Health Journal Online

Category: Nutrition

  • A Cancer-Causing Contaminant in Meds and Meat

    A Cancer-Causing Contaminant in Meds and Meat

    Billion-dollar drugs have been pulled from the market for less carcinogenic contamination than is found in a single serving of grilled chicken.

    In 2018, one of the bestselling blood pressure drugs, valsartan—sold as Diovan—was found to be contaminated by the “probably carcinogenic” nitrosamine known as N-nitrosodimethylamine (NDMA). It’s believed that about 20 million people worldwide were prescribed the drug tainted with this contaminant, which has a cancer risk shown to exceed that of many known potent carcinogens, such as asbestos, PCBs, and benzo[a]pyrene.

    As I discuss in my video Cancer-Causing NDMA in Medications (Zantac, Metformin) and Meat, the U.S. Food and Drug Administration (FDA) estimated that taking the drug for a few years could cause cancer in as many as 1 in 8,000 people, whereas the European equivalent of the FDA estimated the cancer risk could be as high as 1 in 5,000. It is unlikely, researchers wrote in this 2019 paper, that drugs like valsartan are “a unique case.” And indeed, a few months later, the FDA announced it had found NDMA in ranitidine. Ranitidine, the acid reflux drug sold as Zantac, is one of the most prescribed drugs on the planet, in addition to being sold over the counter.

    Then in 2020, some formulations of metformin, a popular diabetes drug sold as Glucophage, were found to be contaminated. The finding of NDMA in common medicines led the FDA to call for the immediate withdrawal of all Zantac from store shelves, yanking the drug from the market because its testing showed NDMA levels could, in some circumstances, exceed the acceptable daily intake limit of 96 nanograms per day. It was so bad that the FDA found levels of this carcinogenic contaminant in Zantac are similar to the exposure levels you would experience if you ate grilled or smoked meats!

    Wait, what?

    NDMA has not only been found in contaminated drugs. It is a known byproduct of tire plants, pesticide manufacturing, and leather tanning, and it is found in food and beverages, including processed meat and beer. Now that we know NDMA can transfer through the placenta, this may explain the relationship between maternal cured meat consumption during pregnancy and the risk of childhood brain tumors. For example, eating hot dogs while pregnant may increase childhood brain tumor risk by 33%, and sausages by 44%. Bacon consumption may increase childhood brain tumor odds by 60 or 70%. But it’s not just processed meat. Researchers have found it in poultry products as well. A single serving of chicken contains more than 100 nanograms of NDMA, as you can see below and at 3:02 in my video.

     

    Remember how the FDA said the acceptable daily intake limit is 96 nanograms? Just half a chicken breast contains 110 nanograms.

    Now, raw poultry doesn’t have any NDMA; it comes from the cooking process. In fact, the dry-heat cooking of meat, like broiling or grilling, even creates airborne NDMA, releasing this very potent carcinogenic compound into the air. So, even if you’re getting a salad at a charcoal grill restaurant, just being indoors where meat is being grilled could be a significant cancer risk.

    Nitrosamines are also found in cigarette smoke, and pressure was put on the tobacco industry to try to remove them, arguing “there is simply no logical reason why a removable carcinogen should be allowed to remain in a consumer product….” That’s the same reason Zantac was yanked from store shelves.

    Okay, so let’s get this straight. Zantac—which is one of the best-selling drugs in history, bringing in billions of dollars—was pulled from the market because it contained a probable carcinogen that exceeded the acceptable daily limit, but there may be more of the contaminant in a single serving of chicken?! So, my question is: Why aren’t they pulling poultry off the shelves, too?

    Doctor’s Note

    NDMA is a nitrosamine, a class of carcinogens also found in processed meat. See, for example, How Much Cancer Does Lunch Meat Cause?.

    How can you make meat less cancer-causing? See Carcinogens in Meat.

    Is Organic Meat Less Carcinogenic? Check out the video to find out.

    Note: The article shown at minute 1:04 of the video I reference has since been retracted due to analytical artifact.



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  • Peeling Back the Onion Claims

    Peeling Back the Onion Claims

    What did randomized, controlled human trials find about the ways we may—or may not—benefit from eating onions?

    Onions are potentially a good source of antioxidants, which, interestingly, are concentrated in the outer layers just beneath the papery peel. White onions, for example, contain more than ten times the antioxidants in the outer layer compared to the inner core. Unfortunately, most people discard the most nutrient-rich outermost layers, “thus losing a valuable part of the antioxidant-rich material.” In general, yellow onions have more antioxidants than white onions. Red onions beat them both, based on three different antioxidant testing methods, as seen at 0:39 in my video Are Onions Beneficial for Testosterone, Osteoporosis, Allergies, and Cancer?

    Though red onions are indeed slightly better, yellow and white onions are no slouches, containing considerable levels of antioxidant activity. We know they’re nutritious, but are there any particular clinical benefits to eating onions? There are all sorts of headlines in the medical literature touting miraculous benefits, but what are these claims based on?

    For example, there’s a review purporting to have evidence that testosterone levels in males are enhanced by onion, but the researchers were referring to studies like one on the effects of onion juice after testicular torsion in rats. Who cares what happens after a rat’s testicle is rotated 720 degrees counterclockwise? (Except, of course, the rat.) You don’t know what happens in people until you put human testes to the test. Only then was it discovered that onion extract doesn’t appear to affect men’s testosterone.

    What about bone health? Evidently, older white women who ate onions at least once a day had an overall bone density that was 5% greater than women who ate onions no more than once a month. Now, 5% might not sound like a lot, but that improvement in bone density could potentially mean decreasing their hip fracture risk by more than 20% if, indeed, it is cause and effect.

    Daily administration of onion for four weeks did cause a big bump in bone density. This could lead to a safe, effective, and low-cost approach to osteoporosis in—you guessed it—rats. Another rodent study!

    Great strides have been made in treating osteoporosis with drugs, but they have the potential for serious adverse side effects, so scientists have turned their attention to natural remedies. In one study, researchers randomized people to drink onion juice or placebo onion juice for 8 weeks. Improvement was noted for a marker of bone health; however, they didn’t actually follow participants long enough to compare osteoporosis rates.

    Do shallots exhibit anti-allergy activity or offer any therapeutic effects for relieving allergic runny noses? Sixteen patients were randomized equally into an antihistamine group or a group that got antihistamines and capsules containing dried shallot powder. It looked like the shallot group did better after four weeks, but there was no statistically significant difference in total symptoms between the two groups. So, another #onionfail.

    What about testing the effects of eating fresh yellow onion to try to decrease the toxic effects of a chemotherapy drug called doxorubicin in breast cancer patients? Unfortunately, no significant benefit was found in decreasing damage to the liver or heart. But eating fresh yellow onion was found to help reduce high blood sugar levels and insulin resistance in breast cancer patients during doxorubicin-based chemotherapy. The drug isn’t just toxic to the liver and heart—it may also contribute to insulin resistance.

    So, researchers performed a randomized, triple-blind, controlled clinical trial, randomizing patients to eat a whole onion a day or a third of an onion a day for eight weeks. What happened? The higher-dose onion group experienced a significant decrease in blood sugars and insulin resistance compared to the lower-dose group. Levels rose in the lower-dose group but fell in the higher-dose group, as you can see below and at 4:28 in my video.

    So, make onions your friend. What’s the worst that can happen—a little onion breath and body odor?

    Doctor’s Note

    What else can we do for breast cancer? See related posts below.



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  • How to Boost Your Life Expectancy by 12 to 14 Years

    How to Boost Your Life Expectancy by 12 to 14 Years

    What can physicians do to promote healthy, life-extending lifestyle changes?

    A pivotal paper published in Europe more than a decade ago entitled “Healthy Living Is the Best Revenge” found that practicing just four simple, healthy lifestyle factors compared to none could potentially have a strong impact on preventing chronic diseases. We’re talking nearly 80% less chronic disease risk, slashing diabetes risk by 93%, dropping heart attack risk by 81%, and cutting stroke risk in half and cancer risk by 36%. Think about what that means. The potential for preventing disease and death is enormous. In the United States alone every year, there are a half million first heart attacks, a half million first strokes, a million new cases of diabetes, and a million new cancer diagnoses. The message is clear: Practicing a few healthy behaviors can have a huge impact.

    What are those four fabled factors?

    • never smoking
    • not being obese
    • averaging about a half hour of exercise a day
    • following healthful dietary principles, including a lot of fruits, vegetables, and whole grains, and less meat

    Follow those four simple rules and boom! Enjoy nearly 80% reduced risk of major chronic diseases.

    What does that mean for mortality risk? As I discuss in my video How to Increase Your Life Expectancy 12 to 14 Years, a similar combination of four healthy behaviors predicted “a 4-fold difference in total mortality in men and women, with an estimated impact equivalent to 14 y[ears] in chronological age,” meaning the individuals were dying at such a reduced rate that it was as if they were 14 years younger. “Finally, a Regimen to Extend Human Life Expectancy,” proclaimed a commentary in reference to a study that had made a similar analysis of the impact of healthy lifestyle behaviors on life expectancies. But this time, it looked directly at the U.S. population, which is particularly important, since Americans have a shorter life expectancy compared to people living in nearly all other higher-income countries. The researchers concluded that a healthy lifestyle could substantially reduce premature mortality and increase life expectancy in U.S. adults. Okay, but by how much? They estimated that adhering to a low-risk lifestyle could extend life expectancy at age 50 by 14 years in women and 12.2 years in men. So, if you’re 50 right now, instead of only living to 79 if you’re a woman and 75½ if you’re a man in the United States, taking even just basic care of yourself could propel you to an average life expectancy of 93 if you’re a woman and 87½ if you’re a man.

    The bottom line is it’s never too late to turn back the clock. A midlife switch just to the basics—at least five daily servings of fruits and vegetables, walking 20 minutes a day, not smoking, and maintaining a healthy weight—leads to a substantial reduction in mortality even in the following few years. We’re talking a 40% lower risk of dying in the subsequent four years. Indeed, “making the necessary changes to adhere to a healthy lifestyle is extremely worthwhile, and…middle-age is not too late to act.”

    As an aside, when I realized the 12 to 14 years of added life expectancy were based on data from health professionals, I got excited about all the potential ripple effects. If health professionals start getting healthier, they can become role models for more healthful living and potentially save more lives than just their own. But that may have been wishful thinking. Practicing what you preach can sometimes backfire. Evidently, “displays of excellence can paradoxically turn off the very people they are trying to inspire.”

    It’s reasonable to assume that not being a hypocrite and trying to walk the walk would lead to positive consequences, inspiring confidence in others. Don’t you want a dance instructor who can dance, a music teacher who can play, and a health professional who’s healthy? But “this simple intuition fails to take into account the concerns about devaluation than an expert’s superior behavior elicits in others”—that is, that may make people feel inadequate. For example, you know how vegetarians often become targets of ridicule and hostility? That’s because they may come off as morally superior and make other people feel like they’re being looked down upon.

    There was an elegant demonstration of this phenomenon in a study where “principled deviants who take the high road threaten others’ moral self-worth.” Participants were asked to complete “a racist task,” and those “moral rebels” who refused to do so were cheered on by observers but disparaged by their fellow participants who had done the task. Why? Because the rebels’ stance was “an implied indictment of their spinelessness.” Isn’t that interesting?

    So, when doctors portray themselves as “the picture of health,” patients might think they’re being holier-than-thou, which can unintentionally alienate those who need the doctors’ help the most. It’s easy to imagine how someone with a weight issue might feel threatened and judged by a physician triathlete. But what are we supposed to do? We want healthy practitioners. Physicians who smoke are less likely to tell their patients to quit smoking, physicians who are overweight are less likely to advise about weight loss, and physicians who don’t work out are less likely to talk about exercise. What doctors can do to make patients more comfortable is emphasize that their role is to help people meet their own personal health goals, whatever they may be. Studies show that when doctors take this approach, it increases the appeal of “fitness-focused” physicians to overweight patients. So, doctors can then display model behavior without inadvertently alienating those who would most benefit from their counsel.

    Doctor’s Note

    For more on lifestyle medicine, see related posts below. 



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  • Do Vitamin C Supplements Help Reduce Anxiety?

    Do Vitamin C Supplements Help Reduce Anxiety?

    What are the risks and benefits of using vitamin C for depression and anxiety?

    “In adults, emerging evidence suggests that higher daily intake of fiber-rich fruit and vegetable servings is associated with lower incidences of anxiety, greater happiness, higher life satisfaction, and greater social-emotional well-being,” says a review in the journal Nutrients. So, “persuading people to consume more fruits and vegetables may not only benefit their physical health in the long-run, but also their mental well-being in the short-run,” concluded a study in Social Science & Medicine. Fruit consumption, for example, has a protective association with leading killers like heart disease, stroke, diabetes, and cancer, as well as depression. The question is why?

    Several mechanisms have been proposed. For example, one posits it’s the antioxidant and anti-inflammatory properties of produce, which scavenge the free radicals that are involved in some of the inflammation associated with depression. If that’s the case, what about simply taking vitamin C supplements? The brain has some of the highest levels of vitamin C in the body, so it’s thought that if extra vitamin C is consumed, it may have some sort of therapeutic role in brain diseases, especially given that it is not just an antioxidant, but also has other critical functions in the brain, such as helping to build neurotransmitters like dopamine. But you don’t know whether it actually helps until you put it to the test.

    One study found a beneficial effect of adding vitamin C as an adjunct treatment to an antidepressant, while another study found no benefit from vitamin C supplementation.

    So, there are mixed results for vitamin C and depression. Another study found no benefit when it came to depression, but those randomized to vitamin C instead of placebo pills did show a significant decrease in anxiety level. And this wasn’t only seen in that study.

    The effects of oral vitamin C supplementation on anxiety in high school students were studied in a double-blind, randomized, placebo-controlled trial. The teens were given 500 mg a day of vitamin C or a placebo. That daily amount of vitamin C is about what you’d find in five oranges, four yellow kiwifruit or guavas, or one and a half yellow bell peppers. Within just two weeks, the vitamin C reduced anxiety levels compared to placebo, as well as provided a significant drop in heart rate.

    Given these data showing that vitamin C may have an anxiety-reducing effect, researchers sought to find out if a single dose could acutely affect emotional states. And indeed, within only two hours of taking some vitamin C, study participants experienced a significant drop in anxiety compared to placebo, though only among those who started out the most anxious in the first place, as you can see below and at 2:42 in my video Do Vitamin C Supplements Help With Anxiety?.

     

    As a bonus, vitamin C supplementation may lower our blood pressure a few points, but whole fruits and vegetables can do the same thing—and may even do it better for those who need it the most, as shown below and at 2:53 in my video.

    As I’ve shown previously, simply adding just two servings of fruits and vegetables a day can have psychological well-being benefits within only two weeks—and without the kidney stone risk associated with vitamin C supplements, though that appears to be only a problem in men.

    Doctor’s Note

    For more on vitamin C and on anxiety, check out related posts below.



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  • Which Potato Is the Most Nutritious?

    Which Potato Is the Most Nutritious?

    Are yellow-fleshed potatoes healthier than white? And what about the glycoalkaloid toxins?

    The high glycemic impact of potatoes may increase the risk of type 2 diabetes, perhaps by chronically overstimulating the insulin-producing cells in the pancreas. In my last two blogs, I explained how you can decrease the glycemic impact of white potatoes by eating them cold, chilling then reheating them, or adding broccoli, lemon juice, or vinegar. What else can we do?

    Well, the pigments in brightly colored berries can act as starch blockers, as you can see below and at 0:38 in my video The Healthiest Type of Potato.

    So, if you’re going to eat a high glycemic food, you may be able to moderate its impact by, for example, spreading raspberries on your toast, adding strawberries to your cornflakes, or sprinkling blueberries into your pancake batter. I’m not saying you have to put blackberries in your baked potato, but given that the natural color compounds in fruits can slow down starch digestion, what about pigmented potatoes?

    Even regular yellow potatoes like Yukon gold may be preferable to white, but the best may be purple potatoes—not just purple-skinned potatoes but purple-fleshed potatoes. If you’ve never seen purple potatoes, they are remarkable—they have almost a neon-blue glow, which you can see below and at 1:14 in my video.

    And not only do they look cool, but purple potatoes cause less of an insulin spike and less of a blood sugar spike compared to even the yellow-fleshed potatoes, suggesting that switching from yellow or white potatoes to purple ones “could have large potential in maintaining public health.”

    How do we know the pigments themselves are responsible, rather than other differences between the different potato varieties? Researchers tried using a control made of berries in a potato starch jelly, but that approach would seem to add even more variables. In a test tube, extracts of purple- and red-fleshed potatoes can act as starch blockers. So, if you extract and purify the purple potato pigments, you could remove any other effects of the different potato varieties by adding those purple pigments to yellow potatoes. And lo and behold, compared to plain yellow potatoes, this results in suppressions of blood sugar and insulin spikes. Instead of an overshoot reaction, where blood sugars can actually drop below fasting levels, you get the gentler rise and fall in blood sugars you’d expect from a lower glycemic food, as you can see below and at 2:25 in my video.

    The authors suggest purple potato extracts could be produced to make supplements or fancy functional foods, but it might be more cost-effective to get these compounds from consuming purple potatoes themselves.

    The purple potato pigments may also affect inflammation. The Potato Association of America likes to paint potatoes as an anti-inflammatory food, but what it doesn’t tell you is that this benefit may be limited to pigmented potatoes. When study participants were randomized to eat a small white potato every day for six weeks versus a yellow- or purple-fleshed potato, those in the purple potato group achieved significantly lower levels of inflammation compared to those in the white potato group, measuring both C-reactive protein and interleukin-6, shown below and at 3:13 in my video.

    Pigmented potato consumption also alters oxidative stress. Within hours of eating a large purple potato, you get a nice 60% bump in the antioxidant power of your bloodstream, and this translates into less free radical DNA damage. If you compare the antioxidant activity of white potatoes, yellow potatoes, and purple potatoes, Yukon gold has about twice the antioxidant power as white, but purple has 20 times the antioxidants. That’s comparable to what you might see in berries. Half a purple potato has about the same polyphenol antioxidant content as half a cup of blueberries.

    Purple potatoes can increase the antioxidant capacity of our bloodstream, whereas straight white potato starch can act as a pro-oxidant and decrease it. Eat a purple potato, and, over the next eight hours, the antioxidant capacity of your bloodstream goes up. In contrast, if you eat white potato starch devoid of any pigment, you can end up worse off than where you started, as you can see below and at 4:12 in my video.

    Okay, but does this translate into different physiological effects? Yes, indeed. When people ate either purple potatoes or white potatoes for two weeks, the purple potatoes improved a measure of arterial stiffness, whereas the white potatoes did not. And this translates into a drop in blood pressure, even in those already taking high blood pressure drugs, suggesting purple potatoes are an effective blood pressure–lowering agent.

    But what about the toxic glycoalkaloid compounds found in potatoes? The toxic human dose starts around 2 to 5 mg/kg of body weight, and the lethal dose is not too far behind. But the average amount of total glycoalkaloids found in most potatoes, however, is less than 100 mg/kg; so, at the average American weight of 180 pounds, a toxic dose is like four to nine pounds of potatoes. What happens when you approach that amount? It’s possible you can get nausea, vomiting, or diarrhea that could be easily confused with something like gastroenteritis or food poisoning. Some people can start to get sick at just 1.25 mg/kg of body weight or even experience symptoms at 1 mg/kg. That would only be about two pounds of potatoes at the average American weight. It’s also possible that the glycoalkaloids could start accumulating if you eat potatoes day in and day out. But what about those people who go on a fad potato diet and eat three or four pounds a day? They can do that without risking getting sick if they peel their potatoes, which removes nearly all of the glycoalkaloids.

    Doctor’s Note

    This is the last in a five-video series on potatoes. If you missed any of the others, see:

    You may also be interested in The Best Way to Cook Sweet Potatoes.

    The video on berries I mentioned is Getting Starch to Take the Path of Most Resistance.



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  • How to Tame Blood Sugar Spikes after Eating Potatoes

    How to Tame Blood Sugar Spikes after Eating Potatoes

    Broccoli, vinegar, and lemon juice are put to the test to blunt the glycemic index of white potatoes.

    White potatoes have a high glycemic index, and consumption of high glycemic impact foods may increase the risk of diabetes. Normally, after a meal, we’d like our blood sugars to rise and fall gently and naturally. But with high glycemic foods like potatoes, we get an exaggerated blood sugar spike. This leads our body to over-compensate with insulin, forcing our blood sugars lower than when we started, which results in negative metabolic consequences, such as a rise in triglyceride fats in the blood, as you can see below and at 0:34 in my video How to Reduce the Glycemic Impact of Potatoes.

    However, potatoes are a good source of vitamin C, potassium, and polyphenols, which may counterbalance their glycemic impact. This may explain why potatoes appear to have a neutral effect when it comes to lifespan, unlike other whole plant foods that have been associated with actively living longer.

    In my last blog, I explained how the act of chilling cooked potatoes can dramatically lower their glycemic index, even if you then reheat them in a microwave. How else might we reduce the glycemic impact of white potatoes? The same way you make anything better in your nutritional life—add broccoli. Eating two servings of cooked broccoli with your mashed potatoes would certainly do it, immediately cutting the insulin demand by nearly 40%. In contrast, adding chicken breast makes things worse, and adding tuna fish makes things even worse still, nearly doubling the amount of insulin your body has to pump out, as shown below and at 1:31 in my video.

    Why does plant protein make things better, but animal protein makes things worse? Because decreased consumption of branched-chain amino acids improves metabolic health. I cover this in my book How Not to Diet, as well as in my video on the topic.

    Speaking of How Not to Diet, remember the section on vinegar? The graph below illustrates the blood sugar and insulin spikes that someone with prediabetes may experience after eating a bagel. When that same bagel is consumed alongside a tablespoon or so of apple cider vinegar diluted in about a quarter cup of water, though, the spikes are significantly reduced, as you can see below and at 2:10 in my video.

    Does it work for potatoes, too? Simply chilling potatoes may cut down on the blood sugar and insulin spikes, but to get significant drops in both, you just have to add about a tablespoon of vinegar to drop levels by 30% to 40%. And that was just plain white distilled vinegar.

    Is it the vinegar itself, or would any acidic condiment do? In a test tube, lemon juice appeared to have a remarkable starch-blocking effect, but you can’t know if it works in people until you put it to the test. And indeed, lemon juice reduces the glycemic responses to bread. And not just by a little, but by about 30%, as you can see below and at 2:50 in my video.

    Now, the study participants were drinking a half cup of lemon juice, but that makes it even more remarkable that it was helpful because that added an extra half teaspoon of sugar, yet they still had a better blood sugar response. Vinegar is more potent, though. Just one to two tablespoons a day of vinegar diluted in water can significantly improve both short- and long-term blood sugar control in people with diabetes, which is why clinicians may want to include vinegar consumption as part of their dietary recommendations for their patients with diabetes.

    Doctor’s Note

    This is the fourth video in a five-part series on potatoes. Missed the first three? See:

    What about the glycoalkaloid toxins in potatoes? I cover that and discuss the best kind of potato in my upcoming final video in the series: The Healthiest Type of Potato.



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  • Why Cooling Potatoes Lowers Their Glycemic Load

    Why Cooling Potatoes Lowers Their Glycemic Load

    If you eat potatoes when they’re cold, as in potato salad, or chilled and reheated, you can get a nearly 40% lower glycemic impact.

    If you systematically pull together all the best studies on potato consumption and chronic disease risk, an association is found for the risk of type 2 diabetes and hypertension—but that’s for French fries. Consumption of boiled, baked, or mashed potatoes was not associated with the risk of high blood pressure, but there was still a pesky link with diabetes. Overall, eating potatoes is not related to risk for many chronic diseases, but boiled potatoes could potentially pose a small increase in risk for diabetes. That’s one of the reasons some question whether they should be counted as vegetables when you’re trying to reach your recommended daily servings of fruits and vegetables.

    If you look at other whole plant foods—nuts, vegetables, fruits, and legumes (which are beans, split peas, chickpeas, and lentils)—they’re associated with living a longer life. Significantly less risk of dying from cancer, dying from cardiovascular diseases like heart attacks, and 25% less chance of dying prematurely from all causes put together. But no such protection is gained from potatoes for cancer, heart disease, or overall mortality. So, the fact that potatoes don’t seem to affect mortality can be seen as a downside. Now, it’s not like meat, which may actually actively shorten your life, as you can see below and at 1:28 in my video Glycemic Index of Potatoes: Why You Should Chill and Reheat Them.

    But there may be an opportunity cost to eating white potatoes, since every bite of a potato is a lost opportunity to put something even healthier in your mouth—something that may actively make you live longer.

    So, potatoes are kind of “a double-edged sword.” The reason that potato consumption may have just a neutral impact on mortality risk is that all the fiber, vitamin C, and potassium in white potatoes might be counterbalanced by the adverse effects of their high glycemic index. Not only are high glycemic impact diets “robustly associated” with developing type 2 diabetes, but current evidence suggests that this relationship is cause and effect.

    A front group for the potato industry called the Alliance for Potato Research and Education funded a study that found that intake of non-fried potatoes does not affect blood sugar markers, when compared with the likes of Wonder Bread, that is, so that isn’t really saying very much. Foods with a glycemic index (GI) higher than 70 are classified as high-GI foods (high glycemic index foods), and those lower than 55 are low-GI foods. Pure sugar water, for example, is often standardized at 100, and white bread and white potatoes are also way up there as high glycemic index foods. But when you compare them to an intact grain, like barley groats (also known as pot barley), which is a super-low GI food, you can see how refined grains and potatoes are simply no match. Check out the numbers below or at 2:47 in my video.

    Is there any way we can have our potatoes and eat them too, by somehow lowering their glycemic index? Well, if you boil potatoes and then put them in the fridge to cool, some of the starch crystallizes into a form that can no longer be broken down by the starch-munching enzymes in your gut, as you can see below and at 3:06 in my video.

    However, the amounts of this so-called resistant starch that are formed are relatively small, making it hard to recommend cold potatoes as a solution. But when put to the test, you actually see a dramatic drop in glycemic index in cold versus hot potatoes, shown below and at 3:23 in my video.

    So, by consuming potatoes as potato salad, for instance, you can get nearly a 40% lower glycemic impact. The chilling effect might, therefore, also slow the rate at which the starch is broken down and absorbed. So, people who want to minimize dietary glycemic index may consider precooking potatoes and having them chilled or reheated. The downside of eating potatoes cold is that they might not be as satiating as eating hot potatoes. But you may get the best of both worlds by first cooling them and then reheating them, which is exactly what was done in that famous study I profiled in my book How Not to Diet. The single most satiating food out of the dozens tested was boiled-then-cooled-then-reheated potatoes, as you can see below and at 4:09 in my video.

    There is actually an appetite-suppressing protein in potatoes called potato protease inhibitor II, but the way you prepare your potatoes makes a difference. Both boiled and mashed potatoes are significantly more satiating than French fries, as shown below and at 4:26 in my video.

    That was for fried French fries, though. What about baked French fries? Folks had a big drop in appetite after eating boiled mashed potatoes, compared to white rice or white pasta, which is right where fried French fries were stuck, as well as baked French fries. So, though baked fries may be your BFF, they’re not very satiating.

    Doctor’s Note

    Just to be clear, you don’t have to reheat. Chilling is the crucial step to dramatically lower the glycemic index, so you can certainly enjoy a cold potato salad. If you’re trying to control your weight, though, you may want to avoid even baked fries.

    This is the third in a five-video series on potatoes. If you missed the first two, see Do Potatoes Increase the Risk of Diabetes? and Do Potatoes Increase the Risk of High Blood Pressure and Death?.

    Chilling isn’t the only trick to blunt the glycemic impact. You can also add vinegar, lemon, or broccoli.

    Stay tuned for the final two videos in this series: How to Reduce the Glycemic Impact of Potatoes and The Healthiest Type of Potato.

    Join the resistance! Check out related posts below.



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  • Explore NutritionFacts.org Resources

    Explore NutritionFacts.org Resources

    NutritionFacts.org has a wide range of resources to help you on your journey to a healthier life.

    Primers

     

    The How Not to Die Documentary

    In celebration of the 10th anniversary of the publication of How Not to Die, the Greenbaum Foundation commissioned a documentary about Dr. Greger’s life and work. The film also includes interviews with many of the leading luminaries in the evidence-based nutrition movement.

     

    Daily Dozen Meal Planning Guide

    The healthiest diet is one that maximizes the intake of foods-as-grown—whole plant-based foods—and minimizes the consumption of processed and animal-based foods. In his New York Times Best Seller, How Not to Die, Dr. Greger covers the whys of eating healthfully, exploring diet’s role in the prevention, treatment, and sometimes even reversal of the fifteen leading causes of death in the United States, before diving into the hows of eating healthfully and sharing his Daily Dozen checklist, grocery shopping tips, and meal planning ideas.

    In our Daily Dozen Meal Planning Guide, we walk you through the steps of incorporating the Daily Dozen into your life and give you additional strategies to help you build more healthful eating habits. Download your free copy of the guide today.

     

    Infographics

    Interested in Spanish infographics or Chinese infographics?

     

    Social Media

     

    Email Series

    We offer three, free, engaging and motivating email series to support you in living healthfully:

    • Join us for our How to Live Longer series, where we go through some of the most important information Dr. Greger uncovered on the science behind healthy aging. Sign up for this free email series and learn how to live longer, vibrantly. 
    • Our weekly Plant-Based Living email series gives you simple takeaways and actionable tips on healthy eating. Whether you’re new to a whole food, plant-based lifestyle or would benefit from reminders on some of the key aspects of evidence-based nutrition, this free series is for you.
    • Join us for 11 weeks of Daily Dozen support emails to help you Do the Dozen with ease. Sign up for this free series today.

     

    Dr. Greger’s Live Presentations

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  • Do Potatoes Shorten Your Life?

    Do Potatoes Shorten Your Life?

    Do potato eaters live longer or shorter lives than non-potato eaters?

    Is there a link between potato intake and the incidence of hypertension? Harvard researchers followed the diets and diseases of more than 100,000 men and women for decades and found that those who ate potatoes on most days—not only French fries and potato chips, but even mashed, boiled, or baked—appeared to be at higher risk of developing high blood pressure. But what do people put on potatoes? Salt, not to mention butter, so might the potatoes just be innocent bystanders? The researchers made attempts to tease out the effects of salt and saturated fat, and there still seemed to be a link between potato consumption and high blood pressure.

    Maybe potato eaters are meat-and-potatoes people. After all, these same Harvard researchers found that meat, including poultry, seemed to be associated on its own with an increased risk of hypertension, and the same goes for even a moderate amount of canned tuna. So, in the potato study, they were careful to try to factor out any effects from the consumption of all types of animal flesh. Yet, they still found an increased risk and became concerned that associating potato intake with hypertension could be a “critical public health problem.” It was assumed potatoes might actually decrease high blood pressure, given their high potassium content, but they found evidence of the opposite effect.

    As I discuss in my video Do Potatoes Increase the Risk of High Blood Pressure and Death?, two similar studies performed in Mediterranean Europe did not find any association between potato consumption and high blood pressure, though. Perhaps this is because they don’t smother their potatoes in butter and sour cream in that neck of the woods and instead eat potatoes with other vegetables. Now, the Harvard researchers tried to control for the salty and fatty dietary components associated with eating potatoes in the West, just like these researchers tried to factor out all the extra vegetables, but you can’t control for everything.

    One of the main reasons we care about blood pressure is because we care about the consequences. In two studies done in Sweden, where they primarily eat their potatoes boiled, no evidence was found that potato consumption was associated with the risk of major cardiovascular disease. No relationship between potato consumption and risk of premature death was found in Southern Italy either. In the United States, however, potato consumption was associated with increased mortality: a whopping 65% increased risk of dying from heart disease, a 26% increased risk of fatal stroke, a 50% increased risk of dying from cancer, and an increased risk of dying from all causes put together. However, this association disappeared after adjusting for confounding factors. In other words, it wasn’t the potatoes at all. Potato eaters must just smoke more, drink more, or eat more saturated fat or something. Once you control for all these other factors, the link between potatoes and death disappears.

    This was confirmed in the NIH-AARP study, the largest such study of diet and health in human history. If you separate out just the potatoes, researchers find they are not associated with increased risk of death, with the possible exception of French fries, which are associated with an increased risk of dying from cancer. Put all the studies together—20 in all—and no significant association has been found between potato consumption and mortality, though again, fried potatoes may be the exception. Even just twice a week, fries may double one’s risk of dying prematurely, independently of other factors, but the consumption of unfried potatoes seemed to be neutral.

    I’ve talked a lot about how all plant foods are not created equal, as well as healthy versus unhealthy plant-based diets. To this end, researchers created not only an overall plant-based diet index (PDI)—just scoring plant versus animal foods—but also a healthy plant-based diet index (hPDI) and an unhealthy plant-based diet index (uPDI). The healthy index puts a greater emphasis on whole plant foods, whereas the unhealthy index scores how much low-quality plant foods you’re eating, grouping potatoes along with soda, cake, and Wonder Bread. When you run the numbers, the more plant-based you eat, the longer you live, and the lower your risk of cardiovascular disease. In other words, more plant foods and less animal foods are associated with a significantly lower risk of dying prematurely. This benefit was limited, though, to those eating the healthier plant-food diets. However, the researchers were surprised that those eating the less healthy plant-based diets with processed plant-based junk did not live significantly shorter lives. Maybe that’s just because they were eating fewer animal products, and that’s really the primary determinant of lifespan here, or maybe the lack of an association between less healthy plant-based diets and mortality is because potatoes were kind of coming to the rescue. And indeed, higher intake of potatoes did appear protective; so, given these conflicting results, future studies may consider just resigning fried potatoes to the unhealthy list.

    Now, in terms of mortality, fried potatoes may not be as bad as fried meat—fried chicken and fried fish—but that’s not really saying much. The French fry/death data gave the industry trade group Potatoes USA a bit of a chip on its shoulder, reminding readers that observational studies can only prove correlation, not causation, to which the authors replied, “Our data add to the pressing public health calls to limit fried potato consumption.” French fries may be so bad for you that it wouldn’t be ethical to do an interventional study and randomize people to eat them.

    Doctor’s Note

    This is the second in a five-part series on potatoes. The first installment was Do Potatoes Increase the Risk of Diabetes?.

    Aside from French fries, potato consumption is not associated with mortality. Potato eaters tend to live just as long as non-potato eaters. That’s actually bad news. A whole plant food that’s not associated with living longer? One that has a neutral effect on lifespan? That’s a lost opportunity. But what if you really like white potatoes? Then you should chill and reheat them, as I explain in my next video.

    Coming up:

    For more on preventing and treating high blood pressure, see related posts below.



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  • Potatoes and Diabetes: It’s Complicated

    Potatoes and Diabetes: It’s Complicated

    Does the link between white potatoes and diabetes extend to non-fried potatoes without butter or sour cream?

    The trouble for white potatoes began in 2006, when the Harvard Nurses’ Health Study, which had followed the diets and diseases of tens of thousands of women for 20 years, found that greater potato intake was associated with a greater likelihood of getting type 2 diabetes. However, of the hundred or so pounds of potatoes Americans eat every year, most are in the deep-fried forms of potato chips, french fries, or other processed products. What happened when they looked specifically at mashed or baked potatoes? They found the same link with diabetes. Okay, but what might potato eaters eat more of? Maybe I should rephrase that: What might meat-and-potatoes people eat more of? Indeed, people who ate more potatoes ate more meat, and we know that animal protein may be associated with increased diabetes risk. But the researchers tried to statistically adjust for that and still found increased risk with potatoes.

    Well, what do people put on baked and mashed potatoes? Butter and sour cream. Again, the researchers tried to adjust for other dietary factors like these as well as effectively looking at the ratio between plant and animal fats and whether potato eaters drank more soda or maybe skimped on other vegetables. Yet, still, there seemed to be this association between potatoes and diabetes.

    Okay, but that was just one study. By 2015, Harvard researchers had also looked into other cohorts, including the all-male Health Professionals Follow-up Study to complement the all-female Nurses’ studies, and they continued to find a small increased diabetes risk associated with baked, boiled, or mashed potatoes, though french fries do indeed appear nearly five times worse. The authors concluded that potatoes are considered to be a healthy vegetable in dietary guidelines, but the current evidence “casts serious doubts on this classification.” Walter Willett, the chair of Harvard’s nutrition department at the time, went a step further, suggesting potatoes should be siloed up there with candy, as you can see below and at 2:18 in my video Do Potatoes Increase the Risk of Diabetes?.

    A meta-analysis of potato consumption and risk of type 2 diabetes published in 2018 combined all six of the prospective studies that had been done to date, and the researchers found about a 20% increase in diabetes risk associated with each serving of potatoes a day, concluding “[l]ong-term high consumption of potato…may be strongly associated with increased risk of diabetes.” But, again, the great majority of the potatoes consumed were fried, and we know deep-fried foods contain all sorts of nasty things, like advanced glycation end-products. The researchers weren’t able to assess french fries versus non-fried potatoes. Even just three servings of fries a week is associated with nearly 20% greater risk of type 2 diabetes, whereas there was only a tiny associated risk with potatoes in general, and that included the fries mixed in.

    The world’s largest manufacturer of frozen french fries took issue with this conclusion. Claiming to make one in three fries eaten on planet Earth to the tune of billions of dollars, the company has the money to fund reviews to cast doubt on the science. One review said that the scientific literature should be read with caution because the impact of potatoes on disease risk factors may depend on the foods they’re grouped with as part of a dietary pattern. Indeed, they do have an actual point. Observational studies can never prove cause and effect, and maybe potato consumption—even baked potato consumption—may just be a marker for an unhealthy diet in general. As much as researchers try to adjust for these other factors, as the journal of the Potato Association of America is quick to remind us, it’s not possible to separate the effects of potatoes and fries from the effects of the overall crappy Standard American Diet.

    Is there a country where potato consumption is associated with a healthy diet? If potato consumption was still associated with diabetes there, then that would be concerning. Enter a seventh study, but this time out of Iran, where most potato consumption is of boiled potatoes. In fact, those who ate potatoes had the healthiest diets and ate the most whole plant foods—fruits, vegetables, legumes, and whole grains. And though the researchers tried to tease out those other dietary factors, those eating the most boiled potatoes had only half the odds of developing diabetes. This supports the notion that it may be hard to completely separate out just the potatoes. The bottom line, this systematic review concluded, is that we really don’t have “convincing evidence” that the intake of potatoes in general is linked to type 2 diabetes, but we should still probably hold the fries.

    Doctor’s Note

    This is the first in a five-part series on potatoes. Stay tuned for:

    Interested in a sampling of diabetes videos? Check out the related posts below.



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