How Should I Organize My Diet To Help My Diabetes?

Diabetes is one of the most commonly occurring long-term medical conditions in the world.

According to the World Health Organization, as of 2014, over 422 million people worldwide have diabetes. Diabetes complications can include blindness, kidney problems, and heart disease.

Similar to many long-term diseases, complications may be prevented with proper management of the condition.

“Diet is one of the key elements in managing diabetes,” Amparo Gonzalez, RN, CDE, of the Johnson and Johnson Diabetes Institute. “People with diabetes need to manage the amounts of carbohydrates, fat, and overall calories they eat daily.”

“When it comes to diet, it’s also important to remember moderation and portion control are essential.”

The basics of diabetes

The two major types of diabetes are type 1 diabetes and type 2 diabetes.

A girl holding a glucometer.
Making the right food choices is important for both type 1 and type 2 diabetes.

Type 1 diabetes often develops early in life, and the cause is not fully understood. Type 1 diabetes occurs when the immune system damages the cells that make a hormone called insulin. The result is insufficient insulin production.

Type 2 diabetes is associated with a sedentary lifestyle and being overweight. It can develop in both children and adults. People with type 2 diabetes do not produce enough insulin, or the insulin they do produce is not used efficiently.

Fortunately, both types of diabetes can be managed through medication and lifestyle choices, such as healthy eating. Making healthy food choices and limiting unsuitable foods is a large part of a diabetes treatment plan.

Important goals for managing diabetes through diet include controlling blood sugar levels and maintaining a healthy weight.

The role of diet in diabetes

After eating, food breaks down into glucose. Glucose is a type of sugar and a major source of energy for the body.

In response to an increase in glucose levels, the body releases insulin. Insulin is an essential hormone because it allows the cells in the body to absorb glucose. It also plays a role in helping the body store protein and fat.

In people who have diabetes, their body may stop making insulin, not make sufficient levels of insulin, or may not use insulin efficiently. Without proper insulin production and use, glucose may not be absorbed by the cells. Instead, glucose levels rise in the bloodstream.

There are a couple of problems when blood sugar levels in the bloodstream become high. The cells don’t get the energy they need, and fatigue can occur.

High blood sugar levels over time can also damage blood vessels in the body. When the blood vessels become damaged, various complications can occur, such as kidney and heart disease, and vision loss.

The good news is that by making the right choices, people can manage their diabetes more effectively, keep glucose levels steady, and lower the risk of possible complications.

How does food affect blood sugar levels?

Different foods affect blood sugar levels differently. The three macronutrients the body uses are fat, protein, and carbohydrates. Carbohydrates affect glucose levels the most. When eaten alone, protein and fat do not have a significant impact on glucose levels.

It’s important to remember that many foods contain a combination of carbohydrates, protein, and fat. Since food can have a significant impact on blood sugar levels, it’s essential to make good food choices and monitor carbohydrate intake.

There is no “one-size-fits-all” diet for people with diabetes. Several individual factors play a role in dietary choices, including whether a person is overweight, has kidney disease, and whether they have type 1 diabetes or type 2 diabetes.

It’s always best to get nutritional advice from a registered dietitian. The guide below provides some general dietary guidelines to help manage diabetes.

Suitable food choices for people with diabetes

It’s difficult to state recommendations for an exact number of grams of nutrients, such as carbohydrates, a person with diabetes should eat.

A glucometer with fruit, vegetables, and grains.
Fresh fruits, vegetables, and whole grains are good choices for people with diabetes.

According to dietary guidelines released by the American Diabetic Association (ADA), there is no conclusive evidence supporting an ideal amount of carbohydrates or other nutrients for people with diabetes.

Instead, an emphasis is placed on choosing healthy foods, including:

Complex carbohydrates

Complex carbohydrates differ from simple carbohydrates. Complex carbohydrates are broken down slowly. They also often contain fiber, and they do not affect blood sugar levels as significantly as simple carbohydrates.

Foods containing complex carbohydrates include:

  • Beans
  • Peas
  • Whole grains
  • Vegetables
  • Fruits
  • Sweet potatoes

Lean protein

The ADA guidelines do not provide a specific protein intake recommendation for blood sugar control. Again, the focus is on healthy choices.

People with diabetes should keep in mind that some sources of protein can be high in fat, which can contribute to weight gain.

The ADA recommend lean sources of protein including:

  • Fish (herring, sardines, salmon, tuna)
  • Eggs
  • Chicken
  • Nuts (cashews, peanuts, soy nuts)
  • Lentils

Healthy fats

Fat is an essential nutrient. Certain types of fat, such as monounsaturated and polyunsaturated fat are considered healthy fats. More important than the quantity of fat is the type of fat eaten, however.

Suitable fat choices include:

  • Sesame seeds
  • Olive oil
  • Avocados
  • Nuts
  • Flaxseed

Unsuitable food choices for people with diabetes

People with diabetes should also be aware of food choices that can cause spikes in blood sugar and contribute to being overweight. When choosing foods, it’s helpful to limit those listed below.

A selection of foods that are bad for people with diabetes.
People with diabetes should limit refined carbohydrates and foods containing hidden sugars.

Refined carbohydrates

Refined carbohydrates may include foods containing processed sugar or refined grains. Most refined carbohydrates have their fiber removed and have limited nutritional value. They also lead to rapid spikes in blood sugar levels.

Refined carbohydrates to be limited include:

  • White bread
  • White rice
  • Cookies
  • Pastries
  • Cereal with added sugar

Trans fat and saturated fat

Excessive amounts of saturated fats and any amount of trans fats are unhealthy for everyone. They can raise “bad” cholesterol and contribute to heart disease.

Foods that are high in trans fat and saturated fat include:

  • Fried food
  • Chips
  • Commercially baked cookies and cakes
  • Vegetable shortening
  • Food containing partially hydrogenated oil

Hidden sugar

People with diabetes should also be aware of foods with hidden sugar. Some foods may look healthy but have a high sugar content on closer inspection.

Always check food labels to determine the sugar and carbohydrate content.

Foods that often contain hidden sugar include:

  • Yogurt
  • Granola
  • Canned fruit packed in syrup
  • Canned pasta sauce
  • Frozen dinners
  • Bottled condiments

Daily and weekly menu planning tips

People with diabetes may benefit from daily and weekly meal planning. Meal planning can help someone choose foods that keep glucose levels steady and help them maintain a healthy weight. Meal planning should also include keeping track of what is eaten.

There are three main ways for people to track what they eat: carbohydrate counting, glycemic index, and the plate method.

Plate method: Divide the plate into three categories. Half the plate should consist of non-starchy vegetables. One-fourth should consist of whole grains and complex starchy food. The remaining fourth of the plate should contain lean protein.

Carb counting: Carbohydrate counting involves planning how many grams of carbohydrates are eaten with each meal and snack.

Glycemic index: The glycemic index categorizes food by how much it increases blood sugar. Foods that have a high glycemic index raise blood sugar more than foods with a low glycemic index. Meal planning using the glycemic index involves choosing foods that are low or medium on the glycemic index.

Whether planning daily or weekly menus, it’s also important for people with diabetes to keep the following in mind:

  • Eating at regularly set times
  • Avoiding skipping meals as it can affect blood sugar levels
  • Spacing meals and snacks out to prevent large changes in blood sugar levels
  • Eating a wide range of foods
  • Thinking about the size of servings
  • Avoiding carbohydrate-only meals that can cause higher blood sugar spikes

Legumes May Lower Risk of Type 2 Diabetes

Type 2 diabetes is a serious health concern in the United States and across the globe. New research shows that a high consumption of legumes significantly reduces the risk of developing the disease.
[various types of legumes]
A new study suggests that a high consumption of legumes can reduce the risk of type 2 diabetes by 35 percent.

The legume family consists of plants such as alfalfa, clover, peas, peanuts, soybeans, chickpeas, lentils, and various types of beans.

As a food group, they are believed to be particularly nutritious and healthful. One of the reasons for this is that they contain a high level of B vitamins, which help the body to make energy and regulate its metabolism.

Additionally, legumes are high in fiber and contain minerals such as calcium, magnesium, and potassium. They also comprise a variety of so-called phytochemicals – bioactive compounds that further improve the body’s metabolism and have been suggested to protect against heart disease and diabetes.

Finally, legumes are also considered to be a “low glycemic index food,” which means that blood sugar levels increase very slowly after they are consumed.

To make people aware of the many health benefits of legumes, the year 2016 has been declared the International Year of Pulses by the Food and Agriculture Organization of the United Nations. Pulses are a subgroup of legumes.

Because of their various health benefits, it has been suggested that legumes protect against the onset of type 2 diabetes – a serious illness that affects around 29 million people in the U.S. and more than 400 million adults worldwide. However, little research has been carried out to test this hypothesis.

Therefore, researchers from the Unit of Human Nutrition at the Universitat Rovira i Virgili in Tarragona, Spain, together with other investigators from the Prevención con Dieta Mediterránea (PREDIMED) study, set out to investigate the association between legume consumption and the risk of developing type 2 diabetes in people at an increased risk of cardiovascular disease.

The study also analyzes the effects of substituting legumes with other foods rich in proteins and carbohydrates, and the findings were published in the journal Clinical Nutrition.

High intake of lentils lowers risk of type 2 diabetes by 33 percent

The team investigated 3,349 participants in the PREDIMED study who did not have type 2 diabetes at the beginning of the study. The researchers collected information on their diets at the start of the study and every year throughout the median follow-up period of 4.3 years.

Individuals with a lower cumulative consumption of legumes had approximately 1.5 weekly servings of 60 grams of raw legumes, or 12.73 grams per day. A higher legume consumption was defined as 28.75 daily grams of legumes, or the equivalent of 3.35 servings per week.

Using Cox regression models, the researchers analyzed the association between the incidence of type 2 diabetes and the average consumption of legumes such as lentils, chickpeas, dry beans, and fresh peas.

Overall, during the follow-up period, the team identified 266 new cases of type 2 diabetes.

The study revealed that those with a higher intake of legumes were 35 percent less likely to develop type 2 diabetes than their counterparts who consumed a smaller amount of legumes. Of all the legumes studied, lentils had the strongest association with a low risk of type 2 diabetes.

In fact, individuals with a high consumption of lentils (defined as almost one weekly serving) were 33 percent less likely to develop diabetes compared with their low-consumption counterparts – that is, the participants who had less than half a serving per week.

Additionally, the researchers found that replacing half a serving per day of legumes with an equivalent portion of protein- and carbohydrate-rich foods including bread, eggs, rice, or potatoes also correlated with a reduced risk of diabetes.

The authors conclude that:

“A frequent consumption of legumes, particularly lentils, in the context of a Mediterranean diet, may provide benefits on type 2 diabetes prevention in older adults at high cardiovascular risk.”

Eating 10 Portions of Fruits and Vegetables Daily Best for Health

Eating five portions of fruits and vegetables daily is considered sufficient for good health. But according to a new study, the greatest benefits come from eating 10 portions a day.
[A colorful selection of fruits and vegetables]
Researchers say eating 10 portions of fruits and vegetables daily is best for preventing disease and premature death.

From an analysis of 95 studies assessing the health benefits of fruit and vegetable consumption, researchers found that eating 800 grams of fruits and vegetables daily – or around 10 portions of 80 grams – was associated with the lowest risk of disease and premature death.

Apples, pears, green leafy vegetables, and cruciferous vegetables were found to be among the most beneficial for health.

Lead author Dr. Dagfinn Aune, of the School of Public Health at Imperial College London in the United Kingdom, and colleagues recently reported their findings in the International Journal of Epidemiology.

Current guidelines recommend that adults should aim to eat around five cups of fruits and vegetables daily – two cups of fruits and three cups of vegetables – to help reduce the risk of heart disease, stroke, cancer, and other chronic diseases.

While consuming five portions of fruits and vegetables daily is beneficial, Dr. Aune and colleagues set out to determine how many fruits and vegetables need to be consumed for maximum protection against disease and early death.

To reach their findings, the researchers analyzed the data of 95 studies that looked at the health benefits of fruit and vegetable intake.

In total, the studies involved almost 2 million participants and around 43,000 cases of heart disease, 47,000 cases of stroke, 81,000 cases of cardiovascular disease (CVD), and 94,000 deaths.

The team analyzed the fruit and vegetable intake of each participant, looking specifically at how much they consumed daily and the specific fruits and vegetables consumed.

Up to 33 percent lower risk of disease and death with 10 portions daily

One portion of fruits of vegetables was defined as 80 grams – the equivalent of a small banana, pear, or apple, or three heaped tablespoons of cooked vegetables, such as peas, broccoli, or cauliflower.

The researchers then calculated the association between fruit and vegetable intake and the risks of heart disease, stroke, CVD, cancer, and premature death.

The team found that, compared with no fruit and vegetable consumption, participants who ate just 200 grams of fruits and vegetables a day – the equivalent to around 2.5 portions – saw health benefits. These included an 18 percent reduced risk of stroke, a 16 percent reduced risk of heart disease, a 13 percent lower risk of CVD, and a 4 percent reduced risk of cancer.

Eating 200 grams of fruits and vegetables daily was also associated with a 15 percent lower risk of premature death.

However, the researchers found that the more fruits and vegetable participants ate daily, the greater the benefits.

Compared with subjects who consumed no fruits and vegetables, those who ate up to 800 grams – or 10 portions – each day were found to have a 33 percent lower risk of stroke, a 28 percent reduced risk of CVD, a 24 percent lower risk of heart disease, and a 13 percent decrease in cancer risk.

A 31 percent reduction in premature death was also associated with a daily fruit and vegetable intake of up to 800 grams.

What is more, the researchers calculated that if everyone ate 10 portions of fruits and vegetables daily, then around 7.8 million premature deaths could be prevented across the globe annually.

Which fruits and vegetables are best?

The team found that apples, pears, citrus fruits, green leafy vegetables (such as chicory and spinach), and cruciferous vegetables (such as cabbage and broccoli) were best for reducing the risk of stroke, CVD, heart disease, and premature death.

The greatest reduction in cancer risk was associated with intake of green vegetables (such as green beans), yellow vegetables (such as peppers and carrots), and cruciferous vegetables.

Consumption of raw and cooked vegetables was associated with reduced risk of premature death, but the team did not have enough data to determine which specific fruits and vegetables reduced this risk.

While the study did not investigate the mechanisms behind high fruit and vegetable intake and reduced risk of disease and death, the team notes that fruits and vegetables have been linked to lower cholesterol and improved blood vessel and immune system function.

“This may be due to the complex network of nutrients they hold,” notes Dr. Aune. “For instance, they contain many antioxidants, which may reduce DNA damage, and lead to a reduction in cancer risk.”

Overall, the researchers believe their findings highlight the importance of fruits and vegetables as part of a healthful diet.

“We need further research into the effects of specific types of fruits and vegetables and preparation methods of fruit and vegetables. We also need more research on the relationship between fruit and vegetable intake with causes of death other than cancer and cardiovascular disease.

However, it is clear from this work that a high intake of fruit and vegetables hold tremendous health benefits, and we should try to increase their intake in our diet.”

Dr. Dagfinn Aune

Your 12 Best Organic Bets

When considering your produce, remember that nine out of ten Americans do not eat the recommended 2 portions of fruit and 2 1/2 portions of vegetables each day. So your first step might be to simply incorporate more fruits and vegetables into your diet. However, with all the headlines about pesticides, hormones, antibiotics, and other food-safety issues, many people are considering organic options more often.While more research is needed for confirmation, “some evidence suggests that organic produce may contain more vitamins, minerals, and other beneficial plant compounds than conventionally grown produce,” says Dawn Jackson Blatner, RD, the national media spokesperson for the American Dietetic Association in Chicago. In any case, in addition to the advantage of lower pesticide levels, organically grown products is also Earth-friendly: sustainable organic farming enhances the soil and conserves water—a boon to all of us in the long term.

Get to know the top 12

Since organics often cost more to produce and therefore may cost shoppers more, those not up to buying organic everything can still benefit their families’ health by concentrating on where they get the most bang for the buck.

The Environmental Working Group—a Washington DC-based watchdog organization of scientists, policy experts, lawyers, and other professionals who review studies and data to expose threats to our environment and health—has compiled a list based on extensive analysis of contaminants in produce. The EWGclaimsthat you can lower your pesticide exposure by 90% simply by choosing the organic varieties of the following fruits and vegetables—presented from most to least important.

  1. Celery
  2. Peaches
  3. Strawberries
  4. Apples
  5. Domestic blueberries
  6. Nectarines
  7. Sweet bell peppers
  8. Spinach, kale, and collard greens
  9. Cherries
  10. Potatoes
  11. Imported grapes
  12. Lettuce

You can start slowly and purchase just a few items each week. Make one out of every ten foods you buy organic. Pick one thing—apples, peaches, or potatoes, for instance. Environmentalists and health professionals agree: If we can get a lot of people to do a little, it will make a big difference!

15 low-risk favorites

The produce in this list does not appear to absorb pesticides as easily and is safe to consume in non-organic form, including:

  1. Onions
  2. Avocados
  3. Sweet corn
  4. Pineapples
  5. Mango
  6. Sweet peas
  7. Asparagus
  8. Kiwi fruit
  9. Cabbage
  10. Eggplant
  11. Cantaloupe
  12. Watermelon
  13. Grapefruit
  14. Sweet potatoes
  15. Sweet onions

Remember, the important thing is to get what fruits and veggies you can into your home. If they’re within reach—such as in your fridge or in a fruit bowl on the dining room table—you’re more likely to eat more. And eating more fruits and vegetables may well be more important to your health bottom line than avoiding pesticides. Counsels Blatner, “Consume the minimum recommended amount every day—no matter how it’s grown!”

What is Healthy Eating? What is a Healthy Diet?

Healthy eating means consuming the right quantities of foods from all food groups in order to lead a healthy life.

Diet is often referred to as some dietary regimen for losing weight. However, diet simply means what food we eat in the course of a 24-hour, one week, or one month, etc. period.

A good diet is a nutritional lifestyle that promotes good health. A good diet must include several food groups because one single group cannot provide everything a human needs for good health.

When we eat matters too

A large breakfast helps control body weight – a team of researchers from Tel Aviv University, Israel, explained in the journal Obesity that a big breakfast – one containing about 700 calories – is better for losing weight and lowering one’s risk of developing heart disease, high cholesterol, and diabetes.

Prof. Daniela Jakubowicz and team stressed that when we eat our food may matter as much as what we eat.

How do you define healthy eating?

The crucial part of healthy eating is a balanced diet. A balanced diet – or a good diet – means consuming from all the different food groups in the right quantities. Nutritionists say there are five main food groups – whole grains, fruit and vegetables, protein, dairy, and fat & sugar.


Whole grains

According to the USDA (United States Dept. of Agriculture), we should consume at least 3 ounces of whole grains per day. A whole grain, unlike refined grains, still has the bran and the germ attached. Whole grains are rich in fiber, minerals, and vitamins. When grains are refined the bran and germ are removed.

It is not possible to know whether food is made from whole grain just by looking at it.

To be really sure you have to read the label. In the list of ingredients, the word whole or whole grain needs to appear before the name of the grain.

Whole grain products include bread, pasta, and cereals – they need to be made with 100% whole grain.

Whole grain foods and flours include 100% whole wheat, brown rice, bulgur, corn, buckwheat, oatmeal (oats), spelt and wild rice.

Fruit and vegetables

Fruit and vegetables are rich in vital vitamins, minerals, and fiber.

Fruit and vegetables have a high vitamin, mineral and fiber content – these nutrients are vital for your body to function well.

Several studies have proven that a good intake of fruit and vegetables may protect from developing heart disease, diabetes type 2, and cancer.

Most health departments throughout the world recommend that we consume five portions of fruit and vegetables each day. This could include either fresh, frozen or canned, or dried fruit and veggies.

A portion means either one large fruit, such as an apple, mango, or a banana, or three heaped tablespoons of vegetables. It could also include one glass of 100% fruit or vegetable juice.

A fruit/vegetable drink is one portion, no matter how big it is. Beans and pulses can also count as one portion.


Protein

We need protein for the building and repairing of tissue in our body. Protein-rich foods also include essential minerals, such as iron, magnesium, zinc, as well as B vitamins.

Douglas Paddon-Jones, Ph.D., Associate Professor, The University of Texas Medical Branch says that proteins should make up about 20 to 25 percent of our nutritional intake.

The following foods are good sources of protein:

Tofu, an example of a plant sourced protein.
  • meat
  • poultry
  • fish
  • eggs
  • beans
  • nuts
  • quorn
  • soya (includes tofu)

Nutritionists advise that the fat in meat should be trimmed and drained away after cooking. The skin should be removed from poultry.

For people who are not vegetarians, nutritionist advises we consume fish at least twice a week, preferably fish rich in omega oils, such as trout, fresh tuna, sardines, mackerel, and salmon.

The canning process of tuna removes the essential oils, hence only fresh tuna is considered as an oily fish.

It is better for your health to grill, roast or microwave meats and fish, rather than frying them.

Vegans, who do not eat any foods from animal sources, may get their protein from nuts, seeds, soya, beans, and quorn. Vegans may have to supplement their zinc and B12 vitamin intake as these foods are not rich in them.


Legumes

Legumes are plants in the pea family that produce pods that split open naturally along a seam (dehisce), revealing a row of seeds.

Legumes help improve glycemic control.

The following are the most commonly eaten legumes:

  • soy
  • peas
  • peanuts
  • mesquite
  • lupins
  • lentils
  • clover
  • carob
  • beans
  • alfalfa

Researchers from the University of Toronto, Canada, reported in Archives of Internal Medicine, October 2012 issue, that eating plenty of legumes helps improve glycemic control in people with diabetes type 2, as well as reducing the risk of developing coronary heart disease.


Dairy

Although butter, cream and even sometimes eggs are often classed as dairy products, in nutrition they are more frequently placed in the protein (eggs) or fat & sugar category. Dairy products are a good source of calcium which is important for healthy bones and teeth.

Dairy products include milk, yogurts, cheese, and some soy dairy products. Nutritionists say we should aim for low-fat dairy products.

People who do not consume animal sourced foods can get their calcium intake from other products, such as broccoli, cabbage and soya milk and yogurts with added calcium.


Fats and sugars

These include sugar, chocolate, cakes, biscuits, jam, butter, margarine, mayonnaise, non-diet sodas, etc. – all products with a very high fat or sugar content.

There are two basic types of fats – saturated and unsaturated. Cream, margarine, and fried foods are high in saturated fats, while vegetable oils and oily fish are rich in unsaturated fats. Saturated fat consumption should be kept to a minimum because excess consumption significantly increases the risk of developing such diseases as heart disease.

Even sugary foods and drinks, like some sodas and sweets, should be kept to a minimum because they are high in calories and bad for your teeth.

Healthy eating and the World Health Organization (WHO)

The WHO makes the following 5 recommendations – they apply both to populations and individuals:

  • We should aim for an energy balance and a healthy body weight.
  • We should limit our energy consumption from total fats. We should also aim for more unsaturated fats and less saturated fats.
  • We should up our consumption of fruits, vegetables, legumes, whole grains, and nuts.
  • We should consume as little simple sugars are possible.
  • As well as making sure our salt is iodized, we should also limit our consumption of salt/sodium.

WHO also recommends that we:

  • Consume enough vital amino acids to provide “cellular replenishment and transport proteins”. These can be found in animal-sourced proteins and some selected plant sourced proteins. A combination of other plants, with the exception of rice and beans, may also provide essential amino acids.
  • Consume essential quantities of vitamins and certain minerals.
  • Should avoid directly poisonous and carcinogenic substances.
  • Avoid consuming foods that may are contaminated with human pathogens, such as E. coli and tapeworm eggs.

The Healthy Eating Index (HEI) issued by the USDA (United States Department of Agriculture)

The HEI is a measure of diet quality that reviews how people are conforming to Federal dietary guidance. The HEI was first formulated by the USDA in 1995 and was renewed in 2005.

The standards were created using a density approach – they are expressed as a percentage of calories per 1,000 calories. The components of the 2005-HEI can be seen below:

Healthy Eating Index – 2005 components and standards for scoring

  • Total Fruit (includes 100% juice)
    Maximum points 5
    Standard for maximum score ≥0.8 cup equiv. per 1,000 kcal
    Standard for minimum score zero – No Fruit
  • Whole Fruit (not juice)
    Maximum points 5
    Standard for maximum score ≥0.4 cup equiv. per 1,000 kcal
    Standard for minimum score zero – No Whole Fruit
  • Total Vegetables
    Maximum points 5
    Standard for maximum score ≥1.1 cup equiv. per 1,000 kcal
    Standard for minimum score zero – No Vegetables
  • Dark Green and Orange No Dark Green or Orange Vegetables and Legumes
    Maximum points 5
    Standard for maximum score ≥0.4 cup equiv. per 1,000 kcal
    Standard for minimum score zero – No dark green or orange Vegetables or Legumes
  • Total Grains
    Maximum points 5
    Standard for maximum score ≥3.0 oz equiv. per 1,000 kcal
    Standard for minimum score zero – No Grains
  • Whole Grains
    Maximum points 5
    Standard for maximum score ≥1.5 oz equiv. per 1,000 kcal
    Standard for minimum score zero – No Whole Grains
  • Milk
    Maximum points 10
    Standard for maximum score ≥1.3 cup equiv. per 1,000 kcal
    Standard for minimum score zero – No Milk
  • Meat and Beans
    Maximum points 10
    Standard for maximum score ≥2.5 oz equiv. per 1,000 kcal
    Standard for minimum score zero – No Meat or Beans
  • Oils4
    Maximum points 10
    Standard for maximum score ≥12 grams per 1,000 kcal
    Standard for minimum score zero – No Oil
  • Saturated Fat
    Maximum points 10
    Standard for maximum score ≤7% of energy
    Standard for minimum score zero – ≥15% of energy
  • Sodium
    Maximum points 10
    Standard for maximum score ≤0.7 gram per 1,000 kcal
    Standard for minimum score zero – ≥2.0 grams per 1,000 kcal
  • Calories from Solid Fats, Alcoholic beverages, and Added Sugars (SoFAAS)
    Maximum points 20
    Standard for maximum score ≤20% of energy
    Standard for minimum score zero – ≥50% of energy

Consequences of unhealthy eating

According to Gov.UK, most people in England are either overweight or obese (This includes 61.3% of adults and 30% of children aged between 2 and 15).

In the US, the states of Mississippi and Alabama have obesity rates above 30%, while 22 other states have obesity rates all over 25%.

A balanced diet is a crucial part of healthy eating.

At least 200,000 people in the UK die prematurely each year as a result of stroke, coronary heart disease and some other illnesses that are linked to unhealthy eating and lifestyle. Many who do not die do not enjoy a painless, unrestricted and disability-free old age.

According to many studies, the USA ranks last among industrialized countries when it comes to preventable deaths – many of these deaths are due to poor diet, as well as the lack of exercise.

Nutritionists say that over four-fifths of men and over two-thirds of women consume excessive amounts of dietary salt in the UK. What many don’t know is that 75% of their salt intake is already in the food they buy.

It is estimated that one-third of all cancers could be prevented if everybody had a good diet. Healthy eating also protects from diabetes, osteoporosis, heart disease, strokes, and rotting teeth.

Plant-based diets protect from chronic diseases

An article published in Food Technology, in October 2012 showed that plant-based diets either minimize or completely eliminate many people’s genetic propensity to developing chronic diseases, such as diabetes type 2, cardiovascular disease, and cancer.

Peter Tarver, senior writer/editor of the journal referred to a WHO (World Health Organization) bulletin which informed that in 2008, worldwide, 63% of all deaths were caused by non-communicable chronic diseases and conditions, such as diabetes type 2, cardiovascular disease, obesity and certain cancers.

Poor diets contribute significantly towards the development and progression of all of these diseases.

What is Beta-Carotene? What Are The Benefits of Beta-Carotene?

Beta-carotene is a red-orange pigment found in plants and fruits, especially carrots and colorful vegetables.

The name beta-carotene comes from the Greek “beta” and Latin “carota” (carrot). It is the yellow/orange pigment that gives vegetables and fruits their rich colors. H. Wachenroder crystallized beta-carotene from carrot roots in 1831, and came up with the name “carotene”.

Beta-carotene’s chemical formula – C40H56 – was discovered in 1907.

The human body converts beta-carotene into vitamin A (retinol) – beta-carotene is a precursor of vitamin A. We need vitamin A for healthy skin and mucous membranes, our immune system, and good eye health and vision.

Beta-carotene in itself is not an essential nutrient, but vitamin A is.

Fast facts on beta-carotene

Here are some key points about beta-carotene. More detail and supporting information is in the main article.

  • Beta-carotene is a red/orange pigment found in many fresh fruits and vegetables
  • Beta-carotene is converted into vitamin A, an essential vitamin
  • Vitamin A is toxic at high levels
  • Beta-carotene is a carotenoid and an antioxidant
  • Foods rich in vitamin A include onions, carrots, peas, spinach and squash
  • One study showed that smokers with high beta-carotene intake might have an increased risk of lung cancer
  • Some evidence suggests that beta-carotene might slow cognitive decline
  • Beta-carotene supplements interact with certain drugs, including statins and mineral oil
  • Beta-carotene might help older people retain their lung strength as they age.

Beta-carotene from food is a safe source of vitamin A

Vitamin A can be sourced from the food we eat, through beta-carotene, for example, or in supplement form. The advantage of dietary beta-carotene is that the body only converts as much as it needs.

Excess vitamin A is toxic. Toxic vitamin A levels can occur if you consume too many supplements.

Beta-carotene is an antioxidant

A Flamingo
The flamingo’s characteristic red-orange color is caused by beta-carotene in their diet.

Beta-carotene, like all carotenoids, is an antioxidant. An antioxidant is a substance that inhibits the oxidation of other molecules; it protects the body from free radicals.

Free radicals damage cells through oxidation. Eventually, the damage caused by free radicals can cause several chronic illnesses.

Several studies have shown that antioxidants through diet help people’s immune systems, protect against free radicals, and lower the risk of developing cancer and heart disease.

Some studies have suggested that those who consume at least four daily servings of beta-carotene rich fruits and/or vegetables have a lower risk of developing cancer or heart disease.

beta-carotene-foodsWhich foods are rich in beta-carotene?

The following foods are rich in beta-carotene:

  • Apricots
  • Asparagus
  • Broccoli
  • Carrots
  • Chinese cabbage
  • Chives
  • Dandelion leaves
  • Grapefruit
  • Herbs and spices – chili powder, oregano, paprika, parsley
  • Kale
  • Ketchup
  • Many margarines
  • Onions
  • Peas
  • Peppers
  • Plums
  • Pumpkin
  • Spinach
  • Squash
  • Sweet potatoes.

If you follow a healthy diet rich in beta-carotene you do not need supplements. As mentioned above, supplements can lead to undesirable excesses in beta-carotene levels – this cannot occur if your source is from the food you eat.

Smokers and beta-carotene lung cancer risk

A French study involving adult females published in the Journal of the National Cancer Institute (September 2005 issue) found that smokers with high beta-carotene levels had a higher risk of lung cancer and other smoking-related cancers than other smokers. They also found that non-smokers with high beta-carotene intake had a lower risk of lung cancer.

They found that the risk of lung cancer over a ten-year period was:

  • 181.8 per 10,000 women for non-smokers with low beta-carotene intake
  • 81.7 per 10,000 women for non-smokers with high beta-carotene intake
  • 174 per 10,000 women for smokers with low beta-carotene intake
  • 368.3 per 10,000 women for smokers with high beta-carotene intake.

Further research has suggested that the high intake among smokers is nearly always due to supplements, and not food intake.

Beta-carotene may slow down cognitive decline

beta-carrot-juice
Carrots are an excellent source of beta-carotene.

Men who have been taking beta-carotene supplements for 15 or more years are considerably less likely to experience cognitive decline than other males, researchers from Harvard Medical School reported in Archives of Internal Medicine (November 2007 issue).

Oxidative stress is thought to be a key factor in the cognitive decline, the researchers explained. Studies have shown that antioxidant supplements may help prevent the deterioration of cognition.

Their study, involving 4,052 men, compared those on beta-carotene supplements for an average of 18 years to others who were given a placebo. Over the short-term, they found no difference in cognitive decline risk between the two groups of men, but in the long-term, it was clear that beta-carotene supplements made a significant difference.

The researchers emphasized that there may have been other factors which contributed to the slower decline in cognitive abilities among the men in the beta-carotene group.

Beta-carotene drug interactions

Drug interaction refers to a substance interfering in how a medication works, by either making it less effective, increasing its potency, or changing what it is supposed to do.

The following drugs may be affected by beta-carotene supplements:

  • Statins – the effectiveness of simvastatin (Zocor) and niacin may be decreased if the patient is taking beta-carotene with selenium and vitamins E and C.
  • Some cholesterol-lowering drugs – cholestyramine and colestipol can reduce blood levels of dietary beta-carotene by thirty to forty percent.
  • Orlistat (Xenical, Alli) – this is a weight control medication. It can undermine the absorption of beta-carotene by up to 30%, resulting in lower blood beta-carotene levels. Those choosing to take a multivitamin while on orlistat should take them at least two hours before having their medication.
  • Mineral oil – used for the treatment of constipation can lower blood levels of beta-carotene.

Long-term alcohol consumption can interact with beta-carotene, raising the chances of developing liver problems.

Beta-carotene slows down lung power decline as people age

The British Medical Journal published a report in March 2006 which showed that high blood beta-carotene levels compensate for some of the damage to the lungs caused by oxygen free radicals.

They measured the FEV1 of 535 participants and measured their beta-carotene blood levels. FEV1 measures how much air you can breathe out in one go. They found that those with high beta-carotene levels had a much slower decline in FEV1 measures.

Food as Medicine: Okra (Abelmoschus esculentus, Malvaceae)

History and Traditional Use


Range and Habitat

Okra (Abelmoschus esculentus) is a naturalized tropical and subtropical annual grown extensively in Asia and Africa. Growing up to 6 feet in height, okra plants have sturdy stems, long, broad, serrated, deeply-lobed leaves, and delicate yellow flowers marked with red or purple color toward the base.1,2 The edible portion of okra is the immature pod or fruit which contains the seeds.3 Inside the tapering, the fuzzy pod is a soft tissue that exudes a mucilaginous (sticky) juice when cooked.4 The pods are commonly green, but other varieties have red or burgundy pods. Considered one of the most reliable annual edible vegetable crops of the tropics (the Latin term esculentus means edible), okra is tolerant of both hot, dry as well as hot, humid climates and is widely cultivated in West Africa, India, Southern Europe, and the Americas.5

Related to hibiscus (Hibiscus sabdariffa) and marshmallow (Althaea Officinalis), okra was originally classified in the genus Hibiscus and was later reclassified into the genus Abelmoschus in the 18th century.3 Okra is believed to have originated in Ethiopia, where it still grows wild, although there is no definitive proof of its origin.3 Okra has been cultivated by the Egyptians since the 12th century BCE. From there it traveled to central Africa, the Mediterranean, and India.6 By the 17th century CE, okra had reached the New World via the slave trade in Africa and by the 19th century, it had spread to China.2

Phytochemicals and Constituents

Okra is comprised primarily of water, carbohydrates, and protein with very little fat and a fair amount of dietary fiber.3 Okra is also a significant source of vitamin C and contains many other micronutrients such as calcium, phosphorus, iron, beta-carotene, and B vitamins. The carbohydrate content of okra is primarily in the form of mucilage, a long chain polysaccharide molecule made up of sugar units and amino acids. Thin-layer chromatography analytical methods indicate that the polysaccharides in okra gum contain galactose, galacturonic acid, rhamnose and glucose.7 This water-soluble mucilage is the source of okra’s viscous, slippery consistency, which is linked to okra’s effectiveness in treating gastritis and other conditions where the mucilage acts as a demulcent agent, i.e., it provides relief to inflamed mucous membranes.

Phytochemical studies show that okra pods contain flavonoids, tannins, sterols, and triterpenes.5Flavonoids are important compounds that are responsible for protecting tissues from oxidative damage in a variety of ways. Quercetin is the major antioxidant in okra gum, which is a key player in controlling inflammation in the body.7

Okra contains a moderate amount of oxalate, a compound that both is created by the human body and is present in plants. Because oxalate is excreted through urine and can calcify in the kidneys, high levels of oxalate intake along with genetic predisposition may lead to the development of kidney stones. Different types of kidney stones exist, but approximately 75% of patients diagnosed with kidney stones in the United States suffer from stones made of calcium oxalate.8 Physicians may recommend that patients with kidney stones or with a history of kidney stones follow a low-oxalate diet; however, a food’s oxalate content does not necessarily correlate with its oxalate bioavailability in the human body. Okra has been shown to have low oxalate bioavailability as compared to similar oxalate-rich foods such as peanuts (Arachis hypogaea) and almonds (Prunus dulcis).9 Oxalate absorption from dietary sources can be reduced when paired with foods with high calcium or magnesium content.10

Historical and Commercial Uses

Ancient cultures quickly noted okra’s mucilaginous nature and its subsequent benefits to the digestive system. Okra was used by Egyptians to prevent the development of kidney stones.5 In folkloric practice, fresh, tender okra pods were consumed to cure constipation, leucorrhea (abnormal vaginal discharge), spermatorrhea (excessive, involuntary ejaculation), diabetes, and jaundice. The mucilage from okra is used commonly in traditional Asian and African medicine to treat gastritis, gastric ulcers, and to lubricate the intestines.5,11,12

The acceptance of okra as a relatively modern medicinal agent can be found in J.M. Nickell’s Botanical Ready Reference, a book published in 1911 in the United States for physicians and pharmacists.13 Arranged alphabetically by Latin binomial, okra appears as the first entry on the list of herbal drugs and medicinal agents. The actions noted for okra capsule (fruit) are “mucilaginous, demulcent, and edible.”

Okra mucilage has been used traditionally in Arabic, West African, Caribbean, and Eastern Mediterranean cooking.6 The most common culinary application of okra is as a thickener for soups and stews. The most well-known application may be in Louisiana’s Creole gumbo stew, which may derive its name from a corruption of the Bantu word for okra: kingombo. It is also used as a substitute for egg whites and as a fat replacement in chocolate bars, cookies, and frozen dairy desserts.7 Okra can be boiled, baked, sautéed, stuffed, or fried. Sautéing or quickly frying the okra reduces the sticky texture significantly.4 The gummy texture can also be mitigated by cooking okra with cornmeal.14

The water extract of okra, also known as okra gum, is used as an industrial lubricant and as an emulsifier to stabilize foams and suspensions.9 It is also utilized medically in plasma replacement therapy.3 The seeds of the okra pods are roasted and powdered into a flour for use as a coffee substitute in Turkey, and in Nigeria, the nutritious flour is an important staple and often added to soups and other foods.4,15

In vitro studies done on the chemical composition and antioxidative properties of Nigerian okra, seed flour demonstrated that antioxidant activity correlated positively with roasting time.15 This study showed that antioxidants within the okra seeds had the greatest benefit in protecting the human large intestine from oxidative damage.

okraModern Research

Laboratory research suggests that okra and its extracts can be useful in the treatment of a variety of disease states. A recent in vitro study indicated that Abelmoschus esculentus lectin (AEL), a protein extracted from okra, binds carbohydrates on the surface of cancer cells, thus causing apoptosis (programmed cell death) and significantly and selectively inhibiting breast cancer cell proliferation.16

Modern research suggests that okra’s effectiveness in the treatment of gastrointestinal complaints can be attributed to the presence of rhamnogalacturonan polysaccharides, which disrupt the adhesion of Helicobacter pylori bacteria to stomach tissue;11 these bacteria are associated with stomach ulcers.

The polysaccharide compounds bind non-specifically to different strains of H. pylori, inhibiting the binding of the pathogens to gastric cells. The rhamnogalacturonan’s appear to interact with H. pylori’s surface proteins, potentially providing a preventative treatment approach. Okra’s mucilage could also inhibit the recurrence of H. pylori infections by preventing re-colonization of the stomach following antibiotic eradication therapy.

An in vitro study published in 2007 by the USDA Agricultural Research Service compared the effectiveness of the bile acid-binding, cholesterol-lowering drug cholestyramine to the natural bile acid-binding ability of the common vegetables okra, beets (Beta vulgaris), asparagus (Asparagus Officinalis), eggplant (Solanum malongena), turnips (Brassica rapa subsp. rapifera), green beans (Phaseolus vulgaris), carrots (Daucus carota subsp. sativus), and cauliflower (B. oleracea var. botrytis).17 Okra was found to be more effective at binding bile acids than any other vegetable evaluated in the study, and 34% as effective as cholestyramine.

An animal study conducted in 2011 found that okra peel and seed powder had the ability to normalize blood levels of both lipids and sugars in diabetic rats.18 Oral administration of okra significantly reduced blood levels of total cholesterol, triglycerides, low-density lipoproteins (LDL), very low-density lipoproteins (VLDL), and hemoglobin A1C as well as significantly increased blood levels of high-density lipoproteins (HDL) and hemoglobin. While both parts of the plant were effective in a dose-dependent manner, the seed powder had a more pronounced effect than the peel, especially on blood glucose levels. These results indicate that consumption of okra may help reduce hyperlipidemia and hyperglycemia in diabetics, thus helping to prevent cardiovascular disease and other comorbidities associated with diabetes. These effects could be related to okra’s ability to bind bile acids.

Among other factors (e.g., soil, climate, season, etc.), cooking and preparation methods can impact the nutrient content of vegetables. A study on the effects of different cooking methods on the nutrient content of okra pods compared the mineral content of raw and cooked okra of both organic and conventional varieties.19 Raw okra had the highest concentration of all elements tested, indicating some degree of nutrient losses during cooking, with the most pronounced difference found in potassium concentration, while calcium losses were relatively minimal.

There were significant mineral losses following boiling and baking, but the effect was less pronounced with sautéing.19 This could be due to the water solubility of nutrients found in okra, including but not limited to its mucilage. While the loss of mineral content may seem undesirable, the marked reduction of minerals from cooking could be beneficial for those with kidney disease. For example, potassium levels can be reduced by up to 60% by boiling okra and pouring off the water, making boiled okra safer than raw okra for a potassium-restricted diet.

An in vitro study in 2011 examined the effects of okra gum extract on both cell viability and bacterial growth.7 Okra gum extract had antibacterial effects on seven of eight strains of bacteria tested, and was most effective against Staphylococcus aureus, Mycobacterium sp., M. aurum, Xanthobacter Py2, and Pseudomonas aeruginosa. In fact, okra gum extract was completely effective in inhibiting the growth of S. aureus (which can cause skin infections, pneumonia, meningitis, and septicemia) as well as P. aeruginosa(known for causing fatal lung infections in patients with cystic fibrosis). Major lipid fractions isolated from okra gum extract were 34% palmitic acid and 26% stearic acid, both of which have antibacterial properties against S. aureus and Listeria monocytogenes. The results of this study demonstrate the potential use of okra extract as an antibacterial agent with possible applications in the food and pharmaceutical industry.

A study on rats explored the traditional uses of okra in liver disease.5 Hepatotoxicity was induced in rats that were then given an okra gum extract that quenched all free radicals present, thus preventing lipid peroxidation of liver cell membranes. The hepatoprotective and antioxidant activities of the okra extract are comparable to standard silymarin, isolated from milk thistle (Silybum marianum) fruit, making okra extract a potentially important substance for protecting chemically-damaged liver tissue. Human clinical trials are needed to explore this potential therapeutic application.


Nutrient Profile20

Macronutrient Profile: (Per 1 cup [approx. 100 g] raw okra pods)

33 calories
2 g protein
7.5 g carbohydrate
0.2 g fat

Secondary Metabolites: (Per 1 cup [approx. 100 g] raw okra pods)

Excellent source of:

Vitamin K: 31.3 mcg (39.1% DV)
Vitamin C: 23 mg (38.3% DV)

Very good source of:

Folate: 60 mcg (15% DV)
Vitamin A: 716 IU (14.32% DV)
Magnesium: 57 mg (14.3% DV)
Thiamin: 0.2 mg (13.3% DV)
Dietary Fiber: 3.2 g (12.8% DV)
Vitamin B6: 0.22 mg (11%DV)

Good source of:

Potassium: 299 mg (8.5% DV)
Calcium: 82 mg (8.2% DV)
Phosphorus: 61 mg (6.1% DV)
Niacin: 1 mg (5% DV)

Also provides:

Zinc: 0.6 mg (4% DV)
Iron: 0.6 mg (3.3% DV)
Vitamin E: 0.27 mg (2.5% DV)

DV = Daily Value as established by the US Food and Drug Administration, based on a 2,000 calorie diet.

Recipe: Spicy Okra Stew

Adapted from New Flavors for Vegetables21
Ingredients:

  • 3 large ripe tomatoes
  • 1 lb fresh okra, stems removed, sliced 1/4-inch thick
  • 2 tablespoons canola oil
  • 1 yellow onion, diced
  • Salt and freshly-ground black pepper, to taste
  • 2 cloves of garlic, minced
  • 1/2 teaspoon cayenne pepper
  • 1/2 teaspoon ground coriander
  • 1/2 teaspoon ground cumin
  • 1/4-1/3 cup fresh parsley, chopped

Directions:

  1. Prepare a small saucepan of boiling water and a separate bowl of ice water. Blanch the tomatoes: cut a shallow “x” at the bottom of each tomato, then cook in boiling water for 10 seconds. Immediately submerge in the ice water, let stand for 10 more seconds, then drain. Peel the skin from the tomatoes and chop the flesh.

  2. Heat the oil in a saucepan over medium heat. Add the onions and cook until just softened, 2-3 minutes. Add the okra and sauté until lightly browned, approximately 10 minutes, then lower the heat to medium-low and cook until tender.

  3. Add the garlic, salt, pepper, and spices, stirring until combined and fragrant, then add the tomatoes and 1 cup of water. Simmer until the tomatoes have broken down and the mixture begins to thicken. Adjust seasoning to taste, then remove from heat and stir in the chopped parsley.

References

  1. Van Wyck B. Food Plants of the World. Portland, OR: Timber Press; 2006.
  2. Madison D. Edible: An Illustrated Guide to the World’s Food Plants. Washington, DC: National Geographic Society; 2008.
  3. Benchasri S. Okra (Abelmoschus esculentus (L.) Moench) as a valuable vegetable of the world. Ratarstvo i povrtarstvo. 2012:49:105-112.
  4. Onstad D. Whole Foods Companion: A Guide for Adventurous Cooks, Curious Shoppers, and Lovers of Natural Foods. White River Junction, VT: Chelsea Green Publishing; 2004.
  5. Alqasoumi SI. ‘Okra’ Hibiscus esculentus L.: A study of its hepatoprotective activity. Saudi Pharmaceutical Journal. 2012:20:135-141.
  6. Green A. Field Guide to Produce: How to Identify, Select, and Prepare Virtually Every Fruit and Vegetable at the Market. San Francisco, CA: Quirk Books; 2004.
  7. de Carvalho CCCR, Cruz PA, da Fonseca MR, et al. Antibacterial properties of the extract of Abelmoschus esculentus. Biotechnology and Bioprocess Engineering. 2011:16:971-977.
  8. Nephrology Department. Oxalate Content of Foods. The Children’s Medical Center of Dayton website. July 14, 2005. Available here. Accessed July 16, 2015.
  9. Brinkley LJ, Gregory J, Pak CY. A further study of oxalate bioavailability in foods. J Urol. 1990;144(1):94-96.
  10. Liebman M, Al-Wahsh IA. Probiotics and other key determinants of dietary oxalate absorption. Adv Nutr. 2011;2:254-260. Available here. Accessed July 16, 2015.
  11. Messing J, Thole-C, Niehues M, et al. Antiadhesive properties of Abelmoschus esculentus (okra) immature fruit extract against Helicobacter pylori adhesion. PLoS ONE. 2014:9(1):[e84836].
  12. Pitchford P. Healing with Whole Foods: Oriental Traditions and Modern Nutrition. Berkeley, CA: North Atlantic Books; 1993.
  13. Nickell JM. J.M. Nickell’s botanical ready reference: specially designed for druggists and physicians: containing all of the botanical drugs known up to the present time, giving their medical properties, and all of their botanical, common, pharmacopoeial and German common (in German) names. Chicago, IL: Murray & Nickell Mfg. Co.; 1911.
  14. Davidson A. The Oxford Companion to Food. Oxford, UK: Oxford University Press; 1999.
  15. Adelakun OE, Oyelade OJ, Ade-Omowaye BIO, et al. Chemical composition and the antioxidative properties of Nigerian okra seed (Abelmoschus esculentus Moench) flour. Food and Chemical Toxicology. 2009:47:1123-1126.
  16. Monte LG, Santi-Gadelha T, Reis LB, et al. Lectin of Abelmoschus esculentus (okra) promotes selective antitumor effects in human breast cancer cells. Biotechnol. Lett. 2014:36:461-469.
  17. Kahlon TS, Chapman MH, Smith GE. In vitro binding of bile acids by okra, beets, asparagus, eggplant, turnips, green beans, carrots, and cauliflower. Food Chemistry. 2007:103:676–680.
  18. Sabitha V, Ramachandran S, Naveen KR, et al. Antidiabetic and antihyperlipidemic potential of Abelmoschus esculentus (L.) Moench. in streptozotocin-induced diabetic rats. Journal of Pharmacy and Bioallied Sciences. 2011:3:397-402.
  19. Ivanice F, Ana MP, Uenderson A, et al. Multivariate analysis of the mineral content of raw and cooked okra (Abelmoschus esculentus L.). Microchemical Journal. 2013:110:439-443.
  20. Basic Report: 11278, Okra, raw. Agricultural Research Service, United States Department of Agriculture website. Available here. Accessed July 16, 2015.
  21. Liano J. Williams-Sonoma New Flavors for Vegetables: Classic Recipes Redefined. Birmingham, AL: Oxmoor House; 2008.

In The Raw: To Cook Or Not To Cook?

Imagine never again savoring the smell of baking cakes or charbroiled steak. Could you? Why would you? Yet some people worldwide are turning away not only from meat and processed food but also from cooking.
[fruit]
Fresh fruit and vegetables…why spoil them with cooking?

Welcome to the raw food diet.

As the Standard American Diet becomes more fat-laden, sugar-sated, and processed, the prevalence of metabolic disorders, obesity, type 2 diabetes, and cardiovascular disease (CVD) are soaring.

According to the Centers for Disease Control and Prevention (CDC), obesity now affects nearly 35 percent of the population of the United States, over 29 million people have been diagnosed with type 2 diabetes, and heart disease is the number one killer.

High levels of LDL (bad) cholesterol and triglycerides and low HDL (good) cholesterol have all been linked to atherosclerosis, the main cause of cardiovascular disease (CVD).

Most scientists would agree that less saturated fats, lower sugar and salt intake, and more fresh fruit and vegetables go a long way to avoiding a range of “lifestyle diseases.”

National health guidelines recommend at least five portions, or 400 grams, of fruits and vegetables a day. Some studies suggest that one extra portion of fruit or vegetables daily could lower the risk of ischemic stroke by 6 percent.

Others go further. To be healthy, they say, a person should eat only raw food.

The principle of a raw food diet is that, just as the human body cannot tolerate temperatures above 40 degrees Celsius, or 104 degrees Fahrenheit, neither can food. Whatever we eat, say, advocates, should not be heated above 104 degrees Fahrenheit.

In the raw food diet, foods may be eaten fresh, dehydrated with low heat, or fermented.

This, say the raw food dieters, leaves the food “live,” and “live” food is full of life energy. Cooked food is “dead.” It has no life energy.

What types of raw food diet are there?

A person on a raw food diet eats between 70 percent and 100 percent of their food raw. Some raw food dieters eat some food cooked, but mainly food is eaten raw. A raw food diet is not “all or nothing.” It is about eating as much raw food as possible.

A raw food diet can be quite sophisticated, using blenders and smoothie makers to make green smoothies, or dehydrators that blow air through food at a temperature below 115 degrees Fahrenheit, to make it crispy.

In 2010, the U.S. already had over 100 raw food restaurants. High-profile personalities who follow the diet include Demi Moore and Gwyneth Paltrow. Mainstream magazines provide recipes. The message seems to be: You can fit more raw food into your life.

Elsewhere, people live simply in raw food communities or “eco-villages.” Members cultivate their own food, without chemicals. They allow “weeds” such as dandelions to grow for consumption, and they harvest wild food in the mountains. For some, making the raw food diet a total lifestyle choice is more satisfying.

Beetles, worms, insects, and wild bird’s eggs are considered “very tasty” by one writer, although he goes on to ask if it is really right to kill and eat animals. He notes that this question is “very disputed in the raw food scene,” and he calls on people to respect each others’ differences.

Some “fully raw” dieters eat only whole foods, without chopping or juicing, to maximize fiber and nutrients. Studies have shown that the body may metabolize juice differently from whole foods.

There are also recommendations about mixing foods, for example, not mixing sweet and acid fruits. Fasting is recommended in some circles.

A raw food diet does not have to be only fruit and vegetables. Raw vegans eat no animal produce, but a mixed raw food diet can include meat, fish, liver, and eggs. Clearly, these must be consumed fresh, to avoid disease.

Raw food dieters may be:

  • Mixed raw food dieters, consuming small amounts of meat and fish, mostly uncooked
  • Ovo-lacto-vegetarian raw food dieters, eating no meat or fish
  • Vegan raw food dieters, avoiding all animal products.

A raw food diet, then, is not a single entity.

What kind of food do raw food dieters eat?

Foods in their natural state are suitable. Popular foods include fruit, vegetables, nuts, water-soaked and sprouted seeds, beans, and grains. Some recommend fermented foods, such as kimchi and yogurt.

[dandelion salad]
Dandelion: Wild, healthy and free.

“Sprouts” provide protein. They are prepared by soaking and sprouting beans or seeds in large glass containers or “sprouters.”

Raw nuts provide oil, and dried fruits give energy.

Wild foods such as mushrooms, plantain, and dandelion can be harvested freely, but wild food harvesters are warned to learn what is safe and what to avoid.

Some say that water should come mostly from fruit and vegetables, but if extra is needed, it should be purified through distillation to eliminate additional chemicals.

In one study, a group of 201 “raw fooders” were found to eat 95 percent of their food raw. They consumed between 1,029 and 1,313 grams of fruit a day, and 411 to 457 grams of vegetables. Overall, 97 percent of food consumed was of plant origin, with minimal bread, cereals, rice, legumes, and dairy products, such as unpasteurized milk and raw yogurt.

Their diet was high in fiber and low in energy. Most of the energy was from carbohydrates.

Organic produce is preferable where possible, to avoid toxic pesticide residues. However, advocates concede that may nonorganic foods may be appropriate if limited availability would mean going without essential nutrients.

Foods should be locally produced to reduce transportation and storage time, as this will start to “kill” the food.

What are the benefits of a raw food diet?

Raw food dieters say that eating only raw food relieves the body of toxins, as toxins enter the body more slowly than they are eliminated. Web sites include testimonials of individuals whose chronic disease disappeared once they started the raw food diet.

One website claims that cooking removes electrons from the food, detracting from the energy it provides.

Expressions such as “light,” “energy” and “life force” may be used. Sprouts, for example, as the start of a plant, are said to contain all its “life force.” Eaten “live,” this goodness is supposed to be passed on to the consumer.

Adherents claim that reducing protein intake is beneficial because too much protein causes fermentation in the digestive system. Moreover, since the body naturally produces enzymes, some say, protein is not really needed.

On the other hand, say raw food experts, cooking kills the enzymes in food, so that the body is unable to benefit from them anyway.

Not all of these claims are supported by scientific research. Some, for example, regarding “life force,” are not verifiable by scientific means. The U.S. Food and Drug Administration (FDA) have previously questioned some of the health claims for bean sprouts on one website.

Does it make nutritional sense?

Fresh fruit and vegetables are undoubtedly healthy, but a raw food diet can lead to nutritional deficiencies if not followed with care.

Some raw food proponents urge individuals to make their own diet plan, to avoid nutritional problems. People who are prone to deficiencies may need to adjust their diet, eat some cooked food, or take supplements. Each raw food dieter should be sensitive to their own body and needs.

Let’s look at some of the issues.

Vitamin B12

Vitamin B12 is needed to keep red blood cells healthy, prevent anemia, and potentially protect against CVD. Animal produce is a good source of vitamin B12. One study found that 79 percent of raw food dieters had low or marginal levels of B12. Some successfully avoided this by using B12 supplements.

B12 deficiency was most likely in vegan raw food dieters, and least likely among mixed raw dieters, suggesting that B12 deficiency stems from the lack of animal produce rather than not cooking, although eating only raw food also implies eating less meat.

Triglycerides and cholesterol

A diet rich in fruit and vegetables is generally associated with low levels of triglycerides and cholesterol. In one study, 90 percent of raw food had healthy levels of LDL (bad) cholesterol and triglycerides.

However, 46 percent also had low concentrations of HDL (good) cholesterol, and the more raw food consumed, the lower the level of both types of cholesterol. HDL is seen as useful in reversing the effects of LDL, but since LDL levels were low anyway, this was not considered a major problem, especially as all the participants had a lower risk of CVD than the general population.

Calcium

The intake of calcium, needed for healthy bones, can be low in a plant-based diet. Raw food dieters can get calcium from tofu, mustard and turnip greens, bok choy, and kale. Spinach is high in calcium, but it can oxalate, which inhibits absorption. Careful planning is needed to ensure sufficient calcium.

Carotenoids, and vitamin A

Dietary carotenoids and vitamin A are associated with a reduced risk of chronic diseases. Raw food diets are said to be healthy because they provide high levels of carotenoids, but there has been little research to confirm this.

In one study, where 95 percent of dietary intake was raw food, mostly fruits, 82 percent of participants had normal vitamin A levels, and 63 percent had concentrations of b-carotene that are linked with the prevention of chronic disease.

The team concluded that very high consumption of fruit and vegetables in a raw food diet can provide enough vitamin A to protect from disease, as long as it is consumed with fat in the same meal, as, for example, by eating fruits with nuts and seeds.

What about the benefits of cooking?

It is true that certain nutrients, notably vitamin C, are lost in cooking. The National Cancer Institute warn that charred food can produce carcinogenic substances.

[chick peas]
Bean and garbanzo sprouts provide protein but watch out for bacteria.

However, cooking can make food more suitable for human consumption.

Not only does heat kill bacteria, but it also breaks down fibers and substances that release more nutrients and help digestion. Root vegetables, for example, provide a range of nutrients, but they are hard to digest unless cooked.

Some scientists have found that cooking tomatoes make more lycopene available for the body to use. Lycopene may help to protect against cancer, although this has not been confirmed. One study has found that levels of lycopene were below the recommended levels in 77 percent of raw food dieters.

Some chemicals in food prevent the absorption of minerals such as zinc, iron, calcium, and magnesium, but heat reduces the levels of these substances. Cooking spinach, for example, makes more iron and calcium available.

Cooking also makes food safe. Not only meat, but also sprouts can carry salmonella, listeria, and E. coli. Food Safety.gov recommends not giving raw sprouts to children, the elderly, pregnant women, and people with a weakened immune system.

Claims that cooking damages or destroys “most” nutrients and leaves “mostly empty calories,” do not, perhaps, help the raw food cause, since people have been cooking, eating, and thriving for at least 200,000 years.

It’s a detox

“Detoxification” is a popular concept, but there is little scientific evidence that a raw food “detox” eliminates toxins from the body.

For one thing, a detox tends to focus on the gut and the liver, but toxins can collect anywhere in the body, not just these two places.

As the Mayo Clinic point out, “Detoxification (detox) diets are popular, but there is little evidence that they eliminate toxins from your body.”

In the British Medical Bulletin, Dr. E. Ernst notes that the benefits of “detox” are unproven. There is a lack of serious research, he says, and it could lead to malnutrition.

Dr. Ernst concludes that currently, “Alternative detox is biologically not plausible, and clinically unproven. We should warn our patients from using it.”

Sustainability

Raw food advocates often note that people did very well before the fire was invented. Animals do not cook, they say, so why should we? But the discovery of fire, up to 1 million years ago, radically transformed human life.

Eating raw means less damage to the environment from cooking fuels. But how much of the world’s population can be sustained on wild, raw food, straight from the source? And how much transportation and refrigeration would be needed if everyone were to require raw food?

As one skeptic notes, “In a natural setting, without electricity, anyone located outside of a narrow belt of land near the equators, which have year-round growth potential, would need to dedicate their entire day to growing, gathering, preserving, and storing food.”

Raw food in the balance

The raw food diet can be controversial. Few would disagree that more fresh food is good.

Dr. Simon Capewell, of Newcastle University in the United Kingdom, told MNT recently that, as a doctor, he would recommend “almost unlimited” fruit and vegetable consumption.

But not everyone finds the “raw” argument convincing.

As Cornell University researcher Rui Hai Liu points out, cooking makes vegetables taste good, and if they taste good, people are more likely to eat them.

One research team suggests abandoning terms like vegan and vegetarian and talking instead about eating healthy, whole, plant-based foods and minimizing the consumption of animal products.

Raw food specialists point out that a raw food diet is not healthful in itself. It must be used in the right way. People must be aware of their own body, how to avoid deficiencies, and how to keep healthy. A raw food diet needs planning, discipline, and a good understanding of what one is eating. It does not have to be extreme: People should just eat as much raw as they can.

Any radical dietary change should be discussed first with a doctor.

“Meenhard,” from a raw food community in Southern Spain, stresses that eating raw is not about dogma or ideology; it is about being healthy. Making raw food ideology damages relationships between people. That is not what eating raw is about.

Perhaps one-day scientific research will prove that raw food really is the healthiest option.

Then again, would we really turn away from the smell of freshly baked bread?

Food as Medicine: Rutabaga (Brassica napus subsp. rapifera, Brassicaceae)

Rutabaga (Brassica napus subsp. rapifera, Brassicaceae), also known as “swede” or “Swedish turnip,” is a natural hybrid between cabbage (B. oleracea) and turnip (B. rapa).1 It can also be found under the subspecies “napobrassica.” Considered a root vegetable, the rutabaga is actually the enlarged base of the stem of the plant.2 Most commonly, rutabagas have a pale yellow or white inner flesh and a darker yellow or purple exterior.

Rutabaga is a relative newcomer to the world of domesticated crops, with its first mention in botanical literature appearing in the 17th century.3 The nickname “swede” comes from the plant’s geographical origin, as it became a fixture in Swedish agriculture before spreading around the world.4 It was introduced in North America in the early 19th century.

A biennial plant that stores well, rutabaga thrives in cooler climates where the summer season is not excessively hot.5 Rutabagas are considered a root crop and lend themselves to longer post-harvest storage when placed in a root cellar or similar environment that is damp and cool, lasting up to six months in storage.6,7 To prevent loss of moisture during storage or transit, the green tops are removed and the bulbs are waxed.5


Phytochemicals and Constituents

Rutabagas are rich in carbohydrates and fiber and contain little fat or protein.8 They contain about half of the calorie content of potatoes and are relatively high in vitamin C and potassium.

A diet high in fiber has many benefits, primarily for the gastrointestinal tract.9 Insoluble fiber, which cannot be absorbed and digested, promotes healthy bowel movements and lowers the risk of developing disorders such as acid reflux, ulcers, constipation, hemorrhoids, and diverticulosis, a condition in which small, bulging pouches develop along the digestive tract. These pouches can become inflamed, which is known as diverticulitis, causing abdominal pain and fever and requiring treatment. The fiber content of rutabagas consists mostly of insoluble fiber, which, in addition to maintaining bowel health, may also lower the risk of cardiovascular disease, hypertension, diabetes, stroke, and obesity.10

Potassium is an essential mineral for the body. It functions as an electrolyte, conducting electricity through the body, ensuring the proper function of cells, tissues, and organs.11 Other important electrolytes include sodium, chloride, calcium, and magnesium. Maintaining healthy potassium levels is vital for maintaining bone health, especially for the aging population, and people with diets high in potassium are at lower risk for stroke and heart disease. Additionally, potassium levels depend on an inverse relationship with salt intake: those who consume too much sodium in proportion to potassium will have less potassium available for absorption by the body.12

Other bioactive components in rutabagas include glucosinolates and phenols, similar to other plants in the Brassicaceae family, such as broccoli (Brassica oleracea)13. Glucosinolates are precursors to isothiocyanates, which may reduce the risk of certain cancers.14 In the plant, glucosinolates are converted to isothiocyanates by an enzyme called myrosinase. However, the enzyme is deactivated with excessive heat so cooking rutabaga will impact the conversion of glucosinolates to isothiocyanates. Gut bacteria also have this ability to convert glucosinolates to isothiocyanates. Phenols act as antioxidants, which reduce free radicals in the body.


Historical and Commercial Uses

The cultivation of rutabagas began in the 1600s in Bohemia (which now makes up the western Czech Republic) before they made their way to Scandinavia, where the cold-weather crop was embraced as both foods for humans and livestock.6 By the 18th century, rutabaga consumption had spread to France and England.2 Rutabagas were introduced in the United States in the early 19th century, where they were primarily grown as livestock fodder. Because the plant is so hardy and grows well in bad weather conditions, rutabagas became associated with times of scarcity, which impacted their popularity as a food product. Even in modern times in the United States, they are not as widely consumed as other, more familiar root vegetables. However, the rutabaga has had some interesting cultural impacts.

Jack o’ lanterns are a Halloween tradition with roots in Irish culture. The origin myth tells the story of a trickster named Jack, who thwarted the devil’s plan to take his soul and found his way out of hell with the aid of a burning ember and a hollowed-out rutabaga (or “turnip”).15 Though the rutabaga’s colloquial name of “turnip” in the British Isles has resulted in the erroneous belief that Brassica rapa was used, it is accepted by the standard lore that rutabagas were, in fact, the first jack o’ lanterns. When the practice migrated to the United States, where pumpkins (Cucurbita pepo, Cucurbitaceae) were readily available and already involved in many fall celebrations, the pumpkin replaced the rutabaga.

Many towns with a prominent Scandinavian population have events to celebrate the rutabaga and its place in cultural traditions. One of the more tongue-in-cheek celebrations is the International Rutabaga Curl competition, which has been a tradition in Ithaca, New York, since 1996.16 Notably, in 2016, the town of Cumberland, Wisconsin, held its 84th Annual Rutabaga Festival Parade.
Modern Research

In a recent study, rutabaga methanol extracts killed human liver cancer cells in vitro and also decreased the rate of cancer cell proliferation.17 The normal, non-cancerous cells were not affected. Compared to root or seed extracts, rutabaga sprout extracts were more effective at battling liver cancer cells. This was due to the significantly higher levels of flavonoids found in the rutabaga sprout, which correlated to stronger antioxidant activity.

Rutabaga is a variety of the rapeseed plant (Brassica napus, Brassicaceae).Brassica napus contain plant sterols that, in isolation, have shown effects against prostate cancer cells.18 The sterol called brassinolide induced apoptosis (normal, pre-programmed cell death) in these prostate cancer cells during in vitro trials. Researchers concluded that brassinolide “might, therefore, be a promising candidate for the treatment of prostate cancer.”

The bioactive compounds present in cruciferous vegetables, including rutabagas, have been studied for many different conditions. A randomized, crossover, controlled study showed that intestinal bacteria were changed within two weeks of eating a diet rich in cruciferous vegetables, although the bacterial colonization was different with each study participant.19 A hospital-based, case-control study showed that consumption of raw, rather than cooked, cruciferous vegetables decreased the risk of bladder cancer.20Additionally, growth conditions can impact the glucosinolate content in cruciferous vegetables.21Supplementing the soil with selenium, nitrogen, or sulfur was correlated with an increase in glucosinolate content, but when applied in excess had an inhibiting effect.

Rutabaga’s status as a nutritious food has often been overlooked in the United States. Combined with its ease of preparation and possible health benefits, this less glamorous cousin of cabbage and turnips deserves a popularity renaissance.

Nutrient Profile8

Macronutrient Profile: (Per 1 cup raw rutabaga cubes [approx. 140 g])

52 calories
1.5 g protein
12.07 g carbohydrate
0.22 g fat

Secondary Metabolites: (Per 1 cup raw rutabaga cubes [approx. 140 g])

Excellent source of:
Vitamin C: 35 mg (58.3% DV)

Very good source of:
Potassium: 427 mg (12.2% DV)
Dietary Fiber: 3.2 g (12.8% DV)

Good source of:
Manganese: 0.18 mg (9.2% DV)
Thiamin: 0.13 mg (8.7% DV)
Phosphorus: 74 mg (7.4% DV)
Folate: 29 mcg (7.3%DV)
Magnesium: 28 mg (7.0% DV)
Vitamin B6: 0.14 mg (7.0% DV)
Calcium: 60 mg (6.0% DV)

Also provides:
Niacin: 0.98 mg (4.9% DV)
Riboflavin: 0.06 mg (3.5% DV)
Iron: 0.62 mg (3.4% DV)
Vitamin E: 0.42 mg (1.4% DV)

DV = Daily Value as established by the US Food and Drug Administration, based on a 2,000-calorie diet.

Recipe: Honey-Lemon Glazed Rutabagas and Carrots

Adapted from: Bon Appétit22

Ingredients:

  • 1 1/4 pounds rutabaga, peeled and sliced into matchstick-sized strips
  • 1 pound carrots, peeled and sliced into matchstick-sized strips
  • 1/4 cup unsalted butter
  • 1/4 cup freshly-squeezed lemon juice
  • 1 teaspoon grated lemon zest
  • 3 tablespoons honey
  • 1/2 cup fresh chives, minced
  • Salt and pepper to taste

Directions:

  1. In a large saucepan, bring lightly salted water to boil. Add rutabagas and cook for 2 minutes. Add carrots and cook until vegetables are tender about 3 minutes. Drain.

  2. Melt butter in a large saucepan over medium-high heat. Add lemon juice, zest, and honey. Bring to a boil.

  3. Add the vegetables and cook until glazed, stirring occasionally about 6 minutes. Season to taste with salt and pepper.

  4. Remove from heat and stir in chives.

References

  1. Van Wyk BE. Food Plants of the World. Portland, OR: Timber Press; 2006.
  2. Davidson A. The Oxford Companion to Food. New York, NY: Oxford University Press; 1999.
  3. Undersander DJ, Kaminski AR, Oelke AE, Doll JD, Schulte EE, Oplinger ES. Rutabaga. Alternative Field Crops Manual. St. Paul, MN: University of Minnesota; Madison, WI: University of Wisconsin; January 1992. Available at: https://hort.purdue.edu/newcrop/afcm/rutabaga.html.
  4. Shields, DS, Spratt S. Rutabaga. American Heritage Vegetable website. Columbia, SC: University of South Carolina. Available at: http://lichen.csd.sc.edu/vegetable/vegetable.php?vegName=Rutabaga.
  5. Onstad D. Whole Foods Companion. White River Junction, VT: Chelsea Green Publishing Company; 2004.
  6. Ensminger AH, Ensminger ME, Konlande JE, Robson JRK. The Concise Encyclopedia of Food and Nutrition. Boca Raton, FL: CRC Press; 1995.
  7. Yepsen R. A Celebration of Heirloom Vegetables. New York, NY: Artisan; 1998.
  8. Full Report (All Nutrients): 11435, Rutabagas, raw. USDA Agricultural Research Service website. Available at: https://ndb.nal.usda.gov/ndb/foods/show/3151. Accessed July 25, 2016.
  9. Mayo Clinic Staff. Dietary fiber: Essential for a healthy diet. Mayo Clinic website. September 22, 2015. Available at: www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fiber/art-20043983. Accessed July 21, 2016.
  10. Anderson JW, Baird P, Davis RH Jr., et al. Health benefits of dietary fiber. Nutrition Reviews. 2009;67(4):188-205.
  11. Ehrlich SD. Potassium. University of Maryland Medical Center. August 5, 2015. Available at:http://umm.edu/health/medical/altmed/supplement/potassium. Accessed July 25, 2016.
  12. Mateljan G. The World’s Healthiest Foods. Seattle, WA: George Mateljan Foundation; 2015.
  13. Bauman H. Food as medicine: broccoli (Brassica oleracea, Brassicaceae). HerbalEGram. March 2016;13:3. Available at:http://cms.herbalgram.org/heg/volume13/03March/FoodAsMedicine_Broccoli.html. Accessed July 25, 2016.
  14. Li H, Tsao R, Deng Z. Factors affecting the antioxidant potential and health benefits of plant foods.Can J Plant Sci. 2012;92:1101-1111.
  15. History of the Jack o’ Lantern. Heritage and History website. October 25, 2011. Available at:http://www.heritageandhistory.com/contents1a/2011/10/history-of-the-jack-o-lantern/. Accessed July 25, 2016.
  16. Game History. The International Rutabaga Curl website. Available at:http://www.rutabagacurl.com/history.html. Accessed July 25, 2016.
  17. Pasko P, Bukowska-Strakova K, Gdula-Argasinska J, Tyszka-Czochara M. Rutabaga (Brassica napus L. var. Napo brassica) seeds, roots, and sprouts: A novel kind of food with antioxidant properties and proapoptotic potential in Hep G2 hepatoma cell line. J Med Food. 2013;16(8):749–759.
  18. Wu YD, Lou YJ. Brassinolide, a plant sterol from the pollen of Brassica napus L., induces apoptosis in human prostate cancer PC-3 cells. Pharmazie. May 2007;62(5):392-395.http://www.ncbi.nlm.nih.gov/pubmed/17557751
  19. Li F, Hullar MAJ, Schwarz Y, Lampe JW. Human gut bacterial communities are altered by the addition of cruciferous vegetables to a controlled fruit and vegetable-free diet. J Nutr. 2009;139:1685-1691.
  20. Tang L, Zirpoli GR, Guru K, et al. Consumption of raw cruciferous vegetables is inversely associated with bladder cancer risk. Cancer Epidemiol Biomarkers Prev. 2008;17:938-944.
  21. Sarikamis G. Glucosinolates in crucifers and their potential effects against cancer: Review. Can J Plant Sci. 2009;89:953-959.
  22. Kelley JT. Carrots and Rutabagas with [sic] Lemon and Honey. Bon Appétit. November 1, 2001. Available at: http://www.bonappetit.com/recipe/carrots-and-rutabagas-wtih-lemon-and-honey. Accessed August 3, 2016.

Food as Medicine: Tomato (Solanum Lycopersicum, Solanaceae)

History and Traditional Use

Range and Habitat

Tomato (Solanum Lycopersicum, Solanaceae) is, botanically, a fruit. Nevertheless, in the 1893 Nix v. Hedden decision, the United States Supreme Court classified tomatoes as a vegetable, which created an economic advantage for US producers, because taxes were levied on vegetables, but not fruits, imported into the US.1 The Supreme Court decided that “in the common language of the people, whether sellers or consumers of provisions, all these are vegetables … are usually served at dinner … and not, like fruits generally, as dessert.”2 The tomato is a common ingredient in cuisines around the world, and is cultivated as an annual food crop, although technically it is classified as a short-lived perennial.3

A member of the nightshade family, the tomato is related to the potato (Solanum tuberosum), eggplant (S. melongena), bell pepper (Capsicum annuum), and chili pepper (C. frutescens). Tomatoes are colorful, with various tomato cultivars producing fruit that is generally red, orange, and yellow in different sizes and shapes. Tomato plants grow 3-10 feet in height and have a sprawling growth habit, with hairy stems, bright green compound leaves, and small yellow flowers.4,5 The tomato plant produces a fleshy fruit with seeds embedded in a watery matrix that requires delicate care during transport.6

Tomatoes grew wild as a weed in South and Central America, and the size of the original tomato was more comparable to the cherry tomato than the larger varieties.6,7 Aztecs and Incas were among the first to cultivate the tomato due to its resemblance to the green tomatillo (Physalis philadelphica and P. ixocarpa, Solanaceae), one of their cuisine staples.4,6 After arriving in Mexico, Spanish conquistadors were intrigued by the tomato and took seeds to Europe. The tomato spread throughout Europe and made its way into Mediterranean cuisine during the 16th century. Today, the tomato and potato dominate the US vegetable market in dietary intake and economic value.1


Phytochemicals and Constituents

Tomatoes are a good source of vitamin C, vitamin A, folate, potassium, carotenoids, and flavonoids.5 The tomato skin contains 98% of the tomato’s total flavonol content, which includes quercetin and kaempferol. Studies have shown that potassium and vitamin C in the diet lower blood pressure, which is good because high blood pressure is a risk factor for cardiovascular disease (CVD).8 Tomatoes also contain minerals including phosphorus, magnesium, molybdenum, and calcium.5 Tomato-based products, including tomato paste, contain these same nutrients in varying concentrations depending on how the tomatoes were processed.9

The fruit is dense in lycopene and several other carotenoids, including phytoene, phytofluene, zeta-carotene, beta-carotene, gamma-carotene, and neurosporene.5 Carotenoids give tomatoes their varying colors.10 Tomatoes and tomato products are the richest sources of lycopene in the American diet, representing more than 85% of all dietary sources of lycopene.

Because of its chemical structure, lycopene is one of the most potent antioxidants.11 Lycopene provides many health benefits, including reducing the risk of cellular oxidative damage, inflammation, and modulation of cellular signaling pathways. There is a strong correlation between lycopene/tomato product intake and the reduction of CVD and cancer incidence.5,8 In vitro studies demonstrate that lycopene reduces cellular proliferation induced by insulin-like growth factors in various cancer cell lines, and protects important cellular biomolecules, including lipids, proteins, and DNA.11 Additionally, lycopene can suppress carcinogen-induced phosphorylation of regulatory proteins and stop cell division in cancer cell lines, providing a mechanism to explain putative cancer preventive effects.


Historical and Commercial Uses

The tomato was not a popular food when introduced to Europe and was originally grown as an ornamental plant. The Solanaceae family famously contains some plants that are poisonous, such as deadly nightshade (Atropa belladonna) and black henbane (Hyoscyamus niger), which made many people suspicious of the bright red fruit.4,6 Europeans overcame their fear of the tomato by the late 18th century, but conflicting information persists in modern times regarding tomato leaves.6,12 The leaves were believed to be as poisonous as the fruit — once thought to be toxic as well — but scientific literature remains undecided on the leaves’ actual toxicity to humans and animals.12 Some chefs and home cooks have reported no adverse effects while cooking with and consuming tomato leaves, but evidence remains largely anecdotal on both sides.

Though little research exists on tomato’s efficacy for skin conditions, such as acne or sunburn, folk remedies recommend preparations of tomato mixed with other ingredients, such as avocado (Persea Americana, Lauraceae), honey, yogurt, or lime (Citrus x latifolia, Rutaceae) juice, applied to the face or other afflicted areas.13

As tomato consumption spread throughout Europe, it gained more acceptance as a versatile food, which inspired Italians to begin mass-producing and canning tomatoes (known as pomodoro, or “golden apple” in Italian) by the early 19th century. The US soon followed, and by the 1830s, ketchup (catsup) became the “national condiment.”4 Currently, the tomato has a wide variety of uses and is one of the most popular vegetables worldwide. In the US, the tomato is the most commonly consumed vegetable.1 The average American consumes nearly 18 pounds of fresh tomatoes and almost 69 pounds of processed tomato products every year.10The Economic Research Service of the US Department of Agriculture estimates that of total raw tomato processing, 35% is processed into sauces, 18% into tomato paste, 17% into canned tomatoes, 15% into juices, and 15% into ketchup. The tomato was the first genetically-engineered food, modified to maintain the firmness of the fruit for longer periods of time during transport.7

Modern Research

The tomato and tomato products have gained greater attention because of the increasing research surrounding their antioxidant and anti-inflammatory properties.9

Tomatoes have a variety of nutrients and compounds that may contribute to the prevention of CVD and certain cancers by decreasing inflammation. Recent studies have identified lycopene as a beneficial compound that reduces inflammation and oxidation. Oxidative stress at the cellular level leads to the damage of cell membranes and eventually causes inflammation. The chemical transfer of electrons of ascorbic acid (vitamin C) and alpha-tocopherol (vitamin E) prevents damage to fat cells, therefore indirectly preventing inflammation.

Lycopene and Inflammation

Vitamin C and vitamin E may work in combination with lycopene to increase beneficial effects. Researchers observed a greater production of anti-inflammatory cytokines with the combination of the three compounds (lycopene, ascorbic acid, and alpha-tocopherol) compared to the individual compounds or a combination of two.14 (Cytokines are chemical messengers produced by immune cells to communicate with damaged cells and initiate an immune response.) This indicates that consuming tomato provides greater health benefits versus isolated single compounds.

Tomato products may also benefit overweight or obese individuals.15 After 20 days of consuming 330 mL of tomato juice daily while otherwise maintaining their normal diet, overweight and obese women had a decrease in the concentration of certain inflammatory factors compared to baseline and compared to the control group, possibly decreasing the risk of inflammatory conditions such as CVD, diabetes, and other chronic diseases.

Cancer

Chronic inflammation is associated with an increased risk of degenerative diseases like cancer. In healthy human subjects, dietary supplementation with lycopene for just one week increased serum lycopene levels and reduced oxidation of lipids, proteins, lipoproteins, and DNA, whereas subjects with diets free of lycopene supplementation or tomato products showed low blood levels of lycopene and increased lipid oxidation.11 Blood and tissue levels of lycopene were inversely associated with risks of breast cancer and prostate cancer. Several epidemiological studies have found that high intake of tomatoes/tomato products was linked to lower incidences of gastrointestinal (GI) cancer and a 50% reduction in cancer death rates in an elderly US population.16 In a review of 72 epidemiological studies, 57 (79%) confirmed an inverse association between tomato intake and risk of several different types of cancer, measured by serum lycopene levels and predisposition to cancer.

Increased lycopene intake from various tomato products has been shown to correlate with a reduced risk of developing prostate cancer.11 Lycopene’s prostate cancer-prevention benefits are thought to stem from mechanisms of inhibiting proliferation, anti-androgen and antigrowth factor effects, and decreasing levels of oxidative damage to DNA and T-cells.9 In fact, consumption of 10 or more servings per week showed a 35% reduction in risk of even the most aggressive types of prostate cancer. Epidemiological evidence confirms the relationship between tomato/lycopene consumption and prostate cancer risks. A survey of 51,529 male health professionals between 40 and 75 years old found that consuming more than two servings a week of tomato products resulted in a dose-dependent risk reduction in the incidence of prostate cancer. Greater risk reduction is associated with tomato sauce consumption than with lycopene supplementation alone.9

Cardiovascular Health

More than 70 million Americans have some form of CVD, which accounts for 38% of all deaths in the US.9 Higher concentrations of lycopene in fat tissue were noted to be protective against CVD. When tomatoes/tomato products are removed from the diet, the antioxidant capacity of plasma decreases and then increases when they are added back. Consuming tomato products daily for two-four weeks increases antioxidant enzyme defenses and has been shown to reduce plasma lipid peroxides and the susceptibility of low-density lipoprotein (LDL) to oxidation.17 In 2004, researchers reported an inverse association for women consuming more than seven servings per week of tomato-based products and CVD. This association was not observed with lycopene supplementation alone.

Different tomato products contain various concentrations of lycopene and other nutrients. Tomato paste is one of the most lycopene-rich tomato products. A 2012 study examined the effect of tomato paste in the endothelial function of 19 young, healthy individuals.9 After consuming 70 g of tomato paste daily for 15 days, researchers reported that subjects experienced a significant increase in flow-mediated dilation and a significant decrease in total oxidative stress (TOS) compared to baseline. This may indicate that the decrease of TOS increases endothelial function, therefore decreasing the risk of future CVD.

Bioavailability

The bioavailability of a compound refers to the amount that is absorbed and used by the body. Thus, increased bioavailability means increased activity and possible benefits from that compound. Tomatoes are one of the few fruits or vegetables whose nutrients are absorbed more readily when cooked. When tomatoes are processed, lycopene becomes more bioavailable, especially when heat is used, which softens cell walls in tomato tissues, and other dietary lipids are present during processing.11,17

The popular combination of tomatoes with olive oil may be as healthy as it is delicious. Researchers observed subjects who consumed tomatoes in conjunction with olive oil and those who consumed tomatoes alone.18 The results found significantly increased plasma concentrations of lycopene in the olive oil group. The dietary sources that deliver the most concentrated sources of lycopene are processed tomato products including tomato juice, ketchup, paste, sauce, and soup.19 Consuming lycopene from whole food products, including tomatoes, instead of in supplement form, confers the benefits from the interaction with and enhancement from different constituents.17


Nutrient Profile20

Macronutrient Profile: (Per 1 large tomato [approx. 182 g])

33 calories
1.6 g protein
7.08 g carbohydrate
0.36 g fat

Secondary Metabolites: (Per 1 large tomato [approx. 182 g])

Excellent source of:
Vitamin C: 24.9 mg (41.5% DV)
Vitamin A: 1,516 IU (30.3% DV)

Very good source of:
Vitamin K: 14.4 mcg (18.0% DV)
Potassium: 431 mg (12.3% DV)
Molybdenum: 9 mcg (12.0% DV)
Manganese: 0.21 mg (10.5% DV)

Good source of:
Dietary Fiber: 2.2 g (8.8% DV)
Vitamin B6: 0.15 mg (7.5% DV)
Folate: 27 mcg (6.8% DV)
Niacin: 1.08 mg (5.4% DV)

Also provides:
Magnesium: 20 mg (5.0% DV)
Vitamin E: 0.98 mg (4.9% DV)
Thiamin: 0.07 mg (4.7% DV)
Phosphorus: 44 mg (4.4% DV)
Iron: 0.5 mg (2.8% DV)
Riboflavin: 0.04 mg (2.4% DV)
Zinc: 0.31 mg (2.1% DV)
Calcium: 18 mg (1.8% DV)

DV = Daily Value as established by the US Food and Drug Administration, based on a 2,000-calorie diet.


Recipe: Gazpacho Salad

Adapted from The New Spanish Table21

Ingredients:

  • 2 1/2 cups day-old dense country bread diced into 1-inch cubes
  • 2 garlic cloves, peeled and chopped
  • 1/4 teaspoon kosher salt
  • 1/4 teaspoon cumin seeds
  • 3 tablespoons sherry vinegar or red wine vinegar
  • 1/3 cup extra-virgin olive oil
  • 1 2/3 pounds fresh tomatoes, cored and diced into 3/4-inch cubes
  • 1/2 cup cucumber, seeded and diced
  • 1/2 cup white onion, finely diced
  • 1/2 cup seedless green grapes, cut in half
  • 1/2 cup slivered fresh mint or basil (or combination)

Directions:

  1. Heat the oven to 350°F.

  2. Arrange the bread cubes in a single layer on a large rimmed baking sheet and bake until they are lightly browned, 8 to 10 minutes, stirring once. Let the bread cubes cool to room temperature.

  3. Using a mortar and pestle, mash the garlic, salt, and cumin seeds into a paste. Add vinegar and olive oil and whisk to combine.

  4. Add toasted bread, tomatoes, cucumber, onion, grapes, and herbs in a large bowl and toss to combine. Add the dressing and toss to coat. Let the salad stand for 5 to 10 minutes before serving to allow the bread to soak up the dressing and vegetable juices.

References

  1. Food Consumption and Demand: Tomatoes. USDA Economic Research Service website. February 3, 2016. Available at: www.ers.usda.gov/topics/crops/vegetables-pulses/tomatoes.aspx. Accessed June 23, 2016.
  2. Nix v. Hedden. No. 137 (United States Supreme Court 1893).
  3. Van Wyk B-E. Food Plants of the World. Portland, OR: Timber Press; 2006.
  4. The National Geographic Society. Edible: An Illustrated Guide to the World’s Food Plants. Lane Cove, Australia: Global Book Publishing; 2008.
  5. Perveen R, Suleria HA, Anjum FM, Butt MS, Pasha I, Ahmad S. Tomato (Solanum Lycopersicum) carotenoids and lycopene chemistry; metabolism, absorption, nutrition, and allied health claims: A comprehensive review. Crit Rev Food Sci Nutr. 2015;55(7):919-929.
  6. Murray M, Pizzorno J, Pizzorno L. The Encyclopedia of Healing Foods. New York, NY: Atria Books; 2005.
  7. Green A. Field Guide to Produce. Philadelphia, PA: Quirk Books; 2004.
  8. Willcox JK, Catignani GL, Sheryl. L. Tomatoes and cardiovascular health. Crit Rev Food Sci Nutr.2010;1(43):1-18.
  9. Xaplanteris P, Vlachopoulos C, Pietri P, et al. Tomato paste supplementation improves endothelial dynamics and reduces plasma total oxidative status in healthy subjects. Nutr Res. 2012;32(5):390-394.
  10. Canene-Adams K, Campbell JK, Zaripheh S, Jeffery EH, Erdman JW. The tomato as a functional food.J Nutr. 2005;135(5):1226-1230.
  11. Agarwal S, Rao AV. Tomato lycopene and its role in human health and chronic diseases. CMAJ.2000;163(6):739-744.
  12. McGee H. Accused, Yes, but Probably Not a Killer. The New York Times. July 28, 2009. Available at:  www.nytimes.com/2009/07/29/dining/29curi.html?_r=2&ref=dining. Accessed June 20, 2016.
  13. Khan B. Tomato for Clear Skin. The Times of India. April 21, 2013. Available at:http://timesofindia.indiatimes.com/life-style/beauty/Tomato-for-clear-skin/articleshow/7686230.cms. Accessed June 20, 2016.
  14. Hazewindus M, Haenen GR, Weseler A, Aalt. B. The anti-inflammatory effect of lycopene complements the antioxidant action of ascorbic acid and a-tocopherol. Food Chem. 2012;132(2):954-958.
  15. Ghavipour M, Saedisomeolia A, Djalali M, et al. Tomato juice consumption reduces systemic inflammation in overweight and obese females. Br J Nutr. 2013;109(11):2031-2035.
  16. Giovannucci E. Tomatoes, tomato-based products, lycopene, and cancer: a review of the epidemiologic literature. J Natl Cancer Inst. 1999;91:317-31.
  17. Burton-Freeman B, Reimers K. Tomato consumption, and health: emerging benefits. Am J Lifestyle Med. 2010;5(2):182-191.
  18. Fielding JM, Rowley KG, Cooper P, O’Dea K. Increases in plasma lycopene concentration after consumption of tomatoes cooked with olive oil. Asia Pac J Clin Nutr. 2005;14(2):131-136.
  19. Burton-Freeman B, Sesso HD. Whole food versus supplement: comparing the clinical evidence of tomato intake and lycopene supplementation on cardiovascular risk factors. Adv Nutr.2014;5(5):457-485.
  20. Basic Report: 11529, Tomatoes, red, ripe, raw, year round average. USDA Agricultural Research Service website. Available at: https://ndb.nal.usda.gov/ndb/foods/show/3223?manu=&fgcd. Accessed June 22, 2016.
  21. Von Bremzen A. The New Spanish Table. New York, NY: Workman Publishing Company; 2005.