Potatoes & Diabetes: Dietary Trends & Truths About Taters

A place to get your questions answered from McDougall staff dietitian, Jeff Novick, MS, RDN.

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Re: Potatoes & Diabetes: Dietary Trends & Truths About Tater

Postby Gennell » Mon Apr 08, 2013 4:41 am

Jeff, you have been a great mentor for my husband and I. Thanks for your advice! :D
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Re: Potatoes & Diabetes: Dietary Trends & Truths About Tater

Postby KittyMcKnitty » Mon Apr 08, 2013 11:06 am

I'm going to print this out and hand it to people on the street!

Okay, maybe I'll just give it to my friends who keep telling me that potatoes are unhealthy. After all, as a member of S.P.U.D.S., it's my duty.
Proud member of S.P.U.D.S. (Society for the Protection of Underrated and Devalued Starches).
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Re: Potatoes & Diabetes: Dietary Trends & Truths About Tater

Postby JeffN » Fri Jun 28, 2013 1:01 pm

UPDATE:

1) Potatoes & The Glycemic Index

White Vegetables: Glycemia and Satiety.
Adv Nutr May 2013 Adv Nutr vol. 4: 356S-367S, 2013

http://advances.nutrition.org/content/4/3/356S.abstract

"...by using the potato as an example, the glycemic index of white vegetables can be misleading if not interpreted in the context of the overall contribution that the white vegetable makes to the carbohydrate and nutrient composition of the diet and their functionality in satiety and metabolic control within usual meals. It is concluded that application of the glycemic index in isolation to judge the role of white vegetables in the diet and, specifically in the case of potato as consumed in ad libitum meals, has led to premature and possibly counterproductive dietary guidance. "

2) Potatoes & Health

White Potatoes, Human Health, and Dietary Guidance
White Vegetables: Glycemia and Satiety.
Adv Nutr May 2013 Adv Nutr vol. 4: 393S, 2013

http://advances.nutrition.org/content/4/3/393S.abstract

"The white potato is a concentrated source of carbohydrate, dietary fiber, and resistant starch and continues to be the staple food of choice for many cultures. The white potato is also a concentrated source of vitamin C and potassium. Two of the nutrients in white potatoes, dietary fiber and potassium, have been designated as nutrients of concern in the 2010 Dietary Guidelines for Americans. Potatoes are often maligned in nutrition circles because of their suspected link to obesity, and popular potato foods often contain more fat calories than carbohydrate calories. Some food guides do not include potatoes in the vegetable group because of their association with high-fat diets. However, potatoes should be included in the vegetable group because they contribute critical nutrients. All white vegetables, including white potatoes, provide nutrients needed in the diet and deserve a prominent position in food guides."


3) Potatoes & Diabetes

https://www.facebook.com/notes/national ... 3052782614

From a Q & A with David Richards, D.C., M.D....

Do you recommend that diabetics avoid white potatoes?

I certainly do not. I encourage my diabetic patients to eat freely of baked, steamed, microwaved, or boiled potatoes of any variety (prepared without added salt, oil, or sugar) as part of a healthy diet that also includes fruits, raw and cooked vegetables, whole grains, and legumes.

The idea that white potatoes are problematic for diabetics stems partly from the concept of the glycemic index, and partly from the inaccurate way that potatoes have been categorized in some scientific studies.

The glycemic index measures the extent to which a food raises blood sugar levels after it is eaten.1 Because white potatoes have been characterized as having a high glycemic index, it is often assumed that they can worsen diabetes. However, the glycemic index has not been found to be a useful concept when devising optimal diets for diabetics.2,3 One of the major problems with the glycemic index is its variability; not only do blood sugar responses to similar foods differ between individuals, they can vary significantly in the same person on different occasions.4 A recent review of the scientific literature conducted by the American Diabetes Association concluded that there is little difference in blood sugar control between “low-glycemic index” and “high-glycemic index” diets.5 For this reason, in their most updated guidelines, the American Diabetes Association has deleted a statement suggesting benefit from the glycemic index.6

Studies that have associated white potatoes with worsening of blood sugar control included the consumption of fried potato products (i.e., French fries and potato chips) under the category of “potatoes.”7,8 It is, therefore, not surprising that potato intake led to worse health outcomes when studied in this way. However, when processed potatoes are excluded, there is no evidence that white potato consumption is linked to diabetes or other negative effects on health. On the contrary, when looking at the nutritional makeup of a potato, it becomes clear that it can be included in a health-promoting eating plan. While I don’t want people to become obsessed with the nutrient composition of the foods that they are eating, it is important to know that potatoes rank high in a number of areas.

For example, a medium-sized Russet potato:(9, 10, 11)

- has only 168 calories

- is an excellent source of vitamin C

- has no sodium, fat, or cholesterol

- is a good source of potassium and vitamin B6

- has 8 percent of the daily requirement for fiber

- has one of the highest overall antioxidant activity among vegetables (more than broccoli)

- is a source of “resistant starch,” which improves insulin sensitivity

I can assure you that our epidemic of diabetes is not a result of Americans eating too many baked or boiled potatoes. Furthermore, there is no evidence that in people already diagnosed with diabetes, white potato consumption (when consumed without added oil, salt, or sugar) worsens control of blood sugar levels. Diabetes (as well as obesity and metabolic syndrome) are due to eating a diet composed of foods that are calorically dense, low in fiber and other beneficial nutrients, and high in fat. Potatoes have none of these attributes and should be regarded as an excellent food for both diabetics and nondiabetics. Labeling white potatoes as unhealthy because of the problems associated with French fries and potato chips is akin to claiming that apples are not wholesome because eating apple pie causes weight gain.

References:

1. Monro JA, Shaw M. Glycemic impact, glycemic glucose equivalents, glycemic index, and glycemic load: definitions, distinctions, and implications. Am J Clin Nutr. 2008 Jan;87(1):237S-243S.

2. Wolever TM, Gibbs AL, Mehling C et al. The Canadian Trial of Carbohydrates in Diabetes (CCD), a 1-y controlled trial of low-glycemic-index dietary carbohydrate in Type 2 diabetes: no effect on glycated hemoglobin but reduction in C-reactive protein. Am. J. Clin. Nutr. 87(1), 114–125 (2008).

3. Ma Y, Olendzki BC, Merriam PA et al. A randomized clinical trial comparing low-glycemic index versus ADA dietary education among individuals with Type 2 diabetes. Nutrition 24(1), 45–56 (2008).

4. Vega-López S, Ausman LM, Griffith JL, Lichtenstein AH. Interindividual variability and intra-individual reproducibility of glycemic index values for commercial white bread. Diabetes Care 30(6), 1412–1417 (2007).

5. Wheeler ML, Dunbar SA, Jaacks LM et al. Macronutrients, food groups, and eating patterns in the management of diabetes: a systematic review of the literature, 2010. Diabetes Care 35(2), 434–445 (2012).

6. American Diabetes Association. Evidence for changes in recommendations. Standards of Medical Care in Diabetes – 2012. http://www.care.diabetes%20journals.org ... denceTable

7. Halton TL, et al. Potato and French fry consumption and risk of type 2 diabetes in women. Am J Clin Nutr. 2006;83(2):284-290.

8. Mozaffarian D, et al. Changes in Diet and Lifestyle and Long-Term Weight Gain in Women and Men. N Engl J Med 2011; 364:2392-2404.

9. USDA National Nutrient Database for Standard Reference, Release 25. http://ndb.nal.usda.gov/ndb/foods/show/ ... set+potato

10. Wu X, Beecher GR, Holden JM, et al. Lipophilic and hydrophilic antioxidant capacities of common foods in the United States. Journal of Agricultural and Food Chemistry. 2004; 52:4026-4037.

11. Murphy MM, Douglass JS, Birkett A. Resistant starch intakes in the United States. J Am Diet Assoc. 2008;108:67-78.

David Richards, D.C., M.D., is a chiropractor and board certified internist currently practicing internal medicine in St Louis, MO. His philosophy is to provide the highest quality, evidence-based health care with as little medical intervention as possible.

Reprinted (with Permission) from the magazine, Health Science, Winter 2013
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Re: Potatoes & Diabetes: Dietary Trends & Truths About Tater

Postby JeffN » Sun Oct 26, 2014 3:06 pm

Update

Potatoes, Glycemic Index, and Weight Loss in Free-Living Individuals: Practical Implications
DOI:10.1080/07315724.2013.875441
Published Online - 10 Oct 2014

http://www.tandfonline.com/doi/full/10. ... E1hqL6eH20

Abstract

Background:
The role of glycemic index (GI) and foods with negative attributes related to GI as part of a weight loss regimen has not been thoroughly assessed in free-living individuals. This study examined the effects of a dietary prescription for energy intake modification, GI, and potato consumption on weight loss, dietary prescription adherence, body composition, and glucose control in a free-living, self-selecting overweight population.

Methods:
Ninety overweight (body mass index [BMI] 29.6 ± 3.9) men and women were randomly assigned to one of 3 groups for 12 weeks. Two groups were counseled to reduce their energy intake by 500 kcal/day and consume diets that were predominantly composed of either low- or high-GI foods (low glycemic index energy reduced [LGI-ER] or high glycemic index energy reduced [HGI-ER] diet, respectively). The third group received no energy restriction, GI provision, or nutritional counseling. All groups were instructed to consume 5–7 servings of potatoes per week. Changes in weight, body composition, glucose tolerance, and triglycerides were determined at baseline and 12 weeks.

Results:
There were no significant differences in weight loss or changes in body composition between the groups; however, modest weight loss and body composition changes were seen from week 0 to week 12 for all groups (p < 0.05). Difficulty achieving the prescribed GI diets was evident in this free-living setting. There were no significant changes within or among treatments for fasting concentrations of triglycerides, glucose tolerance, insulin, or insulin sensitivity.

Conclusions:
The results indicate that in a free-living population of men and women, weight loss is associated with energy intake reduction. Potato intake did not cause weight gain and following either a high- or low-GI dietary prescription was difficult for free-living subjects, emphasizing the complex nature of changing dietary patterns.
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Re: Potatoes & Diabetes: Dietary Trends & Truths About Tater

Postby JeffN » Mon Aug 27, 2018 1:12 pm

Soon to be breaking news

"Long-term high consumption of potato (each serving a day increase) may be strongly associated with increased risk of diabetes. These findings suggest that dietehealth policy may be of importance in the prevention of diabetes."

Potato consumption and risk of type 2 diabetes: A dose response meta-analysis of cohort studies, Clinical Nutrition ESPEN (2018), https://doi.org/10.1016/j.clnesp.2018.06.004

Background & aims: High potato intake has been suggested as a risk factor for the development of type 2 diabetes. We aimed to investigate the association between potato consumption and risk of type 2 diabetes.

Methods: A systematic review was conducted on PubMed and Embase from the database commence- ment until September 2017 (updated by June 2018) following the MOOSE guidelines. The random effect model doseeresponse meta-analysis method of Greenland and Longneck was used to estimate the maximally adjusted log hazard ratio (HR) for a unit (serving per day) increment of potato consumption. A restricted cubic spline model with three knots was used to evaluate the potential non-linear relationship. Results: A total of 3544 citations were retrieved from the databases, of which six prospective cohort studies including 4545230 person-year of follow-up and 17,758 diabetes cases met the inclusion criteria. The pooled doseeresponse HR per an increment of 1 serving/day of total potato consumption was 1.20 (95% CI 1.13 to 1.127, P < 0.001, I2 1⁄4 27.1%, P for heterogeneity 1⁄4 0.23) both in men and women. The larger risk were observed for 2 serving/day (HR 1.44, 95% CI 1.28 to 1.63) and 3 serving/day (HR 1.74, 95% CI 1.45 to 2.09). We found significant evidence of a non-linear association between total potato consumption and risk of type 2 diabetes (X2 1⁄4 17.5, P for linearity < 0.001).

Conclusion: Long-term high consumption of potato (each serving a day increase) may be strongly associated with increased risk of diabetes. These findings suggest that dietehealth policy may be of importance in the prevention of diabetes.

From the text…

4.3. Biological plausibility

All the included studies in this meta-analysis conducted on the western community and the prior reports showed that consumption of potatoes is very high in western countries. A great majority of this potato consumption is belong to fried potato [24,25]. It has been demonstrated that consumption of French fries and other fried foods is in association with dietary advanced glycation end products and other degradation products from frizzing oil which may lead to increased risk of insulin resistance and diabetes [26,27].

4.4. Limitations

limitations in this meta-analysis. First, although we used maximally adjusted HR, but the possible effect of residual confounding and reverse causality is unknown. Second, measuring dietary data are imperfect in current nutritional sciences, as a result measuring of potato intake using self-administered questionnaire in the included studies have some level of misclassification, which most likely re- sults in attenuation of the association to null. Third, the small number of included studies restricted the ability for using subgroup analysis for assessing the reliability of the association in different subgroups. Fourth, we were unable to assess French fries, boiled or mashed potato and Chips, because the reported information in the included paper was not enough for evaluating these associations.
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Re: Potatoes & Diabetes: Dietary Trends & Truths About Tater

Postby JeffN » Tue Aug 28, 2018 12:10 pm

An earlier one in the same topic

Potatoes and risk of obesity, type 2 diabetes, and cardiovascular disease in apparently healthy adults: a systematic review of clinical intervention and observational studies.
Am J Clin Nutr. 2016 Aug;104(2):489-98. doi: 10.3945/ajcn.116.132332. Epub 2016 Jul 13.

Abstract
BACKGROUND:
Potatoes have been related to increased risks of obesity, type 2 diabetes (T2D), and cardiovascular disease (CVD) mainly because of their high glycemic index.
OBJECTIVE:
We conducted a systematic review to evaluate the relation between intake of potatoes and risks of obesity, T2D, and CVD in apparently healthy adults.
DESIGN:
MEDLINE, Embase, the Web of Science, and the Cochrane Central Register of Controlled Trials were searched for intervention and prospective observational studies that investigated adults without any known illnesses at baseline, recorded intake of potatoes, and measured adiposity (body weight, body mass index, or waist circumference), cases of T2D, cases of cardiovascular events, or risk markers thereof.
RESULTS:
In total, 13 studies were deemed eligible; 5 studies were related to obesity, 7 studies were related to T2D, and one study was related to CVD. Only observational studies were identified; there were 3 studies with moderate, 9 studies with serious, and one study with critical risk of bias. The association between potatoes (not including french fries) and adiposity was neutral in 2 studies and was positive in 2 studies. French fries were positively associated with adiposity in 3 of 3 studies. For T2D, 2 studies showed a positive association, whereas 5 studies showed no or a negative association with intake of potatoes and T2D. French fries were positively associated with T2D in 3 of 3 studies that distinguished this relation. For CVD, no association was observed.
CONCLUSIONS:
The identified studies do not provide convincing evidence to suggest an association between intake of potatoes and risks of obesity, T2D, or CVD. French fries may be associated with increased risks of obesity and T2D although confounding may be present. In this systematic review, only observational studies were identified. These findings underline the need for long-term randomized controlled trials. This trial was registered at the PROSPERO International prospective register of systematic reviews (http://www.crd.york.ac.uk/PROSPERO/) as CRD42015026491.


And one on Potatoes and BP

Potato Consumption Does Not Increase Blood Pressure or Incident Hypertension in 2 Cohorts of Spanish Adults.
J Nutr. 2017 Dec;147(12):2272-2281. doi: 10.3945/jn.117.252254. Epub 2017 Oct 18.

Abstract
Background: Potatoes have a high glycemic load but also antioxidants, vitamins, and minerals. It is unclear what mechanisms are involved in relation to their effect on blood pressure (BP) and hypertension.Objectives: This study aimed to assess the association between potato consumption, BP changes, and the risk of hypertension in 2 Spanish populations.Methods: Separate analyses were performed in PREDIMED (PREvención con DIeta MEDiterránea), a multicenter nutrition intervention trial of adults aged 55-80 y, and the SUN (Seguimiento Universidad de Navarra) project, a prospective cohort made up of university graduates and educated adults with ages (means ± SDs) of 42.7 ± 13.3 y for men and 35.1 ± 10.7 y for women. In PREDIMED, generalized estimating equations adjusted for lifestyle and dietary characteristics were used to assess changes in BP across quintiles of total potato consumption during a 4-y follow-up. Controlled BP values (systolic BP <140 mm Hg and diastolic BP <90 mm Hg) during follow-up were also assessed. For SUN, multivariate-adjusted HRs for incident hypertension during a mean 6.7-y follow-up were calculated.Results: In PREDIMED, the total potato intake was 81.9 ± 40.6 g/d. No overall differences in systolic or diastolic BP changes were detected based on consumption of potatoes. For total potatoes, the mean difference in change between quintile 5 (highest intake) and quintile 1 (lowest intake) in systolic BP after multivariate adjustment was -0.90 mm Hg (95% CI: -2.56, 0.76 mm Hg; P-trend = 0.1) and for diastolic BP was -0.02 mm Hg (95% CI: -0.93, 0.89 mm Hg; P-trend = 0.8). In SUN, the total potato consumption was 52.7 ± 33.6 g/d, and no significant association between potato consumption and hypertension incidence was observed in the fully adjusted HR for total potato consumption (quintile 5 compared with quintile 1: 0.98; 95% CI: 0.80, 1.19; P-trend = 0.8).Conclusions: Potato consumption is not associated with changes over 4 y in blood pressure among older adults in Spain or with the risk of hypertension among Spanish adults. This trial was registered at www.controlled-trials.com as ISRCTN35739639.
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