Category: Nutrition

  • 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.

     

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    Interested in Spanish infographics or Chinese infographics?

     

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    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

    From the comfort of your own home, join Dr. Greger as he dives into the content of each of his acclaimed books with these recordings of his live presentations. Be sure to check out his newest presentation on ultra-processed foods.

     

    Optimum Nutrient Recommendations

    Check out our Optimum Nutrient Recommendations for more on vitamin B12, calcium, vitamin D, omega-3 fatty acids, iodine, iron, and selenium. 

     

    Topic Pages

    To view our entire video library organized by subject, explore our topic pages

     

    Recipes

     

    Each recipe in our collection uses only health-promoting ingredients, based on Dr. Greger’s Daily Dozen and dining by traffic light system. These whole food, plant-based dishes, sauces, condiments, and sides come from The How Not to Age Cookbook, The How Not to Die Cookbook, and The How Not to Diet Cookbook, part of Dr. Greger’s award-winning series, as well as contributions from the NutritionFacts.org team and friends.

    VIEW ALL RECIPES

     

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    Listen to the Nutrition Facts with Dr. Greger podcast while you’re on the road, enjoying a walk, cooking a delicious meal in your kitchen, or relaxing in a favorite spot.

     

    Live Q&As

    Join Dr. Greger live each month for an exciting Q&A. Sign up for our free newsletter to get the date and link of the upcoming live Q&A directly in your inbox. You can also check out past Q&A sessions recordings.

     

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    Six of our webinars are now available for on-demand CME credits via the LearnWorlds platform. What’s a CME? CME stands for Continuing Medical Education for doctors and other medical professionals. Physicians need to get a certain amount of credits to stay licensed, and we’re honored we can offer accredited classes.

     

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    The entire NutritionFacts.org website has been translated into Spanish, and we also have Spanish Facebook and Instagram pages. On DrGreger.org, you’ll find shirts, stickers, and Evidence-Based Eating Guides in Spanish, too.

    Check out our NutritionFacts in China page for links to all our Chinese content, including social media, books, and infographics. On DrGreger.org, we also have shirts and Evidence-Based Eating Guides in Chinese.

    Dr. Greger’s books have been translated in many languages. Check out this page for more information. 

    Want to see all the NutritionFacts videos available in your language? Visit our search page and check out the ‘Subtitle Language’ menu on the right side or press the ‘Filters’ button if you’re on a mobile device. After you make your selection, the results will list all the videos subtitled in that language. For instructions on how to access subtitles and translations in our videos, see Closed Captions and Translations. For more on translations, check out our Information About Our Translated Resources page. 

     

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    As a token of our gratitude, thank you gifts are available for each donation tier. You will have the opportunity to opt-in once your donation is made. Thank you!

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    Share the latest in evidence-based nutrition with your community by hosting a free screening of Dr. Greger’s How Not to Die, Evidence-Based Weight Loss, or How Not to Age presentation. Each video runs for approximately one hour. Your free Digital Event Kit will include the video, an introduction to NutritionFacts, and tips for hosting. An engaging, fun trivia game for attendees is also included in the How Not to Die and Evidence-Based Weight Loss screening kits. Each screening event is approximately two hours long.

    By providing these fun and educational event kits, we hope to make it easier than ever to spread the message about evidence-based eating.

     

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    Want to see Dr. Greger in person and get your books signed? Check out his speaking tour calendar

     

    DrGreger.org

    In the DrGreger.org store, you can find digital downloads of our video collections, shirts, and outreach materials

     

    The Daily Dozen App

    Download the free Daily Dozen app today and start including some of the healthiest foods in your diet. Track your servings, analyze your progress, and learn along the way. The app is available in the App Store and Google Play.

     



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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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  • Prunes: Nature’s Answer to Constipation

    Prunes: Nature’s Answer to Constipation

    Prunes, figs, and exercise are put to the test as natural home remedies for constipation.

    The act of defecation is very private and the object of cultural taboos, so much so that it’s rarely thought of, even by physicians—but it should be. Constipation accounts for three million annual visits to doctors in the United States and 800,000 emergency room visits. Depending on how you define it, up to 80% of the population may be suffering. Even people who don’t think they’re constipated may very well be clinically constipated. A quarter of so-called healthy study participants reported experiencing “incomplete emptying,” and about half “indicated increased straining.” In fact, more than half had found blood on their toilet paper within the past year. In severe cases, the blood pressure spike associated with straining while passing stool can even trigger a heart attack or a stroke.

    There are drugs for it. There are always drugs, resulting in side effects like nausea, diarrhea, headache, and abdominal pain, leaving most patients unsatisfied. So why not instead just try to treat the cause? Common causes of chronic constipation include a lack of whole plant foods containing fiber or insufficient water intake, so changing one’s diet and lifestyle is the preferred method for constipation relief. Such nonpharmacological, clinically effective interventions include engaging in physical activity for about 30 minutes a day.

    A systematic review and meta-analysis found that aerobic exercise interventions help, starting at about 140 minutes a week. And then, of course, a diet centered around whole plant foods—the only naturally concentrated sources of fiber—helps as well. Any plants in particular?

    When elderly women with severe constipation were given about a dozen prunes a day, they experienced significant improvement within the first week. The control group in the study wasn’t told to do anything, though. When one group does something while the other does nothing at all, you can’t discount the placebo effect. And, indeed, the placebo effect for constipation trials can range up to 44%, meaning up to nearly half of the people given a sugar pill claimed to experience an improvement.

    That’s why we need studies like this: Participants were randomized to about 8 prunes a day plus a large glass of water, 12 prunes and water, or just the water alone. So, even the control group got an intervention (the water), which might help with constipation. Previous studies mostly assigned about 10 prunes a day, so the researchers wanted to see if more prunes provided greater benefit or whether fewer would work just as well. They found a significant improvement in stool bulk on the prunes and a significant increase in bowel movement frequency, as you can see below and at 2:45 in my video Prunes: A Natural Remedy for Constipation, though there was no real difference between 8 and 12 prunes. So, 8 a day seems sufficient.

    Prunes even seem superior to psyllium, sold as Metamucil, beating it out in terms of improved stool frequency and consistency.

    We used to think it was just all the fiber in prunes that was helping, but prune juice evidently works too, which, like most juices, has had the fiber removed. Other potential active components include a natural sugar alcohol known as sorbitol that’s used in some sugar-free gums. Once you eat more than a dozen or so large prunes a day, however, the dose of sorbitol could start reaching laxative levels in susceptible individuals. So, be careful.

    If you don’t have constipation, should you avoid prunes? That question has been put to the test, and the answer appears to be no—most people should be able to eat a dozen or so a day without any issues. In fact, it’s interesting to note that prunes have been traditionally used as a laxative and an antidiarrheal remedy.

    What about dried figs, one of the few medicinal plants mentioned explicitly in the Bible? Researchers took patients with the type of irritable bowel syndrome (IBS) characterized by constipation and randomized them to one fig with breakfast and one fig with lunch, each with a glass of water, and there was a significant improvement in frequency of defecation and a significant drop in the frequency of hard stools, compared to the control. But what was the control? The control group was just asked to continue their normal diet. In other words, do nothing special. The placebo response for irritable bowel is infamous. Give people with IBS a fake sugar pill, and sometimes 72% say they magically feel better.

    That’s why we need this kind of study: a randomized, double-blind, placebo-controlled trial. Researchers made a gross-sounding fake fig paste placebo that supposedly had the same taste, smell, and appearance as the real deal. Those who got the real figs, about six a day, seemed to experience “a significant reduction in colon transit time and a significant improvement in stool type [consistency] and abdominal discomfort,” compared to the placebo. Researchers measured transit time by having people swallow little beads that would show up on X-rays so they could track the progress through their digestive system. They found that those eating the real figs sped up their gut movement by a full 24 hours. Defecation frequency per week didn’t beat out placebo, though. In fact, they tested so many different outcomes, even the stool consistency and abdominal discomfort results may have been statistical flukes. So, it looks like prunes would be the better treatment choice.

    Doctor’s Note

    What about carbonated drinks? See Club Soda for Stomach Pain and Constipation.

    I previously discussed prunes and constipation in Prunes vs. Metamucil vs. Vegan Diet.

    What else can prunes do? See Prunes for Osteoporosis.

    Can we do anything else for IBS? Check out the related posts below.



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  • The DNA-Damager in Fried Foods

    The DNA-Damager in Fried Foods

    Glycidol may help explain why people who eat fried foods get more cancer.

    “The main purpose of frying is to produce foods with good consumer acceptability. However, not all acceptable foods are safe.” Food chemists have been very interested in the newly discovered toxic compounds produced by frying.

    We’ve been refining vegetable oils for more than a century, but only recently have we discovered that this can produce concerning compounds such as 3-MCPD and, even worse, glycidol. 3-MCPD is considered a nongenotoxic carcinogen with a tolerable daily intake, while glycidol is a known genotoxic carcinogen, meaning it can cause cancer by directly damaging our DNA, as I discuss in my video The Carcinogen Glycidol in Cooking Oils.

    If a compound is not directly DNA-damaging, it’s assumed that it acts through a mechanism that exhibits a threshold; a so-called no-effect level may exist, a level below which it may not be harmful. But if a compound does damage DNA, it’s generally assumed to follow “a non-threshold mechanism…and no ‘safe level of intake’ can be derived,” because it may only take DNA mutation to start the march towards cancer. So, such substances are not allowed to be added intentionally to foods. For so-called unavoidable contaminants, the “ALARA” principle is followed, meaning that the level should be as low as reasonably achievable or as low as reasonably practicable. Since that’s what glycidol appears to be, we should try to avoid it as much as possible.

    A lifetime cancer risk of 1 in 100,000 is “often used as a figure for acceptable risk in the population.” Based on lab animal data, this might be exceeded if someone weighing about 150 pounds consumed less than a microgram a day. However, thanks to the use of refined oils in so many food products, the average glycidol exposure may be more than 50 micrograms. And in children, the level of intake may exceed acceptable cancer risk by 200-fold.

    So, do people who eat more fried food get more cancer? There is said to be strong evidence that there may be a higher risk of developing chronic disease among frequent consumers of fried foods, but that’s talking largely about cardiovascular health. For example, in a study of more than 100,000 women, frequently consuming fried foods, especially fried chicken and fried fish, was associated with a higher risk of all-cause mortality, meaning such consumers lived, on average, significantly shorter lives. But that was due largely to cardiovascular mortality, whereas fried food consumption was not generally associated with dying from cancer. In men, however, a larger intake of fried food was associated with a 35% increased risk of prostate cancer. Therefore, perhaps men with an increased risk of prostate cancer should, as a precaution, limit their consumption of fried foods.

    These refined oils are also used in infant formulas, which presents a problem for babies who aren’t breastfed. The German Federal Institute for Risk Assessment has come to the conclusion that “infants who are fed exclusively industrially prepared infant milk formula would take in harmful levels of glycidol.” It should be noted that U.S. formulas contain levels of glycidol contamination comparable to those found in Europe—yet another reason that breast is absolutely best. Meanwhile, there are calls on the manufacturers of these products to do everything they can to reduce levels as low as possible.

    But, evidently, the industry has yet to find a way to refine vegetable oils without creating these kinds of by-products, “while at the same time maintaining the quality of the refined product.” It was therefore concluded that this problem has no simple solutions, but I disagree. We can choose to avoid the use of oils and fried foods.

    Doctor’s Note

    I previously talked about 3-MCPD in The Side Effects of 3-MCPD in Bragg’s Liquid Aminos and 3-MCPD in Refined Cooking Oils.

    There is no substitute for human breast milk. Adoptive families or those who use surrogates may want to look for a nearby milk bank.



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  • Building an Anti-Inflammatory Diet

    Building an Anti-Inflammatory Diet

    What does an anti-inflammatory diet look like?

    “Intervention studies to enhance healthy ageing need appropriate outcome measures, such as blood-borne biomarkers, which are easily obtainable, cost-effective, and widely accepted.” We need blood-borne biomarkers of mortality risk. For example, having higher levels of C-reactive protein in your blood may increase your risk of dying prematurely by 42%. C-reactive protein is one of the most widely used inflammatory biomarkers for predicting mortality, but those with the highest levels of interleukin-6 (IL-6), another marker of inflammation, may increase premature death risk by 49%. What can we do to bring it down?

    I’ve previously talked about foods that can contribute to inflammation, like meat and sugar, versus foods like nuts that don’t. But what about anti-inflammatory foods that actually attenuate that inflammation?

    What happens when blueberries are added to a high-fat, high-glycemic-load meal consisting of white potatoes, white bread, ham, cheese, and butter? Adding a single cup of blueberries caused a significant drop in IL-6 from that meal, as you can see below and at 1:15 in my video Which Foods Are Anti-Inflammatory?.

    What about raspberries? People were fed eggs, butter, white potatoes, white flour biscuits, and sausage with or without two cups of frozen raspberries blended with water into a smoothie, compared to giving others the same amount of calories and carbs in banana form. Bananas were no match for meat, eggs, dairy, and crappy carbohydrates; that meal resulted in a tripling of IL-6 levels within four hours. But by drinking those two cups of raspberries instead, their bodies were able to hold the line, as you can see below and at 1:45 in my video.

    Why did raspberries work but bananas didn’t? Maybe it’s the antioxidants.

    Well, antioxidant supplements failed miserably. There was no benefit from antioxidant vitamins and minerals like vitamins C or E, beta-carotene, or selenium. Maybe it’s those special antioxidant pigments, the anthocyanins, that give berries those bright red, blue, and purple colors? Indeed, that’s what dozens of randomized controlled trials have demonstrated, whereas a half-dozen studies combined show pomegranates, a fruit packed with anthocyanin pigments, can bring down inflammation over time.

    What about adding spices to meals as an approach to cool down inflammation? Supplementation with grape and turmeric extracts did not affect the inflammatory response to a milkshake. But giving people one teaspoon a day of actual turmeric—that is, the whole spice, not purified curcumin supplements—resulted in a significant drop in IL-6 levels.

    Garlic powder reduced IL-6 levels as well, starting at about half a teaspoon a day. Ginger powder (ground ginger) had the same results with doses ranging from half a teaspoon to one and a half teaspoons.

    Of course, another way to mediate the inflammation caused by a Sausage and Egg McMuffin is to not eat it in the first place. What about just eating a plant-based diet? To my surprise, the drop in IL-6 did not reach statistical significance. Whenever a dietary intervention doesn’t have the result you expect, you always have to ask, “What exactly was the diet they actually ate?” The study mostly looked at the Mediterranean diet, which certainly has more plants, but maybe the diets didn’t go far enough? For more clarity, we turn to Dr. Turner-McGrievy’s famous New DIETs study, where people either continued to eat their fully omnivorous diets or were randomized to eat a vegan diet, a vegetarian diet, a pesco-vegetarian diet, or a semi-vegetarian diet that, for example, limited red meat. So, whereas the vegan might eat red beans and brown rice with chopped tomatoes and roasted peppers for dinner, the vegetarian might add some cheese, the pesco-vegetarian might add shrimp, and the semi-vegetarian might add some turkey sausage. Below is a more in-depth look at the five diet patterns, which you can also see at 4:01 in my video.

    What happened within two months to their Dietary Inflammatory Index scores? The Dietary Inflammatory Index is a measure of how inflammatory your diet is. Negative scores mean your overall diet is anti-inflammatory, and the lower, the better, whereas positive scores mean your overall diet is on balance pro-inflammatory, which is exactly where the people in the study started. That comes as no surprise, given that they were eating regular diets and our nation is awash with inflammation-related disease.

    But when the study participants switched to strictly plant-based nutrition, their diet flipped to become an anti-inflammatory diet. That was the case even if they just cut out meat or all meat except fish. But if they instead switched mostly to poultry or only limited their meat intake, their diet remained inflammatory. You can see the results below or at 4:47 in my video.

    Now, not all plant foods are anti-inflammatory. If all you do is boost your intake of less healthy plant foods, like juice, white bread, white potatoes, soda, and cake, you can end up even more inflamed. But if you eat a really clean diet of whole plant foods, you get significant reductions in lipoprotein(a)—Lp(a)—which we didn’t even think was possible with diet—as well as drops in LDL cholesterol and even the most dangerous form of LDL cholesterol. Also, nearly across the board, you get a drop in inflammatory markers; we’re talking a 30% drop in C-reactive protein and a 20% drop in IL-6. So, maybe previous studies with plant-centered diets were unsuccessful because they weren’t plant-based enough, with animal products still being substantially consumed. Therefore, the total “elimination of animal products and processed foods…may be a more prudent dietary strategy” to combat inflammation.

    Doctor’s Note

    Hungry for more? See Foods That Cause Inflammation.

    For more on plant-based diets, see related posts below.



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  • What Foods Trigger Inflammation?

    What Foods Trigger Inflammation?

    Inflammatory markers can double within six hours of eating a pro-inflammatory meal. Which foods are the worst?

    Excessive inflammation may play a role in a number of leading causes of death and disability, including type 2 diabetes, obesity, and heart disease. “But what are the stimuli that jumpstart the destructive inflammatory cascade?” You typically hear about the pro-inflammatory nature of a chronic high-fat diet, but the inflammatory effect “may not be limited to chronic intake but may be evident after the consumption of a single meal.”

    Within hours after eating an unhealthy meal, inflammatory markers like interleukin-6 (IL-6) can skyrocket, doubling within six hours. The majority of studies show an increase in IL-6 after consuming a high-fat meal. But the meals they tested weren’t just filled with meat, eggs, dairy, and oil, but also junky refined carbohydrates like white flour and added sugar.

    When people are given essentially straight butter fat and no carbs, they can still get a spike in inflammation within hours, proving the added fat itself is pro-inflammatory. But when people are given straight sugar water without any fat, the result is the same, proving the added sugar is pro-inflammatory, too, as you can see below and at 1:26 in my video Foods That Cause Inflammation.

    Why should we be concerned with the inflammatory responses after unhealthy meal ingestion? Because extensive research points to the idea that “persistent low-grade inflammation is an underlying factor in several high-mortality chronic diseases and that diet can contribute to, or attenuate, that inflammation.”

    You’ll note in the graph below that IL-6 levels jumped up to about 3 pg/mL after the meal. (You can also check it out at 1:55 in my video.)

    When levels start regularly getting up to about 3 pg/mL, that’s associated with twice the risk of death. That increased risk was found across the board, compiling eight other similar studies, likely because it’s linked with increased risk of heart disease, the number one killer of men and women, even as strongly as some other major well-known risk factors like high cholesterol.

    Now, not all high-fat foods cause inflammation. More than a dozen studies combined show that whole plant foods such as nuts do not increase inflammatory markers, even when eating up to handfuls of nuts a day. In fact, spread half an avocado on a beef burger, and you may be able to blunt some of the inflammation caused by the meat—even lean meat—as you can see below and at 2:35 in my video.

    There are reviews purporting to show a drop in inflammatory markers after eating wild game, which is about as lean a meat as you can get, but that’s only compared to store-bought meat. Give people some really fatty meat and their IL-6 shoots up, as do their tumor-necrosis factor and C-reactive protein. Inflammatory, inflammatory, inflammatory—within hours of consumption. But what if you instead eat a kangaroo steak, which is extremely low in fat, similar to elk or moose? You’ll get the same strong inflammatory response within hours of eating it, as you can see below and at 3:15 in my video.

    Now, certainly less inflammatory than conventional meat you might get at the store, but pro-inflammatory nonetheless, increasing markers of inflammation within mere hours.

    Doctor’s Note

    Stay tuned for Which Foods Are Anti-Inflammatory?, up next.

    For more on diet and inflammation, see related posts below.



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