The chapter provides a brief but incisive view on the importance to health of the quantity and quality of carbohydrates in the human diet from ancient times to the present day. Deep insight is given into how carbohydrate-based foods can be assessed to communicate accurately with the consumer. Evidence is also provided that sweeteners and sugar alternatives, as well as low-glycaemic starchy foods, have significant roles in controlling metabolism, which, if let go, commonly leads to metabolic crises, incident diabetes, coronary heart disease, stroke, even cancer and many other conditions. The author shows how food-based advice on fruits, vegetables and whole grains, helpful as it is, only partially communicates about the quality and quantity of carbohydrate foods. Meanwhile, evidence is presented that the appropriate use of sweeteners and sugar alternatives could help to lower the risk of prevalent metabolic disorders, while table sugar in doing little harm when not overly consumed may also do little good.