Reconsidering carbohydrate timing and pairing for healthy ageing in older adults

A recent report challenges the common practice of severely restricting rice and starchy foods among older adults, emphasising the importance of strategic carbohydrate consumption to support muscle maintenance, blood sugar control, and overall healthy ageing.

Many older adults cut back sharply on rice and other starchy foods because they fear a rise in blood sugar, but that approach can backfire, according to a recent report in CDNS and commentary from family physician Li Sihsien. Li argued that avoiding carbohydrates altogether is not the same as eating healthily, and said the better question is when carbohydrates are eaten and what they are paired with.

Li said muscle maintenance depends not only on protein but also on carbohydrates, which provide the energy needed to train hard enough to preserve strength. A review on ScienceInsights likewise notes that carbohydrates do not directly build muscle in the way protein does, but they help fuel intense exercise, support recovery and reduce the risk of the body breaking down existing muscle tissue. That matters particularly for older adults, whose muscle mass tends to decline with age.

The CDNS report said Li recommends placing most carbohydrate intake at lunch, then adding movement afterwards, such as walking, stair-climbing or resistance training. Research published in the American Journal of Clinical Nutrition has examined how different carbohydrate types affect insulin action and muscle metabolism, underscoring the point that not all carbs behave the same way in the body. Separate work in Diabetes Care has also found that changing macronutrient balance can improve insulin sensitivity in people at metabolic risk, reinforcing the idea that food composition affects blood sugar control.

Li also warned against treating dinner as a no-carbohydrate zone. The CDNS report said some research suggests that a moderate serving of rice three to four hours before bed may shorten the time it takes to fall asleep, although too much can impair sleep quality. The bigger issue for many older adults, Li said, is protein: the report said studies have found that among people with diabetes over 65, very few reach recommended protein intake at breakfast, often because the meal is limited to congee, side dishes or soy milk. His broader message was that healthy ageing depends less on blanket restriction than on balancing carbohydrates, protein, vegetables and healthy fats across the day.