Cholesterol Smart
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Carbohydrates are a vital source of energy and fibre in a heart-healthy diet, but making smart choices is key. Despite the confusion and myths surrounding carbohydrates, they are a positive part of a balanced diet when chosen wisely. Discover what carbohydrates really are, the truth behind the myths, and how smart choices like whole grains can benefit your heart health every day.
What are carbohydrates?
Very few foods are purely carbohydrate. In fact, most foods are a mix of fat, protein, and carbohydrates as well as vitamins and minerals. Carbohydrates, fats and proteins play an important role in providing energy for your body. Understanding how they work, and how to make smart carbohydrate choices, is key to managing your cholesterol and supporting heart health.
There are three types of carbohydrates – sugars, starch and fibre.
Sugars
Sugars are the simplest form of carbohydrate and are quickly digested and absorbed into your bloodstream, providing a fast source of energy. They also add sweetness to food and drinks.
Natural sugars in food
Sugars naturally occur in many whole foods, such as fruits, vegetables, and in small amounts in some cereals like rice and oats. Because these simple sugars are contained inside the plant cells, they take longer to digest, meaning they have a gentler effect on your blood sugar levels. Additionally, when you eat whole foods that naturally contain sugars, you also benefit from many other essential nutrients that support heart health.
Whole foods naturally containing sugars:
- Fruits and vegetables. Vegetables contain less sugar than fruits. Learn more about the heart health benefits of vegetables and fruit.
- Milk and dairy products: Naturally occurring milk sugar is known as 'lactose', which gives milk its slight sweetness. However, lactose is digested differently from other sugars and doesn’t impact your blood sugar levels or harm your teeth.
- Cereals: Some grains, like rice and oats, contain very small amounts of natural sugars, but these don’t pose a significant concern for health.
Health experts are generally not concerned about sugars found in whole foods, as they come with other nutrients that benefit your heart and general health. The real concern lies with foods that have added sugars.
Added sugars (free sugars)
Free sugars are those that are added to food and drinks during food processing or home cooking. These sugars are extracted from their natural sources and concentrated, so they are absorbed quickly by the body, causing a rapid spike in blood sugar levels. Added (free) sugars are just that, pure sugar with no other nutrients or fibre.
While we enjoy the sweetness added to food, these added sugars contribute little to our overall nutrition. Consuming them in excess can lead to various health issues, including:
- poor blood sugar control
- increased risk of type 2 diabetes
- poor dental health
- poor heart health outcomes.
Added sugars are found in:
- Sweets, chocolates, biscuits, and cakes
- Soft drinks and some speciality coffees and teas
- Flavoured milk and plant-based drinks
- Flavoured dairy and plant-based yogurts
- Fruit drinks
What counts as a free sugar |
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Includes those labelled as raw (cane), organic, natural, pure, whole, unrefined |
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Unsweetened fruit and vegetable juices and smoothies |
By being mindful of added sugars in your diet, you can make heart-healthy choices that help keep your cholesterol in check and support your overall wellbeing.
How much?
Adults should aim to keep their free sugar intake below 30g per day, which is roughly 7 teaspoons. This limit applies to the total amount of free sugar in all the foods and drinks you consume throughout the day, and it can add up quickly.
Check the label
It can be difficult to keep tabs of all the free sugars you consume throughout the day. Using food labels is an easy way to keep your free sugars intake down!
Most food products have front of pack labelling which shows how much sugar is in the product at-a-glance. Look out for foods and drinks with a green traffic light for sugar, or check the amount of sugar per 100g or per portion.
| How much sugar in processed foods | Low | Medium | High |
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Foods amount of sugars per 100g |
5g or less | betwen 5g and 22.5g |
more than 22.5g (per 100g) OR more than 27g per serving (if the serving size is greater than 100g) |
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Drinks amount of sugars perper 100ml |
2.5g or less | betwen 2.5g and 11.25g |
more than 11.25g OR more than 13.5g per serving (if the serving size is greater than 150ml) |
The figures on food labels show the total amount of sugar in a product, including sugars naturally present in milk, fruit, and vegetables, as well as any free or added sugars. While this doesn’t isolate free sugars, checking labels can still help you identify if a product is high or low in sugar and compare options to choose a healthier one.
To get a better idea of the free or added sugar content, check the ingredients list. If added or free sugar appears near the top or multiple types are listed, the product is likely to contain a high amount.
Keep in mind that many different terms are used to describe free sugars.
| Ingredients list 'free sugars' terms include: Agave syrup, caramel, corn syrup, crystalline sucrose, dextrose, fructose, fruit juice concentrate, fruit puree, fruit syrup, gelactose, glucose, glucose syrup, golden syrup, high-fructose corn syrup, honey (all varieties including manuka and organic), lactose, malt extract, maltose, maple syrup, molasses, muscovado, nectars (such as blossom), sucrose, sugar (including brown, cane, caster, demerara, golden caster, granulated, icing), treacle. |
Get our practical tips on how to cut down on sugar
Starchy carbohydrates
Starchy carbohydrates are made up of long chains of simple sugars linked together. The body needs to break down these links to release the simple sugars so they can be absorbed into the blood to provide us with energy.
Starchy carbohydrate play a vital role in our diet, providing essential energy. However, not all starchy carbohydrates are created equal. While some offer valuable heart-healthy nutrients like fibre, vitamins, minerals, and unsaturated fats, others provide little more than calories.
Smart choices for starchy carbohydrates. The way starchy foods are prepared also affects their heart healthiness. Making smart choices in both the type of starchy foods you eat and how they’re prepared is key to supporting heart health.
Starchy foods:
- Tubers including potatoes, yams, plantains, cassava
- All grains and foods made from them including
- Wheat flour, bread, caphattis, wraps, pasta
- Breakfast cereals
- Rice, barley
- Corn
- Oats and porridge
- Other grains such as couscous, buckwheat, sorghum, rye, barley, millet
Type of starchy foods
1. Refined carbohydrates
Refined carbohydrates have had their nutrient-rich outer bran layer and germ removed, leaving mainly the starchy core. This process strips away fibre, minerals, unsaturated fats, and vitamin E, resulting in a carbohydrate that is quickly broken down into sugar. Examples include white bread, white rice, cakes, biscuits, and sugary products. These refined carbs are often linked to negative health outcomes, such as rapid blood sugar spikes.. It is refined carbohydrates that give carbs a bad name!
2. Wholegrain carbohydrates
Wholegrains retain the bran and germ, preserving fibre, vitamins, minerals, and unsaturated fats. Their complex structure slows digestion, promoting steady blood sugar levels. Studies consistently link wholegrains to improved heart and gut health, better blood sugar control, and lower cholesterol. Examples include wholemeal bread, oats, brown rice, wholegrain pasta, and wholegrain breakfast cereals.
3. Tubers
Tubers like potatoes and yams are excellent sources of fibre, vitamins, and minerals. Keeping the skin on enhances fibre content. Heart healthiness depends on preparation—avoid cooking with animal fats, tropical oils like palm and coconut, or adding excessive salt..
Fibre
Fibre is found in wholegrains, tubers, legumes, fruits, and vegetables. While the body doesn’t digest or absorb it, fibre plays a vital role in maintaining overall health
Benefits of fibre
- Promotes a healthy body weight
- Improves heart health and lowers blood cholesterol
- Enhances gut health and reduces the risk of bowel cancer
- Lowers the risk of type 2 diabetes
Cholesterol-lowering fibres
Certain fibres are particularly effective at lowering cholesterol by forming a gel-like
substance in the gut that can trap cholesterol and prevent its absorption into the blood:
- Beta-glucan found in oats and barley. Find out more.
- Pectin found in fruit and vegetable. Read more about the benefits of fruit and vegetables.
Find out more about beta-glucan
Making smart carb choices
The UK government recommends that around half of our energy intake should come from carbohydrates, with a focus on fibre-rich options. At the same time, we should limit our intake of sugars and refined starchy carbs.
However, many of us consume too much sugar and not enough fibre-rich wholegrains and tubers. Use the table below to help you make healthier choices.
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Sugary carbs |
Refined starchy carbs |
Fibre-rich carbs So much choice & variety |
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Keep to a minimum |
Limit these |
Eat more of these |
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Smart ways to prepare healthy carbs
How we prepare wholegrains and tubers, and the ingredients we add to them, play a key role in determining their overall nutritional quality.
| Instead of preparing or serving with... | ...try this healthier option... |
| Butter, ghee, other animal fats or tropical fats - palm and coconut fat | Vegetable oils or their spreads such as rapeseed, olive, sunflower, peanut |
| Deep fat frying or using lots of oil | Try to use little oil in cooking and try alternatives like boiling, steaming, baking, or air-frying |
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Cheese, cream or full fat milk sauces Coconut milk, cream or yogurt |
Low fat milk or plant-based alternative sauces Zero fat dairy yogurt or plant-based alternatives other than coconut Tomato sauces using vegetable oils |
| Salt or stock cubes | Low salt stock cubes and use more herbs and spices |
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Adding animal fats, tropical fats (such as coconut and palm oil), or creamy and cheese-based sauces not only adds excess calories but also increases saturated fat, which can raise blood cholesterol levels.
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Opting for healthier unsaturated oils like olive or rapeseed oil boosts heart-healthy unsaturated fats. Replacing saturated fats with unsaturated fats has been shown to help lower blood cholesterol.
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Switching to tomato and oil-based sauces, rather than rich, creamy or cheese options, also supports healthier fat intake and reduces saturated fat.
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Be mindful of salt, which is often found in high amounts in stock and contributes to high blood pressure. Reducing salt intake is important for heart health.
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Finally, bulk up meals with beans and plenty of vegetables to further boost fibre and essential vitamins and minerals
What about low carb diets?
The idea that low-carb or ketogenic diets are inherently good for your health is a common myth. The truth is, it all comes down to making smart carbohydrate choices - opting for wholegrains, tubers, and fibre-rich options while keeping refined carbs and free sugars to a minimum.
Low-carbohydrate diets, like the ketogenic diet, can limit heart-healthy foods such as fibre-rich vegetables, legumes, and wholegrains. These diets often lead to higher consumption of saturated fats from foods like meat, cheese, and butter, which will raise blood cholesterol. A more balanced approach focuses on reducing sugary foods and including fibre-rich carbohydrates for better health.
What about weight loss? We're all individuals, and there’s no single ‘diet’ that works for everyone. For weight loss, it’s essential to consume fewer calories than you use while ensuring you maintain a healthy balance of nutrients. Fibre-rich carbs like porridge, wholemeal bread, and brown rice are filling and nutritious, making them excellent choices for weight management.
A diet that supports a healthy body weight must also be realistic and sustainable in the long term. Avoiding entire food groups over an extended period is often impractical. For people with diabetes, prioritising fibre-rich carbs over sugary ones can help with blood sugar levels - but they should discuss their diet with their dietitian.
