The Secret to a Healthy Old Age May Be in the Type of Carbs You Eat

A large study of more than 47,000 women found that eating healthy carbohydrates, such as fruits, vegetables, whole grains, and legumes, is linked to healthier aging, fewer diseases, and better memory. Refined carbohydrates, such as white bread and sugar, increase the risk of problems in old age. In other words, the quality of carbohydrates is essential for living well for longer.

In the next 40 years, the elderly population in the United States is expected to double. This group tends to have more chronic diseases and physical and mental losses as they age. Therefore, understanding how to stay healthy as we age is a priority. And diet, especially the quality of carbohydrates we consume, can play an important role in this.

Carbohydrates account for about half of the calories in the American diet. However, most of these come from refined carbohydrates, such as white bread, candy, and soda, and only a small portion comes from healthy sources, such as fruits, vegetables, whole grains, and legumes.

Previous research has shown that consuming low-quality carbohydrates is linked to a higher risk of heart disease, diabetes and early death. But little was known about the effect this has on so-called “healthy aging”, that is, living longer without serious diseases, with good memory, physical autonomy and mental health.

Researchers analyzed data from 47,513 women from the large American study called the Nurses' Health Study, followed for more than 30 years.

The focus was to observe how the amount and type of carbohydrate consumed in middle age influenced the chances of these women reaching old age in good health.

They evaluated several aspects of diet, such as the total carbohydrate intake, the percentage of refined versus healthy carbohydrates, fiber intake, glycemic index (GI) (how quickly a food causes blood sugar to rise), and glycemic load (GL) (which takes into account the glycemic index and the total amount of carbohydrate consumed.

Only 7.8% of women were classified as having healthy aging at the end of the study. But the chances of achieving this goal were higher among those who consumed:

• More high-quality carbohydrates, such as those from fruits, vegetables, whole grains and legumes

• More dietary fiber, especially from natural foods

• Fewer refined carbohydrates, such as white sugar, refined flour and processed foods

For example, for every 10% increase in calories from good-quality carbohydrates, the chance of aging healthily increased by up to 31%. Higher consumption of refined carbohydrates reduced this chance by 13%.

Additionally, women with diets with a high glycemic index or a high proportion of carbohydrates to fiber were less likely to age healthily.

This study reinforces something that many nutritionists have already warned: it’s not just about how many carbohydrates you eat, but where they come from. Natural, whole-grain carbohydrates, rich in fiber and nutrients, help keep the body and brain functioning well for longer.

Swapping refined carbohydrates, bad fats, and animal proteins for healthy carbohydrates can be a simple and effective strategy for those who want to age with greater health, autonomy, and well-being.

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Dietary Carbohydrate Intake, Carbohydrate Quality, and Healthy Aging in Women

Andres V. Ardisson Korat, Ecaterina Duscova, M. Kyla Shea, Paul F. Jacques, Paola Sebastiani, Molin Wang, Sara Mahdavi, A. Heather Eliassen, Walter C. Willett, and Qi Sun

JAMA Netw Open. 2025; 8 (5): e2511056.

DOI: 10.1001/jamanetworkopen.2025.11056

Abstract:

Dietary carbohydrate quality is inversely associated with risks of chronic disease and all-cause mortality. However, limited evidence exists regarding the role of carbohydrate quality and dietary carbohydrate types in promoting healthy aging. To evaluate the long-term role of dietary carbohydrate intake and carbohydrate quality in healthy aging. This prospective cohort study used data from the Nurses’ Health Study (NHS) from January 1984 to December 2016 and included participants aged younger than 60 years in 1984. Data were analyzed from January 2023 to February 2025. Intakes of total carbohydrates; refined carbohydrates; high-quality carbohydrates from whole grains, fruits, vegetables, and legumes; dietary fiber; and the dietary glycemic index (GI) and glycemic load (GL). Nutrient intakes were derived from 1984 and 1986 food frequency questionnaires. The primary outcome was healthy aging, defined as the absence of major chronic diseases, lack of cognitive and physical function impairments, and having good mental health, according to 2014 or 2016 NHS questionnaire data. Multivariate logistic regression was used to calculate associations of each carbohydrate variable with healthy aging. Among 47 513 participants (mean [SD] baseline age, 48.5 [6.2] years), 3706 (7.8%) met our healthy aging definition. Every 10%-calorie increment in intakes of total carbohydrates (odds ratio [OR], 1.17; 95% CI, 1.10-1.25) and high-quality carbohydrates (OR, 1.31; 95% CI, 1.22-1.41) was positively associated with healthy aging. Refined carbohydrates were associated with lower odds of healthy aging (OR, 0.87; 95% CI, 0.80-0.95). Intakes of carbohydrates from fruits, vegetables, and whole grains were positively associated with odds of healthy aging (ORs ranging from 1.11; 95% CI, 1.07-1.15 to 1.37; 95% CI, 1.20-1.57 per 5% energy increment). Additionally, intakes of total dietary fiber and fiber from fruits, vegetables, and cereals were associated with higher odds of healthy aging (ORs ranging from 1.07; 95% CI, 1.03-1.11 to 1.17; 95% CI, 1.13-1.22 per 1-SD increment). GL was positively associated with healthy aging, which was attenuated by dietary fiber adjustment. A higher GI (OR, 0.76; 95% CI, 0.67-0.87) and carbohydrate-to-fiber ratio (OR, 0.71; 95% CI, 0.62-0.81) were inversely associated with healthy aging when comparing extreme quintiles. There were positive associations for isocaloric replacements of refined carbohydrates, animal protein, total fat, or trans fats with high-quality carbohydrates (ORs ranging from 1.08; 95% CI, 1.01-1.16 to 1.16; 95% CI, 1.11-1.21). In this cohort study of women, intakes of high-quality carbohydrates and dietary fiber were associated with positive health status in older adulthood, suggesting that dietary carbohydrate quality may be an important determinant of healthy aging.