucose levels, warping the body’s insulin response and raising the risk of diabetes over time.

Rapid flip-flops on nutritional advice make it impossible to plan a healthy breakfast, let alone a nutritious meal. Is butter better than toast? Should eggs be replaced with flavoured yoghurt? Are fresh juices healthier than milk? The questions are many and simple online research does not throw up any certain answers.

A study saying it’s carbohydrates, not fats, that kill you muddied the waters further this week. The Lancet study of more than 135,000 people across 18 countries found that processed and refined carbohydrates — in polished rice, refined flour, bread, pasta, etc — are more deadly than the worst kind of fat.

All healthy foods must have three essential macronutrients — fat, carbohydrate and protein. Current global nutritional guidelines recommend that 50% to 65% of a person’s daily calories come from carbohydrates, and less than 10% from saturated fats found in meats and dairy.

The Lancet study recommends 50% to 55% from carbohydrates and about 35% from total fat, including both saturated and unsaturated fats.

So are fats good and carbs bad? Yes, but only when the carbs are refined and highly processed.

Much has been said about fats, so we’ll focus on how eating home-cooked meals with whole grains and low salt and sugar content can help keep weight, blood sugar and blood pressure at healthy levels.


Refined carbs don’t exist in nature and are formed when natural whole foods are refined through processing – polishing, extrusion puffing, high-heat treatment – to get rid of the bran (outer coating) and kernel (seed).

By rule of the thumb, avoid powdery grains because the small particle size that makes them easier to cook, digest and absorb by the digestive tract leads to sudden spikes in glucose levels and warps the body’s insulin response, raising the risk of diabetes over time.

Traditional stone-ground grains, cracked-kernel grains and whole legumes are the least refined, have the most nutrients and take more time to digest, making them the healthiest source of carbohydrates.


Eating too much salt raises your odds of developing high blood pressure and heart disease, which in turn ups risk of heart attack, stroke and heart failure. Apart from its most common use as a seasoning, salt can be found in several hidden sources as it is used widely to enhance taste, add texture and add bulk to processed food products, including bread, processed meat, cheese, biscuit, cookies, cakes, chips and savoury mixes.

The recommended daily amount of salt is less than 5 gm (one teaspoon), but most people consume close to double that amount. An average Indian consumes about 9 gm of salt a day. The World Health Organization estimates that about 2.5 million deaths could be prevented each year if global salt consumption were reduced to the recommended level.

Nutritional labels usually mislead by listing the amount of sodium, not salt, because the salt content is typically two and a half times higher than the sodium value. So to know how much salt is really in the crisps, multiply sodium value by 2.5.

Low-sodium options are no easy way out either. These are often high in potassium and can cause severe electrolyte imbalances in people with kidney disease or in those taking potassium-conserving prescription drugs (certain diuretics, ACE inhibitors and angiotensin II-receptor blockers) prescribed for conditions such as high blood pressure, kidney damage and heart failure.


Sugar is terrible for you, not just because it adds to weight and cavities but also because, much like refined carbs, it plays havoc with blood glucose levels and overworks pancreas to lead to diabetes.

It also fills you up with empty calories that do not contain healthy fibre, vitamins, minerals and other nutrients needed for optimal physical and mental function.

A Harvard School of Public Health study linked high sugar intake with heart disease, irrespective of how healthy the rest of the diet was.

To put the spotlight on the health risks, nutrition labels in the US will be required to list the total sugars and added sugars in packaged foods from 2018, with the daily recommended limit for added sugars being 50 gm or 12 teaspoons.

The American Heart Association recommends less than 100 calories of added sugar per day (about 6 teaspoons) for women and 150 calories per day (about 9 teaspoons) for men. A 350 ml can of an aerated drink has 140 calories and 39 gm of sugar, so just one sweetened drink can put all women and most men over their daily sugar limit.

First Published: Sep 02, 2017 16:20 IST