105 - ‘Low-Digestible Carbohydrates in Practice’. Journal of the American Dietetic Association. 108, 10, (1677–1681)

Introduction

Low-digestible carbohydrates are carbohydrates that are incompletely or not absorbed in the small intestine but are at least partly fermented by bacteria in the large intestine. Products of fermentation include short-chain fatty acids and gases. Fiber, resistant starch, and sugar alcohols are types of low-digestible carbohydrates. Given potential health benefits (including a reduced caloric content, reduced or no effect on blood glucose levels, non-cariogenic effect), the prevalence of low-digestible carbohydrates in processed foods is increasing. Low-digestible carbohydrate fermentation in the gut causes gastrointestinal effects, especially at higher intakes.

Aims

The current article reviews the wide range of low-digestible carbohydrates in food products, offers advice on identifying low-digestible carbohydrates in foods and beverages, and makes suggestions for intakes of low-digestible carbohydrates.

Conclusions

Nutrition advice in the mass media uses terms such as good, bad, simple, complex, and net carbs to describe carbohydrates, and often promotes counting or cutting carbohydrates. How do registered dietitians (RDs) address carbohydrates? They can begin by recommending that carbohydrates comprise 45% to 65% of total energy intake. However, not all carbohydrates are equal with respect to nutrition and health effects. Therefore, recommendations have been made for specific types of carbohydrates: The Adequate Intake (AI) for fiber is 25 g/day for women and 38 g/day for men; added sugars should be limited to 25% of the total energy intake. Considering that most Americans do not meet the AI for fiber, RDs often counsel clients to increase their intake of fiber as well as decrease their consumption of foods with added sugars, especially if clients need to lose weight or have other health conditions like diabetes. RDs promote fruits, vegetables, and whole grains as sources of fiber and suggest patients limit their consumption of convenience foods and other processed or refined foods, which are often high in added sugar and low in fiber. Consumers, however, want the benefits of a high-fiber, low-sugar diet without having to change their eating habits. The food industry has responded by adding low-digestible carbohydrates to various products to increase the fiber content and/or decrease the sugar content of these foods.