From spaghetti and meatballs to tuna casserole to pasta salad, we really love our pasta. In part, it’s the easy preparation. Boil water, open box, voil?! Also there’s the comfort that comes from eating a plate of pasta, a comfort we can hardly resist. On average, Americans eat about 30 pounds of pasta per year.

Although it contains a little protein and fat, pasta is mainly a complex carbohydrate food. But while a serving of pasta is one cup cooked (a half-cup dried), it’s not uncommon for Americans to eat three cups of pasta with sauce at a meal—a habit that contributes to obesity and diabetes. Megan Tempest, a registered dietitian from the University of Chicago Medical Center, explains: “Carbohydrates break down to glucose, and glucose causes the body to secrete insulin, to store glucose as fat.”

Italian pasta is traditionally made from durum wheat semolina, the hardest of all wheat varieties, and a bit higher than others in protein and gluten content. Gluten (Latin for glue) is a composite of two proteins—it gives pasta its golden tint and makes dough malleable so it can be easily rolled, sliced, shaped and dried.

Today pasta has become the generic term for any flour-based noodle. While pasta and noodles are made from dough that is boiled, noodles can be made from any grain (like wheat, buckwheat, millet and rice) or starchy substance (such as soy, beans or potatoes). While pasta is traditionally Italian, noodles are common around the world. We have rice noodles in China, soba or buckwheat noodles in Korea and Japan, bean thread noodles in Southeast Asia and even noodles that incorporate potatoes—like gnocci—in European cuisines. Noodles are usually served in broth, while pasta is served with a sauce; the firm, hard wheat picks up sauces better.

If you had visited Florence or Naples in the 16th century, you would have seen pasta hung out to dry on clotheslines. In contrast, modern pasta is an industrial product. Machines move flour and water from holding tanks to kneaders to flatteners to vacuum mixers that eliminate excess water and air bubbles. The dough is heated to kill bacteria, then cut. From spaghetti to rigatoni, lasagna to ravioli, there are about 1,000 different pasta shapes.

Short, thick tubes like penne are best for pasta salads. Thick-walled, sturdy pasta is good in casseroles. Farfalle, radiatore or fusilli mix well with chunky, bite-sized veggies. For soups, a fine pasta like ditalini (tiny tubes) or orzo is best.

After it’s dried in huge ovens (up to an acre in size), conveyor belts move the pasta to a packaging station, where it is measured by machines into pre-printed boxes or bags. Commercial pasta has truly become ubiquitous. The latest innovation is no-boil pasta that is partially cooked at the plant, making this already easy-to-prepare food even simpler. Just add cooked meat or veggies and jarred sauce, heat, and dinner is on the table.

Most commercial pasta is made from refined grain which has been stripped of bran and germ. Dr. Marvin Kunikiyo, author of Revolutionizing Your Health (BCH Fulfillment and Distribution), says: “Being a highly processed food, pasta is basically stripped of all its nutrients, leaving behind a bunch of empty calories.”

Today, there are many healthier alternatives to durum semolina pasta. Manufacturers are adding beans or chickpeas (such as Barilla Plus) to enhance the protein and fiber content. Whole grain pastas provide more nutrients and fiber. Increasingly, rice noodles and other pasta-like products are being made from other grains for those who can’t eat wheat or gluten. Organic brown rice, bean, quinoa or spelt pastas are available in health food stores.

For centuries, noodles have been made at home. Modern pasta machines allow home cooks to create various pasta shapes with ingredients of their choosing. Small new firms have arisen to compete with giant factories. They make artisanal pastas, using old-fashioned metal dies to cut dough rather than modern Teflon-coated dies. The rougher texture is better for picking up sauces, and it keeps home pasta-making free from Teflon-related chemical worries.

When small servings of pasta are mixed with lots of vegetables that boost bulk and add antioxidants, pasta can make a quick, healthy meal. Organic, whole-grain pasta, which has not been stripped of important trace nutrients and provides dietary fiber, is a better choice. But, Dr. Kunikiyo adds, “Unfortunately, all pasta (even brown rice or quinoa pasta) is highly processed, so it’s still not a very healthy alternative.”