New England Health Advisory

By Inger Pols

In the last issue, I began a series on how to make healthier food choices. I discussed how refined flour is stripped of its nutrients and then “enriched” with lab-created versions of the nutrients. I discussed how flour can spike blood sugar levels and suggested some healthier bread choices. Today, I’m going to look at traditional starch options like pasta, rice and potatoes to see why pasta comes out as the best choice.

I want to talk briefly about why the Glycemic Index is a helpful guide (but not an absolute rule) and look at how it applies to bread to provide context when we look at how pasta, potatoes and rice measure up.

As I discussed on Monday with the bread issue, certain foods spike blood sugar levels. The Glycemic Index is the scientific system that measures and monitors those increases across all carbohydrates. The lower the number, generally speaking, the better because that means the food will be digested more slowly, will result in less insulin spiking and will provide more protection from diabetes, high blood pressure, high triglycerides, heart disease and obesity.

In addition to helping you to avoid certain health conditions, lower Glycemic Index (GI) foods also aid in weight control. A study of overweight teenagers eating a low GI breakfast showed that they ate 45% fewer calories throughout the day than when they began their day with a high GI breakfast. Foods that stimulate insulin have been shown to increase calorie consumption at the next meal and research shows that if calorie intake is equal, eating lower GI food will result in weight loss.

Problems with the Glycemic Index

But there are a number of problems with relying completely on the index as a food guide. First, GI food measurements are imprecise. Generally speaking, the test is done several times and the results are an average of those outcomes.

For example, a baked russet potato has been shown to have a GI value as low as 56 and as high as 111. As a result, it is listed in the high 70s on most indexes. The GI index for fruit increases as it ripens and changes depending on the food processing method and time. Grinding or cooking will increase the GI as will cooking for longer periods of time.

The GI of any one food is also altered significantly based on what it is combined with. I recommend eating healthy fat, protein and fiber with every meal because it reduces insulin spiking and decreases the likelihood that higher sugar foods will be stored as fat. But how much you eat matters too: Some foods have a high GI but you likely wouldn’t eat a lot of them, so their overall “load” is lower, while others may be lower, but you are more likely to consume a good portion. And lastly, individual responses to carbohydrate digestion vary, as do insulin responses, and those responses have been shown to vary based on the time of day the food is consumed.

As a result, the Glycemic Index can be a helpful tool but should not be relied upon in absolute. It is helpful for making relative comparisons and tradeoffs. Something that falls in the 80s is a less healthy food choice than something that lands in the 40s. Generally speaking, it’s a good idea to minimize consumption of foods with scores over 55 on the GI. But some of those foods have great nutritional benefits, so that doesn’t mean you should never eat them. Instead, consume them in moderate portions, on occasion, combined with fiber, healthy fats and protein. It’s easy to see why a processed bakery product might need to be eliminated, but a potato or watermelon can be eaten in moderation.

Now let’s talk about how the Glycemic Index applies to pasta and rice compared to bread.

Bread, Potatoes, Rice and Pasta

In addition to being nutrient devoid, traditional white bread and most whole wheat bread (made from enriched white flour) is high on the Glycemic Index. Typical white or wheat bread and bagels fall in the 70s, while pita bread lands in the high 50s. I love a good French bread as much as the next person, but baguettes fall in the mid-90s!

As you go toward more whole grain products, the Glycemic Index declines, with multigrain bread in the high 40s and sprouted grain breads in the low to mid-40s. Whole grain, multi-grain and sprouted grains are lower GI choices that also offer more nutrient value. (Ezekiel bread, for example, is a complete protein source offering all nine essential amino acids and 18 amino acids in total, all from plants; it’s more than just bread.)

It seems logical that pastas would go much the same way as breads, with traditional white and wheat pastas being significantly higher glycemically than whole grain and sprouted grain versions. But that is not the case.

Earlier I said that white bread and baked potatoes have GI scores in the 70s, but there are some better potatoes choices: Boiled, new or sweet potatoes are all in the mid-50s. In addition, brown rice comes in at 55 on the GI, while white rice shows up between 56-64. (Note: Though the Glycemic Index between brown and white rice may seem close, brown rice has much greater nutrient density and is a better food choice.)

Even though some potatoes and brown rice have levels in the mid-50s on the GI, which makes them viable options on occasion, pastas have an even lower GI. During processing, ungelatinized starch granules get trapped in the sponge-like gluten (protein) network inside the pasta dough. This does not occur in the processing of bread or rice and as a result, pastas tend to have a lower Glycemic Index overall.

Traditional spaghetti comes in at 41 on the GI scale, with its whole-wheat version at 37, making these clear winners, with a few caveats.

An Exception: Brown Rice Pasta

There is one surprising exception: brown rice pasta. Brown rice pasta comes in at a whopping 92 on the Glycemic Index: A surprise to me since brown rice itself is not high on the GI and whole grain brown rice is a nutrient-rich food. I’m still researching what it is about the transformation from rice to pasta that makes brown rice so high on GI scale. But until I learn more, avoid brown rice pasta and stick to traditional pastas.

I do continue to recommend whole grain brown rice as a healthy, nutrient-laden option on occasion; it’s got a host of health benefits and comes in at 55 on the GI scale. (Asian noodles also have a relatively low Glycemic Index, so I recommend experimenting with udon, rice vermicelli or hokkein for variety.)

As always, try to limit serving size and frequency; we Americans tend to eat enormous plates full of pasta whereas Europeans eat much smaller portions. And always cook your pasta al dente: The longer you cook it, the higher the Glycemic Index, as the gelatinous protein network breaks down. (One GI table showed that spaghetti boiled for 10-15 minutes came in at 44, but when boiled for five minutes, it dropped down to 38. Regardless of the exact cooking time, which will vary by product, be sure not to overcook. Try for that al dente firmness that leaves more of the protein intact.)

When you do eat pasta, combine it with healthy fats, proteins and carbohydrates to create a balanced meal; here’s where fresh homemade vegetable sauces made with healthy fats can take your meal to a whole new health level. And here’s a tip if you are concerned about blood sugar: Add some acid like vinegar or lemon to help lower the GI of the meal.

While you do get some additional nutrient value from a whole grain, multi-grain or sprouted grain pasta, the glycemic difference of whole wheat is not significant versus traditional pastas. Some of the newer whole grain and sprouted grain versions have not even been tested yet and while their scores may be lower, the baseline for traditional pasta is pretty good to begin with.

While I encourage you to experiment and try some of these nutrient-rich grain products–variety in food choices is always a good thing–if the taste does not appeal to you, it’s OK to indulge in some traditional pasta on occasion. Mangia!

To your health!

Inger Pols
Editor of New England Health Advisory

P.S. We receive a lot of emails from our readers, but last week, we were honored to receive an actual paper letter! Not only that, but its content was so interesting and thought provoking that we published it on our website. Please take a moment to read it and add comments.

By Inger Pols

Today, we are going to begin another five-part series, looking at five food swaps you can make to take an unhealthy food choice and improve it, perhaps even turning it into a healthy choice. We’re going to start by looking at bread and learn why enriched flours are nutrient poor and how we can make better bread choices. To understand why most bread today wreaks havoc in our systems, we need to learn more about how wheat is turned into the flour that becomes our bread.

We know that consuming too much white sugar can be hazardous to our health, but many people are unaware that white flour reacts the same way in the body. It doesn’t taste sweet, but it does break down into glucose and create the same problems with blood sugar spikes that can lead to metabolic syndrome and Type 2 diabetes. In addition, white flour is devoid of any real nutritional value, so the calories we consume are empty and stored as fat.

A White Bread World

Whole wheat contains many nutrients including vitamins (vitamin E, vitamin B6 and niacin) and minerals (selenium, magnesium and phosphorus), as well as fiber, protein and antioxidants. It’s made up of the outside layer called the bran, a middle starch layer and the inside layer called the germ. Most of the nutrients are contained in the bran and the germ. Traditional flour making, however, strips away those two layers leaving just the middle or starch layer. This layer doesn’t have any fiber or nutrients to slow its absorption, so it is broken down and absorbed rapidly. (When you eat the whole grain, it is broken down and absorbed slowly and steadily without blood sugar spikes.) The processed version floods the body with too much sugar at once, spiking your blood sugar level and causing the excess sugar to be stored as fat.

Once stripped, the wheat is then often bleached and a few synthetic lab-created vitamins are added to replace what was lost. This process is what enables it to be called “enriched.” But there is nothing rich about this process of taking away a wealth of nutrients and leaving a poor imitation; there are dozens of vitamins and minerals in the original grain and only a few are replaced. Those that are replaced are usually lab-created versions that our bodies cannot absorb as well and they do not have the co-factors found in the original form that would afford full nutritional benefit. In fact, they can even cause some harm to people with sensitivities.

Flour is rich in B vitamins that work together in harmony and balance. The “enrichment” process adds back some synthetic B vitamins that then require the body to rebalance what is already present with what has just been added. The result can be a B-vitamin deficiency. If severe enough, it can manifest as insomnia, heart palpitations, muscle tenderness, fatigue, anxiety, depression or poor memory.

Manufacturers do this because the stripping process leaves flour with a finer texture, increases its shelf life and decreases its attractiveness to bugs. But if a bug won’t eat the flour because there is nothing to sustain its life, why should we consume it?

The original whole grain is also rich in fiber, which helps sweep waste out through the colon; the refined version has no fiber. If you want to try a science experiment, mix about a quarter cup of flour with four tablespoons of water and see what you get: The perfect white glue paste. Now consider what happens as that travels through your colon.
That waste is hard to remove, especially if, like the typical fiber deficient American, you do not have a bowel movement after every meal. Much of that waste will remain in the body creating the perfect environment for parasites to thrive on as well as adding some extra pounds.

But many people love bread, so how can we still enjoy it while minimizing the damage to our health?

Finding a Less-Harmful Bread

The first step is to get rid of the dangerous additives like partially hydrogenated oil and high fructose corn syrup.  If you can only do one thing, read the labels and find a bread without those additives. In a typical grocery store, that may not be an easy task! You may need to ask your market to carry breads without these additives.

The second step is to reduce or eliminate white flour breads. (Ideally this can be done in conjunction with step one, but I separated it for those who may feel overwhelmed and want to move slowly toward these changes over time.) If you can’t eliminate it completely, try to cut down to two to three white bread portions a week. When you do eat it, always eat it as part of a balanced meal with proteins and healthy fats.

Read the labels of the products you buy and put back anything that says enriched flour on it. Look for a true whole grain product. Be aware that most whole wheat breads are nothing more than enriched white flour with caramel added and are often no better for you than white bread. You want whole grain, (100% whole wheat is fine), but read the ingredient label not the marketing slogans and look for 100% whole grains. Multi-grain combination breads are also good. Keep in mind that true whole grains will lose their nutritional value within days of grinding, so they need to be consumed quickly or frozen.

Making those changes will take your bread from being an unhealthy addition to your diet to one that can be a neutral element when consumed in balance. But if you want to take it to the next level, and make your bread something that can actually be a part of a good healthy diet, consider moving toward sprouted grain products.

A Healthy Approach to Bread

All grains, nuts and seeds contain something called phytic acid, which blocks the absorption of minerals. In addition, grains have enzyme inhibitors and compounds that can irritate and inhibit digestion. When grains have been used traditionally, native peoples knew that to avoid these problems, grains needed to be soaked and sprouted. This process not only eliminates the phytic acid concerns, it increases the nutritional value.

The only bread in my house is Ezekiel bread, a dense sprouted grain bread. I keep it in the freezer and use it for the kids’ sandwiches for school. By the time the kids open their lunch bags, it’s thawed and ready to eat. If they want it now, we toast it. It has a chewier texture and richer flavor that can take some getting used to if you have lived on white bread, but once you get used to it, you’ll find white bread uninteresting and bland. You can get Ezekiel bread (and English muffins) in the freezer section of the organic aisle at most grocery stores; I get mine at Hannaford. It’s also available at Whole Foods and Trader Joe’s.

Some other healthy options include Alvarado Street Bakery and Shiloh Farms Bakery, which you can find online. And if you need to be gluten free or want to reduce gluten, Cybro’s makes gluten-free sprouted-grain breads and you can find them online, too. If you look around, you’ll find many options in your local organic markets and you’ll likely find local organic bread makers nearby as well.

If you are a baker, you can look for whole grain and sprouted grain flours or try brown rice flour. I do not have any white flour in my house: If I bake, I typically use brown rice flour, which doesn’t spike blood sugar levels like white flour. I find it easily in the organic section of any large supermarket.

You may be ready to make a big change and jump to sprouted grain products immediately and if so, that’s great. But if traditional bread is a passion, you don’t need to give it up completely. Keep your favorite staple, try to cut back on the frequency, eat it in balance with fiber, protein and healthy fats, but add some healthier options in as well. Experiment with different types of breads, and slowly try to move toward healthier choices. You may just find that as you experience the richer flavors of whole and sprouted grains, your taste for the white flour products will dissipate over time.

To your health!

Inger Pols
Editor of New England Health Advisory

P.S. Connect with me on Twitter and Facebook!

By Al Sears, M.D.

If you enjoy breakfast or lunch on-the-go, I understand. Our lives are so busy; we don’t always have time to cook.

But beware: Some “convenience foods” aren’t worth it. You’ll pay for it with added inches to your waistline. And those excess pounds lead to chronic diseases like obesity, cancer, and heart disease.

Here are three foods that will put you on the fast track to fat:

Breakfast Cereal: This one is a little deceptive. No one thinks of cereal as being a threat to their health.

But no matter which one you choose, breakfast cereals are high on the glycemic index (GI). For many people, a dose of high-glycemic carbs in the morning is the prescription for building excess body fat.

You’d almost be better off eating a candy bar or a piece of cake.

The GI of an average piece of chocolate cake is between 31 and 38… a Snickers bar is about 43. Not bad.

Compare that to the GI of Kellogg’s Corn Flakes… which registers a whopping 132. That means corn flakes break down into sugar in your bloodstream faster than pure glucose!

And if you add fuel to the fire by putting sugar on your cereal, you’re sending an overwhelming surge of sugar into your system.
Remember, high blood sugar triggers a wave of insulin. And insulin is the hormone that sends the message to build and store fat.

Even “healthy” cereals like Grape-Nuts have a GI of 80. That’s also very high.

It might be a fast fix when you’re rushing in the morning, but cereal in the morning will make you fat. Avoid it at all costs.

French Fries: Possibly the worst foods you can eat. First off, potatoes are high-glycemic and not good for you in any form. But when you take potatoes and deep-fry them in trans fatty oil, you have a recipe for sickness and disease.

While white potatoes aren’t the best choice, the oil they’re cooked in adds much more danger than the potatoes do. If you need a potato fix now and then, opt for a baked potato or, better yet, sweet potatoes. They’re loaded with carotenoids, vitamin C, potassium, and fiber.

Bagels and Breads: Don’t fall for the “whole-grain goodness” trap. When it comes to the glycemic index, it matters very little whether breads are made from whole grain or not. Grains spike your blood sugar, and you know what that means.

Forget about the commercials you see on TV. Unless you are very poor and can’t get enough calories without them, you should avoid grains at least until you get as lean as you want to be. You’ll be better off without them.

In the morning, take a few extra moments and scramble some eggs. Before you throw the eggs in, sauté some sliced tomatoes and spinach. Maybe some onion, too. In less than 10 minutes, you can have a breakfast that will make you feel pumped and energetic for the whole morning.

And if you need a fast lunch, try a wrap instead of a sandwich. More and more restaurants offer wraps these days. They come in all styles – spinach is my favorite. (Try and avoid the heavy flour tortillas.)

To your good health,

Al Sears, M.D.

Bibliography

1.    Whitehouse MW, Macrides TA, Kalafatis N. “Anti-inflammatory activity of a lipid fraction (Lyprinol®) from the N. Z. green-lipped mussel.” Inflammopharmacology. 1997;5:237-46.