Harvard Study: Fruit Reduces Diabetes Risk

Swedish Strawberries (Photo: Swedish Embassy)

People are always asking me if fruit is too high in sugar to eat, especially if you have diabetes. This fear of fruit, I believe, is leftover from the Atkins craze, making foods like fruits, and even vegetables like carrots, verboten. This is one of the most tragic consequences of this diet fad, because avoiding fruit can actually damage your health.

People who eat fruit have a lower incidence of Type 2 Diabetes, the most common form of the disease, according to a recently published Harvard study. But this study isn’t alone in its conclusions. It corroborates decades of research showing the nutritional value and health benefits of fruits.

Fruit is high in water content and fiber, which help you feel full with fewer calories. Even though it contains simple sugars and carbohydrates, most fruits have a relatively low glycemic index, that is, when you eat it, your blood sugar raises only moderately, especially when compared with refined sugar or flour products.

Fruit is loaded with nutrients scientists believe protect people from major chronic diseases such as heart disease, cancer, type 2 diabetes, and more. The potassium in fruit helps lower blood pressure and actually helps neutralize the blood pressure-raising affects of sodium.

Eating more fruits and vegetables – as high as 5 cups per day or more – is a habit which could help you stabilize and even reverse Type 2 Diabetes. Yes, it is possible!

And, the best part of fruit? It’s delicious! It’s easy to eat, to pack in your lunch box for the office or school, and it’s such a refreshing snack or dessert. What could be better?

The study:

Dietary flavonoid intakes and risk of type 2 diabetes in US men and women

Nicole M Wedick, An Pan, Aedín Cassidy, Eric B Rimm, Laura Sampson, Bernard Rosner, Walter Willett, Frank B Hu, Qi Sun, and Rob M van Dam

From the Departments of Nutrition, Epidemiology, and Biostatistics, Harvard School of Public Health, Boston, MA; Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; the Department of Nutrition, Norwich Medical School, University of East Anglia, Norwich, United Kingdom; and the Departments of Epidemiology and Public Health and Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Supported by NIH grant from the National Heart, Lung, and Blood Institute.

Abstract

Background: Data from mechanistic studies support a beneficial effect of specific flavonoids on insulin sensitivity. However, few studies have evaluated the relation between intakes of different flavonoid subclasses and type 2 diabetes.

Objective: The objective was to evaluate whether dietary intakes of major flavonoid subclasses (ie, flavonols, flavones, flavanones, flavan-3-ols, and anthocyanins) are associated with the risk of type 2 diabetes in US adults.

Design: We followed up a total of 70,359 women in the Nurses’ Health Study, 89,201 women in the NHS II, and 41,334 men in the Health Professionals Follow-Up Study who were free of diabetes, cardiovascular disease, and cancer at baseline.

Results: During 3,645,585 person-years of follow-up, we documented 12,611 incident cases of type 2 diabetes. Higher intakes of anthocyanins were significantly associated with a lower risk of type 2 diabetes after multivariate adjustment for age, BMI, and lifestyle and dietary factors. Consumption of anthocyanin-rich foods, particularly blueberries and apples/pears, was also associated with a lower risk of type 2 diabetes. No significant associations were found for total flavonoid intake or other flavonoid subclasses.

Conclusion: A higher consumption of anthocyanins and anthocyanin-rich fruit was associated with a lower risk of type 2 diabetes.

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5 So-Called Health Foods You Should Avoid

Featured on CNN’s Health Minute
Read it to find out why this article went VIRAL!
Recently published in LiveScience.com, published in “The Washington Post,” and broadcast on WOR Radio New York City…

Eating healthy can be harder than you think, thanks to an enterprising food industry that wants us to consume more than we need. That’s because our country’s agricultural system produces twice what most people require – 3,900 calories per person per day, according to the U.S. Department of Agriculture’s Economic Research Service. This encourages creative marketing to unload the excess, much of it made with cheap ingredients, having long shelf-lives, and minimal nutritional value – the kinds of “food” with the highest profit margins.

As a nutrition consultant, I know that words such as “low fat,” “high fiber,” “multigrain,” gluten free,” and “natural” can confuse even the most sophisticated customers into believing what they’re buying is healthful. In fact, market research proves it.

What can you do? First, make a habit of reading the ingredients list, not just the Nutrition Facts panel. And remember the following products worth resisting…

Reduced-fat peanut butter

The oil is the healthiest part of a peanut* or a tree nut, containing most of the nutrients, so there’s no advantage to taking it out. In fact, it’s worse because it robs the peanut butter of its health benefits. “Reduced-fat peanut butter has as many calories and more sugar than the regular,” says Bonnie Liebman, nutrition director for the Center for Science in the Public Interest.

Instead: Buy regular peanut butter. Eating one or two ounces of nuts daily is associated with reductions in heart disease and cancer risk. A recent Harvard study showed that eating nuts is associated with lower body weights.

Enhanced water

Sports drinks, diluted soft drinks with salt, are only needed during intense exercise exceeding one hour or in extreme heat. Drinks such as Vitaminwater (c) are essentially sugary drinks with a vitamin pill. They are “unequivocally harmful to health,” says Walter Willett, professor of epidemiology and nutrition at Harvard’s School of Public Health. “Whether vitamins dissolved in water have any benefit will depend on who you are and whether you are already getting enough. . . . Some people may be getting too much of some vitamins and minerals if they add vitamin water on top of fortified foods and other supplements.” A recent Iowa Women’s Health Study found an association between certain commonly used vitamin and mineral supplements and increased death rates. But the worst offenders in this category are energy drinks such as Red Bull, Sobe Life Water, or Monster Drinks.  They’re not only high in sugar, but most contain stimulants which may be harmful, especially with medical conditions like high blood pressure.

Instead: Drink water, ideally from the tap (“Eau du Potomac,” as it’s known locally). It’s the best drink for hydrating your body, is naturally calorie-free and contains fluoride to prevent tooth decay. No supplement matches the nutrients in whole foods such as fruits, vegetables, nuts and whole grains.

Energy bars

The reputation of these bars, also known as meal replacement bars, is that they are healthy, aid in weight loss or help build muscle. In fact, they are calorie bombs: candy bars with vitamins, protein or fiber added. For most of them, sugar is either the first (predominant) or second ingredient.

Instead: Snack on fruit or veggies for weight loss and yogurt for muscle gain. If you’re hiking a long distance and want a healthful, nonperishable calorie bomb, try nuts and dried fruit.

Multigrain foods

Multigrain breads, crackers and cereals are often the most confusing foods. People see “multigrain” and think “whole grain.” That’s not necessarily so. This is an important distinction because people who eat whole grains have a lower incidence of diabetes, heart disease and cancers, and are less likely to be overweight compared with those who eat refined grains. Note that when “enriched wheat flour” is listed in the ingredients, that’s refined flour.

Instead: Be sure a whole grain, such as whole wheat, whole rye, whole oats or brown rice, is the first and preferably the only grain in the ingredient list. A great example is a cereal listing whole rolled oats as the only grain or a bread listing whole wheat as the only wheat. Alternatively, consider an egg for breakfast. “The huge amounts of refined starch and sugar that many people eat for breakfast, often thinking that this is the healthy choice, does far more damage to their well-being than an egg,” says Harvard’s Willett.

Non-fried chips and crackers

It’s easy to believe these foods are healthful because of labels such as “baked,” “low fat” or “gluten free.” But most are made with refined grain or starch, which provide plenty of calories and few nutrients. Popchips, for example, are a new product marketed as healthful. But the ingredients are highly refined potato flakes, starch, oil, salt and about 14 additional things. Pita chips, made with white flour, oil, salt and several more ingredients, are no better. To boot, research shows that too much refined grains and starches increases the risk for heart disease, cancers, diabetes and weight gain.

Instead: Try Wasa or Finn Crisp Original Rye crackers. They’re 100 percent whole grain and have little sodium. If you’d like a chip, try Terra Chips, made with sliced vegetables, or even a 100 percent whole grain chip fried in a healthy oil, such as olive or canola. Tortilla chips and SunChips are two examples. “Now that trans fats have been removed from most cooking oils, the healthiest part of potato chips is the fat,” Willett says. “And chips made of whole grains rather than potatoes, like Frito-Lay’s SunChips, can legitimately be considered a health food,” so long as you keep to the one-ounce serving size.

*Peanuts are technically a legume, but we call them nuts nutritionally because their nutritional characteristics and health benefits closely match those of tree nuts.

Find this article originally printed in The Washington Post February 28, 2012

Listen to me discuss “Health Foods You Should Avoid” on WOR 710  Talk Radio NYC ”The Joan Hamburg Show”

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Harvard Study Finds Certain Foods – NOT Calories – Have a Strong Impact on Weight Gains and Losses

Individual foods are more important than calories when it comes to long term weight gains or losses, according to the study. Specifically, potatoes are associated with weight gain, along with sugar-sweetened beverages and meats, while foods like fruits, vegetables, whole grains, nuts and yogurt, are associated with weight loss, according to the study.

 “Modest changes in specific foods and beverages, physical activity, TV-watching, and sleep duration were strongly linked with long-term weight gain. Changes in diet, in particular, had the strongest associations with differences in weight gain… The idea that there are no ‘good’ or ‘bad’ foods is a myth that needs to be debunked,” said a researcher in a press release. The study appears in the June 23, 2011, issue of the New England Journal of Medicine.

When I was contacted by USA Today reporter, Oliver St. John, to comment on the Harvard Study, this gave me an opportunity to look over the study so that I could offer an analysis which would help not only “USA Today” readers, but me and my clients better understand it.

I found some of the claims made regarding the study incomplete.

While this is an interesting study and confirms much of what we know about healthy and unhealthy foods, I’m concerned about the sweeping conclusions for the following reasons:

The Harvard study is epidemiological, the kind of study which analyzes large populations and their health outcomes. Because the facts cannot be precisely measured, as it would be in a clinical study -nobody is weighing and measuring the foods people are eating, their body weights, or their lifestyle patterns – the conclusions which can be made are limited. This is true for many reasons. First, there are no “controls” in the study; making it difficult to tease out confounding variables having an effect beyond the particular foods being studied. What I mean is: eating certain foods is associated with specific behavior patterns, so it’s impossible to determine if the effect (weight loss/gain) is due to the food or the behavior pattern. For instance, studies of whole-grain eating find it is a “marker” for engaging in many healthy behaviors. People who eat whole grains are more likely to exercise and eat more vegetables. SO when epidemiological studies find whole grain- eaters are healthier, one must ask: is the effect due to eating whole grains or the lifestyle associated with eating whole grains? The only way to answer this question is, once the epidemiological data is observed, to take the observations into a lab and do a controlled clinical study. The clinical study would need to control for everything – exercise, diet, body weight, etc – and change only whether people are eating refined or whole grains, to determine if the health effect is due to the whole grain eating or the lifestyle.

POTATOES

The Harvard study found potato-eating associated with weight gain. The researchers warned against eating potatoes, attributing the weight gain to the rise in blood sugar caused by potatoes.

I am not quite convinced. Why?

First, many foods cause rises in blood sugar – including whole wheat bread and whole grain cold cereals. But they aren’t associated with weight gain, in fact, quite the opposite.

Second, in America, most potatoes are eaten as french fries or potato chips, and these are very fattening versions of potatoes. So, the way potatoes are cooked – not the potato itself – may be why Harvard’s epidemiological study found potato-eating is associated with weight gain. This argument points to excess calories as a factor.

Also, and this may be an important factor explaining why potatoes are associated with weight gain. When people eat french fries, they are usually eating hamburgers and hot dogs alongside.  Not only that, the beverage they’re drinking is SODA (a known contributor to obesity in adults and children). Therefore, instead of the potatoes causing the problem, could it be the meal pattern or high calorie lifestyle associated with people who eat french fried potatoes? In the United States, french fries are eaten together with fattening, unhealthy foods, known to be correlated with increased weight, diabetes, heart disease, you name it. Same with potato chips. People who regularly eat french fries, potato chips, and sodas also eat other fattening and unhealthy foods. In fact, studies show soda-drinking, for instance, is another “marker”  but this time, for engaging in unhealthy behaviors like smoking and being sedentary. These confounding variables could influence the study’s results.

This brings me to the last piece of evidence – and what convinces me the most – that potatoes do not a cause weight gain:  SWEDEN

In Sweden, people are no fatter than Americans, in fact, they’re slimmer. But, they eat potatoes every day, and often more than once a day. But when Swedes eat potatoes (and I’m sure of this as I am a Swede and visit often), they eat them in small portions, they’re boiled, topped with a little butter (oops), alongside FISH. Not burgers, not fried fish, just grilled, steamed, cured, smoked, or sauteed FISH.

So, if eating potatoes in Sweden is not associated with weight gain, could it be because the potatoes are cooked in a healthier way than in the United States and the meal pattern is a healthier one?  1) the potatoes are boiled, not fried, 2) the potatoes are eaten in smaller, more reasonable portions, and 3) the potatoes are more often eaten together with other healthy foods, such as fish – not burgers and sodas.

And, how do you explain all those poor, skinny Irish and Russians – heck, anyone living in the northern parts of the world – people who subsisted on and depended on potatoes as their only vegetable for centuries. Why didn’t the potatoes make them fat?

Do I believe potatoes are a wonder food? No. But I also do not believe potatoes are  “POISON,” as some commentators have stated.

Should you be eating larger portions of watery vegetables and smaller portions of starchy vegetables, such as potatoes? Yes.

Do I occasionally enjoy French Fries and Potato Chips, known to be fattening, unhealthy foods? Yes I do.

Do I eat French Fries and Potato Chips on a regular basis? No, I do not. Do I wish I could?
Yes I do, but I’d rather be healthy and slim.

NUTS

People eating nuts were more likely to have lower body weights, according to the Harvard Study. Their explanation is that nuts are satiating; they make us feel full, inferring that they lead to eating fewer calories overall. Clinical studies have found years ago that adding nuts to meals, especially breakfast, decreased overall calorie intake, making weight loss easier. This is one reason why I have been encouraging nut-eating for many years. Also, we’ve known for quite a while that nut-eaters around the world have fewer heart attacks and are healthier in other ways.

Does this mean you cannot gain weight eating too many nuts? No. Plenty of people eat too many nuts and can become overweight because of it. Nuts are healthy, but fattening little morsels. One ounce, or a small handful, contains about 180 calories. This is why I recommend most people eat one ounce per day. But if weight is not an issue, two ounces a day – or more, if you can afford the calories, is fine – and is even heart healthy. When I work with people wanting to gain weight healthfully, I advise snacking on nuts!

Are certain nuts better than others? I’m not convinced of this. Every time a new study comes out about a nut – any nut – it’s positive news. Certain nuts, though, are more commonly eaten, have a bigger consumer base, and more money to fund scientific studies. This may be why you hear about some nuts over others. It is also a very expensive and time-consuming process for a food to be approved for a health claim on a food label. So, only certain nut growers can afford to put health claims on their labels, and educate you about their health benefits.

While you already know each nut has a different look and flavor, each nut also has its own unique nutritional characteristics. For instance, almonds are the highest in protein and Vitamin E, and the lowest in artery-clogging saturated fat. Walnuts are the only nut with omega-3-fatty acids. Pecans have the highest antioxidant content. Pistachios contain lutein, a compound which may significantly improve eye health.

Bottom Line: Eat nuts every day.
They’re good for you and may help you eat fewer overall calories because they’re so satiating!
Yes, calories matter: So, stick with just one or two ounces, if weight is an issue. If not, eat more.

YOGURT

"Yogurt Spinach Dip" from "Diet Simple"

The study found yogurt-eating associated with lower body weights. Whole civilizations have known about yogurt’s health benefits for thousands of years.

When my mother was recovering from hip replacement surgery I advised her to live on yogurt, fruits and vegetables for healing AND to prevent weight gain from being immobile. It worked. She healed very quickly and lost a little weight at the same time. She was thrilled. I’ve repeated the same advice to my clients, when appropriate, and they’ve been thrilled with the results, too.

Yogurt has many positive qualities. I’m convinced: Yogurt is a Superfood; it may be one of the best overall foods you can eat. Yogurt creates a natural way to boost your immune system by providing probiotics which  increase the healthy bacteria in your gastrointestinal tract, according to my friend and colleague, Jo Ann Hattner, MPH, RD, in her book, Gut Insight.”

Probiotics are live bacteria that promote digestive health. As we age, it is thought that bacterial populations in our gut change – resulting in increased harmful, disease-causing bacteria and fewer protective bacteria.   When you add probiotics you repopulate the gut with beneficial bacteria that protect against infection-causing toxins.

You also improve colon health by lowering pH of the colon, so it’s receptive to the beneficial bacteria and detrimental to the disease-causing bacteria, you protect the intestinal lining, and strengthen immunity.  Exciting research is evolving on the health benefits of probiotics.

But correlating yogurt with lower body weights is complicated. Do you believe people who regularly eat french fries, potato chips, burgers and sodas eat much yogurt? I don’t think so. This is another case where lifestyle probably plays a huge role and why Harvard’s epidemiological study found yogurt was associated with lower body weights.

While it may be true that yogurt has health benefits causing leanness, this hasn’t been proven conclusively in clinical studies yet. There have been studies showing dairy foods are very satiating… That is, when you eat yogurt, you feel full in relation to the calories. And when you feel extra satiated by something, such as yogurt or nuts, it helps you eat fewer overall calories for the day. There is some evidence that the protein in yogurt may be especially high quality, spare lean muscle (and bone), and increase metabolism, thereby making weight loss a little easier. Diary products may also contain other bioactive compounds contributing to leanness. The Harvard researchers speculated the probiotics in yogurt may be responsible for the weight benefit. All of these reasons could be significant. But, the most significant factor probably is: Yogurt-eaters are more likely to live a healthy lifestyle, exercise, and eat other healthy foods.

My clients, family and friends have known this for years. Why? I love keeping up with the science and keep myself and them informed.

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