May 30 2016

Nutrition, Hypertension, High Carb diets

This study, published recently in the BMJ and reviewed in the NY Times, definitely caught my attention.  The study links the consumption of potatoes to high blood pressure and I have quite a few thoughts about it. Here are my take home points:

 

  • Potatoes are often recommended in the “DASH” diet (Dietary Approaches to Stop Hypertension) because they are high in potassium, low in sodium and fat, and depending on the type, a good source of fiber.
  • However, there have been concerns about the glycemic index of potatoes and how that might have a negative impact on cardiovascular health.
  •  The researchers of this study wanted to determine whether a higher intake of baked or boiled potatoes, french fries, or potato chips is associated with higher incidence of hypertension.
  •  To answer this, more than 180,000 women and men from 3 large U.S. health studies were followed for over 25 years The participants of the study self reported how often they ate potatoes AND also self reported whether they had been diagnosed with hypertension by a health professional.
  • The study found that  after controlling for physical activity, weight, and a few other factors, more potato consumption was associated with hypertension.
  • Specifically, having 4-6 baked or boiled potatoes  a week increased the risk of hypertension by 11% compared to having 1 potato once a month.  The result was unsurprisingly worse with french fries. Four or more 4 oz servings of French fries a week increased the risk by 17 %. Strangely, consumption of potato chips was not associated with any increased risk.
  • The researchers also found that replacing one serving a day of of boiled, baked or mashed potatoes with one serving of non-starchy vegetables was associated with a lower risk of developing hypertension.
  • There are some important limitations of this study that should give one pause before giving up potatoes, especially if you enjoy them, feel great on them, and you are healthy without high blood pressure.

These limitations include the following:

  1. Because this type of study was observational, it CANNOT establish a cause and effect relationship between potatoes and high blood pressure. However, reading a title in the NY Times that states “Potatoes Tied to High Blood Pressure Risk” can be alarming to those who don’t realize this.
  1. The frequency with which the study participants ate potatoes was not objectively measured, but only self-reported. In other words, the participants reported how much potatoes they’d eaten during a certain time period, which may mean less accuracy of this data.
  1. The participants’ blood pressures were also not measured during the study.The participants simply reported whether or not they had been diagnosed with high blood pressure by a health professional. Therefore, there may have been more cases of elevated blood pressure in EITHER group, and it is hard to conjecture which group would have more under-reported cases.
  1. The glycemic index of a potato varies depending on the type of potato and the method in which it is cooked; this was not fully addressed in the study.
  1. One detail of this study that I think is a glaring issue, is that there was no analysis of what was eaten with the potato. Digestion and efficient assimilation of the carbohydrates/sugars in a food can be extremely affected by what other foods it is combined with. For example, a baked potato with steamed kale may result in a very different glycemic and/or BP response than baked potato with sour cream and a side of steak. 

Bottom Line

I will avoid ranting about fear-based news articles around whole foods. Instead I will just say that there are several limitations with this study, and they are described above. Please remember to read any writing that disparages whole unprocessed foods with a very discerning eye. 

Some personal thoughts on the study

While I eat a living foods/raw vegan diet, I have witnessed many patients and clients become healthier after shifting from a diet heavy in processed foods to that of a cooked plant-based diet with foods that are primarily whole/unprocessed. And one such cooked whole plant based food is the potato.  Rich in fiber, magnesium, potassium, and vitamin C, it is a more nutrient rich food than a bagel or white pasta. All carbs are definitely not created equally. 

It has been my clinical experience that patients on a standard western diet who reduce their usually high intake of animal proteins and replace processed sugars and processed carbs with whole food carbs (like fruit, potatoes, sweet potatoes, and other root vegetables), experience expedited healing. I’ve seen this with diabetes, hypertension, definitely obesity, as well as a lot of cases of irritable bowel syndrome, among other health issues. 

All that being said, as I say often to my patients and clients, no matter what I or any other physician is telling you, the most important person to check in with, when considering changing your diet, is you. And your body, if you give it a chance and truly listen, is extremely communicative. How do you feel after you’ve had potatoes? Not just when eating them, but an hour after, and the morning after? 

Our bodies are incredible guides, especially once they have gone through a detoxification process, and can often clue us into what does and doesn’t work for us as individuals, even before we get the blood tests for verification. 

Quick Quiz

Dance Link

This dance piece features one of my favorite foods. Not potatoes, but longans. It is called It Only Takes One.  Enjoy!

Choreography: Tumi Johnson

Dancer: Tumi Johnson

Music:  “Juicy” by ALBIS

Videography: Žare Manojlovič

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