The Calorie Density Approach

Calorie density is simply a measure of how many calories are in a given weight of food, most often expressed as calories per pound. A food high in calorie density has a large number of calories in a small weight of food, whereas a food low in calorie density has much fewer calories in the same weight of food. Therefore, one can consume a larger portion of a low-calorie dense food than a high-calorie dense food for the same number of calories. On a day-to-day basis, people generally eat a similar amount of food, by weight.  Therefore, choosing foods with a lower calorie density allows us to consume our usual amount of food (or more) while reducing our caloric intake.

Foods low in calorie density also tend to be higher in satiety so by consuming foods lower in calorie density, one can fill up on much fewer calories without having to go hungry and without having to weigh, measure or portion control our food. In addition, the foods that are lower in calorie density (fruits, veggies, starchy vegetables, intact whole grains and legumes) are also the foods highest in nutrient density. Therefore, by following a diet lower in calorie density, one also automatically consumes a diet higher in nutrient density.

Principles of Calorie Density

• Hunger & Satiety. Whenever hungry, eat until you are comfortably full.  Don’t starve and don’t stuff yourself.
• Sequence Your Meals. Start all meals with a salad, soup, and/or fruit.
• Don’t Drink Your Calories. Avoid liquid calories.  Eat/chew your calories, don’t drink or liquefy them. Liquids have little if any satiety so they do not fill you up as much as solid foods of equal calories.
• Dilution is the Solution: Dilute Out High Calorie Dense Foods/Meals. Dilute the calorie density of your meals by filling 1/2 your plate (by visual volume) with intact whole grains, starchy vegetables, and/or legumes and the other half with vegetables and/or fruit.
• Be Aware of the Impact of Vegetables vs. Fat/Oil. Vegetables are the lowest in calorie density while fat and oil are the highest.  Therefore, adding vegetables to any dish will always lower the overall calorie density of a meal, while adding fat and oil will always raise the overall calorie density of a meal.
• Limit High Calorie Dense Foods. Limit (or avoid) foods that are higher in calorie density (dried fruit; high fat plant foods; processed whole grains; etc).  If you use them, incorporate them into meals that are made up of low calorie dense foods and think of them as a condiment to the meal. For example, add a few slices of avocado to a large salad, or add a few walnuts or raisins to a bowl of oatmeal and fruit.

What Are Calorie-Dense Foods?

Calorie Density Chart

Research has shown that people can freely eat foods that are 300 calories per pound or less and not gain weight. People can consume relatively large portions of foods that are between 300 and 800 calories per pound and still lose or maintain their weight depending on their individual activity levels and metabolism. The intake of foods with a calorie density of 800-1,800 should be limited as these can contribute to weight gain and interfere with efforts to lose weight. Additionally, the intake of foods over 1,800 calories per pound should be extremely limited as these foods can very easily contribute to weight gain and obesity and can also greatly interfere with efforts to lose weight.

The 2007 report from the American Cancer Institute and the World Cancer Research Fund recommended lowering the average calorie density of the American diet to 567 calories per pound. One can easily do this by following the above principles of calorie density, which allows us to eat freely of unrefined, unprocessed fruits, veggies, starchy veggies, intact whole grains and legumes without the addition of salt, sugar and/or fat/oil.

Summary

Calorie density really is a common-sense approach to sound nutrition and is the cornerstone of good health. It is the simplest way to lose and/or manage your weight for life. By following a few simple principles, you will increase the amount of food on your plate while decreasing your overall caloric intake, all without ever having to go hungry.  At the same time, you will be optimizing your overall nutrient intake.

This article was originally published on Jun. 19, 2012, and has been updated.

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Some Background
Around the turn of the century, Americans were using butter, lard, schmaltz (chicken fat), and other rendered animal fats as an ingredient in food and as a cooking medium. The good news about these fats: They had many properties that made them excellent for these uses. They could withstand high heat, were very stable, and had a creamy, smooth texture. The bad news about these fats: Their high levels of saturated fat made them harmful to our health. However, at the time no one realized the negative health impact of saturated fats. The percentage of fat in the American diet stayed fairly consistent from 1900 to 1960.

The American Oil Change
Things began changing in the 1960s. By this time, we had learned of the negative impact of saturated fats on our health. In 1961, the American Heart Association Central Advisory Statement advised Americans to replace the saturated fat in their diets with polyunsaturated fats (PUFAs). Vegetable oils and, to a lesser extent, shortening and margarine, were recommended as replacements for animal fats such as butter, cream, and cheese.

The best way to do this would have been to swap out saturated fat–rich foods with foods rich in PUFAs. Exchange a breakfast of bacon and eggs for one of oatmeal and fruit. Exchange saturated fats such as butter and lard for a liquid oil higher in PUFAs, such as soybean oil. By exchange, they meant on an equal calorie basis without increasing total calories.

Unfortunately, this is not what happened. No one wanted to change what they were eating, and no one wanted to use liquid PUFAs because they do not work as well as saturated fats in the food supply. PUFAs have a much lower smoke point, oxidize easily, are less stable, have a shorter shelf life, and don’t have the same creamy texture. However, when manufacturers partially hydrogenated these liquid oils and turned them into margarine and shortening, they acquired the beneficial characteristics of saturated fats. As a result, increasing amounts of these chemically altered fats ended up in the food supply—but not on an equal calorie basis. Instead, we saw one of the largest increases in calories, driven mostly by added fats, since 1960. The 1961 AHA Central Advisory Statement preceded the largest increase in the consumption of soybean oil (much of it partially hydrogenated) in U.S. history.

The Ticking Time Bomb
So, some of the saturated fat was replaced with shortening, margarine, and other partially hydrogenated oils. As a result, trans fat intake went way up while saturated fat intake barely nudged down and total fat and calorie intake shot up. That was not the intent of the 1961 AHA statement, nor the 1977 hearings of the Senate Select Committee on Nutrition and Human Needs, nor the 1980 Dietary Guidelines for Americans. What they did not realize at the time was the way these recommendations would be interpreted and applied by the commercial food industry, thus releasing a ticking time bomb—trans fats—into the food supply.

When the world of science and the food industry were first becoming aware of the problem with trans fats from partially hydrogenated oils, margarine, and shortening, they began looking for a replacement. It had to have the same characteristics as saturated fat–rich animal fats and trans fat–rich vegetable fats. It had to be stable, with a high smoke point, a creamy texture, and a long shelf life. Manufacturers experimented with many alternatives, including various oil blends, interesterified fats, and trans fat–free, fully hydrogenated oils, but nothing worked. In 2004, food companies and cities started banning trans fats, pushing industry to find an immediate replacement for solid fats in the food supply.

Manufacturers could not go back to butter or lard, which had already been proven harmful. Liquid oils only worked when solidified (hydrogenated), yet that created trans fats, which are even more harmful than the saturated fat. One immediately available option remained, and it had great marketing potential: tropical oils and fats. Rich in saturated fat but also plant-sourced, vegan, natural, and cholesterol-free, coconut oil, palm kernel oil, and palm oil were ripe for a public relations makeover.

Mass-Market Mania
Let’s look at the original publication dates of the first mass-market books that “helped launch the consumer revolution” of these saturated fat–rich tropical oils.

The original publication date of The Coconut Oil Miracle by Bruce Fife was 2004. Interestingly, Fife’s previous books focused on get-rich-quick schemes, including Make Money Reading Books; Get Published!: How to Break into Print With a Small Press and Become Rich and Famous; and Dr. Dropo’s Balloon Sculpturing for Beginners.

In 2005, Sally Fallon’s Eat Fat, Lose Fat: Lose Weight and Feel Great with the Delicious, Science-Based Coconut Diet was published. That same year, The Coconut Diet: The Secret Ingredient That Helps You Lose Weight While You Eat Your Favorite Foods, by Cherie Calbom and John Calbom, made its debut.

Before the release of these misguided books, virtually no one was promoting the “miracle health benefits” of coconut and other tropical oils. These books helped create a huge diet fad. Similar books flooded the market, with each author trying to outdo the last with even more fantastic claims about the supposed health benefits of coconut oil.

This diet fad coincided exactly with the moment food manufacturers were forced to reformulate their products or lose customers who were increasingly worried about trans fats.

Industry Changes
Let’s look at the timeline of the pressure on the food industry to reformulate its products and the resulting changes in the food industry.

May 2003: BanTransFats.com, Inc., a U.S. nonprofit, filed a lawsuit against Kraft Foods in an attempt to force Kraft to remove trans fats from the Oreo cookie.

July 2003: The Food and Drug Administration published a final rule in the Federal Register amending its food labeling regulations to require that trans fatty acids be declared in the nutrition label of conventional foods and dietary supplements. This rule went into effect on Jan. 1, 2006.

2004: The J.M. Smucker Company, manufacturer of Crisco (the original partially hydrogenated vegetable shortening), released a new formulation made from solid saturated palm oil cut with soybean and sunflower oils.

May 2004: Unilever Canada announced that they had eliminated trans fats from all their margarine products in Canada.

2005: Loders Croklaan, a wholly owned subsidiary of Malaysia’s IOI Group, began providing trans fat–free bakery and confectionery fats made from palm oil to giant food companies in the United States to make margarine.

2006: The Center for Science in the Public Interest sued KFC over its use of trans fats in fried foods. In response, KFC announced that it would replace the partially hydrogenated soybean oil used in its U.S. restaurants with a zero–trans fat, low-linoleic soybean oil by April 2007.

June 2006: Wendy’s announced plans to eliminate trans fats from 6,300 restaurants in the United States and Canada, starting in August 2006.

October 2006: The Walt Disney Company announced that they would begin removing trans fats from meals sold at U.S. theme parks by the end of 2007, and would stop the inclusion of trans fats in licensed or promotional products by 2008.

November 2006: Taco Bell promised to remove trans fats from many of their menu items by switching to canola oil. By April 2007, 15 Taco Bell menu items were completely free of trans fats.

January 2007: McDonald’s announced they would start phasing out the trans fats in their French fries.

May 2007: Burger King announced that its 7,100 U.S. restaurants would begin the switch to zero–trans fat oil by the end of 2007.

October 2007: Chick-fil-A’s menu became trans fat–free.

City Bans
Let’s look at the timeline of the first cities, counties, and states to ban trans fats.

May 2005: Tiburon, California, became the first American city wherein all restaurants voluntarily cooked with trans fat–free oils.

December 2006: The NYC Board of Health voted to ban trans fat in restaurant food.

December 2006: Massachusetts state Rep. Peter Koutoujian filed the first state-level legislation banning restaurants from preparing foods with trans fats.

February 2007: The Philadelphia City Council voted unanimously to ban trans fats.

April 2008: Nassau County, a suburban county on Long Island, New York, banned trans fats in restaurants.

May 2007: Legislators of New York’s Albany County adopted a trans fat ban after a unanimous vote by the county legislature.

January 2008: San Francisco officially asked its restaurants to stop using trans fat.

The Scientific Evidence for the Use of Coconut Oil
Even after the big mistake of recommending the substitution of hydrogenated oils into the food supply in 1961, you would figure more care would be taken before doing the same with coconut oil. I searched the National Library of Medicine for articles published between 1985 and 2004 on coconut oil and human health to support the substitution of coconut oil into the food supply. I found five related to heart disease and none of them were favorable. I didn’t find any on Alzheimer’s disease.  

1) Reiser R, Probstfield JL, Silvers A, et al. Plasma lipid and lipoprotein response of humans to beef fat, coconut oil and safflower oil. American Journal of Clinical Nutrition, August 1985. The test subjects in the coconut oil group experienced a worsening of their total and LDL cholesterol levels.

2) Mendis S, Kumarasunderam R. The effect of daily consumption of coconut fat and soya-bean fat on plasma lipids and lipoproteins of young normolipidaemic men. British Journal of Nutrition, May 1990. Researchers found that during the coconut-oil-eating phase, total cholesterol levels increased significantly compared with the soybean oil­–eating phase. “Results of the present study show that even when the proportion of total fat in the diet is low … a high intake of saturated fat elevates both these lipid fractions.”

3) Ganji V, Kies CV. Psyllium husk fiber supplementation to the diets rich in soybean or coconut oil: hypercholesterolemic effect in healthy humans. International Journal of Food Sciences and Nutrition, March 1996. In this study, investigators found that the coconut oil diet increased serum cholesterol, LDL, and apolipoprotein B.

4) Zhang J, Kesteloot H. Differences in all-cause, cardiovascular and cancer mortality between Hong Kong and Singapore: role of nutrition. European Journal of Epidemiology,  May 2001. Investigators in this study found that ischemic heart disease mortality was approximately three times higher in both men and women in Singapore versus Hong Kong and that there was “a higher consumption of coconut and palm oil, mainly containing saturated fat, in Singapore.”

5) Mendis S, Samarajeewa U, Thattil RO. Coconut fat and serum lipoproteins: effects of partial replacement with unsaturated fats. British Journal of Nutrition, May 2001. Researchers reduced the amount of coconut fat consumed over time, and as they did, the participants’ total cholesterol and LDL levels declined. The more they lowered the amount of coconut oil, the lower the total cholesterol and LDL went.

The Marketing Miracle of Coconut Oil
As we just saw, from the early to mid-2000s, there was no credible science demonstrating the health benefits of coconut and other tropical oils. However, there was a growing body of evidence proving trans fats were unhealthy. From around 2003 to 2007 and beyond, there was growing pressure on the food industry to remove the now unquestionably bad trans fats. Industry needed an immediate replacement, and tropical oils filled the bill perfectly—thanks to the PR makeover by wannabe nutrition experts.

The rise in use of these tropical fats was driven not by science but by consumers and industry based on their need and desire to keep eating the same processed and packaged junk foods they were hooked on. Looks like another ticking time bomb has been released into the food supply.

Producing this much coconut oil created a lot of coconut byproducts that the industry had to figure out a way to use. Shortly after the rise in coconut oil, we began to see the miracle of coconut water promoted as a sports and performance drink, and soon after came the miracles of coconut sugar, coconut nectar, coconut syrup, coconut aminos, coconut mulch, and finally, just in time for grilling season, coconut briquettes.

This story will one day be taught in a marketing class at the Wharton School of Business as the Marketing Miracle of Coconut Oil.

The post The Real Coconut Oil Miracle: How a High-Fat, High-Calorie Condiment Became a “Superfood” appeared first on Forks Over Knives.

Did you hear about the study in the news today?

Health information these days is much more commonplace than ever before. Every day, if not every hour, we hear of another new study or report on health. These reports can be very confusing, because if you listen to them, one day (or hour) something is good and the next day (or hour), it is bad.

In trying to understand all of this conflicting and confusing information, it is important to realize that real science doesn’t work this way, and/or change its mind every day (or hour), even though the media wants us to think it does. According to them, one day coffee is good and one day coffee is bad. One day chocolate is good and one day chocolate is bad. One week eggs are bad, the next week eggs are good. What’s a person to do?

The truth is, this kind of information just keeps the public dazed and confused. They throw their hands up in frustration, thinking that no one really knows anything, so people just continue doing what they were doing all along. Or they use this confusion as an excuse to do whatever they want to do and continue indulging in any bad habits they may have. After all, no one really knows. Right? Wrong. Outside of the media hoopla on these topics through its various outlets, a real scientist and student of health should not be swayed by the results of any one study — ever. The reason is, true science is really a slow-moving unfolding of information that builds on what is known and adds to it little by little, over time. It also looks for and acknowledges its own flaws and weaknesses. It makes conclusions based on established and proven methods that deal with methodology, power, strength, and levels of significance. It doesn’t suddenly jump from one place to another every time a new study comes out. Eggs didn’t go from bad to good this week, and neither did coffee. But the mass media, media outlets, and even some health care professionals, thrive on this endless flow of (mis)information that we hear in the news. They also thrive on presenting it in such a way that it creates endless doubt and confusion, which is very good for readership, advertisers, and product sales. And, because of human nature and the way our minds work, people are drawn to these types of “reports” and the faulty conclusions that the media presents on a daily, if not hourly, basis these days.

Unfortunately, it is not good for true science or for your health, as these reports, and the confusion they create, rarely if ever address the primary problems that cause the majority of our health problems. They act as little more than distractions, because as long as people continue to argue over or focus their energies on these ancillary issues, they miss putting their real time, energy, and efforts into doing what we know really works and what really matters. Remember, studies have repeatedly shown that only about 3% of Americans follow the basic healthy lifestyle habits (with regard to smoking, alcohol, body weight, and activity) and only about 0.5% follow the basic nutrition guidelines of a healthy diet. Yet up to 90% claim they consume a healthy diet, and over 1/3 of those say they consume a very healthy diet. In regard to health, decisions about what we eat and how we live should be based on a logical and reasoned analysis of the overwhelming majority of evidence, as evaluated and supported by the majority of the research studies. It should not be based on any one study (or two), especially when it has just come out, and especially if all we have read (or know) is a mass media account of the new study. Sure, you can always find a study that appears to say the opposite or support an opposing view, but we have to look closely at it: the methodology, the statistical analysis, how the results were interpreted, who funded it, its strengths and limitations, and the totality of the evidence to date. And, of course, our own biases, which we all have. And, while some may think my perspective and the conclusions I draw (with which you are welcome to disagree) are alternative, holistic, complimentary, hygienic, natural, vegetarian, vegan, etc. etc., to me they are just simple, conservative, basic common-sense guidelines and principles of good health that are supported by sound science — and not just today’s passing headline.

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I was a little surprised to hear this, since this is one of the oldest myths related to vegetarianism and was disproved long ago. When I pointed this out, the woman identified herself as a medical resident and stated that her current textbook in human physiology states this and that in her classes, her professors have emphasized this point.

I was shocked. If myths like this abound not only in the general population but also in the medical community, how can anyone ever learn how to eat healthfully? It is important to correct this misinformation, because many people are afraid to follow healthful, plant-based, and/or total vegetarian (vegan) diets because they worry about “incomplete proteins” from plant sources.

How did this “incomplete protein” myth become so widespread?

No Small Misconception
The “incomplete protein” myth was inadvertently promoted and popularized in the 1971 book, Diet for a Small Planet, by Frances Moore Lappé. In it, the author stated that plant foods are deficient in some of the essential amino acids, so in order to be a healthy vegetarian, you needed to eat a combination of certain plant foods at the same time in order to get all of the essential amino acids in the right amounts. It was called the theory of “protein complementing.”

Lappé certainly meant no harm, and her mistake was somewhat understandable. She was not a nutritionist, physiologist, or medical doctor; she was a sociologist trying to end world hunger. She realized that converting vegetable protein into animal protein involved a lot of waste, and she calculated that if people ate just the plant protein, many more could be fed. In the tenth anniversary edition of her book (1981), she retracted her statement and basically said that in trying to end one myth—the inevitability of world hunger—she had created a second one, the myth of the need for “protein complementing.”

In this and later editions, she corrects her earlier mistake and clearly states that all plant foods typically consumed as sources of protein contain all the essential amino acids, and that humans are virtually certain of getting enough protein from plant sources if they consume sufficient calories.

Amino Acid Requirements
Where did the concept of essential amino acids come from and how was the minimum requirement for essential amino acids derived? In 1952, William Rose and his colleagues completed research to determine the human requirements for each of the eight essential amino acids. They set the minimum amino acid requirement equal to the greatest amount required by any single person in their study. Then to arrive at the recommended amino acid requirement, they simply doubled the minimum requirements. This recommended amount was considered a definite safe intake.

Today, if you calculate the amount of each essential amino acid provided by unprocessed plant foods and compare these values with those determined by Rose, you will find that any single whole natural plant food, or any combination of them, if eaten as one’s sole source of calories for a day, would provide all of the essential amino acids and not just the minimum requirements but far more than the recommended requirements.

Modern researchers know that it is virtually impossible to design a calorie-sufficient diet based on unprocessed whole natural plant foods that is deficient in any of the amino acids. (The only possible exception could be a diet based solely on fruit).

Pride and Prejudice
Unfortunately, the “incomplete protein” myth seems unwilling to die. In an October 2001 article on the hazards of high-protein diets in the medical journal Circulation, the Nutrition Committee of the American Heart Association wrote, “Although plant proteins form a large part of the human diet, most are deficient in one or more essential amino acids and are therefore regarded as incomplete proteins.”¹ Oops!

Medical doctor and author John McDougall wrote to the editor pointing out the mistake. But in a stunning example of avoiding science for convenience, instead of acknowledging their error, Barbara Howard, Ph.D., head of the Nutrition Committee, replied on June 25, 2002 to Dr. McDougall’s letter, stating (without a single scientific reference) that the committee was correct and that “most [plant foods] are deficient in one or more essential amino acids.” Clearly, the committee did not want to be confused by the facts.

Maybe you are not surprised by this misconception in the medical community, but what about the vegetarian community?

Behind the Times
Believe it or not, an article in the September 2002 issue of Vegetarian Times made the same mistake. In a story titled “Amazing Aminos,” author Susan Belsinger incorrectly stated, “Incomplete proteins, which contain some but not all of the EAAs [essential amino acids], can be found in beans, legumes, grains, nuts and green leafy vegetables…. But because these foods do not contain all of the EAAs, vegetarians have to be smart about what they eat, consuming a combination of foods from the different food groups. This is called food combining.”

A Dangerous Myth
To wrongly suggest that people need to eat animal protein for proper nutrition encourages consumption of foods known to contribute to the incidence of heart disease, diabetes, obesity, many forms of cancer, and other common health problems.

This article on complementary protein was originally published on Jeff Novick’s website.

¹ Circulation 2001;104: 1869-74.

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Chris Voigt is the executive director of the Washington State Potato Commission. In an effort to educate the public about the nutritional value of potatoes, he ate 20 potatoes a day, for 60 days straight. That’s right, his diet consisted of only potatoes and nothing else. No toppings, no chili, no sour cream, no cheese, no gravy – just potatoes and maybe some seasonings or herbs and a little oil for some of the cooking.

Watch the video about Chris Voigt’s potato diet:

Chris’s diet started on October 1, 2010 and ended November 29, 2010. His mission was to show the world that the potato is so healthy that you could live off them alone for an extended period of time without any negative impact to your health.

Of course, those of us involved in the science and practice of healthy living were curious what impact this would have on his health and well-being. We all know how potatoes have received a lot of bad press over the last few years. They’ve been said to be high in the glycemic index, will raise your blood sugar, increase your risk for diabetes, raise your triglycerides and increase your risk for heart disease and even possibly some cancers.

For the record, his goal was not to lose weight but to consume enough calories (2,200) to maintain his weight – which is the equivalent of 20 average potatoes a day.

Take a look at Chris’s numbers:

Before (9/24/2010)
Height: 6’1″
Weight: 197
BMI: 26
Cholesterol: 214 (high)
Triglycerides: 135
HDL: 45
LDL: 142 (high)
Glucose: 104 (high)
Chol/HDL ratio: 4.75
LDL/HDL ratio: 3.15

After 60 Days (11/29/2010)
Height: 6’1″
Weight: 176
BMI: 23
Cholesterol: 147
Triglycerides: 75
HDL: 48
LDL: 84
Glucose: 94
Chol/HDL ratio: 3.0
LDL/HDL ratio: 1.75

Overall Results (After 60 Days)
Weight: -21 lbs (-11%)
BMI : -3 pt
Cholesterol:-67 pts (-31%)
Triglycerides: -60 pts (-44%)
HDL: +3 pt
LDL: -58 pts (-41%)
Glucose: -10 pts (-9%)
Chol/HDL ratio:-1.75 pts (-37%)
LDL/HDL ratio: -1.40 pts (-44%)

As we can see, even though Chris was not attempting to lose weight, he did; but more importantly he had highly significant reductions in his cholesterol, triglycerides, LDL, glucose, TC/HDL ratio, LDL/HDL ratio. These numbers indicate that Chris dramatically reduced his risk for heart disease and diabetes.

The improvements were in fact greater than what we see from drugs and many intensive lifestyle programs. And he did it all in 60 days!

While I would not recommend an all potato diet for the long-term for anyone, all of this points to the simple fact that in spite of all the bad press, potatoes are a nutritious and healthy food.

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You might think so if you followed the headlines. In 2006, the media was full of reports making these claims, some of which are still being made today. All of this attention was based on the results of a study published in the American Journal of Clinical Nutrition.¹

The prospective study followed 84,555 women in the famed Nurses’ Health Study. At the start, the women, aged 34–59 years, had no history of chronic disease, and completed a validated food frequency questionnaire. These women were then followed for 20 years with repeated assessments of their diet. The study concluded, “Our findings suggest a modest positive association between the consumption of potatoes and the risk of type 2 diabetes in women. This association was more pronounced when potatoes were substituted for whole grains.”

So, let’s take a closer look at the study and see how accurate these claims are, and where the truth really lies. Specifically, we will look at five key points.

Are all potatoes equal? Or “When is a potato not a potato?”

In the study, participants were asked how often, on average, in the previous year, they had consumed potatoes. The options they were given to choose from were either:

a) One baked or one cup mashed potato
b) 4 ounces of french-fried potatoes

These were the only two choices the subjects could pick from. So, while these may represent how potatoes are often consumed here in America, they do not account for any differences in how the potatoes were prepared and served. And mashed potatoes were counted in with baked potatoes, which are two completely different forms of preparing potatoes.

In America, whether it is at home or in restaurants, most all mashed potatoes are made with milk and butter and/or margarine. In addition, most all baked potatoes are served with butter, sour cream and/or cheese.

The following analysis represents these important differences. They are of a serving of mashed potatoes, a loaded baked potato and a plain baked potato as served in a popular national restaurant chain. They are typical for how mashed potatoes and baked potatoes are often served and consumed in America. In addition, I have included the analysis of a plain medium baked potato for comparison.

   Mashed Potatoes (Restaurant):

367 calories
24 grams of fat
59% calories from fat
11.4 grams of saturated fat
28% calories from saturated fat
9 milligrams of cholesterol

   Loaded Baked Potato (Restaurant):

505 calories
22 grams of fat
39% calories from fat
10 grams of fat
18% calories from saturated fat
30 milligrams of cholesterol

   Regular Baked Potato (Restaurant):

329 calories
4.5 grams of fat
12% calories from fat
.4 grams of saturated fat
1% calories from saturated fat
22 milligrams of cholesterol

   Baked Potato (Home):

160 calories
.2 grams of fat
1% calories from fat
.1 grams of fat
.05% calories from saturated fat
0 milligrams of cholesterol

So, compared to an at-home, plain baked potato:

• The mashed potato gets more than ½ its calories, plus nearly all its fat (about 24 grams) and cholesterol (9 mgs) from “non-potato” ingredients;
• The loaded potato gets more than 2/3 of its calories, plus nearly all of its fat (about 22 grams) from “non-potato” ingredients;
• Even the regular baked potato from the restaurant gets ½ its calories, plus nearly all its fat (about 4 grams) and cholesterol from “non-potato” ingredients (most likely oil and/or butter used on the outside and/or as a regular topping).

As we can see, the potato is contributing only a small percentage to what is most likely being counted as “potatoes” in this study. The association applied to potatoes may be more accurately applied to how potatoes are prepared and consumed and the toppings they are served with here in America, more so than just the potato itself. The study admitted that “cooking methods” were not assessed, so it is safe to assume that these were typical Americans consuming potatoes in the way they are typically served.

In addition, other studies on the Nurses database show the majority of their diets are not low fat, low saturated fat, low cholesterol or high fiber which confirms that they are not choosing or consuming the healthier versions.

So, when is a potato not a potato? When nurses in America consume them.

The Potato: Is It a Marker for Something Else?

In this study, was the potato the problem itself, or was the potato acting as a marker and pointing to something else that was associated with potato consumption?

Quoting the researchers:

“White potatoes and French fries are large components of a “Western pattern” diet. This dietary pattern is characterized by a high consumption of red meat, refined grains, processed meat, high-fat dairy products, desserts, high-sugar drinks, and eggs, as well as French fries and potatoes. A Western pattern diet previously predicted a risk of type 2 diabetes. Thus, we cannot completely separate the effects of potatoes and French fries from the effects of the overall Western dietary pattern.”

The researchers found that the study subjects who ate more potatoes also ate more red meat, more refined grains and consumed more total calories (in fact more than 500 additional calories per day). In addition, potato intake was also associated with higher intakes of saturated and trans fat, and less physical activity.

So, was the potato the problem, or was the potato a marker for a dietary pattern and lifestyle that was responsible for the results? In this study, the potato seems to be a marker for a high-fat, high refined grain diet.

Trends and Truth in Taters

If a food really is a causative factor in a disease, then as we consume more of the food (as an individual or as a nation) we should see the disease rates go up accordingly. In addition, when we remove or lessen the consumption of the food, we should see disease rates (as an individual or as a nation) go down. However, this is not the case for potatoes and diabetes. Let’s take a closer look:

   Total Potato Consumption per person per year:

1970: 122 pounds
1996: 145 pounds
2008: 117 pounds

   Prevalence of Diabetes (% of population):

1970: 2.00%
1996: 2.89%
2008: 6.29%

We see here that consumption of potatoes is trending down since 1996 yet the prevalence of diabetes is rising faster than ever. In fact from 1996 to 2008, potato consumption fell 19% while the percentage of people with diabetes increased by more than 200%.

Most importantly, the prevalence of diabetes really began to increase in 1996-1998, which is the same time that potato consumption began to fall sharply.

Replication

In science, the results of any one study are always interesting but never prove anything unless they can be replicated and/or reproduced. Reproduction and replication are what increase the validity of any claim.

In a 4-year prospective study of 36,787 adults which was done one year later, researchers investigated the association between a variety of dietary patterns and type 2 diabetes.³ The study results, which were published in the American Journal of Epidemiology, found an association between potatoes and diabetes only when they were cooked with oil. In fact, they concluded that consuming a variety of cooked vegetables, including potatoes, cooked in ways other than frying, was associated with a reduced risk of developing type 2 diabetes.

Other studies, similarly, have not found any correlation between diabetes and plain potatoes, and another also showed a decrease incidence of diabetes.^2,3

What Causes Diabetes and Do Potatoes Play a Role?

During the 20 years that the subjects in the Nurses study were followed, we saw a dramatic shift in the dietary and lifestyle pattern of Americans. Not only has potato consumption and the type of potato changed dramatically, but there have been significant changes in other areas. Americans have sharply increased their consumption of refined sugars/sweeteners, refined grains/carbohydrates, added oils/fats, hydrogenated fats/trans fat, cheese, calories, etc. Meanwhile the percentage of Americans who are overweight, and even obese, increased, while the percentage who are active fell dramatically.

These factors, and not the potato itself, are what is responsible for the dramatic increase in the incidence of diabetes. Sure, mashed potatoes, loaded baked potatoes and french-fries, which are calorie dense, high in fat, saturated fat, cholesterol, sugar, and salt increase your risk for disease and should be avoided.

However, there is no credible evidence that potatoes, when consumed close to their natural state and cooked conservatively by baking, boiling, and/or steaming, will cause diabetes or are associated with an increased risk.  In fact, potatoes have long been part of healthy diets around the world.

A more detailed version of the article was published here.

¹ Potato and French fry consumption and risk of type 2 diabetes in women– Am J Clin Nutr 2006;83:284 –90.

² “Dietary Patterns and Risk for Type 2 Diabetes Mellitus in U.S. Men. Ann Intern Med. 2002;136:201-209.

³ Dietary Patterns and Diabetes Incidence in the Melbourne Collaborative Cohort Study Am J Epidemiol 2007;165:603–610

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