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There seems to be a war against carbohydrates today, with the Atkins and similar diets. Do carbohydrates really pose health risks?

Walter C. Willett: This is a war that has some justification, but we do need to distinguish between good and bad carbohydrates. The reality is that the vast majority of carbohydrates in the American diet are refined starches, sugar, and potatoes, and a war against these is justified. High-fructose corn sweetener should be considered the same as regular table sugar. These carbohydrates provide many empty calories (meaning that they contain few or no nutrients) and have multiple adverse metabolic effects, including the elevation of blood triglycerides and blood pressure and reduction of HDL (good) cholesterol. Reducing these carbohydrates should be a top nutritional priority.

On the other hand, whole grains come with lots of fiber, minerals, and vitamins, and we do see that higher intakes of these carbohydrates are related to less weight gain and lower risks of diabetes and heart disease. Thus, replacing the huge amounts of refined starch and sugar in our diets with healthy forms of carbohydrates can have very positive benefits. If we are consuming healthy fats and healthy carbohydrates, the exact proportions don't make a major difference, which gives people many options for creating delicious and healthy meals.

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