A new, large-scale study led by researchers from Tufts University and other institutions offers fresh insight into the role of carbohydrates in women’s health and aging. Published in JAMA Network Open, the research analysed data from over 47,000 women aged 70 to 93, participants in the longstanding Nurses’ Health Study, and found that the quality of carbohydrate intake during midlife strongly predicts healthier aging.

The study tracked dietary habits over three decades, focusing on types and sources of carbohydrates consumed. Women who ate higher amounts of complex carbohydrates and dietary fibre in midlife had up to a 37% greater chance of aging healthily — defined as maintaining cognitive and physical function, good mental health, and being free from major chronic diseases such as heart disease, diabetes, and cancer.

The researchers emphasised the significance of the findings: “Our findings suggest that consuming high-quality carbohydrates from whole grains, fruits, vegetables, and legumes during midlife is strongly linked to healthier aging later in life.”

The researchers meticulously analysed food frequency questionnaires from 1984 to 2016, calculating glycaemic index (GI) and glycaemic load (GL) to understand blood sugar impacts. Their analysis revealed that diets rich in high-quality, unrefined carbohydrates and fibre were consistently associated with better health outcomes in older age.

Conversely, refined carbohydrates — such as white bread, white pasta, white rice, and foods high in added sugars — were linked to lower odds of healthy aging. These foods tend to cause rapid spikes in blood sugar and insulin levels, increasing risks for obesity, cardiovascular disease, type 2 diabetes, cognitive decline, mood disorders, and chronic inflammation.

The study also found that replacing refined carbohydrates, animal protein, or unhealthy fats with high-quality carbohydrates increased the odds of healthy aging by 8% to 16%. This underscores the importance of nutrient quality rather than total carbohydrate quantity alone.

Commenting on the biological mechanisms, the researchers noted that high-quality carbohydrates provide beneficial dietary fibre which supports gut health, reduces inflammation, and improves blood sugar regulation. These effects likely contribute to better physical and cognitive function as people age.

In general, these findings align well with existing dietary recommendations promoting whole foods. High-quality carbohydrates are rich not only in fibre but also in essential vitamins like B vitamins (folate, B6, thiamine), which support vascular health and metabolic function.

However, the authors caution that their results are primarily based on a population of mostly white female health professionals in the US, so further research is needed to confirm applicability across genders and diverse ethnic groups.

Authors of the study mentioned: “Not all carbohydrates are equal when it comes to ageing well; choosing fibre-rich, nutrient-dense sources matters. Our research supports dietary guidelines that advocate for increasing whole plant foods and reducing refined sugar and starch intake to promote longevity.”

Beyond diet, the study acknowledges healthy aging is multifactorial. Physical activity, sleep quality, social connections, and stress management all contribute significantly to wellbeing in later life. For women especially, balanced nutrition during menopause—focusing on quality carbohydrates alongside lean proteins and healthy fats—is vital for maintaining heart health, bone density, and muscle mass.

In an era when low-carb and ketogenic diets have gained popularity, this research offers a nuanced perspective: eliminating all carbohydrates may risk nutrient deficiencies important for long-term health. Instead, focusing on carbohydrate quality—whole grains, fruits, vegetables, legumes—and fibre intake supports not only longevity but life quality.

As populations worldwide age rapidly, this study reinforces the need for sustainable dietary strategies that prioritise nutrient-rich foods. Healthcare providers can use this evidence to guide patients toward carbohydrate choices that nourish the body effectively.

Starting good dietary habits in midlife can have profound effects decades later. Carbohydrates should not be feared but chosen wisely. Filling plates with fibre-rich whole grains like oats and brown rice; colourful fruits such as berries and apples; leafy vegetables like spinach and broccoli; and hearty legumes including lentils and chickpeas can help lay a foundation for a longer, healthier life.