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Abstract

Background: Starchy vegetables, including white potatoes, are often categorized as “lower-quality” carbohydrate foods, along with refined grains, 100% fruit juices, sweetened beverages, and sugars, snacks and sweets. Among “higher-quality” carbohydrates are whole grains, non-starchy vegetables, legumes, and whole fruits.

Objective: To apply multiple nutrient profiling (NP) models of carbohydrate quality to foods containing >40% carbohydrate by dry weight in the USDA Food and Nutrient Database for Dietary Studies (FNDDS 2017-18).

Methods: Carbohydrate foods in the FNDDS (n = 2423) were screened using four recent Carbohydrate Quality Indices (CQI) and a new Carbohydrate Food Quality Score (CFQS-4). Cereal products containing >25% whole grains by dry weight were classified as whole grain foods.

Results: Based on percent items meeting the criteria for 4 CQI scores, legumes, non-starchy and starchy vegetables, whole fruit, and whole grain foods qualified as “high quality” carbohydrate foods. Distribution of mean CFQS-4 values showed that starchy vegetables, including white potatoes placed closer to non-starchy vegetables and fruit than to candy and soda.

Conclusion: Published a priori determinations of carbohydrate quality do not always correspond to published carbohydrate quality metrics. Based on CQI metrics, specifically designed to assess carbohydrate quality, starchy vegetables, including white potatoes, merit a category reassignment and a more prominent place in dietary guidance.

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References

  1. Drewnowski A, Maillot M and Vieux F (2022) Multiple Metrics of Carbohydrate Quality Place Starchy Vegetables Alongside Non-starchy Vegetables, Legumes, and Whole Fruit. Front. Nutr. 9:867378. doi: 10.3389/fnut.2022.867378
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Abstract

This perspective examines the utility of the glycemic index (GI) as a carbohydrate quality indicator to improve Dietary Guidelines for Americans (DGA) adherence and diet quality. Achieving affordable, high-quality dietary patterns can address multiple nutrition and health priorities. Carbohydrate-containing foods make important energy, macronutrient, micronutrient, phytochemical, and bioactive contributions to dietary patterns, thus improving carbohydrate food quality may improve diet quality. Following DGA guidance helps meet nutrient needs, achieve good health, and reduce risk for diet-related non-communicable diseases in healthy people, yet adherence by Americans is low. A simple indicator that identifies high-quality carbohydrate foods and improves food choice may improve DGA adherence, but there is no consensus on a definition. The GI is a measure of the ability of the available carbohydrate in a food to increase blood glucose. The GI is well established in research literature and popular resources, and some have called for including the GI on food labels and in food-based dietary guidelines. The GI has increased understanding about physiological responses to carbohydrate-containing foods, yet its role in food-based dietary guidance and diet quality is unresolved. A one-dimensional indicator like the GI runs the risk of being interpreted to mean foods are “good” or “bad,” and it does not characterize the multiple contributions of carbohydrate-containing foods to diet quality, including nutrient density, a core concept in the DGA. New ways to define and communicate carbohydrate food quality shown to help improve adherence to high-quality dietary patterns such as described in the DGA would benefit public health.

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References

  1. Nicholls J (2022) Perspective: The Glycemic Index Falls Short as a Carbohydrate Food Quality Indicator to Improve Diet Quality. Front. Nutr. 9:896333. doi: 10.3389/fnut.2022.896333
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Abstract

Background

Epidemiologic observations suggest increased potato consumption correlates with weight gain, adiposity, and diabetes risk, while nut consumption is associated with weight control and metabolic health. Randomized controlled trial (RCT) data indicate humans respond to changes in energy intake in single dietary components and compensate for extra energy consumed.

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References

  1. Daniel L Smith, Jr, Rebecca L Hanson, Stephanie L Dickinson, Xiwei Chen, Amy M Goss, John B Cleek, W Timothy Garvey, David B Allison, French-fried potatoes consumption and energy balance: a randomized controlled trial, The American Journal of Clinical Nutrition, 2022;, nqac045, https://doi.org/10.1093/ajcn/nqac045
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Abstract

We examined the association between potato consumption in two different age periods during adolescence and risk of obesity and cardiometabolic dysfunction in White and Black girls. We used data from the biracial prospective National Growth and Health Study. Average potato consumption was derived from multiple 3-d food records in two age periods, 9–11 and 9–17 years, and included white and sweet potatoes from all sources. Multivariable logistic regression models were used to estimate OR for becoming overweight, developing prehypertension, elevated TAG levels or impaired fasting glucose (IFG) at 18–20 years of age according to the category of daily potato intake. We also stratified by cooking method (fried/non-fried) and race. ANCOVA was also used to estimate adjusted mean levels of BMI, systolic blood pressure, diastolic blood pressure, log-transformed TAG, the TAG:HDL ratio and fasting glucose levels associated with potato intake category. Higher potato consumption was associated with higher fruit and non-starchy vegetable intakes and higher Healthy Eating Index scores in Black girls. There were no statistically significant associations overall between moderate or higher (v. lower) intakes of potatoes and risks of overweight, prehypertension, elevated fasting TAG, high TAG:HDL ratio or IFG. Also, no adverse associations were found between fried or non-fried potato intake and cardiometabolic outcomes. Potato consumption has been the subject of much controversy in recent years. This study adds evidence that potato consumption among healthy girls during the critical period of adolescence was not associated with cardiometabolic risk.

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References

  1. Yiannakou, I., Yuan, M., Pickering, R., Singer, M., & Moore, L. (2021). Potato consumption is not associated with elevated cardiometabolic risk in adolescent girls. British Journal of Nutrition, 1-10. doi:10.1017/S0007114521003445
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Abstract

Carbohydrate-containing crops provide the bulk of dietary energy worldwide. In addition to their various carbohydrate forms (sugars, starches, fibers) and ratios, these foods may also contain varying amounts and combinations of proteins, fats, vitamins, minerals, phytochemicals, prebiotics, and anti-nutritional factors that may impact diet quality and health. Currently, there is no standardized or unified way to assess the quality of carbohydrate foods for the overall purpose of improving diet quality and health outcomes, creating an urgent need for the development of metrics and tools to better define and classify high-quality carbohydrate foods. The present report is based on a series of expert panel meetings and a scoping review of the literature focused on carbohydrate quality indicators and metrics produced over the last 10 years. The report outlines various approaches to assessing food quality, and proposes next steps and principles for developing improved metrics for assessing carbohydrate food quality. The expert panel concluded that a composite metric based on nutrient profiling methods featuring inputs such as carbohydrate–fiber–sugar ratios, micronutrients, and/or food group classification could provide useful and informative measures for guiding researchers, policymakers, industry, and consumers towards a better understanding of carbohydrate food quality and overall healthier diets. The identification of higher quality carbohydrate foods could improve evidence-based public health policies and programming—such as the 2025–2030 Dietary Guidelines for Americans.

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References

  1. Comerford, K.B.; Papanikolaou, Y.; Jones, J.M.; Rodriguez, J.; Slavin, J.; Angadi, S.; Drewnowski, A. Toward an Evidence-Based Definition and Classification of Carbohydrate Food Quality: An Expert Panel Report. Nutrients 2021, 13, 2667.
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Abstract

Potatoes are nutrient rich white vegetables, however, research on their impact on public
health is limited. The objective of this study was to provide updated evaluation of the cross-sectional
association between potato consumption and diet quality, nutrient intake and adequacy. Twenty-four
hour diet recall data from adolescents (n = 16,633; age 9–18 years) were used to assess intakes. Usual
intakes of nutrients were determined using the National Cancer Institute method and diet quality
was calculated using the Healthy Eating Index-2015 (HEI-2015) after adjusting for demographic
factors. Consumers of potatoes (baked or boiled potatoes, mashed potatoes and potato mixtures,
fried potatoes, and potato chips) had higher (p < 0.05) HEI-2015 total score and subcomponent
scores for total vegetables, total protein foods, and refined grain than non-consumers. Consumers
also had higher (p < 0.05) intake of energy, dietary fiber, protein, copper, magnesium, phosphorus,
potassium, selenium, sodium, zinc, niacin, vitamin B6, vitamin C, vitamin K and total choline; and
higher (p < 0.05) adequacy for protein, copper, magnesium, phosphorus, potassium, zinc, thiamine,
niacin, vitamin B6, vitamin C, and vitamin K than non-consumers. In conclusion, adolescent potato
consumption was associated with higher diet quality, nutrient intake, and adequacy and therefore
encouraging their consumption may be an effective strategy for improving nutritional status.

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References

  1. Agarwal, S.; Fulgoni, V.L., III. Intake of Potatoes Is Associated with Higher Diet Quality, and Improved Nutrient Intake and Adequacy among US Adolescents: NHANES 2001–2018 Analysis. Nutrients 2021, 13, 2614.
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Abstract

Plant foods are universally promoted for their links to improved human health, yet carbohydrate-containing foods are often maligned based on isolated, reductionist methods that fail to assess carbohydrate foods as a matrix of nutrients and food components. Currently accepted positive carbohydrate quality indices include plant food, whole-grain content, and dietary fiber, while negative health outcomes are linked to high intakes of added sugar and high glycemic index. More recently, negative health aspects have been linked to ultra-processed foods, which are often high in carbohydrates. Yet, carbohydrate staples such as grains and dairy products are both enriched and fortified, resulting in these carbohydrate foods containing important nutrients of concern such as dietary fiber, potassium, vitamin D, and calcium. This Perspective analyzes carbohydrate metrics used in dietary guidance and labeling and finds limitations in accepted indices included in standardized quality carbohydrate definitions and also proposes additional indices to benefit both human and environmental health. As nutrition recommendations shift away from a single-nutrient focus to a more holistic dietary pattern approach that is flexible and adaptable for each individual, it is necessary to determine the quality components that make up these patterns. This review concludes that current approaches that demonize staple carbohydrate foods do little to promote the recommended patterns of foods known to improve health status and reduce disease risk.

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References

  1. Schulz, Joanne Slavin, Perspective: Defining Carbohydrate Quality for Human Health and Environmental Sustainability, Advances in Nutrition, 2021; nmab050.
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Abstract

Guidelines for reducing postprandial blood glucose concentrations include avoiding high glycemic index (GI) foods, such as white potatoes. However, GI testing is often undertaken in the morning with foods consumed in isolation by non-clinical cohorts. We investigated the impact of potato preparation and consumption as part of a mixed-evening meal on postprandial and nocturnal glycemic responses, and postprandial insulin response, in individuals with Type 2 Diabetes Mellitus (T2DM).  In a randomized, cross-over design, 24 males and females (age 58.3 ± 9.3 y; BMI: 31.7 ± 6.8 kg/m2) with T2DM (diet or metformin controlled) completed four experimental trials after consuming a standardized breakfast (25% daily energy intake (EI)) and lunch (35% EI). Dinner (40% EI) was consumed at 1800 h being either: 1) boiled potato (BOIL); 2) roasted potato (ROAST); 3) boiled potato cooled for 24 h (COOLED); or 4) basmati rice (CONTROL). Each meal contained 50% carbohydrate, 30% fat and 20% protein. Blood samples were collected prior to, immediately post meal and at 30-min intervals for a further 120 min. A continuous glucose monitor was worn to assess nocturnal interstitial glucose concentrations. No differences were detected in postprandial venous glucose area under the curve (iAUC) between CONTROL and all three potato conditions. Postprandial insulin iAUC was greater following COOLED compared to CONTROL (P = 0.003; 95% CI: 18.9-111.72 miU/mL). No significant differences between CONTROL and BOIL or ROAST were detected for postprandial insulin concentrations. All potato meals resulted in lower nocturnal glucose AUC than CONTROL (P < 0.001; 95% CI 4.15-15.67 mmol/L x h). Compared to an isoenergetic rice meal, boiled, roasted or boiled then cooled potato-based meals were not associated with unfavourable postprandial glucose responses or nocturnal glycemic control, and can be considered suitable for individuals with T2DM when consumed as part of a mixed-evening meal.

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References

  1. Devlin BL, Parr EB, Radford BE, Hawley JA. Lower nocturnal blood glucose response to a potato-based mixed evening meal compared to rice in individuals with type 2 diabetes. Clin Nutr. 2020. doi: 10.1016/j.clnu.2020.09.049.
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Abstract

Epidemiologic studies suggest that consumption of potatoes is associated with increased risk of cardiometabolic diseases. However, few clinical trials have empirically tested these observational findings. The aim of this single-blind, randomized, crossover study was to evaluate the effect of daily potato consumption, compared to refined grains, on risk factors for cardiometabolic diseases. It was hypothesized that no difference in cardiometabolic endpoints would be detected between conditions, but diet quality would improve with potato consumption. Healthy participants on self-selected diets received one potato-based side dish or one refined grain-based side dish daily, for four weeks, separated by a minimum two-week break. Dishes were isocaloric, carbohydrate-matched, and prepared without excess saturated fat or sodium. Participants were instructed to consume the side-dish with a meal in place of carbohydrates habitually consumed. Lipids/lipoproteins, markers of glycemic control, blood pressure (BP), weight and pulse wave velocity (PWV) were measured at baseline and condition endpoints. Diet quality was calculated, based on 24-hour recalls, using the Healthy Eating Index (HEI)-2015. Fifty adults (female n=34; age: 40±13; BMI: 24.5±3.6 kg/m2) completed this study. No between-condition differences were detected for fasting plasma glucose (-0.97; mg/dL, 95% CI: -2.3, 0.35; p=0.15), the primary outcome, or any other outcomes. Compared with refined grains, the HEI-2015 score (3.5, 95%CI: 0.6, 6.4 p=0.01), potassium (547 mg, 95%CI: 331, 764, p<0.001) and fiber (2.4 g, 95% CI: 0.6, 4.2, p=0.01) were higher following the potato condition. Consuming non-fried potatoes resulted in higher diet quality, potassium and fiber intake, without adversely affecting cardiometabolic risk.

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References

  1. Johnston, E., Petersen, K., & Kris-Etherton, P. (n.d.). Daily intake of non-fried potato does not affect markers of glycemia and is associated with better diet quality compared to refined grains: A randomized, crossover study in healthy adults. British Journal of Nutrition, 1-29. doi:10.1017/S0007114520000252
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Abstract

Resistant starch (RS) has been shown to improve postprandial glycemia and insulin sensitivity in adults with metabolic syndrome. RS is found naturally in potatoes, where the amount varies based on cooking method and serving temperature. Thirty females with a mean BMI of 32.8 ± 3.7 kg/m2, fasting glucose of 110.5 mg/dL, and insulin of 10.3 µIU/L, completed this randomized, crossover study. A quantity of 250 g of boiled (low RS) and baked then chilled (high RS) russet potatoes were consumed on two separate occasions. Glycemic (glucose and insulin) and incretin response, subjective satiety, and dietary intake were measured. Results showed that the chilled potato elicited significant reductions at 15 and 30 min in glucose (4.8% and 9.2%), insulin (25.8% and 22.6%), and glucose-dependent insulinotropic peptide (GIP) (41.1% and 37.6%), respectively. The area under the curve for insulin and GIP were significantly lower after the chilled potato, but no differences were seen in glucose, glucagon-like peptide-1, and peptide YY, or overall subjective satiety. A higher carbohydrate and glycemic index but lower fat diet was consumed 48-hours following the chilled potato than the boiled potato. This study demonstrates that consuming chilled potatoes higher in RS can positively impact the glycemic response in females with elevated fasting glucose and insulin.

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References

  1. Patterson MA, Fong JN, Maiya M, Kung S, Sarkissian A, Nashef N, Wang W. Chilled Potatoes Decrease Postprandial Glucose, Insulin, and Glucose-dependent Insulinotropic Peptide Compared to Boiled Potatoes in Females with Elevated Fasting Glucose and Insulin. Nutrients. 2019; 11(9):2066, doi:10.3390/nu11092066.
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