Western Medicine

Simple vs Complex vs Refined Carbohydrates: What's the Difference?

Don't avoid carbs until you get educated on them.

Edited By:
Alexandra Vaughn , MD

Food is powerful. In the scientific field, research continues to highlight the impact diet has on a person’s appearance, overall health, and even gene expression. The word “diet” seems to appear frequently in mainstream media. It can be a complex conversation with a variety of positive and negative opinions. When discussing diet, it is helpful to know the various forms of carbohydrates and understand how carbohydrates impact the human body. 


Simple vs Complex Carbohydrates

Carbohydrate is a term that describes all sugar and starch products. The terms “simple” and “complex” refer to the molecular structure of the carbohydrate.

Simple carbs

Simple carbohydrates are small sugar molecules such as glucose, fructose, sucrose, lactose, and galactose. These are found in plant sources, as well as processed or refined foods. Examples of simple carbs include table sugar, honey, fruit, juice, pastries, candies, and dairy products. Once eaten, simple carbohydrates are readily digested and absorbed into the bloodstream as glucose and fructose, which are simple sugars that the body uses as fuel.

Complex carbs

Complex carbohydrates are small sugar molecules linked together. When people eat complex carbohydrates, these links first have to be broken. The only exception to this process is dietary fiber. Once complex carbohydrates are processed in this manner, they too are absorbed into the bloodstream as glucose and fructose molecules. Complex carbohydrates are also found in plant sources and refined foods. Plant sources include legumes, lentils, whole grains, as well as starchy vegetables. Refined complex carbohydrates include bread, pancakes, cereals, noodles, pasta, porridge, and tortillas.  


How d=Does the Body Distinguish Between Simple and  Complex Carbohydrates?

It is important to understand that the body does not differentiate between simple and complex carbohydrates. Ultimately, both forms of carbs break down into glucose and fructose, which is then used as energy for all cells. The only difference between simple and complex carbohydrate metabolism is the rate of absorption into the bloodstream. When glucose and fructose enter the bloodstream, the pancreas releases a hormone called insulin. This hormone signals to special channels in surrounding cells to absorb glucose and fructose. When cells do not require any more glucose or fructose for energy, these molecules are then stored as fat.

Regardless of structure, all simple and complex carbohydrates (except fiber) cause an increase in blood glucose and insulin levels after meals. For individuals who suffer from insulin resistance or diabetes, cells do not respond to insulin appropriately, or the pancreas does not produce adequate insulin. This causes elevated blood sugar and cellular dysfunction. Chronic uncontrolled blood sugar can lead to heart attack, blindness, kidney failure, neuropathy, and stroke. It is therefore imperative that those who suffer from these disorders closely monitor ALL carbohydrate intake with proper medical supervision.


How Do Scientists Measure the Impact of Carbohydrates?

Scientists use tools such as glycemic index and glycemic load to estimate how fast carbohydrates increase blood sugar. This is called the glycemic response. Simple sugar products, as well as refined carbohydrates, have been known to demonstrate a high glycemic response. Similarly, diets high in refined carbohydrates have been shown to contribute to numerous chronic diseases such as insulin resistance, chronic inflammation, and the progression of type 2 diabetes, cardiovascular disease, and non-alcoholic fatty liver disease.

Furthermore, scientists have also examined the impact of low glycemic response, confirming the benefits of smarter carbohydrate consumption. In recent publications, low glycemic index/load diets were considered beneficial in warding off acne, chronic disease, as well as metabolic disorder.


Wait, There’s a Link Between Insulin and Acne?

Unfortunately, yes. Lactose is a simple carbohydrate and found in cow’s milk. Not only does milk raise blood sugar (and thus insulin), but also the hormone IGF (insulin-like growth factor). IGF is a growth hormone that enables newborns to double their weight in six months, as well as promotes sexual development/growth during puberty. The elevation of insulin and IGF however, has been linked to excessive sebum production and acne.  

Significant genetic implications have also been connected to dairy consumption. Whey proteins found in dairy products were shown to affect the expression of genes such as IRS-1 (insulin receptor substrate) and FASN (fatty acid synthase). Both of these genes are highly significant in glucose metabolism, implying that dairy in the diet may leave a powerful impact on the regulation of blood sugar.

Gallons of milk in the dairy ailse


Credit: Ariel Maroon

The Take-Away

Diet continues to play a prominent role in relevant global health issues. In particular, excessive refined carbohydrate intake appears to be linked to chronic disease. Not only are refined products stripped of notable health benefits such as fiber, vitamins, and minerals, but manufacturers may add even more sugar for taste and texture. In addition, cow milk products are especially associated with acne flares, most likely due to the profound impact on circulating insulin and IGF levels. The discourse regarding simple, complex, and refined carbohydrates is complex, but it is highly relevant to preventative health and treatment of disease.

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