Resistant Starch and Colon Cancer

Image Credit: Wikimedia Commons. This image has been modified.

The Answer to a Colon Cancer Mystery

Colorectal cancer is the third most common cause of cancer death in the world. Thankfully, the good bacteria in our gut take the fiber we eat and make short-chain fatty acids, like butyrate, that protect us from cancer. We take care of them, and they take care of us. If we do nothing to colon cancer cells, they grow. That’s what cancer does. But if we expose the colon cancer cells to the concentration of butyrate our good bacteria make in our gut when we eat fiber, the growth is stopped in its tracks. If, however, the butyrate stops, if we eat healthy for only one day and then turn off the fiber the next, the cancer can resume its growth. So, ideally, we have to eat a lot of fiber-rich foods—meaning whole plant foods—every day.

What about the populations, like those in modern sub-Saharan Africa, where they don’t eat a lot of fiber yet still rarely get colon cancer? Traditionally, they used to eat a lot of fiber, but now their diet is centered around highly refined corn meal, which is low in fiber—yet they still have low colon cancer rates. Why? This was explained by the fact that while they may be lacking protective factors like fiber, they are also lacking cancer-promoting factors like animal protein and fat. But are they really lacking protective factors?

If you measure the pH of their stools, the black populations in South Africa have lower pH, which means more acidic stools, despite comparable fiber intakes. That’s a good thing and may account for the lower cancer rates. But, wait a second. Low colon pH is caused by short-chain fatty acids, which are produced by our good bacteria when they eat fiber, but they weren’t eating any more fiber, suggesting there was something else in addition to fiber in their diets that was feeding their flora. And, indeed, despite low fiber intake, the bacteria in their colon were still churning out short-chain fatty acids like crazy. But if their bacteria weren’t eating fiber, what were they eating? Resistant starch. “[T]he method of cooking and eating the maize [corn] meal as a porridge results in an increase in resistant starch, which acts in the same way as fiber in the colon,” as a prebiotic, a food for our good bacteria to produce the same cancer-preventing, short-chain fatty acids.

As I discuss in my video Resistant Starch and Colon Cancer, “[r]esistant starch is any starch…that is not digested and absorbed in the upper digestive tract [our small intestine] and, so, passes into the large bowel,” our colon, to feed our good bacteria. When you boil starches and then let them cool, some of the starch can recrystallize into a form resistant to our digestive enzymes. So, we can get resistant starch eating cooled starches, such as pasta salad, potato salad, or cold cornmeal porridge. “This may explain the striking differences in colon cancer rates.” Thus, they were feeding their good bacteria after all, but just with lots of starch rather than fiber. “Consequently, a high carbohydrate diet may act in the same way as a high fiber diet.” Because a small fraction of the carbs make it down to our colon, the more carbs we eat, the more butyrate our gut bacteria can produce.

Indeed, countries where people eat the most starch have some of the lowest colon cancer rates, so fiber may not be the only protective factor. Only about 5 percent of starch may reach the colon, compared to 100 percent of the fiber, but we eat up to ten times more starch than fiber, so it can potentially play a significant role feeding our flora.

So, the protection Africans enjoy from cancer may be two-fold: a diet high in resistant starch and low in animal products. Just eating more resistant starch isn’t enough. Meat contains or contributes to the production of presumed carcinogens, such as N-nitroso compounds. A study divided people into three groups: one was on a low-meat diet, the second was on a high-meat diet including beef, pork, and poultry, and the third group was on the same high-meat diet but with the addition of lots of resistant starch. The high-meat groups had three times more of these presumptive carcinogens and twice the ammonia in their stool than the low-meat group, and the addition of the resistant starch didn’t seem to help. This confirms that “exposure to these compounds is increased with meat intake,” and 90 percent are created in our bowel. So, it doesn’t matter if we get nitrite-free, uncured fresh meat; these nitrosamines are created from the meat as it sits in our colon. This “may help explain the higher incidence of large bowel cancer in meat-eating populations,” along with the increase in ammonia—neither of which could be helped by just adding resistant starch on top of the meat.

“[T]he deleterious effects of animal products on colonic metabolism override the potentially beneficial effects of other protective nutrients.” So, we should do a combination of less meat and more whole plant foods, along with exercise, not only for our colon, but also for general health.


This is a follow-up to my video Is the Fiber Theory Wrong?.

What exactly is butyrate? See:

For videos on optimizing your gut flora, see:

Interested in more on preventing colon cancer? See:

If you’re eating healthfully, do you need a colonoscopy? Find out in Should We All Get Colonoscopies Starting at Age 50?.

When regular starches are cooked and then cooled, some of the starch recrystallizes into resistant starch. For this reason, pasta salad can be healthier than hot pasta, and potato salad can be healthier than a baked potato. Find out more in my video Getting Starch to Take the Path of Most Resistance.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Discuss

Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.


106 responses to “The Answer to a Colon Cancer Mystery

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  1. I love that series.

    I am interested in more things about short-chain fatty acids.

    The gut/brain axis and I am also wondering about what they call the paradoxical effect of butyrate on glucose and lipid metabolism with regard to obesity.

    Do the supplements work?

    And, no, I am not trying to get out of eating my beans and fiber and starches.

    Butyrate is a very popular supplement and I wonder if it does work.

    1. They said that it stimulates the vagal nerve and affects appetite, but I am not sure which direction.

      They mentioned the word, “paradoxical” and I like vagal nerve stimulation very much because it helped me to conquer blueberries and turmeric and cherries and oatmeal and other things, but does vagal nerve stimulation make you hungry or decrease hunger?

      I think I lost another pound. It is ridiculously hard to tell, but I think I might have lost 3 pounds since going off of avocado and mostly lowering nuts. I am going to try 1/3 of an ounce eventually, but I needed to see if I could lose weight at all. I have been working on my thyroid and that might have been sluggish, but either way, I may have lost 3 pounds.

      I am going to up my exercise now to see if I can get my ounce of nuts back, but I have a ways to go before that will happen.

  2. I also wonder about the resistant starch, which they sell.

    Any benefit of it?

    Can you eat your potatoes hot and sprinkle some of that in?

  3. “When you boil starches and then let them cool, some of the starch can recrystallize into a form resistant to our digestive enzymes. So, we can get resistant starch eating cooled starches, such as pasta salad, potato salad, or cold cornmeal porridge.If Starch is made Resistant by cooking and then allowing to cool.”

    By that logic, frozen pasta dinners must be high in Resistant Starch content.

    For those low on fiber, why not just consume your minerals (Ca, Mg, Na, K, etc.) in the form of (mono/di-) butyrate salts, and your oils in the form of butyrate triglycerides ?

  4. Nothing wrong with the content,it’s awesome to have this free resource,but what is up with all those gory photos one can’t unsee! Some of us like watching your videos while we eat/before we eat,well I’m certainly not hungry anymore!

    1. Eo,

      I understand what you are saying. The images are often fairly graphic.

      The one thing I will say is that some of the images being that graphic have helped me to understand things at a different level and have also helped me to take some things more seriously.

      1. An option where one can display the photos if one wants to view them by clicking on a button could be a good idea.Can’t be that difficult to put up.I’m sure one can look up gory photos if that motivates one/suppresses appetite… but for some of that it just makes this website aversive.

        IMO a diagram does a pretty good job at explaining things as a less gory substitute & if one finds the gory photos motivating then one can look them up online,instead of shoving them in people’s faces when one wants to read an article & has less control (can’t disable photos) when watching the videos.I also do not feel comfortable sharing the gory videos,which can come across as manipulating & fear inducing.Maybe that’s just me.

        1. Well, the videos, it doesn’t even affect me at all, except that it is the image you click on.

          I don’t find it manipulative. I find it showing reality.

          I am not sure that diagrams do work as well and I am saying that technically because I have been trying to study science and learn the mechanisms and diagrams do help, but seeing something real is what seems to help me more. I tend to need both.

          Dr. Amen always quotes a study that people who have a healthy fear of health issues are more likely to respond and change their behaviors. I will say that I had zero fear of health for most of my life. I ate junk food and drank 2 liters of soda and loaded up on cheese and butter and refined carbs into my fifties with no fear at all. I also wasn’t going to a doctor to help generate fear.

          I am more neutral about the images. I do find them useful, but some of them are just plain gross, which can affect me, particularly at lunch.

          In general, I want all of the visuals possible. I am a visual learner and I am probably not so good at learning things.

          I watch the videos, then, still have to read the transcripts and pause at the charts and graphs and then, go read the studies.

          I read the blog, and then have to go re-watch the videos and do the whole process again.

          1. When I looked at this photo today, what only came to mind when I looked at the polyp was that I have never had a colonoscopy in my whole life.

            I spoke with a woman, last year at an essential oil workshop at my friend’s house and we talked WFPB and I gave her the doctor’s names and I heard about her recently and she lost a lot of weight and was so excited, but she needed a colonoscopy and they found more cancer.

            I am probably not going to get one, but it is useful to me to really weigh the risks of my decisions.

            1. You should consider a sigmoidoscopy. It is less intrusive, and is much less dangerous as the scope does not go through the whole intestine. It is equally effective at detecting polyps and cancer according to what I have read.

          2. About the learning styles myth https://www.ncbi.nlm.nih.gov/pubmed/27620075

            I highly doubt most of us on here are studying medicine & need that extent of detail(there are of course a few). I thought the whole point of this website was to reach those who do not have this type of education where the videos & articles are short summaries of the studies available in simpler language.

            The key is in getting the balance right to a correct level of fear & that isn’t exactly always easy for the people who are ill & have come here to try to get their health back,they may already be in fear from having their families suffering from the major killers.Added stress probably isn’t very helpful in an already difficult situation & may just make things more overwhelming.(In the I can’t do it all so I might as well give up mentality)

            Some option allowing us to view the images if we want to or not would be the better choice,that way anybody who wants to see the gory images can.

            1. Eo,

              I am coming from serious brain damage and only have 5% function in more than one part of my brain. Learning styles may be a myth, but I have been trying to reverse brain damage and gain brain plasticity and that is why I am here.

              Plus, I had more than 5 symptoms of out of control Diabetes, plus a lump on my breast and eczema on one nipple. I had such bad eye problems that it was like my eyes couldn’t focus as if they were spinning, but the brain problems were the worst. I did the peanut butter left nostril test and it is so highly likely that I have Alzheimer’s and, no, I didn’t get examined for that either, but I had lost my mind and I am getting it back and this process is so important to me.

              I got to Dr. Greger last and he was the exact style of doctor I needed. He had over 500 short vidoes tagged Cancer when I got here and I was up all night long with hallucinations and night terrors and would watch his videos all night long until they started to make sense. There are moderators and YR who would bear witness to the fact that my name would be on posts all night long every night. I came from such a poor diet. I never ate fruits or vegetables or beans at all and hated spices and this site, just as it is, has changed my life.

              Honestly, the other doctors weren’t showing me pictures or charts and they weren’t posting links to the studies and that was my frustration with almost everybody other than Dr. Greger. Sometimes people like Dr. McDougall will show a chart, but mostly they just talk and it flies over my head.

              So, I just learned so much and I can’t even tell you because when my brain was tested and I was scoring 5%, I know that Dr. Greger being entertaining and showing pictures and graphs is such a big part of why I am learning even still.

              1. It may be that it is because I am trying to learn science trying to achieve brain plasticity and trying to get back things like the ability to know that time is passing and the ability to have executive function at all.

                I might need so much more than all of you put together to learn anything.

            2. I am fascinated that it is a myth.

              I tried to read the article and I couldn’t understand it because it didn’t have pictures.

              I don’t understand what subjective versus objective means.

              It is interesting to me because I have been around kids and they can’t learn if it is just in writing. They need pictures, until they can read. That always made me suspicious that there even could be people who learn better by hearing, but I have some friends who are musicians and ones in the film industry who can differentiate the most minor shifts and things like music literally flew over my head, but my relatives taught themselves music without training and I know that I have said that they were people who learned by hearing, but it is a myth. I also have friends who are artists who could draw exact likenesses of people so realistic that I don’t even understand how they could do it. Isn’t that a different part of the brain functioning better?

              So it is just subjective.

              Hmmm.

              1. I didn’t start learning the science until I went to music video lectures with pictures, plus, Dr. Greger with jokes.

                So, I don’t know, I feel like there are definitely ways I learn better and ways I can’t learn at all.

                1. What just crossed my mind is the very sweet mentally retarded and autistic people who I am around.

                  To call visual learner versus auditory learner a myth, means that people must learn the same and the woman who wrote the book about fixing her brain couldn’t read a clock and I have something similar, where I have a hard time recognizing faces and keeping track of time and anything, which changes.

                  You couldn’t make me memorize faces or ages or what date it is, anything that moves is a brain problem for me. Cooking was one, particularly because I had a grandmother who didn’t use bowls or measuring cups or spoons. She poured everything on the counter and used her hands and just washed the counter at the end, but she didn’t have recipes or pictures or anything and I could never learn by watching her do it and she couldn’t teach me any other way.

                  It feels like the myth is denying the reality of brains being so different.

                  1. My blind great-grandmother and blind friends and my deaf relatives and my cousin who works at a school for the deaf and Hellen Keller all just flashed before my eyes.

                    I am trying to understand the subjective versus objective part.

                    I think about the woman who was born without half of her brain and I think about people like my brother who could glance at a Stephen Hawking video and know in a split second that Steven Hawking wasn’t taking time into account in his theory and who could get the top score in his science classes without a book and without doing homework and teachers had to decide whether to fail him or not because it is hard to fail someone who gets 100 percent on every test and who is the only one who understands the labs.

                    1. The woman who changed her brain just kept working on clock faces and kept adding hands and by that I mean she added 12 hands to her clock and it not only helped her to finally understand how to tell time, suddenly she could understand philosophy books for the first time.

                      I almost throw up when I try to read philosophy books and I mean that literally.

                      It is like the War Games computer playing Tic Tac Toe with itself, but I am not sure what she did with all of the hands.

                    2. Maybe the hands are like bookmarks or sticky notes.

                      Kids watch one whole video on the O’Clock position and then the same music video for quarter after and another one for thirty, etc.

                      She still might have needed to reach past the symbolic clock and put one symbolic hand on time itself. Ten thousand little hands for the seconds and very very big hands for the seasons and even bigger hands for the years

                    3. I just realized that if we had 360 days, like the old Jewish calendar did, we could have had clocks which kept track of days and months and seasons and years

                    4. 14 of the ancient calendars were based on 360 days.

                      Chuck Missler has a Mars series and He talked about it in that.

    2. all those gory photos one can’t unsee!
      —————————————————
      And by association, will remember the message. ‘-)

      1. Lonie,

        Yes, there are some messages which I only took seriously and remember at all because of the photos.

        One in particular, didn’t seem like a topic I cared about or had ever heard of and the visuals caused me to take it seriously.

      1. Mims,

        Faster, but you miss Dr. Greger’s awesome reading and the charts and graphs and pictures and the visuals of the studies.

        I do both.

        So are we campaigning for what accent we wish for Dr. Greger to use for his hip replacement.

        Yes, the other kind of hip.

  5. Dr. John McDougall advocates for a starch-based diet that includes not just fiber-filled whole grains, but also white rice, white potatoes, and pasta. He notes that populations around the world that follow a starch-based diet are trim and less prone to cancer. Is resistant starch the reason why consuming even white rice and white potatoes can still lead to a healthy gut flora and good health?

  6. “Resistant starch. “[T]he method of cooking and eating the maize [corn] meal as a porridge results in an increase in resistant starch, which acts in the same way as fiber in the colon,” as a prebiotic, a food for our good bacteria to produce the same cancer-preventing, short-chain fatty acids.”

    I’m curious if taking a prebiotic supplement is also helpful in the production of butyrate?

    I know that generally supplements are les affective when whole foods but I’m not clear on the (potential) benefits, specifically in the case of colon cancer.

    1. I’m curious if taking a prebiotic supplement is also helpful in the production of butyrate?
      ——————————————————————————————————————-
      Good question… but for me, green bananas work quite well.

  7. Hi,
    I have a colonoscopy due next month. I’m vegan plant based since 3 years and finding it difficult to plan what to eat before a colonoscopy as a low fibre diet is essential. Please advise as I am so used to the daily dozen lifestyle.

    Thank you

      1. My mother in law died a year ago from colon cancer. She never had a colonoscopy and by the time it was detected it was too late. She was Japanese and ate a typical Japanese diet, not a lot of meat or junk food. I am sure if she could voice her opinion now, she’d recommend having at least one. I have had two and I had precancerous polyps both times, even though I have been a vegetarian since college (I am 72) and a WPF vegan for about 3 years. I am very glad to have those polyps out. As I mentioned in another post, making sure your doctor is a GE who routinely does them (hundreds per year) and has a sterling record is essential. The statistics cited that scare people are over a large group of doctors that includes incompetent ones.

        1. What scary things/stats are you referring to if I may ask? I had just about the worst 1st colonoscopy a person could have & I still realize they are necessary. They didn’t give me enough or inadequate anesthesia so I was wide awake for the full colonoscopy & it hurt like hell & hadn’t given me enough prep to thoroughly cleanse out my colon. So not only was I mortified from the inadequate prep, I was in hellash pain & told them it was hurting so bad & that if he didn’t get that camera out of my anus, I was going to come off the table & shove it up his. I actually physically tried to flee the table it was so painfu b/c the asshole (no pun intended) wouldn’t stop going further. This wasn’t a sigmoid or partial, but a full complete colonoscopy wide awake w/out any or botched anesthesia job. I’ll never go back to him but am due for another one since that one & have put it off b/c I don’t want the same to happen again. I want adequate anesthesia. It is extremely painful w/out any. I should have decked the doctor & wish I had now. The nurse actually had the nerve to tell me to calm down. CALM DOWN???! Let me shove this all the way up your ass 8 ft deep w/no anesthsia & see how CALM you are lady!! I swore I was in some horror movie. Incompetence all around. Beware of the surgery GI sites where you are just a # in a long line of patients that day they make a lot of money on getting as many done in a day & out as possible. I would know, ironically I managed a GI surgery center as a nurse & administrator before I needed one.

          1. Oh, that is awful. I can’t believe they didn’t stop and correct something.

            That is a horror story.

            I had a friend go through a root canal after a student dentist didn’t give him Novocaine properly and begged him to not say anything because it was his final exam or something like that.

            Yours is officially worse.

            1. Ouch, that root canal would be painful too but yeah, this doc that did this to me actually just kept going despite me being wide awake away & saying No, stop repeatedly b/c I could feel everything. I honestly think he just wanted to get it done & kept pushing it in further thinking I wouldn’t remember it. That’s when I actually leaned up & sat up on from the table & tried to jump down & leave & grabbed the tube to pull it out. They were clearly continuing a procedure against my will & forcibly keeping me there when they had already messed up & I said repeatedly to STOP & they wouldn’t. Gotta get their monies worth & quota for the day. smh. If I had been older & wiser I would have sued their asses for the traumatic event & abuse of patient & inadequate care & botched procedure but I just wanted out of there. I still remember it to this day & I was only in my twenties at the time. I’ve never went back for another since, been 15+ yrs ago & still makes me nervous to do again. I cannot describe how painful it was to have 8+ feet tube up in my colon w/movement with no anesthesia . Worse than childbirth x 100. I honestly thought I was going to die & that’s why I tried to flee the table b/c they would not stop! Do you your research on GI’s!!! Check complaints! Ask for adequate prep & anesthesia BEFORE you agree to one.

              1. The Cologuard where you just do a stool sample and the virtual version seem like so much less invasive options.

                I don’t understand that they did that to you in your twenties at all.

                I live in a place where I genuinely don’t trust any of the doctors I have met at all and they are so aggressive and so domineering and so medical model. I just can’t deal with them.

                On-line labs which On-line doctors prescribe are all I can handle.

                You can pay for full body scans for cancer and can do things like blood work.

                1. Deb,
                  Note that insurance might not cover a virtual colonoscopy (Medicare only covers it if the physician provides the reason a standard one cannot be done and Medicare approves).

                  Cologuard is intended for average risk people over 50.
                  https://www.cologuardtest.com/risk-information

                  “IMPORTANT RISK INFORMATION
                  Cologuard should not be used if you:
                  have a history of colorectal cancer, adenomas or other related cancers
                  had a positive result from another colorectal cancer screening test within the last 6 months
                  have a condition that places you at high risk for colorectal cancer, including Inflammatory Bowel Disease (IBD) or certain hereditary syndromes or a family history of colorectal cancer.”

                  While in some study Cologuard found 92% of cancers, it found only 42% of high risk pre-cancers.

                  To make an informed decision, it is essential to weigh all the risks and benefits. Not an easy decision.

          2. Wow, that sounds truly horrible. I had a somewhat similar but much less traumatic experience 30 years ago. An internist had just obtained a colonoscopy or sigmoidoscopy instrument and since I was complaining of intestinal problems, decided to use it for the first time on me without sedation. It was extremely painful, which was attributed to inflammation.

            Nevertheless as I said before, when I was 60 and 65 I had colonoscopies without any problems. The anesthesia used to sedate me used was propofol, which is the standard these days.

            Using a doctor and facility you trust is also important to make sure they are sterilizing the equipment properly.

            The scary statistics mostly have to do risk of perforations, which can be life threatening. The overall risks are very low, much lower than the risk of getting colon cancer. No doubt incompetent doctors drive the risk way up.

            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4264696/ Risk of colon perforation during colonoscopy at Baylor University Medical Center

            Daniel E. Polter, MD

            Additional article information Abstract

            Colonoscopy is an important procedure in preventing colon cancer. The risk of colonic perforation during colonoscopy at the Baylor University Medical Center (BUMC) Gastrointestinal Laboratory was chosen as a surrogate marker for the safety of colonoscopy. A recent 2-year experience at BUMC was examined and compared with reports in the medical literature. The results are presented here along with a discussion of problems inherent with different health care systems and their ability to accurately track complications. It was concluded that colonoscopy at BUMC is as safe as that reported by comparable health care systems. The risk of perforation at BUMC was 0.57 per 1000 procedures or 1 in 1750 colonoscopies. Continued efforts to make colonoscopy safer are needed.

    1. I am on a WFP diet. I have had two colonoscopies. I ate soy milk and soy ice cream the day before. The procedure instructions said to use dairy products but when I called the office, they said soy substitutes was fine. The key thing was the food had to have no particles.

      By the way, in my view there is a lot of fear mongering about colonoscopies. I have had two colonoscopies and have never had any problems. The important thing is to use a GE who does many hundreds per year and who has an excellent track record when it comes to results. Experience and track record counts. The statistics cited are averages over a large population, lumping incompetent doctors (perhaps not even GEs) in with those who are really skilled. My wife’s mother recently passed away from colon cancer. She never had a colonoscopy. It is quite likely she’d be alive today if she had had one.

      1. I also drank Pedialyte to make sure my electrolytes were sufficient and in balance. Dairy yogurt has quite a bit of potassium, I found, much more, it seems, than soy yogurt, which I also ate.

  8. This dr does not give any detail info on his clinical trials at all. How controlled was his studies and for how long. Be wary of this.

    1. Be wary of what and whom? IF you are talking about Dr Greger, he doesn’t do studies, he reports on them…and the links to them are all listed within the text.

    2. The videos linked have the links to the studies. This is a paraphrase of those videos. The videos, he reads from the studies and the resources are all linked.

  9. If you chill your cooked starches, (say over night) then rewarm them the next day, does it go from resistant to non-resistant starch.

    I cook polenta and place in several covered cups, for 3-4 meals. They are great cold for breakfast and have flaxseed and raisins in it.

    1. Ruthie,

      They did a test on a show called, “Trust Me, I’m a Doctor” which I read a long time ago.

      They cooked pasta and one group ate that.
      Then, one group ate the pasta cold.
      The third group ate the pasta after it had been cold and then it was reheated.

      It was the third group, which had the best blood glucose numbers, which was something they hadn’t expected. It reduced the rise in that third group’s blood glucose by 50 and they called it “even more resistant” but that was a television show. It was real doctors and real test equipment, but it wasn’t exactly a study.

        1. And here’s another on rice

          https://www.ncbi.nlm.nih.gov/pubmed/23945407

          Note long grain rice has the most resistant starch of the varieties tested.

          This is really fascinating.

          Effect of variety and cooking method on resistant starch content of white rice and subsequent postprandial glucose response and appetite in humans.
          Chiu YT 1, Stewart ML .
          Author information Abstract in English , Chinese

          Rice is a staple carbohydrate throughout much of the world. Previous work indicated that resistant starch (RS) content of rice consumed in India varied with rice variety and cooking method. This study quantified RS in 4 white rice varieties (jasmine, long grain, medium grain, and short grain) cooked in three manners (oven baked, conventional rice cooker, and pressure cooker), and analyzed for RS content immediately after preparation or after 3 days of refrigeration at 4°C. The rice varieties with the highest and lowest RS content were selected for a pilot- scale trial to characterize postprandial glycemic response and appetite ratings in healthy adults (n=21). Refrigerated long-grain rice cooked in a conventional rice cooker had the highest RS content (HRS, 2.55 g RS/100 g) and refrigerated short-grain rice cooked in a pressure cooker had the lowest RS content (LRS, 0.20 g RS/100 g). These rice samples were served reheated in the clinical trial. Glucose area under the curve (AUC) were significantly lower with HRS and LRS compared to glucose beverage; however, there was no difference between HRS and LRS. Glycemic indices did not differ significantly between HRS and LRS. Subjects reported an overall increased feeling of fullness and decreased desire to eat based on incremental area under the curve (iAUC) for both HRS and LRS compared to control. This study found that RS naturally occurring in rice had minimal impact on the postprandial glycemic response and appetite.

          1. Thanks, Gengo!

            I loved reading those!

            I was fascinated that the rice cooker had better results and the pressure cooker had the worst results.

            Dr. Greger is going to be doing a pressure cooker video soon. I think it was within the next 2 weeks, followed by Keto.

            I love my rice cooker. I hate my Instapots.

            I wonder what the difference between the 2 things are.

            Is a rice cooker more like a crock pot?

            I am trying to do the logic of how I should cook and I might do better with a crock pot.

            I can open the cover and stir, for instance.

            1. Deb, Right, rice cookers are great. We also cook oat groats and other whole grains in ours. We cook beans in our Instant Pot or veggie soup. That and steamed or raw vegetables makes up our meals. Simple.

              1. gengogakusha,

                I used to cook beans and grains in my rice cooker. Then I bought an electric pressure (Instant Pot), and I eventually gave my rice cooker away.

                I can cook my beans, even without pre-soaking, much faster and more consistently in my IP; this is true for grains, as well. (I can finally make polenta without burning and without lumps!!) Plus, I can make soups and stews, cook veggies, incubate yogurt, and more.

                Plus, once I figure out pot-in-pot cooking, I will be able to cook different kinds of foods at the same time.

                Oh, yes, I also bought an air fryer lid for my IP, so now I can effectively “oven roast” veggies in in IP! And it all is much more energy efficient, and keeps my house cooler, than using my stove top, oven, or even slow or rice cookers.

                So eventually, I gave away my nice Zozirushi rice cooker, and my slow cookers will be next to leave my house. (I do use my wall oven to bake bread — sourdough, whole grain, delicious).

                1. Dr. J, I didn’t even know you can cook beans in a rice cooker. I still presoak beans when using an Instant Pot because my wife likes the beans to dissolve. I think I would have a hard time getting her to give up her beloved Zozirushi rice cooker. I cook the beans and soup in an Instant Pot and she cooks the rice and grains in the rice cooker. Great division of labor.

  10. Should I add powdered potato starch to my morning smoothie? Some claim that there’s a health benefit to doing this – Dr. Mark Hyman is one and I see lots of articles about this online – but I want to hear what Dr. Greger says!

      1. It definitely increased Butyrate in the swine.

        I semi-joked about whether we could cook potatoes, make mashed potatoes and add in some resistant potato starch, but I asked maybe because Dr Greger said that only about 5 percent of starch may reach the colon.

        Can we up that by upping the amount of resistant starch in the dish?

        I know that we also eat beans and fiber, but there are also people who do drink smoothies.

  11. i wonder if the ‘ cooling ‘ is really needed. it may be just the heating/cooking is needed to loosen
    the starch to allow the rearrangement of the starch polymers. when you eat the cooked starch, by
    the time it gets through the stomach and into the upper intestinal tract it will be the same
    temperature regardless, so the starch should recrystalize into the resistant starch before too much
    is digested. or does the digestion process work so fast that if you eat warm starch it does not
    have time to crystallize into the resistant form? any data on the temperature range of
    crystallization?

    1. Well, what I am going to say to that is that if you had people eat potatoes, their blood glucose would rise by a certain amount.

      If you served them cold potatoes, the blood glucose doesn’t spike as much and that includes reheated potatoes.

      That means, to me, that it isn’t the same.

      Can you argue it further from the other side?

    2. Cooling is necessary. The effect is from retrogradation of the starch.

      https://en.m.wikipedia.org/wiki/Retrogradation_(starch)

      “If the viscous solution is cooled or left at lower temperature for a long enough period, the linear molecules, amylose, and linear parts of amylopectin molecules retrograde and rearrange themselves again to a more crystalline structure .”

      Retrograded starch is less digestible (more resistant).

  12. Regarding the amount of digested/undigested material putrefying in the colon, is there a difference if the only meat consumed is in a pâté form rather than a chewed bolus of solid meat? Would the pâté be better digested and absorbed than meat in the solid state, and therefore less likely to putrefy?

    Thanks!

      1. Thanks for your response, Deb. I guess I’m mainly concerned about a pâté that has been cooked and blended at home w/o any curing or nitrate processing. Just home-cooked liver, garlic and onion and a blender. Unappetizing for many, I know, but am looking for someone who takes this “medicinally” for Low RBC, High MCH and low protein but is otherwise Vegan and WFPB.

        1. Dr. Ruby,

          That may have a different answer.

          You can check PubMed, but it is hard sometimes to find the answers to very specific questions.

  13. Have I been laboring under misinformation? I thought Dr. Greger recommended a WFPB diet. What is with this statement at the very end of this article?
    “So, we should do a combination of LESS MEAT and more whole plant foods, along with exercise, not only for our colon, but also for general health.”
    WFPB means NO MEAT to me not less.

    1. Joan,

      Dr. Greger does encourage vegan, but WFPB has branches, which are 5% animal products, like Dr. Fuhrman and, actually a whole lot of doctors. Dr. Hyman calls it Pegan and so does Dr. Oz, Dr. Bredesen is meat a condiment and so is Dr. Axe, who isn’t a medical doctor, but he sure is popular.

      1. Deb,
        Actually it would be more accurate to say that while Dr. Fuhrman prefers no animal foods at all, he does recognize that some people do not thrive on a 100% plant food diet and in those special cases, recommends small amounts of animal foods.

    1. Patti,

      Dr. McDougall has had people healed of Stage 4 Cancer on The Starch Solution.

      He doesn’t allow refined flour or oil on his diet, but he does have people eating starch.

      Go to his site and look at the testimonials.

      You are using Keto logic and there is more than one diet to help against Cancer and Whole Food Plant-Based has testimonials. I know that Dr. Fuhrman Eat To Live has had testimonials on his Nutritarian plan, too.

  14. Let’s see, starches increase blood glucose and arterial inflammation which is what ultimately causes cholesterol to adhere to arterial walls thus causing heart disease. Also a diet high in carbohydrates increases you triglycerides which ultimately leads to weight gain and increase risk of diabetes. Diabetics have a much higher risk of heart disease because of glucose control, again carbohydrates ultimately metabolizes into glucose! Articles like this fly in the face of already proven medical studies to the dangers of high carbohydrate diets. Keto diets (low carb diet) also drastically reduces blood calcium levels which is directly linked to atherosclerosis.

    1. A clearer understanding of “carbs” would seem to clarify your confusion. It’s important to clarify when speaking about carbs if we’re referring to refined carbs such as simple sugars or complex ones, such as whole grains and potatoes. While there are certainly studies that cite the dangers of a high refined carbohydrate diet, studies focusing on diets with high concentration of complex carbs show the benefits of such diets. They hardly “fly in the face of already proven medical studies…” (Consider all the Blue Zone and Seventh Day Adventists studies)
      The good news is in a few days Dr. Greger will begin a whole series of videos on the Keto diet so if you have an open mind to the research done on the Keto diet, stay tuned.

      1. I guess my issue is the end result which is glucose. Complex carbs from plant form starches are broken down into glucose, maltotriose, and maltose by the enzyme amylase found in saliva and small intestine. These compound sugars are then broken down into simple sugars including maltase, lactase and sucrose. Although these complex carbs are broken down more slower, the end is still the same, a pesky dangerous thing called inflammatory sugar or glucose that affects dangerous arterial inflammation. Diabetics are warned against all carbs including complex because all will increase their serum glucose levels, just some more quickly. If you are younger and very active, one can “get away” with potatoes, most Americans are not physically active in jobs and most do not regularly exercise. Refined or not refined, the end result is glucose.

        1. Emanuel,

          Dr. McDougall, with The Starch Solution when people come to him with Diabetes, he said that he has to work with their doctors’ week 1 because they have to drop their Diabetes meds almost immediately.

          People get off all of their meds in a few weeks, if they are Type 2 Diabetes. Look up the site Mastering Diabetes and you will also see testimonials of Type 1 Diabetics, whose A1C’s have dropped.

          People who are Whole Food Plant-Based tend to have lower A1C’s than Keto diet people.

          Dr. Greger has a video about the mechanism. Keto works by lowering blood glucose mostly because fat doesn’t spike glucose. Whole Food Plant-Based works by getting the fat out of the Pancreas and the Pancreas of people with Type 2 Diabetes simply functions normally again.

          Type 1 Diabetes is more complicated, but the fact that so many people with Type 1 Diabetes do so well on high carb (again, see Mastering Diabetes site) I don’t understand the T1D mechanism as well.

          Neither Whole Food Plant-Based, nor Keto want people eating refined carbs or too much sugar.

          Joan-Nurse Educator mentioned the Blue Zones. The Adventists, the Okinawans, and other groups. People who live closer to Whole Food Plant-Based live longer, healthier lives.

          There is a burden of disease study and in that the risk factor for non-communicable diseases and the risk factors they found for people getting disease were:

          Not eating enough fruit
          Not eating enough vegetables
          Not eating enough whole grains
          Not eating enough nuts and seeds
          Not eating enough fiber
          Not drinking enough milk/getting enough calcium
          Not getting enough Omega 3’s balanced with Omega 6
          Too much sodium
          Too much red meat
          Too much processed meat
          Too many sweetened beverages
          Too many trans fats.

          1. Yes, I left Milk on the list, but recently, I learned that when Finland switched to a high dairy country, they started having people die from heart attacks in their 40’s and 50’s and started having the highest rate of Alzheimer’s in the world and that was based on the fat in the milk.

            They started improving their mortality from heart disease and improved it by 84% (I think it was that) by getting rid of saturated fats.

        2. Emanuel Stamathis,
          It’s hard to take you seriously when you have some of your basic terms mixed up, e.g. glucose is a monosaccharide, i.e. a simple sugar (by definition, a mono- or di- saccharide).

          >>>These compound sugars are then broken down into simple sugars including maltase, lactase and sucrose.

          Maltase and lactase are enzymes, not sugars; e.g. lactase (a protein) is the enzyme involved in breaking down the disaccharide lactose (glucose + galactose). Sucrose is a simple sugar, it’s a disaccharide (glucose + fructose) and as such must be broken down into glucose and fructose to be absorbed.

          >>> Although these complex carbs are broken down more slower, the end is still the same, a pesky dangerous thing called inflammatory sugar or glucose that affects dangerous arterial inflammation.

          It makes no sense to simply dismiss out of hand the critical role that the rate of absorption of whole-food carbs plays in human health (not to mention the nutrients and beneficial role played by fiber). There’s plenty of evidence showing that for most people, complex carbs consumed in reasonable amounts are health-promoting. You ignore the fact that it is over consumption of carbs, and in particular simple sugars, that are the root cause of health problems associated with carbs.

          Lack of adequate physical exercise is a serious problem. But the solution is not to load up on fat and shun unprocessed, high carb foods like sweet potatoes or whole grains, but to become physically active. Exercise itself is also anti-inflammatory. (Aside: exercise permits the uptake of sugar directly into muscle cells without the aid of insulin.)

          You mention diabetes, but that’s a special case (really, cases). Here again, you simply ignore the evidence supporting the health benefits of high(er) carb / medium or low fat diets for most people. To generalize from diabetics, a special case, to those who are not is wrong-headed. (Further, you overlook the fact that many type 2 diabetics do very well on relatively high, complex carb, lower fat diets. I won’t focus on this, since I think some do not.) Diets high(er) in complex carbs from whole foods is healthful for most people. The same cannot be said for low-carb/ high fat diets. Cf. e.g.

          https://www.drmirkin.com/nutrition/lowcarbohydrate-diets-can-harm.html

          By the way, you make a similar mistake in reasoning when you generalize from the Inuit to other, genetically quite distinct, populations. As I mentioned in another response to you, the Inuit genetically adapted to their traditional very high fat (high in omega 3), low carb diet. Generalizing from that population to others is unsound.

    2. Deb,
      Just because a “doctor” is popular does NOT mean they are knowledgeable nor correct in their statements. I follow Dr Greger because I believe he comes from the scientific point of view rather than the “popular” point of view. He was the reason I switched to WFPB and it has changed my life!
      I hear doctors and nutritionists say they don’t recommend WFPB because their patients would “never do it”. People will always do what they want but withholding information that might influence their decisions is criminal!

  15. Does Dr. Greger or someone else here have the recipes for African cornmeal porridge that are close to what was consumed in the research mentioned? I see recipes in google but was wondering if this group had one. Thanks.

  16. Speaking of GI issues, what do you recommend for people who are unable to digest vegetables – or, more specifically, can only eat liquid/ pureed foods? How to get in 2000+ calories without resorting to highly processed, sugar/milk/oil-based “nutritional supplements”? And what if I am supposed to get at least 25% of my calories from protein? Are protein powders recommended? What protein powder (or bar) brands are best? Thank you!

    1. If due to a medical condition you cannot eat foods unless they are liquid or pureed, you should be working with a knowledgeable dietitian. Have you discussed with your dietitian and doctor your concern about lack of fiber and approaches to overcoming that? You can certainly make smoothies that will give you 2000 calories, but that does not overcome the risks of not getting enough fiber. While legumes may not be as appealing pureed, you can certainly eat lentils, peas and other beans to get your protein in without resorting to protein powders. This site does not recommend brands, but again get your protein from foods not powders, even if they must be pureed. I hope this is helpful. You indeed have challenges, but eating healthy unprocessed plant foods may be even more important for you as you face medical challenges and need those nutrients.

    2. I don’t want to give a technical answer, but I want to point out that Dr. Greger gave the thumbs up to Hummus and said that beans being pureed didn’t lower their effectiveness.

      1. We were also talking about potato starch powder can be added to pureed foods.

        Beans and resistant starch both feed your gut bacteria.

        1. Watch his video on the beans.

          Doing smoothies and soup or juice does lower fiber, but beans still feed the good gut guys, even pureed.

  17. I may have lost 6 to 8 pounds.

    Going off the avocado and cutting way down on the nuts and walking on a treadmill are working.

    Yes, I am also treating my thyroid, but, well, something is helping and those are all of the somethings.

    It is hard to tell how much weight I am losing because there is an 8-pound swing between day and night for me, but I have started weighing myself morning and night and both of those numbers were 6 to 8 pounds less than where I started and those numbers didn’t have as much of a swing from each other. I may have the scale on a better part of the floor and may be standing on the same spot more consistently or I am losing weight.

    1. I might not be is what I will add back in because I didn’t have the 8-pound swing, so both of my numbers are closer to the low end of where I began so maybe I am being tricked by my scale. I don’t know yet.

    1. Inuits die young. There was a mistaken perception that they lived long lives and they don’t.

      Dr Greger and Dr McDougall have videos explaining that.

      1. The Inuits were dying in their 40’s and Westernizing actually improved their mortality rates, which never happens.

        Finland was another country which was eating high fat and was dying in their 40’s and 50’s.

        My family has that mortality rate with mist of the males.

        1. Cancer rate was ZERO! Heart disease was nil! Inuits we’re dying of infection because they had no Antibiotics! You are not informed enough with facts, medical studies and history to be consulting on very important health issues. READ instead of following you already preconceived loosely hypotheses. Low fat high carbohydrate diets since the 70’s have led to increasing diabetes and heart disease. Why is heart disease the leading side effect of diabetes, glucose control, not fat control. Cancer in real medical studies is not reduced by starchy diets.

  18. I have been noticing that the TV commercials have been alternating

    Burger King Impossible Burger

    Two other companies advertising they have meat or The Meat

    And MorningStar patties

    That seems a significant shift.

    1. I was very excited about the new Burger King Impossible Whopper until I did the research. Beware!  I have had the Impossible Burger (not at Burger King) and it is delicious.  However, the extraordinary high calories (630), fat (34 gr/11 saturated)  and sodium (1080) of the Whopper fail to make this a healthy alternative.  Might was well eat the regular Whopper.  If you care about the environment and your health go Plant Based Vegan and avoid ALL processed food including “junk” vegan food.

  19. So interesting! With Crohn’s disease I have always been worried about developing colon cancer later in life but this is definitely something I’ll have to ask my doctor about. Thanks for the information!

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