Carbohydrates are the body's most important and readily available source of energy. Even though they've gotten a bad rap lately and are sometimes blamed for the obesity epidemic in America, carbs are a necessary part of a healthy diet for both kids and adults.

The two major forms of carbs are:

1. simple sugars (simple carbohydrates), such as fructose, glucose, and lactose, which also are found in nutritious whole fruits
2. starches (complex carbohydrates), found in foods such as starchy vegetables, grains, rice, and breads and cereals

So how, exactly, does the body process carbs and sugar? All carbohydrates are broken down into simple sugars, which are absorbed into the bloodstream. As the sugar level rises, the pancreas releases the hormone insulin, which is needed to move sugar from the blood into the cells, where the sugar can be used as energy.

The carbs in some foods (mostly those that contain simple sugars and highly refined grains, such as white flour and white rice) are easily broken down and cause blood sugar levels to rise quickly.

Complex carbs (found in whole grains), on the other hand, are broken down more slowly, allowing blood sugar to rise more gradually. Eating a diet that's high in foods that cause a rapid rise in blood sugar may increase a person's risk of developing health problems like diabetes and heart disease, although these studies have been done mostly in adults.

Despite the recent craze to cut carbs, the bottom line is that not all foods containing carbohydrates are bad for kids, whether they're complex (as in whole grains) or simple (such as those found in fruits). If carbs were such a no-no, we'd have a huge problem since most foods contain them.

Still, some carbohydrate-dense foods are healthier than others. Healthy sources of carbohydrates include:

• whole-grain cereals
• brown rice
• whole-grain breads
• fruits
• vegetables
• low-fat dairy

For kids over 2 years old, a healthy balanced diet should include 50% to 60% of calories consumed coming from carbohydrates. The key is to make sure that the majority of these carbs come from good sources and that added sugar in their diet is limited.

"Good" vs. "Bad" Carbs

Carbohydrates have taken a lot of heat in recent years. Why? Because many medical experts think excess consumption of refined carbs (refined sugars found in foods and beverages like candy and soda, and refined grains like white rice and white flour, found in many pastas and breads) have contributed to the dramatic rise of obesity in the United States.

But how could any one type of food cause such a big problem? Of course, not exercising and eating larger portions of any foods than we need take the lion's share of blame for the obesity epidemic.

But the so-called "bad" carbs — sugar and refined foods — tend to be significant contributors to excess calories. Why? Because they're easy to get our hands on, come in large portions, taste good, and aren't too filling.

People tend to eat more of these refined foods than needed. And, often, foods like colas and candy provide no required nutrients, so we really don't need to eat them at all.

But this doesn't mean that all simple sugars are bad. Simple carbs are also found in many nutritious foods — like fruits, vegetables, and dairy products, which provide a range of essential nutrients that support growth and overall health. For example, fresh fruits contain simple carbs, but they have vitamins and fiber, too.

The 2010 dietary guidelines recommend that Americans eat more unrefined (often called "good") carbs by saying that everyone — including kids and teens — should increase whole-grain consumption and limit their intake of added sugar. In fact, at least half of grain intake should come from whole grains.

Whole grains certainly sound like the healthy way to go. But what makes them so different from simple carbohydrates? Whole grains are complex carbohydrates (like brown rice, oatmeal, and whole-grain breads and cereals) that are:

• broken down more slowly in the body. Whole grains contain all three parts of the grain (the bran, germ, and endosperm), whereas refined grains are mainly just the endosperm — and that means more for your body to break down. More to break down means the breakdown is slower, the carbohydrates enter the body slower, and it's easier for your body to regulate them.
• high in fiber. Not just for the senior-citizen crowd, foods that are good sources of fiber are beneficial because they're filling and, therefore, discourage overeating. Diets rich in whole grains protect against diabetes and heart disease. Plus, when combined with adequate fluid, they help move food through the digestive system to prevent constipation and may protect against gut cancers.
• packed with other vitamins and minerals. In addition to fiber, whole grains contain more important vitamins and minerals, including B vitamins, magnesium, and iron.

Unrefined carbs found in whole grains are ideal, refined grain products may be fortified with folic acid (also called folate), iron, and other nutrients, and as a result may contain more of these nutrients when compared with whole-grain foods that have not been fortified.

The actual amount of grains will vary depending on a child's age, gender, and level of physical activity. On average, school-age kids should eat about 4- to 6-ounce equivalents from the grain group each day and at least half of these servings should come from whole grains.

An ounce equivalent is like a serving — so one slice of bread; 1 cup of ready-to-eat cereal; or a half cup of cooked rice, cooked pasta, or hot cereal can be considered a 1-ounce equivalent.

Sizing Up Sugar

Foods that are high in added sugar (soda, cookies, cake, candy, frozen desserts, and some fruit drinks) tend to also be high in calories and low in other valuable nutrients. As a result, a high-sugar diet is often linked with obesity. Eating too many sugary foods can also lead to tooth decay.

The key to keeping sugar consumption in check is moderation. Added sugar can enhance the taste of some foods, and a little sugar, particularly if it's in a food that provides other important nutrients, such as cereal or yogurt, isn't going to tip the scale or send your child to the dentist.

Instead of serving foods that are low in nutrients and high in added sugar, offer healthier choices, such as fruit — a naturally sweet carbohydrate-containing snack that also provides fiber and vitamins that kids need.

One way to cut down on added sugar is to eliminate soda and other sugar-sweetened beverages, which can cause erosion of tooth enamel from the acidity and dental cavities (or caries) from the high sugar content. And consider these statistics:

• Each 12-ounce (355-milliliter) serving of a carbonated, sweetened soft drink contains the equivalent of 10 teaspoons (49 milliliters) of sugar and 150 calories. Sweetened drinks are the largest source of added sugar in the daily diets of U.S. children.
• Consuming one 12-ounce (355-milliliter) sweetened soft drink per day increases a child's risk of obesity.

Instead of soda or juice drinks (which often contain as much added sugar as soft drinks), serve low-fat milk, water, or 100% fruit juice.

Although there's no added sugar in 100% fruit juice, the calories from the natural sugars found in fruit juice can add up. The American Academy of Pediatrics (AAP) recommends limiting juice intake to 4-6 ounces (118-177 milliliters) for kids under 7 years old, and no more than 8-12 ounces (237-355 milliliters) of juice for older kids and teens.

Figuring Out Carbs and Sugar

It isn't always easy to tell which foods are good choices and which aren't just by looking at the labels. To figure out carbohydrates, look under Nutrition Facts on food labels, where you'll find three numbers for total carbohydrate: the total number of carbohydrates, the amount of dietary fiber, and sugars.

• Total Carbohydrate: This number, listed in grams, combines several types of carbohydrates: dietary fibers, sugars, and other carbs.
• Dietary Fiber: Listed under Total Carbohydrate, dietary fiber itself has no calories and is a necessary part of a healthy diet. A high-fiber diet promotes bowel regularity and can help reduce cholesterol levels.
• Sugars: Also listed under Total Carbohydrate on food labels, sugars are found in most foods. However, the Nutrition Facts label doesn't make the distinction between natural sugars and added sugars. Natural sugars are found in many foods, including fruit and dairy products. Snack foods, candy, and soda often have large amounts of added sugars. To find out if a food has added sugar, you need to look at the ingredient list for sugar, corn syrup or sweetener, dextrose, fructose, honey, or molasses, to name just a few. Avoid products that have sugar or other sweeteners high on the ingredient list.

Although carbohydrates have just 4 calories per gram, the high sugar content in snack foods means the calories can add up quickly, and these "empty calories" usually contain few other nutrients.

Making Carbs Part of a Healthy Diet

Ensuring that kids get a balanced, nutritious diet isn't as hard as it may seem. Simply make good carbohydrate choices (whole grains, fruits, veggies, and low-fat milk and dairy products), stock your home with healthy choices, limit foods containing added sugar (especially those with little or no nutritional value), and encourage kids to be active every day.

Above all, be a good role model. Kids will see your wholesome habits and adopt them, leading to a healthier lifestyle throughout childhood and into adulthood.

Reviewed by: Mary L. Gavin, MD
Date reviewed: June 2011