Potatoes, Carbs, and Type 2 Diabetes

[Music] [Music] [Music] [Music] oh boy it's gonna be one of those shows okay no music today hi uh welcome to the exam room live brought to you by the physicians committee i am the weight loss champion chuck carroll and this is the healthiest half hour anywhere online today i appreciate you joining us right here on facebook and on youtube let's set the table because today's show is going to be a really interesting one we've got some conventional wisdom that essentially is going to be thrown out the window thanks to some brand spaking new research we'll be talking about that in just a moment but also today we're going to be continuing our discussion about thanksgiving making our preparations that is one week from today and so yesterday with dietitian maggie neola we got some ideas for recipes well today we're going to get some practical tips from dr vinita rahman she is here she's going to help us with how to keep it healthy overall how not to over indulge and and fall into that dreaded food coma dr vinita vermont thanks so very much for joining us today thanks chuck all right we're going to be talking thanksgiving in just a little bit but first that conventional wisdom that i was just discussing recently i had the opportunity to interview with the queen of science dr hana kaliova you know anytime she comes on the show she's bringing that science so strong well this particular time we were talking about potatoes and diabetes you know for years people with diabetes they said no i cannot eat those white potatoes they will send my blood sugar sky high i got to get them off of my plate well lo and behold here comes this brand spanking new research that kind of has people thinking well maybe potatoes may not be such a bad thing they looked at that head to head compared to rice and what didn't you know just in time for thanksgiving the potato may be the way to go here now my conversation with dr hanna kaliova dr kaliova thanks so very much for taking the time thank you chuck you know are our potatoes good for people with type 2 diabetes the conventional wisdom is they're not right they're high in glycemic index and they should be avoided like carbohydrate restriction has been supported so potatoes are high in carbs and also high in glycemic index so you better forget potatoes if you're a diabetic that's the conventional wisdom and this conventional wisdom has been challenged by a recent study that has just been published in clinical nutrition by a research group from melbourne australia and the researchers were looking into glycemic response after potato dishes compared to rice now rice has been shown to be low in glycemic index a lower glycemic index lower than 55 is considered low and basmati your eyes has a glycemic index of 51 so that's considered that that's considered low and potatoes have a glycemic index of 71 and and anything above 70 is considered high glycemic index so these researchers were looking into the differences in glucose response after a meal that was containing potatoes prepared in different ways compared with rice now you know conventional wisdom would be like why are you even doing the study like rice will be better like why why even bother well let's see so let's look at the study design first and the the researchers were looking um at a randomized crossover trial which means that each participant was re receiving all the meals four meals in a different order uh 24 people with type 2 diabetes were participating in the study treated by diet or by metformin the main drug used to treat type 2 diabetes and all the study participants received the same standard breakfast that contained 25 of the daily energy intake a standard lunch that contained 35 of the daily energy intake and they compared four different dinners uh all of them contained the same amount of energy forty percent of energy intake fifty percent coming from from carbohydrate now the three dinners contained potatoes prepared in different ways the first dish contained boiled potatoes the second one roasted potatoes the third one boiled potatoes that were cooled down and then heated up before the consumption this preparation has been shown to increase the amount of resistant starch so like slow down the glycemic response after a meal and then basmati rice so let's see what the researchers found out first let's look at the study population the mean age was 58 years the mean body mass index was 31.7 that means uh most diabetics were in the obese range their a1c was 7.3 percent on average and most of them have had their diabetes for about nine years on average now there was no difference between the meals and the glycemic response two meal two hours after the meal which is kind of unexpected we would we would expect rice to have the lowest glycemic response to two hours after the meal but hey there was no difference between the meals there was a market difference in insulin a secretion though being the lowest after rice which is not a good thing if you're diabetic you you need to secrete your insulin your insulin secretion needs to be high after a meal uh if your insulin situation is low that's you know that's a part of the problem so rice was not really helping with insulin secretion and all the potato dishes had a had a higher insulin secretion than rice but the potatoes that were cooked and cooled down they had the better insulin response they had the best insulin response now the researchers were also measuring the 24-hour glucose response using continuous glucose monitoring and surprisingly the 24-hour insulin response was the highest after rice and it was the lowest after roasted potatoes and most of the difference was coming from the night glucose response from the nocturnal hours uh you know 10 pm at night is here 7 a.m is here so the main difference was that rice was really increasing the glucose levels at night compared with all the other potato dishes roasted potatoes being the best this is the nocturnal or you know the night glucose response specifically being the highest after rice and being lower after all the potato dishes and being the lowest after roasted potatoes so to summarize the results there was no difference between the meals in terms of glycemic levels two hours after the meal which was an unexpected result we would expect the the glycemic levels to be higher after the potatoes compared with rice but this has not been shown there was no difference between the meals two hours after the meal in terms of insulin response higher insulin levels were observed after pre-cooked and cooled potatoes so if you're a diabetic who struggles with postprandial high glucose levels this might be a good method for you you may pre-cook your potatoes cool them down and then heat them up again before you eat them and there was a lower glycemic response after potatoes at night compared with rice and the lowest um glycemic response was observed after roasted potatoes so if you're a diabetic who struggles with a lot high glycemic response at night um you know potato potato dish um for for dinner might be preferable over rice and roasted potatoes might be the best so it really you know also shows that different conditions may require different cooking methods but overall the study has clearly shown that potatoes um you know seem to be beneficial for for type 2 diabetes that's uh really interesting to me and so let's let's talk about this a little bit more here the one thing that stood out to me is we're talking about roasted potatoes uh and boiled potatoes and then cooled potatoes nowhere on there did i see anything like potato chips or fried potatoes or french fries i think that had those foods been a part of this study we would have seen completely different results absolutely i completely agree and most of the sadly most of the potato consumption in the us comes from potato chips and french fries and this is not what we recommend here this is not what the study is suggesting so if we're looking at french fry and potato chip consumption the recommendation is clear we should not be consuming those foods or completely minimize those those foods we're looking into you know cooked potatoes roasted potatoes and eventually pre-cooked and cooled down potatoes um these are the cooking methods that they use in the study yeah and and along those lines you know you can take broccoli broccoli is undisputedly a healthy food but if you you know batter that and then deep fat fry it that's not going to be a health food anymore either i'll tell you another something interesting that i found in this study is right off of the bat in the introduction was that the researchers said that potato consumption had dropped by 20 percent and i believe australia and europe and i suspect other parts of the world as well because we have turned into such a carb phobic society that people just regardless of whether we're talking about blood sugar or other reasons they're just like carbs are the devil i can't eat carbs and so potatoes fall into that category as well when in reality they are one of the most nutritious foods out there on the planet absolutely potatoes contain a lot of fiber the fiber content was two times higher in the potato dishes in this study compared with the rice dishes potatoes are super high in fiber they're high in vitamin c and potassium they're low in sodium and you know people have been surviving on potatoes for for so many years even during the world wars people were surviving on potatoes mainly and they were doing well actually the cardiovascular disease you know went down during world war when people were eating potatoes so they're definitely a nutritious food high in fiber high in vitamin c and there's no reason to avoid them yeah very easy to cook and and very affordable as well if you're looking to stretch that dollar potatoes are another great option there too so nothing but upside when it comes to spuds dr kaliofa yeah one of the staple foods really uh you know one of the cheapest foods you can you can get absolutely i love it when you come on the show i tell you this every time you always bring the most fascinating research to us so thank you you've done it again yeah thank you so much check and i hope you will have some potatoes for lunch or dinner today oh it's a fact you can count on that with the wonders of technology we are back live so isn't that something right potatoes for diabetes white potatoes for diabetes kind of getting that uh a second look now dr hanakaliva always with the interesting research i bet there's a pretty good chance that next week one week from today at thanksgiving there will be potatoes on your table maybe sweet maybe white i don't know but i hope that they are delicious but right now let's continue our look at thanksgiving you know yesterday we talked about specific dishes some turkey alternatives when we had maggie neola on the show wonderful dietitian well today i wanted to bring on a doctor and get the doctor's perspective and for that i wanted to welcome dr vanita rahman to the exam room live and dr rahman i don't want to necessarily talk menu today i want to talk about bigger picture when it comes to thanksgiving because when you think thanksgiving you think about overstuffing yourself can't zip up your pants gotta unbutton the top and just take a food coma ultra nap so let's talk practical tips for people who don't want to begin that holiday weight gain next thursday at thanksgiving so how can we keep it healthy how can we keep ourselves from over indulging at the table next week yeah such an important topic chuck you know i it's hard to believe first of all that thanksgiving is a week from today with the kind of very strange year that we've had but the key to a successful thanksgiving is really just planning ahead you know like when you go on a journey you look at the map you figure out how long it'll take you you fill up the gas tank so we kind of need to do the same thing with our thanksgiving meal let's plan plan plan that's the key and planning not only what we're going to eat but how we're going to eat it how much we'll eat so that we're not caught off guard and feeling overly stuffed needing to unzip our pants and just feeling terrible about it so here are some tips that i have uh first of all prepare a healthy plant-based meal as maggie discussed earlier and there are so many great recipes on the internet great recipes on our website and you know what's important to remember is we don't necessarily crave specific food it's we crave flavor so if you crave a potato dish think of the flavor you're craving and then whip up those potatoes in a healthy way so that you're satisfied now the other thing is you know watching what we eat how much we eat so a couple of tips here it's really easy to overeat on thanksgiving so one thing that i like to do is keep my serving platters away from the table although we all like this beautiful thanksgiving table but then when we sit around it it's so easy to just keep dipping and getting more and more because we're enjoying the time so much so just keeping it even a few feet away at a different counter or in the kitchen while we sit in the dining room can drastically impact how much we're eating and and if you're really worried about over consuming and you know it'll be tempting then maybe instead of pulling out those big dinner size plates pull out the salad size plate make them the entree plates or the the plates that we're eating from and use the dinner plates as on tray plates instead it sounds kind of crazy but what's now the salad size plate used to be our dinner plates many many decades ago but for some reason everything shifted so some of these tips can make a big difference uh you know it's so fun when i was starting to lose weight and i switched to the smaller plate it was completely psychological i still look down i still saw that full plate and i was like man you know it is time to chow down i'm gonna feel so full after this but if you put that same portion on that bigger plate that most of us are using these days it's like where's the rest of the food right so it's it's a mind game but it absolutely works so well i you know this year is kind of wonky we don't know how many people are going to be traveling to be with their family this year because of the pandemic unfortunately but you know if somebody does a lot of times in families there's that one aunt that one uncle that one cousin whomever who pressures you eat more and more and more you know if it's on your plate you gotta eat it and that plate needs to be piled a mile high how do you deal with that kind of pressure yeah good question you know i i know i get that all the time from my family and and you know it's it's very tough because someone may have gone through great lengths to prepare this meal for us and they're really excited and then we don't want to disappoint them or feel like we're being ungrateful so several things you can do you can say you know i'm pacing myself this is just my first round and in a little bit i'm going to have a second round or i'm i'm really working to lower my blood sugars and i found if i just eat like this and then get seconds later that just works much better for me or say that you know i love your cooking so much i'm planning to pack some and take some home with me because i know i will want some again later so just really kind of being firm but polite and and just showing our appreciation and gratitude but also sort of setting our boundaries is so important you know and that gets me to thinking about in my family growing up we always ate at such a weird time like it was literally in the middle of the afternoon like 3 30 and it was like it's too late to be lunch it's too early to be dinner why in the world are we eating right now it doesn't make a whole lick of sense so if you're talking about spreading out the meals i would think that if you do eat closer to regular lunch time at noon or one o'clock then you would be ready for seconds but the seconds would actually then be dinner four five six hours later i think that that would be a good solution here i exactly that's you know because now you've sort of taken care of two problems in with one um action you have prevented yourself from overeating at your thanksgiving meal and you don't have to plan for dinner it's all ready for you so uh you can still enjoy your food but instead of eating so much in one meal we will be splitting it up across two meals have you given any thought to what it is that you're going to be eating this thanksgiving do you know how much time you're going to be spending in the kitchen getting everything ready yeah so i um my teenage daughter has offered to make our thanksgiving meal for us so say it isn't so yes so i'm going to be having a relaxing thanksgiving and she's a great chef and i'm really looking forward to all that she whips up oh that's fantastic is she sharing the menu or is this being kept top secret under wraps classified for your eyes only a little bit of both i'm being consulted but it's being made very clear it's not my decision which is fine i'm happy to be the guest and enjoy the food all right real quick as long as we're talking about not over indulging thanksgiving obviously synonymous with pies and sweets so if you do have a sweet tooth and you're just naturally inclined to go that route and have a huge slice of pumpkin pie or apple pie with ice cream that a la mode you know how can we really kind of take a step back and and make sure that we don't go crazy when it comes to the sweets as well yeah this is so important because you know i've been at many thanksgiving dinners or lunches whatever we want to call it where there are four or five different types of pies and different ice creams and i feel like trying it all and by the time i try i'm really stuffed so yeah you know um i think something to keep in mind is too often when we're reaching for that dessert we're thinking of how great it feels when we put it in our mouth when we taste it as we eat it and how wonderful we feel but maybe we should also be mindful of how we feel 10 minutes after that or half an hour after that or a few hours after that so really being aware of that you know that i know how i feel while i'm eating it but let me also think about how i'll feel a few hours later will my stomach hurt will my blood sugars go up will my blood pressure go up will i just feel bad physically bad or emotionally bad and just being mindful of all aspects of that experience can really make a big difference and that way we're taking that into account when we make that decision about how much pie to eat let's just be realists though about this right we know what we're going to feel like after we overeat yet somehow every single year we just say it's worth it i'm gonna go all in on this meal anyway and whatever happens happens why do you think we're wired that way i know that this is a really deep conversation but it's almost celebrated to gorge on thanksgiving to the point where it is painful i i would think that we're gonna have to do some serious rewiring as a culture to get this idea you know off of the table yeah well i think you hit something right there uh it's definitely cultural it's been ingrained in us from the beginning thanksgiving is the time to just splurge and and throw caution to the wind just eat as much as we want it's okay it's it's somehow that meal doesn't count if you will so there is that huge cultural shift that needs to happen but the other part of it is physiological you know nobody really overeats the broccoli or cauliflower or or the tofurky on thanksgiving it's usually the dessert or the more rich fatty foods so that gets back to you know what makes food so addictive and it's usually the fat the sugar the salt in it so when you have this pie you've got the perfect storm of salt yes desserts have fair amount of salt enough sugar and fat and it just releases these neurotransmitters in our brain that make us happy and we want to hold on to that feeling so we keep eating more and more so some of that is physiology and some of it is cultural it's both all right and and let's just nerd out about nutrition here for a second so we're we're aware of how we feel right but what about metabolically speaking so if we eat this huge enormous meal that's just loaded with fat loaded with calories what is actually happening to us inside the body yeah so several things could be happening let's say the meal is high in sodium uh we will immediately start retaining water we will drink more we will avoid less water and our blood pressure will rise you know and the next day it will show up on the scale that water retention shows up almost overnight so it wouldn't be uncommon to weigh a few pounds more the other thing that can happen is if it's a high-fat meal and someone has pre-diabetes or diabetes they may notice their blood sugars rise two hours after the meal or the morning after that their sugar levels are significantly higher than they normally are the other change that could happen is if the meal is high in saturated fat or if it has any kind of animal based products which will invariably contain cholesterol this can impact our cholesterol levels those levels are going up as as we're ingesting this food so all of these changes can be rather immediate they don't necessarily show up days or weeks later they can happen as we're ingesting and definitely overnight we can see the difference all right now let's go ahead and open up that doctor's mailbag we have a couple of questions that i want to get to today well one is actually a follow-up to what dr kaliova and i were discussing earlier in the show this is a question from elaine dr ramon she wants to know in your opinion as a doctor which is better a sweet potato or a white potato oh well that's you know both are great in terms of nutrition and health both are terrific as uh dr kaliova just showed us from the research uh white potatoes are are not likely to raise our blood sugar any more than white rice so they're healthy for us the the key is how we're eating them uh so avoiding oils avoiding high fat toppings avoiding frying them avoiding the cheese on them it's not the potato it's what we do with it that matter so however you like it enjoy it and get a wide variety of them all right and the next question this is an interesting one this is one that roger sent in he wants to know do complex carbs raise or lower cholesterol do carbs really play a role with cholesterol yeah so this has been a bit of a tricky question a little bit controversial so there are two types of carbohydrates complex and simple simple are things like added sugars or refined grains whereas complex carbohydrates are things like fiber or starchy molecules now the the majority of the research shows that we should stick with complex carbohydrates like fruits vegetables as opposed to fruit juice or vegetable juice with whole grains as opposed to refined grains so and and we know from research uh that has been done across many institutions that eating complex carbohydrates leads to lower a1c levels lower cholesterol levels lower body weight so they are healthy for us the problem comes in when someone is eating predominantly refined carbohydrates like added sugars or fruit juices or sodas those uh can lead to weight gain which could then lead to increases in cholesterol too so it's best to stay away from those but sticking with the complex carbohydrates definitely the way to go all right now if somebody wants to make an appointment to visit with you at the barnard medical center i know that a number of exam roomies have already scheduled appointments to visit with you and i think that actually dr ramon this time of year would be a great time to get started and sit down and map your healthier journey get a jump start while everybody else is going to be taking charge of their health come january 1st why not get going now so you don't gain that traditional holiday weight why not go ahead and make that appointment you can help them out right now all you need to do if you want to make an appointment to visit with dr rahman is go to barnardmedical.org or you can call 202-527-7500 schedule an appointment that way i know that you are licensed in a slew of states obviously bmc covers more than a quarter of the country so if somebody's watching you from texas i believe you can meet with them where else are you licensed oh gosh so i i try to do it geographically so uh texas california florida georgia illinois uh dc maryland virginia new york pennsylvania i think i got that should be 11 states now when you set out to be a doctor did you say i want to practice in 11 states no and i i couldn't have imagined one day i would be seeing people across states through telehealth but it's just a wonderful technology that we have and you know we're able to provide such good care through telehealth and it's it's really been a game changer i think in so many ways that's so awesome all right so all you need to do is visit barnardmedical.org or call 202-527-7500 to schedule that appointment today dr vermond we will talk to you again next week we're going to speak with you i believe on tuesday just in time for thanksgiving so thank you very much for taking the time today we'll talk to you again soon thank you chuck all right if we didn't get to your question today for the doctor's mailbag i promise you we will save it and do our best to get you an answer on an upcoming episode and before we get out of here today oh my goodness gracious if you have not yet subscribed to the exam room podcast over on apple podcast and spotify wherever podcasts are available you need to go look for the exam room by the physicians committee one of the top ranked nutrition podcasts out there today well there is a new episode out today one that's called blind guy his wife their vegan life this is the story of corey and laquita staten from southern virginia and they are absolute characters corey actually lost his sight when he was just 19 years old and so now here we are 20 plus years later he's starting to have a number of other health complications and he didn't want things to progress so dramatically that he couldn't go back so his wife the nurse they're working together got him on a plant-based diet working on his blood pressure working on his diabetes working on a number of things and through their new youtube show they're also singing the praises of a plant-based diet encouraging others to follow suit and in just a matter of months his health is taking a dramatic turn for the better so you gotta check out this interview and oh by the way these two are characters in the best way i love corey and laquita marie because i mean they talk about some of the silly adventures that they have for their youtube show including corey getting behind the wheel of a car i'm not making you i'm not making this up so check out that episode become inspired and get ready to laugh that's over on apple podcast spotify stitcher wherever shows are available just look for the exam room podcast by the physicians committee hit that subscribe button and leave a five star rating but for this show today that my friend is all the time that we have i want to say thank you once again to doctors venita rahman and hana hanakaliova for taking the time to join us today and to the crew behind the scenes that makes the magic happen thank you guys as always and to you exam roomies thank you for tuning in and raising your nutrition iqs right alongside with us on behalf of everyone here at the physicians committee i am the weight loss champion chuck carroll we'll talk to you again tomorrow but until then stay safe take a stand and keep it plant-based

Channel: Physicians Committee

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Id: VMtg7LpNj9U

Length: 32min 12sec (1932 seconds)

Published: Thu Nov 19 2020