Multiple Metrics of Carbohydrate Quality Place Starchy Vegetables Alongside Non-starchy Vegetables, Legumes, and Whole Fruit

Potato Consumption and All-Cause and Cardiovascular Disease Mortality - A Long-Term Follow-Up of a Norwegian Cohort

BACKGROUND

Potatoes are a staple food in many traditional cuisines, yet their impact on long-term risk of cardiovascular disease (CVD) and mortality is unclear, hampering evidence-based dietary guidelines.

OBJECTIVES

This study aimed to examine the association between potato consumption and all-cause and CVD-specific death over a substantial follow-up period within a cohort predominantly consuming boiled potatoes.

METHODS

Adults from 3 Norwegian counties were invited to 3 health screenings in 1974-1988 (>80% attendance). Dietary data were collected using semiquantitative food frequency questionnaires at each screening to categorize weekly potato consumption (≤6, 7-13, or ≥14 potatoes/wk) and calculate daily cumulative mean intakes (grams/day). Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox regression to estimate HRs and 95% CIs for the association between potato consumption and risk of death from all causes, CVD, ischemic heart disease (IHD), and acute myocardial infarction (AMI).

RESULTS

Among 77,297 participants with a mean baseline age of 41.1 y (range: 18.0-63.9 y), we observed 27,848 deaths, including 9072 deaths due to CVD, over a median follow-up of 33.5 y. Participants who consumed ≥14 potatoes/wk had a lower risk of all-cause death compared with those consuming ≤6 potatoes/wk (HR: 0.88; 95% CI: 0.84, 0.93). Potato consumption was associated with a minor, inverse risk of death due to CVD, IHD, and AMI. In continuous analyses of cumulative intakes, each 100 g/d increment was associated with 4% lower risk of death from all causes (HR: 0.96; 95% CI: 0.94, 0.98), CVD (HR: 0.96; 95% CI: 0.93, 0.99), IHD (HR: 0.96; 95% CI: 0.91, 1.00), and AMI (HR: 0.96, 95% CI: 0.91, 1.01).

CONCLUSIONS

In this cohort with a generally high consumption of predominantly boiled potatoes, we find modest, inverse associations between potato consumption and death from all causes, CVD, and IHD.

Perspective: Potatoes, Quality Carbohydrates, and Dietary Patterns

Potatoes have long been a staple food in many cultures and cuisines, but they have gained a reputation as a low-quality carbohydrate source that should be avoided in the diet. Historically, this view has been justified by citing the glycemic index of potatoes as the main indicator of their quality. However, their nutrient composition should also be considered. The association of potatoes with energy-dense Western dietary patterns has also contributed to a perception that potatoes are inherently unhealthy. Although some studies have suggested an association between potato consumption and increased risk of health problems, such as type 2 diabetes, these associations may be confounded by fried potato intake and are strongest at intake levels higher than average consumption rates. Epidemiologic data suggest total potato intake is not a health risk in Eastern populations and can be consumed as part of a healthy diet. Furthermore, clinical trial data demonstrate that potatoes' health impact, irrespective of preparation, is similar to legumes and comparable with refined grains, with few deleterious effects found. These findings highlight the importance of moving beyond the glycemic index and adopting a more nuanced evaluation of the epidemiologic data to better understand the health impact of potato intake. Ultimately, the negative reputation of potatoes stems from an overinterpretation of their glycemic index and association with unhealthy Western dietary patterns, as well as oversimplification of the epidemiologic data. By considering carbohydrate quality, it becomes clear that potatoes can be part of a healthy diet given the proper consideration.

Low-Carbohydrate and Low-Fat Diet with Metabolic-Dysfunction-Associated Fatty Liver Disease

BACKGROUND

This observational cross-sectional study was designed to explore the effects of a low-carbohydrate diet (LCD) and a low-fat diet (LFD) on metabolic-dysfunction-associated fatty liver disease (MAFLD).

METHODS

This study involved 3961 adults. The associations between LCD/LFD scores and MAFLD were evaluated utilizing a multivariable logistic regression model. Additionally, a leave-one-out model was applied to assess the effect of isocaloric substitution of specific macronutrients.

RESULTS

Participants within the highest tertile of healthy LCD scores (0.63; 95% confidence interval [CI], 0.45-0.89) or with a healthy LFD score (0.64; 95%CI, 0.48-0.86) faced a lower MAFLD risk. Furthermore, compared with tertile 1, individuals with unhealthy LFD scores in terile 2 or tertile 3 had 49% (95%CI, 1.17-1.90) and 77% (95%CI, 1.19-2.63) higher risk levels for MAFLD, respectively.

CONCLUSIONS

Healthy LCD and healthy LFD are protective against MAFLD, while unhealthy LFD can increase the risk of MAFLD. Both the quantity and quality of macronutrients might have significant influences on MAFLD.

Carbohydrate confusion and dietary patterns: unintended public health consequences of "food swapping"

The 2025-2030 United States Dietary Guidelines process is currently underway, and the 2025 Dietary Guidelines Advisory Committee is examining and evaluating a list of prioritized scientific questions identified by the United States Department of Health and Human Services and the United States Department of Agriculture. One of the questions that will be evaluated is if changes should be made to USDA Dietary Patterns based on whether starchy vegetables and grains are, or can be, consumed interchangeably. These foods have historically been classified in distinct food groups. Menu modeling analyses evaluating the impact of replacing starchy vegetables with grains result in declines in key nutrients of concern. Given their unique nutrient contributions and the fact that many cultural foodways within the United States population include both starchy vegetables and grains, it is important for dietary recommendations to continue to categorize starchy vegetables and grains separately.

New metrics of dietary carbohydrate quality

PURPOSE OF REVIEW

The aim of this study was to introduce novel metrics of dietary carbohydrates quality relevant for products and diets.

RECENT FINDINGS

Carbohydrate quality has long been associated with a low glycemic index. More recently, novel metrics of carbohydrate quality featuring variations of total carbohydrates-fibers-free sugars ratios have been applied to carbohydrate-rich foods, including grains, beans, vegetables, and fruit. High scoring products had higher levels of health-promoting nutrients (protein, dietary fiber, iron, magnesium, zinc, potassium, selenium, and various B-vitamins) and lower levels of nutrients of public health concern (total sugar, added/free sugars, and fat profile). Cross-sectional studies also found variants of carbohydrate quality metrics to be associated with better markers of cardiometabolic disease, including lower levels of blood triglycerides:high-density lipoprotein cholesterol ratio, homeostatic model assessment of insulin resistance, and SBP.

SUMMARY

New ratio-based carbohydrate quality metrics are built around high fiber and whole grain content, combined with a low free sugar content. Such metrics allow the identification of food products of higher overall nutritional quality, and are associated with improved diet quality and certain health outcomes.

Toward a New Definition of "Healthy" Food: Issues and Challenges

Dietary Guidelines for Americans (DGA) have become increasingly food-based guidelines. The Healthy United States-Style Eating Pattern features fruits, vegetables, whole grains, and low-fat dairy, with limits placed on added sugar, sodium, and saturated fat. Recent measures of nutrient density have followed suit, incorporating both nutrients and food groups. Most recently, the United States Food and Drug Administration (FDA) has proposed to redefine the concept of a "healthy" food for regulatory purposes. To qualify as healthy, foods will need to contain specific minimum amounts of fruits, vegetables, dairy, and whole grains, with limits placed on added sugar, sodium, and saturated fat. The present concern was that the proposed criteria, formulated by the FDA per Reference Amount Customarily Consumed, were so stringent that few foods would pass. We applied the proposed FDA criteria to foods in the USDA Food and Nutrient Database for Dietary Studies (FNDDS 2017-2018). The criteria were met by 58% of fruits, 35% of vegetables, 8% of milk and dairy products, and 4% of grain products. Many foods commonly considered to be healthy by consumers and the USDA alike did not pass the proposed FDA criteria. Federal agencies seem to define healthy in different ways. Our findings have implications for the formulation of regulatory and public health policies. We recommend that nutrition scientists be involved in the development of federal regulations and policies that affect American consumers and the food industry.

Moderate Salinity of Nutrient Solution Improved the Nutritional Quality and Flavor of Hydroponic Chinese Chives (Allium tuberosum Rottler)

Sodium chloride (NaCl), as a eustressor, can trigger relevant pathways to cause plants to produce a series of metabolites, thus improving the quality of crops to a certain extent. However, there are few reports on the improvement of nutrient quality and flavor of hydroponic Chinese chives (Allium tuberosum Rottler) by sodium chloride. In this study, five NaCl concentrations were used to investigate the dose-dependent effects on growth, nutritional quality and flavor in Chinese chives. The results show that 10 mM NaCl had no significant effect on the growth of Chinese chives, but significantly decreased the nitrate content by 40% compared with 0 mM NaCl treatment, and the content of soluble protein and vitamin C was increased by 3.6% and 2.1%, respectively. In addition, a total of 75 volatile compounds were identified among five treatments using headspace solid-phase microextraction gas chromatography/mass spectrometry (HS-SPME/GC-MS). Compared with the 0 mM NaCl treatment, 10 mM NaCl had the greatest effect on the quantity and content of volatile compounds, with the total content increased by 27.8%. Furthermore, according to the odor activity values (OAVs) and odor description, there were 14 major aroma-active compounds (OAVs > 1) in Chinese chives. The “garlic and onion” odor was the strongest among the eight categories of aromas, and its highest value was observed in the 10 mM NaCl treatment (OAVs = 794).Taken together, adding 10 mM NaCl to the nutrient solution could improve the nutritional quality and flavor of Chinese chives without affecting their normal growth.

Thirty Obesity Myths, Misunderstandings, and/or Oversimplifications: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022

Background

This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) is intended to provide clinicians an overview of 30 common obesity myths, misunderstandings, and/or oversimplifications.

Methods

The scientific support for this CPS is based upon published citations, clinical perspectives of OMA authors, and peer review by the Obesity Medicine Association leadership.

Results

This CPS discusses 30 common obesity myths, misunderstandings, and/or oversimplifications, utilizing referenced scientific publications such as the integrative use of other published OMA CPSs to help explain the applicable physiology/pathophysiology.

Conclusions

This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on 30 common obesity myths, misunderstandings, and/or oversimplifications is one of a series of OMA CPSs designed to assist clinicians in the care of patients with the disease of obesity. Knowledge of the underlying science may assist the obesity medicine clinician improve the care of patients with obesity.