In Defense of Carbs

You’ll often hear some version of this:

“I’m cutting out carbs.”

“I don’t want to eat carbs.”

“Carbs make me gain weight.”

Carbohydrates have become one of the first things people think they need to remove when they want to lose weight, improve their blood sugar, feel less bloated, or simply eat healthier.

But we don’t often stop to ask where that belief came from, or how carbohydrates became such a villain in the first place.

Part of the problem is that “carbs” describes an enormous category of foods.

Cake contains carbohydrates.

So do lentils.

Soda contains carbohydrates.

So do potatoes, plantains, fruit, oats, beans, rice, corn, squash, and vegetables.

And perhaps most importantly, fiber is a carbohydrate too.

So before we decide that carbohydrates are the problem, we need to get a little more specific about what we’re actually talking about.

How did carbs become the enemy?

Low-carbohydrate dieting isn’t new.

In the 1800s, an Englishman named William Banting became known for losing weight after reducing foods like bread, sugar, potatoes, and other starch-heavy foods. He eventually published his experience, and carbohydrate restriction became associated with weight loss long before Atkins or keto entered the conversation.

Then carbohydrate restriction took on a completely different role.

In the early 20th century, the ketogenic diet was developed as a therapeutic treatment for epilepsy. By dramatically restricting carbohydrate and increasing fat, physicians were able to reproduce some of the metabolic effects of fasting without requiring patients to stop eating entirely.

It was a clinical intervention designed to reduce the number of epileptic episodes.

Later came Atkins, followed by South Beach, Paleo, keto, and more recently diets centered around avoiding blood sugar “spikes” or carbohydrates almost altogether.

These approaches aren't identical. But over time, a complicated conversation about metabolism, therapeutic diets, and food quality was distilled into something much easier to remember:

Carbs make you gain weight.

And eventually:

Carbs are bad for you.

There is physiology behind some of the concerns around excessive refined carbohydrate intake and glucose regulation.

But somewhere along the way, we stopped distinguishing between a sugary drink and a bowl of beans.

Not all carbohydrates arrive in the same packaging

From a nutrition standpoint, carbohydrates broadly include sugars, starches, and fiber.

Sugars are found naturally in foods like fruit and dairy and can also be added to foods and drinks.

Starches are found in foods like rice, oats, corn, potatoes, plantains, beans, and lentils.

And fiber, despite often being discussed separately, is also a carbohydrate.

That distinction matters because fiber behaves very differently from the sugars and starches we digest more readily. It contributes to bowel regularity, helps support the gut microbiome, can contribute to fullness, and changes how a meal is digested.

So telling someone to simply “avoid carbs” doesn't tell us very much about the quality of their diet.

I find it more useful to look at the food itself.

Consider two days of eating.

One contains beans, rice, roasted vegetables, fruit, oats, and sweet potato.

The other contains soda, pastries, crackers, sugary cereal, chips, and packaged desserts.

Both diets may be relatively high in carbohydrate.

But nutritionally, they are completely different.

Whole and minimally processed foods generally retain more of their original structure, fiber, water, vitamins, minerals, and plant compounds.

Highly processed foods may be refined, milled, sweetened, concentrated, or combined with added fats and salt. They're often easier to eat quickly and in larger amounts.

So the question isn't simply how much carbohydrate a food contains.

You also need to ask "how processed is it...is it minimally, or highly processed"? 

Why do people feel better when they cut carbs?

This is where I think we need to take people’s experiences seriously.

Some people really do feel better after reducing carbohydrates.

They may lose weight.

Their appetite feels more stable.

They're less bloated.

They're less sleepy after meals.

Their blood sugar improves.

But the interesting part is figuring out why.

Imagine someone decides to go low-carb.

Before, breakfast was a pastry and sweetened coffee. Lunch was whatever they could grab quickly. Dinner was often takeout. Snacks filled the gaps between meals.

Then they change their diet.

Now they're grocery shopping.

They're preparing food at home.

Breakfast contains more whole foods.

They're eating more vegetables.

They're drinking more water.

They're planning meals instead of waiting until they're starving.

They've stopped eating as many packaged snacks and desserts.

A few weeks later, they feel dramatically better.

Was eating less carbohydrate part of that improvement?

Very possibly.

But so was everything else they changed.

Sometimes the benefit of going low-carb isn't only that someone removed carbohydrates.

It's that they started eating actual whole food meals.

They started cooking.

They reduced highly processed foods.

Their meals became more satisfying.

Their eating became more structured.

That distinction matters because if we attribute the entire improvement to carbohydrates, we may miss the entire process of what truly happened.

Sometimes carbohydrate reduction really is useful

There are also situations where reducing carbohydrate intake may have a more direct physiological effect.

For someone with insulin resistance or type 2 diabetes, the amount and type of digestible carbohydrate in a meal can matter considerably for blood glucose management.

Someone who routinely eats large amounts of highly refined carbohydrates may also notice that their energy and appetite feel different when meals contain more protein, fiber, fat, and whole foods.

And sometimes the improvement is coming from the digestive system.

Certain carbohydrate-containing foods are more fermentable than others. In someone with IBS or another sensitive digestive system, particular carbohydrates may contribute to gas, bloating, abdominal discomfort, or changes in bowel habits.

A person may remove bread, onions, certain fruits, beans, sweets, and processed foods all at the same time and suddenly feel much better.

It would be understandable for them to conclude:

“Carbs don't agree with me.”

But clinically, I would want to get more specific.

Maybe certain carbohydrates aren't being tolerated well.

Maybe the portion is too large.

Maybe it's their food preparation.

Maybe there is an underlying digestive issue that needs attention.

Those possibilities lead to very different recommendations than simply avoiding an entire macronutrient indefinitely.

How food is prepared matters too

This is something we don't talk about enough.

Food doesn't enter the body as a list of nutrients.

Most times it has been cooked, chopped, blended, juiced, ground, baked, fried, fermented, cooled, reheated, or processed before we ever eat it.

A whole apple is different from apple juice.

A baked potato is different from potato chips.

Whole beans cooked into a meal are different from a highly processed snack made from bean flour.

Preparation can also affect how well a person tolerates a food.

Some people digest well-cooked vegetables much more comfortably than a large raw salad.

Beans may be better tolerated when soaked, cooked thoroughly, and introduced in appropriate portions.

A warm bowl of rice and vegetables may feel completely different from grabbing a processed snack on the way out the door.

This doesn't mean there is one correct way everyone should prepare food.

It means how we eat matters alongside what we eat.

What biomedicine might look at

If someone tells me carbohydrates make them feel poorly, the biomedical lens helps me look for a mechanism.

If blood sugar is the concern, I may be thinking about glucose regulation, insulin sensitivity, A1C, fiber intake, metabolic health, and the composition of the person's meals.

If digestion is the concern, the picture changes.

Now I may be thinking about bowel habits, IBS, celiac disease where appropriate, food intolerances, fermentable carbohydrates, medications, and other gastrointestinal factors.

If someone consistently feels tired after meals, I want to understand whether the meal is very large, mostly refined carbohydrate, low in protein, or whether something else may be contributing.

Biomedicine helps us investigate what may be happening physiologically.

What Chinese medicine adds

Chinese medicine gives me another way to look at the same person.

Rather than only focusing on the nutrient composition of the food, I also pay attention to the person's pattern of digestion and daily life around eating.

Their appetite matters.

So does how they feel after a meal.

Bloating.

Fullness.

Bowel movements.

Cravings.

Post-meal fatigue.

Whether cooked foods are easier to tolerate than raw ones.

Whether meals are eaten regularly or skipped throughout the day.

Whether the person is sitting down and eating or constantly eating on the run.

This is one of the things I appreciate most about the Chinese medicine perspective: food isn't separated from the person eating it.

A food may be considered nutritious and still not be working particularly well for someone in its current form.

A large raw salad may contain plenty of vitamins and fiber, but if someone repeatedly leaves the table bloated, exhausted, and uncomfortable, that response deserves attention.

Maybe cooked vegetables work better.

Maybe the portion needs to change.

Maybe their overall digestion needs support.

Maybe the issue isn't the carbohydrate at all.

Biomedicine helps me understand the mechanism.

Chinese medicine helps me look at the whole person: their digestion, their habits, and the context in which they're eating.

I find both useful.

A better question than “Are carbs bad?”

I don't think everyone needs to eat more carbohydrates.

Some people genuinely feel better eating fewer of them. And there are clinical situations where reducing carbohydrate intake may be an appropriate intervention.

But I also don't think “carbs are bad” tells us very much.

I would rather look at the source, form, preparation, meal, and person.

Fruit and candy both contain sugar, but they don't arrive in the same nutritional package.

And fiber, one of the nutrients we're routinely encouraged to consume more of, is itself a carbohydrate.

So if you go low-carb and feel better, pay attention.

That response may be telling you something important.

Maybe reducing carbohydrate genuinely helped your blood sugar.

Maybe you were eating far more refined food than you realized.

Maybe your meals became more consistent.

Maybe you started cooking.

Maybe a particular type of carbohydrate wasn't agreeing with your digestion.

The point isn't to dismiss the improvement.

It's to understand it.

Because the most useful thing a dietary change can give us isn't always another food rule.

Sometimes, it's a clue.