Potatoes, Nutrition and Health

Abstract

Potatoes have been a dietary staple in the US and the world for centuries. Their hardiness, economy and nutrient density render them an invaluable crop. Potatoes contribute key nutrients to the diet including vitamin C, potassium, and dietary fiber. Despite their nutrient density, their impact on human health remains somewhat controversial. Animal studies and some human research indicates that potatoes and potato nutrients may positively impact risk factors for chronic disease including blood pressure, blood lipids and inflammation. Conversely, there observational data linking potato consumption to an increased risk of weight gain and type 2 diabetes purportedly due to the potato’s high glycemic index (GI). This review provides an overview of the nutrient content of potatoes as well as a critical evaluation of the existing research examining potatoes and potato nutrients in health and disease states.

Full text

INVITED REVIEW
Potatoes, Nutrition and Health
Katherine A. Beals
1
Abstract
Potatoes have been a dietary staple in the US and the world for centuries. Their hardiness, economy and nutrient density render them
an invaluable crop. Potatoes contribute key nutrients to the diet including vitamin C, potassium, and dietary fiber. Despite their
nutrient density, their impact on human health remains somewhat controversial. Animal studies and some human research indicates
that potatoes and potato nutrients may positively impact risk factors for chronic disease including blood pressure, blood lipids and
inflammation. Conversely, there observational data linking potato consumption to an increased risk of weight gain and type 2
diabetes purportedly due to the potato’s high glycemic index (GI). This review provides an overview of the nutrient content of
potatoes as well as a critical evaluation of the existing research examining potatoes and potato nutrients in health and disease states.
Resumen
Las papas han sido un alimento básico en los EU y en el mundo por siglos. Su resistencia, economía y densidad nutritiva la hacen
un cultivo invaluable. Las papas contribuyen con nutrientes clave a la dieta, incluyendo vitamina C, potasio y fibra dietética. A
pesar de su densidad nutritiva, su impacto en la salud humana permanece de alguna manera controversial. Estudios en animales y
algunas investigaciones en humanos indican que las papas y sus nutrientes pudieran impactar positivamente en los factores de
riesgo para enfermedades crónicas, incluyendo la presión sanguínea, su contenido de lípidos e inflamación. Por el contrario, hay
datos de observación que asocian el consumo de la papa a un riesgo cada vez mayor en aumento de peso y de diabetes tipo 2,
supuestamente debido al alto índice glicémico (GI) de la papa. Esta revisión proporciona una vista general del contenido
nutricional de las papas, así como una evaluación crítica de la investigación existente que examina la papa y sus nutrientes en
situaciones de salud y enfermedad.
Keywords Potatoes .Potato nutrition .Weight loss .Potassium .Vitami n C
https://doi.org/10.1007/s12230-018-09705-4
Published online: 19 December 2018
American Journal of Potato Research (2019) 96:102–110
#The Author(s) 2018, corrected publication 2019
Introduction
Potatoes have been a dietary staple in the US and the world for
centuries. The potatoes’hardiness made them the ideal crop
for the mountainous regions of Peru where fluctuating tem-
peratures, poor soil conditions, and thin air made it nearly
impossible to harvest wheat or corn. Today roots and tubers
are the third largest carbohydrate food source in the world,
with potatoes representing nearly half of all root crops con-
sumed (International Potato Center 2018). Potatoes contribute
key nutrients to the diet including vitamin C, potassium, and
dietary fiber (McGill et al. 2013). In fact, potatoes have a more
favorable overall nutrient-to-price ratio than many other veg-
etables and are an important staple worldwide (Drewnowski
2013,IPC2018). However, the impact of potato consumption
on human health remains somewhat controversial. Animal
studies and limited human clinical trials indicate that potatoes
and potato components may positively impact cardiometabol-
ic health (McGill et al. 2013) and some research suggests that
they promote satiety (Holt et al. 1995; Geliebter et al. 2013;
Akilen et al. 2016). Conversely there is some limited evidence
from observational studies linking potato consumption to an
increased risk of weight gain and type 2 diabetes purportedly
due to their high glycemic index (GI) (Halton et al. 2006;
Mozaffarian et al. 2011). This review will provide an over-
view of the nutritional value of potatoes as well as a critical
evaluation of the role of potatoes and potato nutrients in health
and disease.
The original version ofthis article was revised due to a retrospective Open
Access order.
*Katherine A. Beals
katherine.beals@hsc.utah.edu
1
Department of Nutrition and Integrative Physiology, University of
Utah,SaltLakeCity,UT,USA

Potato Nutrition –101
The nutritional data for the most commonly consumed forms
of potatoes are listed in Tables 1and 2. Note that there are two
sets of data for raw (uncooked potatoes) - USDA and FDA.
The USDA data are specific to the potato type analyzed, while
the FDA data represent a “market-basket”analytic approach,
utilizing a weighted average of the nutrients found in potato
varieties available to US consumers (USDA 2018). The fol-
lowing paragraphs provide an in depth look at the nutrient
content of potatoes.
Macronutrients
Potatoes are classified as “starchy vegetables,”highlighting
their predominant macronutrient—carbohydrate—and pre-
dominant type of carbohydrate—starch. Potato starch consists
of amylopectin (branched chain glucose polymer) and amy-
lose (straight chain glucose polymer) in a fairly constant ratio
of 3:1 (Woolfe 1987). A small proportion of the starch found
in potatoes is “resistant”to enzymatic degradation in the small
intestine and, thus, reaches the large intestine essentially in-
tact. This “resistant starch”(RS) is extensively fermented by
the microflora in the large intestine producing short chain fatty
acids which have been shown to lower the pH of the gut,
reduce toxic levels of ammonia in the GI tract, and act as
pre-biotics by promoting the growth of beneficial colonic bac-
teria (Higgins 2004; Brit 2013). Emerging research in animal
models and some limited human studies suggests that RS may
enhance satiety, positively affect body composition, favorably
impact blood lipid and blood glucose levels and increase the
amount of good bacteria in the colon (Brit et al. 2013, Gentile
et al. 2015,Higgins2014, Higgins and Brown 2013,Keenan
et al. 2015,Robertson2012, Zhang et al. 2015).
Potatoes contain two of the five subcategories of RS: RS 2
which is found predominantly in raw potatoes and RS3 that is
formed when potatoes are cooked and cooled such that the
starch gelatinizes and retrogrades (McGill et al. 2013). A re-
cent study examined the amount of RS in three popular potato
varieties (Yukon Gold, Red Norland and Russet Burbank)
prepared in two different ways (baked and boiled) and served
at three different temperatures (hot, chilled for six days, and
chilled followed by reheating) (Raatz et al. 2016). The results
showed that the RS content of potatoes varied significantly by
method of preparation and temperature but not variety. More
specifically, regardless of potato variety, baked potatoes had
more RS (3.6 g of RS per 100 g of potato) than boiled potatoes
(2.4 g of RS per 100 g of potatoes). Also on average, chilled
potatoes (whether originally baked or boiled) contained the
mostRS(4.3gofRSper100gofpotato)followedby
chilled-and-reheated potatoes (3.5 g of RS per 100 g of potato)
and potatoes served hot (3.1 g of RS per 100 g of potato).
Even processed potatoes (e.g., potato flakes) appear to re-
tain a significant amount of resistant starch. Han and col-
leagues (Han et al. 2008) examined the effects of the con-
sumption of various colored (white, red and purple) potato
flakes on cecal fermentation and fecal bile acid excretions in
rats. The results indicated that the ingestion of potato flakes
was associated with an increase in bowel short-chain fatty
acids (SCFA), probably through anaerobic bacterial activities
and fermentation of residual starch actions that are helpful for
the improvement of the colonic environment.
In addition to RS, potatoes contain dietary fiber—
approximately 2 g in a 5.3 oz. potato or 7% of the Daily
Va l u e —which is contained both in the flesh and the skin. It
is estimated that most Americans get only about half of the
recommended amount (i.e., adequate intake (AI)) of dietary
fiber and, thus, could benefit from consuming more fiber-rich
foods (DGA 2015). A study examining the contribution of
white vegetables to nutrient intakes found that white potatoes
Table 1 Energy and macronutrient content of different potato varieties and preparation methods
Potato variety Serving size Calories Total CHO (g) Fiber (g) Fat (g) Protein (g)
Raw Potato
+
5.2 oz 110 26 2 0 4
Russet (baked w/skin)* 1 small (138 g) 134 30 3 0 4
Russet (baked w/o skin)* 1 small (138 g) 128 30 2 0 3
Russet (microwaved w/skin)* 1 small (138 g) 145 33 3 0 3
Russet (microwaved w/o skin)* 1 small (138 g) 138 32 2 0 3
Potatoes (boiled in skin)* 1 small 138 g 120 28 2.5 0 2.5
Potatoes (boiled w/o skin)* 1 small 138 g 119 28 2.5 0 2
Red Potatoes (baked w/skin)* 1 small (138 g) 123 27 2.5 0 3
White Potatoes (baked w/skin)* 1 small (138 g) 130 29 3.0 0 3
Potato skin (raw)* 1 skin (38 g) 22 5 1 0 1
*USDA Standard Reference 28
+
FDA nutrition label information (Department of Health and Human Services 2016)
Am. J. Potato Res. (2019) 96:102–110 103

were positively associated with higher dietary fiber intakes
among both children and adults (Storey and Anderson
2013). Specifically, the results indicated, more than 20% of
dietary fiber intake was provided by white potatoes for 6 out
of 8 age groups for male potato consumers, and > 16% of
dietary fiber intake was provided by white potatoes for 6 out
of 8 age groups for female potato consumers.
Potato crude protein content is comparable to that of most
other root and tuber staples with approximately 2–4 g in a
medium potato (depending on the nutrition data utilized as well
as the potato variety and preparation methods) (Table 1). It is
also comparable on a dry basis to that of cereals and, with the
exception of beans, exceeds that of other commonly consumed
vegetables (Woolfe 1987;USFDA2018). Protein quality is
often expressed in terms of its “biological value”(BV) which
takes into account the amino acid profile of the protein along
with its bioavailability. Egg protein has a biological value of
100 and is considered the reference protein. Potatoes have a
relatively high BVof 90 compared with other key plant sources
of protein (e.g., soybean with a BV of 84 and beans with a BVof
73) (McGill et al. 2013). It is a common misconception that
plant proteins are missing or lacking one or more essential
amino acid. In fact, potatoes contain all nine essential amino
acids and, thus, are a “complete”protein (Woolfe 1987). In fact,
a recent study examining the protein and amino acid content of
commercially available plant-based protein isolates found that
potato protein was superior to other plant-based and was similar
to animal-based proteins in terms of essential amino acid con-
tent (Gorissen et al. 2018).
Peptides isolated from potato protein (e.g., potato protease
inhibitors) have been shown to have antioxidant activity in vitro
and some limited evidence from human studies suggests they
may have a favorable impact on serum lipids and may enhance
satiety (Hill et al. 1990;Kudoetal.2009; Liyanage et al. 2008).
However, it should be emphasized that these peptides are found
in relatively low concentrations in the whole potato, and wheth-
er the concentrations found in potatoes as consumed are
sufficient to produce the effects seen in studies using higher
concentrations of isolates remains to be determined.
Micronutrients
Potatoes contain a variety of essential vitamins and minerals
(Table 2) most notably vitamins C and B6 and the minerals
potassium, magnesium, and iron. A medium (5.2 oz) potato
provides 27 mg of vitamin C, qualifying it as an “excellent
source”of vitamin C per FDA guidelines. And while potatoes
may not rival the vitamin C content (in mg) of citrus fruits and
peppers, they do contribute significantly to daily vitamin C
requirements. In fact, data indicate that potatoes rank 5th in
terms of dietary sources of vitamin C for Americans (Cotton
et al. 2004;O'Neiletal.2012). Potatoes also contain the B
vitamins riboflavin, thiamin and folate and are a good source
of vitamin B6 (12% of the US daily value per serving).
Potassium is a mineral that is under-consumed by the majority
of Americans with only 3% meeting their daily requirement
(Drewnowski and Rehm 2013;DGA2015). Potatoes provide
one of the most concentrated sources of potassium (Table 2)–
significantly more than those foods commonly associated with
being high in potassium, such as bananas, oranges, and broc-
coli (DGA 2015)—and research suggests it is also one of the
most affordable vegetables in the National School Lunch
Program. (Drewnowski 2013). Magnesium is another nutrient
under-consumed by the majority of Americans (Volpe 2013).
A medium (5.3 oz) potato with the skin provides 48 mg of
magnesium and recent research indicates potatoes contribute
5% of the total magnesium intake in the diets of Americans
(Freedman and Keast 2011). And, while the iron content of
potatoes is not particularly high (1.3 mg or 6% of the US daily
value), the bioavailability of iron in potatoes exceeds that of
many other iron-rich vegetables owing to extremely low or
non-existent levels of antinutrients, chelators and ligands that
inhibit iron absorption (e.g., tannins, oxalates, phytates) and
Table 2 Selected micronutrient content of different potato varieties and preparation methods
Potato variety Serving size Vit. C
(mg)
B1
(mg)
B2
(mg)
B3
(mg)
B6
(mg)
Folate
(mcg)
K
+
(mg)
Ca
(mg)
Mg
(mg)
Fe
(mg)
Zn
(mg)
Raw Potato
+
5.2 oz 27 .12 .03 1.6 .2 24 620 20 33 1.1 0.4
Russet (baked w/skin)* 1 small (138 g) 11.5 .10 .07 1.9 .50 36 759 25 41 1.5 .48
Russet (baked w/o skin)* 1 small (138 g) 18 .14 .03 1.9 .41 12 540 7 34 .5 .40
Russet (microwaved w/skin)* 1 small (138 g) 21 .18 .04 2.4 .48 17 617 15 55 1.7 .76
Russet (microwaved w/o skin)* 1 small (138 g) 21 .18 .03 2.2 .44 17 567 7 34 .57 .46
Potatoes (boiled in skin)* 136 g 18 .15 .03 2.0 .41 14 515 7 30 .43 .41
Potatoes (boiled w/o skin)* 125 9 .12 .02 1.6 .34 11 410 10 25 .39 .34
Red Potatoes (baked w/skin)* 1 small (138 g) 17 .10 .07 2.2 .30 37 752 12 39 1.0 .55
White Potatoes (baked w/skin)* 1 small (138 g) 17 .07 .06 2.1 .30 52 751 14 37 .90 .48
Potato skin (raw)* 1 skin (38 g) 4 .01 .01 0.4 .09 6 157 11 9 1.2 .13
*USDA Standard Reference 28
+
FDA nutrition label information (Department of Health and Human Services 2016)
104 Am. J. Potato Res. (2019) 96:102–110

high levels of vitamin C, which has been shown to enhance
iron absorption. (Woolfe 1987).
A common misconception when it comes to potato nutri-
tion is that all of the nutrients are found in the skin. While the
skin does contain approximately half of the total dietary fiber,
the majority (> 50%) of the nutrients are found in the flesh
(Table 2). As is true for most vegetables, processing and prep-
aration methods do impact the bioavailability of certain nutri-
ents in the potato, particularly water soluble vitamins and
minerals. Nutrient loss appears to be greatest when cooking
involves water (e.g., boiling) and/or extended periods of time
at high temperatures (e.g., baking) (Table 2) (Bethke and
Janksy 2008; Woolfe 1987). Vitamin C is probably most im-
pacted since it is not only water soluble but, also, heat and
oxygen labile (McGill et al. 2013;Liu2013)(Table1).
Phytonutrients
Potatoes also contain a variety of phytonutrients, most notably
carotenoids and phenolic acids (Brown et al. 2005, Liu et al.
2013, McGill 2013) and are the largest contributor of vegeta-
ble phenolics to the American diet (Song et al. 2010).
Carotenoids, such as lutein, zeaxanthin, and violaxanthin,
are found mostly in yellow and red potatoes, although small
amounts are also found in white potatoes (Brown et al. 2005).
Total carotenoid content of potatoes ranges widely from 35 μg
to 795 μg per 100 g fresh weight. Dark yellow cultivars con-
tain approximately 10 times more total carotenoid than white-
flesh cultivars (Brown 2008). Anthocyanins are phenolic
compounds that are widely distributed among flowers, fruits
and vegetables and impart colors ranging from shades of red
to crimson and blue to purple (Hou 2003; Liu 2013). The
anthocyanins in greatest amounts in potatoes include acylated
petunidin glycosides (purple potatoes) and acylated
pelargonidin glycosides (red and purple potatoes) (Brown
et al. 2005). Chlorogenic acid, a colorless polyphenolic com-
pound, is a secondary plant metabolite and constitutes up to
80% of the total phenolic content of potato tubers (Brown
2005). It is distributed mostly between the cortex and the skin
(peel). Finally, quercitin is a flavonoid found in highest
amounts in red and russet potatoes (Brown 2005) and has
demonstrated antioxidant and anti-inflammatory properties
in vitro and in vivo (Kawabata et al. 2015). Further research
is needed to determine what role, if any these compounds,
may play in mitigating inflammatory responses in humans.
Glycoalkaloids are produced in potatoes during germina-
tion and serve to protect the tuber from pathogens, insects,
parasites and predators (Woolfe 1987;Friedman2006). The
primary glycoalkaloids in domestic potatoes are α-chaconine
and α-solanine and are found in the highest levels in the outer
layers of the potato skins (i.e., the periderm, cortex, and outer
phloem) (Friedman 2006). Glycoalkaloid levels can vary
greatly in different potato cultivars and may be influenced
postharvest by environmental factors such as light mechanical
injury, and storage (Friedman 2006). Small potatoes also tend
to contain higher levels of glycoalkaloids (per unit weight)
than larger ones.
In high concentrations, glycoalkaloids are toxic to humans
if ingested. Indeed, a number human case studies have docu-
mented illness (most notably gastrointestinal effects such as
nausea, vomiting, abdominal cramping and diarrhea) and even
death due to ingestion of significant amounts of potato
glycoalkaloids. What constitutes a “significant amount”varies
by country and whether it is an amount consumed (i.e.,
milagrams per kilogram body weight) or in the potato itself
(miligrams per kilogram of potato fresh weight). In many
countries (but not the US), the acceptable level
of glycoalkaloids has been set <200 mg/kg of fresh weight
(Friedman 2006). Re-examining dietary intakes from various
case studies, Morris and Lee (1984) calculated that the toxic
doses received were in the range of 2–5 mg/kg of body
weight, whereas a fatal dose was around 3–6 mg/kg of body
weight. Potential toxicity may also depend on whether the
glycoalkaloids are ingested in several small, chronic doses
or in larger, acute doses, the later of which seems to be more
toxic (Friedman 2006).
Similar to other plant phytonutrients, glycoalkaloids not
only have toxic effects but also beneficial effects including
cholesterol lowering, anti-inflammatory, antiallergic and anti-
pyretic effects (Friedman 2006). Research also suggests that
glycoalkaloids have anti-bacterial and antiproliferative (re:
cancer cells) properties in vitro (Friedman 2006), however
these effects have not been studied sufficiently in vivo.
All of this information notwithstanding, it bears emphasiz-
ing that amounts of glycoalkaloids in potatoes available for
human consumption are generally low and removal of sprouts
and peeling of the tissue approximately 3–4 mm from the
outside before cooking removes nearly all of the
glycoalkaloids (Friedman 2006).
Potatoes in the American Diet
Potatoes have been a dietary staple for centuries and currently
they are one of the most frequently consumed vegetables by
Americans (IPC 2018;USFDA2018;DGA2015). Potatoes
are not only well-liked, but they are versatile, economical and
contribute key nutrients to the American diet (Freedman and
Keast 2011; Storey and Anderson 2013).
The 2015–2020 Dietary Guidelines for Americans identi-
fied a number of “shortfall”micronutrients, i.e., vitamins and
minerals that are currently consumed in inadequate amounts
by Americans. These included, but are not limited to, potassi-
um and fiber (2015 DGA). Research indicates that that pota-
toes make significant contributions of key shortfall nutrients
Am. J. Potato Res. (2019) 96:102–110 105

to diets of Americans (Freedman and Keast 2011,Storeyand
Anderson 2013). Using NHANES 2003–2006 data,
Freedman and Keast (2011) examined the contribution of po-
tatoes 205 to nutrient intakes among children and adolescents.
The results indicated that potatoes contributed 10% of daily
intake of dietary fiber, vitamin B6, and potassium and 5% or
more of thiamin, niacin, vitamin C, vitamin E, vitamin K,
phosphorus, magnesium, and copper. Research also suggests
that adding potatoes to a meal may improve the overall nutri-
ent quality ofthe meal. Using data from 4-cycles (2001–08) of
the National Health and Nutrition Examination Survey
(NHANES), Drewnowski et al. (2011) evaluated the impact
of white potato consumption (baked, roasted, or boiled) on
energy and nutrient intakes in children and adolescents aged
4–18 yr. Approximately 10,600 lunches and 11,500 dinners
were characterized by place (at-home or away from home) and
by source of food (e.g., store or school cafeteria). The results
indicated meals containing white potatoes had significantly
higher amounts of vitamin C, potassium and fiber per
1000 cal than meals that did not contain potatoes.
Storey and Anderson (2013) examined the intake and nu-
trient contribution of total vegetables, white potatoes and
French fries in Americans aged 2 and older, based on national
dietary intake survey data from NHANES 2009–2010.
Individuals who consumed white potatoes had significantly
higher total vegetable and potassium intakes than did non-
consumers of potatoes. In addition, the proportion of potassi-
um and dietary fiber contributed by white potatoes was higher
than the proportion they contributed to total energy. Among
white potato consumers aged 14–18 years, white potatoes
provided 23% of dietary fiber and 20% of potassium but only
11% of total energy in the diet.
Potatoes are also economical, providing significantly better
nutritional value per dollar than many other raw vegetables
(Drewnowski and Rehm 2013). Drewnowski and Rehm
(2013) examined the nutrient density per unit cost of the 46
most frequently consumed vegetables as part of the National
School Lunch Program (NSLP) and found that potatoes and
beans were the least expensive sources of not only potassium
but also fiber. Specifically, potassium-rich white potatoes
were almost half the cost of most other vegetables, making
them more affordable to meet key dietary guidelines for good
health.
Potatoes and Potato Nutrients in Health
and Disease
Potatoes contain a number of nutrients and nutritional compo-
nents that may play a role in health promotion and reducing
the risk of chronic disease. These nutrients along with research
supporting their possible roles in human health are described
in the paragraphs below.
Blood Pressure/Hypertension
It is estimated that 29%–32% of American adults suffer from
hypertension (depending on the data source) and another 1 in 3
have pre-hypertension (CDC 2018). Research indicates that
diets low in sodium and rich in potassium may reduce the risk
of hypertension and stroke (Adrogué and Madias 2014;Appel
et al. 2006;Sethetal.2014;Yangetal.2011; Zhang et al.
2013). Although data from individual clinical trials have been
somewhat inconsistent, three meta-analyses of these trials have
documented a significant inverse association between potassi-
um intake and blood pressure in both non-hypertensive and
hypertensive individuals (Appel et al. 2006). Seth et al.
(2014) examined the association between potassium intake
and stroke in a cohort of 90,137 post-menopausal women and
found that a high potassium intake was associated with a lower
risk of all stroke and ischemic stroke, as well as all-cause mor-
tality in older women, particularly those who are not hyperten-
sive (Seth et al. 2014). The US Food and Drug Administration
(FDA) has approved a health claim for potassium and blood pres-
sure which states,“Diets containing foods that are good sources of
potassium and low in sodium may reduce the risk of high blood
pressure and stroke”(USDA FDA food labeling 2016).
Given their high potassium and low sodium content, pota-
toes would seem to be an ideal food to incorporate into a dietary
pattern for managing hypertension. Nonetheless, very few stud-
ies have specifically examined the role of potatoes in blood
pressure regulation and/or hypertension treatment. A recent ep-
idemiological study using data from Harvard’s well-known
Nurses Health Study I and II and Health Professionals
Follow-up Study cohorts concluded that a “Higher intake of
baked, boiled, or mashed potatoes and French fries was inde-
pendently and prospectively associated with an increased risk
of developing hypertension”(Borgi et al. 2016). However, clos-
er examination of the study results actually shows that the as-
sociation varied depending on which cohort was used as well as
which potato groupings were examined. In some cases the pos-
itive association between potato intake and hypertension was
seen only in women and in others potato consumption was
actually associated with lower risk for hypertension in men.
Furthermore, while the study recommends substituting non-
starchy vegetables for potatoes in order to ameliorate the poten-
tial increased risk of hypertension, the results actually indicate
this substitution was beneficial only for the two female cohorts.
In the male cohort, substituting non-starchy vegetables for po-
tatoes actually increased the risk of hypertension. What’smore,
substituting potatoes with other starchy vegetables (e.g., peas,
lima beans, corn and sweet potatoes) did not reduce the risk of
hypertension in any of the cohorts. It should also be emphasized
that epidemiological studies of this nature can only show an
association, not causation.
In contrast to the above-described epidemiological study,
two published human experimental trials indicate that
106 Am. J. Potato Res. (2019) 96:102–110

potatoes may favorably impact blood pressure. Nowson et al.
(2004) examined the effect on blood pressure of two different
self-selected diets: (1) a low sodium, high-potassium diet rich
in fruit and vegetables (LNAHK) and (2) a high- calcium diet
rich in low-fat dairy foods (HC) with a (3) moderate-sodium,
high-potassium, high-calcium diet high in fruits, vegetables
and low-fat dairy foods (OD) for four weeks. In order to
achieve a higher potassium intake, the subjects on the
LNAHK diet and OD diets were given a list of potassium rich
foods and instructed “to eat a potato a day.”The results indi-
cated both the LNAHK and OD produced statistically
significant decreases in blood pressure compared to the HC
diet; however, the decrease was greatest in the LNAHK diet.
In a more recent study, Vinson et al. (2012)fedpurple-
pigmented potatoes (Purple Majesty cultivar) to 18
overweight (average BMI of 29), hypertensive adult subjects
for four weeks in a cross-over design. Subjects in the experi-
mental group consumed six to eight small (~138 g),
microwaved purple potatoes twice daily, while those in the
control group did not consume potatoes. The results showed
that consumption of purple potatoes produced a statistically
significant reduction in diastolic BP by 4 mmHg (4.3% reduc-
tion) and also reduced systolic BP by 5 mmHg (3.5% reduc-
tion) compared to baseline. There were no significant changes
in weight, fasting glucose, serum lipids, or HbA1c during the
potato consumption period. It should be noted that this study
was conducted in a small sample of hypertensive adults.
Additional research with larger, more diverse samples are
needed to confirm these results.
Weight Management/Obesity
Overweight and obesity have increased significantly during the
last three decades both in the US and globally (Ng et al. 2014;
Flegal et al. 2016). Although it is generally accepted that dietary
patterns along with other key lifestyle behaviors (e.g., physical
activity) are more important than single foods when it comes to
obesity and weight management (Dietary Guidelines for
Americans 2015), potatoes have been singled out both in re-
search and the popular press as being somehow uniquely
obesogenic. In a highly-publicized study, Mozaffarian and col-
leagues (Mozaffarian et al. 2011) examined the association be-
tween specific foods and weight gain in three large cohorts
(Nurses Health Study I and II and the Health Professionals
Follow-up Study). The results of this prospective observational
study indicated that four-year weight gain was significantly
associated with the intake of potato chips, potatoes, sugar-
sweetened beverages, and unprocessed and processed red
meats. It is easy to jump to the conclusion that these foods
“caused”weight gain. However, it should be kept in mind that
this was an observational study and can only show association
not causation. It should also be noted that this study suffered
from a number of methodological limitations, most notably the
failure to statistically control for energy intake, a major over-
sight considering that excess energy intake is the primary de-
terminant of weight gain (Bistrian 2011).
A recently published systematic review sought to scientifical-
ly summarize the existing research regarding the relationship
between potato intake and obesity (Borch et al. 2016). In this
review the authors identified five observational studies that in-
vestigated the association between intake of potatoes and over-
weight and obesity. Study durations (i.e., the length of subject
follow-up) ranged between 2 and 20 y, and 170,413 subjects
were included with BMIs that ranged from normal to obese.
Two of the five studies examined showed a positive association
with measures of adiposity; however, both studies had moderate
risk of bias due to methodological weaknesses. The authors con-
cluded that existing epidemiological research does not provide
convincing evidence to suggest an association between intake of
potatoes and risks of obesity. More clinical/experimental trials
that can test for causality are needed. Nonetheless, there is evi-
dence to suggest that potatoes do not need to be excluded from a
weight management diet (Randolph et al. 2014).
Research from single meal studies suggests that boiled po-
tatoes are more satiating than equal calorie portions of other
common carbohydrate-rich foods (e.g. rice, bread and pasta)
(Holt et al. 1995;Leemanetal.2008; Geliebter et al. 2013).
However subjective measures of satiety do not always corre-
late with energy intake or changes in body weight. In the only
long-term intervention study to date to examine the specific
role of potatoes in weight management, Randolph and col-
leagues (Randolph et al. 2014) studied the effects of potato
consumption on weight loss in free living adults.In a 12-
week, 3-arm, randomized control trial, 90 overweight men
and women were randomly assigned to one of three dietary
interventions: (1) low GI, calorie reduced diet (500 kcal/d); (2)
high GI, calorie reduced diet (500 kcal/d); (3) control group
(counseled to follow basic dietary guidance including the
Dietary Guidelines for Americans and the Food Guide
Pyramid). All three groups were instructed to consume five-
to-seven servings of potatoes per week (approximately one
potato per day) and were provided with a variety of recipes
for potato dishes. Modest weight loss was observed in all three
groups (~2% of initial body weight) with no significant dif-
ference in weight loss between the groups, likely due to the
fact that the “control”group spuriously reduced their energy
intake to levels on par with the two intervention groups.
Additional research, particularly clinical trials are needed to
address the role of potatoes in weight management.
Glycemic Response/Type 2 Diabetes
Because of their carbohydrate content and supposed high gly-
cemic index (GI), potatoes are not only frequently restricted in
Am. J. Potato Res. (2019) 96:102–110 107

diabetic dietary guidance, but are also implicated in the devel-
opment of the disease (Halton et al. 2006). While there is some
limited epidemiological evidence suggesting an association
between high GI foods, including potatoes, and diabetes, there
are no clinical/experimental trials demonstrating cause and
effect. Halton and colleagues (Halton et al. 2006)prospective-
ly examined the association between potato consumption and
risk of diabetes in a large cohort of women (i.e., the Nurses
Health Study) who were followed for 20 years. The authors
concluded that potatoes (including baked, boiled, mashed and
French fries) were positively associated with risk of type 2
diabetes and cite the GI of potatoes as the likely mechanism
for the increased risk. In fact, a closer look at the results of the
study shows that once BMI was included in the statistical
model and controlled as a cofactor the association no longer
remained significant for baked, boiled or mashed potatoes
(Halton et al. 2006); only French fries remained significant.
Controlling for BMI is important because overweight/obesity
is the primary risk factor for type 2 diabetes (NIDDK website
https://www.niddk.nih.gov/health-information/diabetes/
overview/risk-factors-type-2-diabetes). It should also be noted
that the authors did not control for other dietary factors that
could account for the association, specifically red meats. In the
discussion section of the paper, the authors themselves admit
to this statistical faux pas, “White potatoes and French fries
are large components of a ‘We ster n pat tern ’diet. This dietary
pattern is characterized by a high consumption of red meat,
refined grains, processed meat, high-fat dairy products, des-
serts, high-sugar drinks, and eggs, as well as French fries and
potatoes. A Western pattern diet previously predicted a risk of
type 2 diabetes. Thus, we cannot completely separate the ef-
fects of potatoes and French fries from the effects of the overall
Western dietary pattern”(Halton et al. 2006). Finally, the hy-
pothesized mechanism for the association (i.e., the “high GI”
of potatoes) is unfounded. In fact, the GI of potatoes is highly
variable and depends upon the type, processing and prepara-
tion. In a study examining the GI of potatoes commonly con-
sumed in North America, GI values ranged from intermediate
(boiled red potatoes consumed cold: 56) to moderately high
(baked US Russet potatoes: 77) to high (instant mashed pota-
toes: 88; boiled red potatoes: 89) (Fernandes et al. 2005).
Another study examined the GI of eight varieties of commer-
cially available potatoes in Great Britain and reported a range
from 56 to 94 (Henry et al. 2005). French fries are reported to
have a GI lower than boiled potatoes (Leeman et al. 2008).
There are currently no published clinical trials examining
potato consumption as a causative factor in development of
diabetes. A recent systematic review of the existing observa-
tional studies identified five which showed a positive associ-
ation between potato consumption and increased risk of type 2
diabetes (including the previously mentioned study by Halton
and colleagues), five showed no association and two actually
showed that potatoes were associated with a decreased risk
(Borch et al. 2016). Again, it should be emphasized that ob-
servational studies cannot show cause and effect, only an as-
sociation. Moreover, it is difficult to tease out the effects of
single foods from larger dietary patterns and make any defin-
itive conclusions relative to the risk of type 2 diabetes. Thus,
randomized controlled intervention trials investigating the re-
lationship between potatoes and type 2 diabetes are needed to
separate potato consumption from other known risk factors.
Gut Health
While there is currently no official definition of “gut health,”in
an article published in the peer-reviewed journal, Biomed
Central Medicine, Bischoff listed some specific signs of gastro-
intestinal (GI) health, including normal bowel function, effec-
tive absorption of nutrients and subsequent adequate nutritional
status, absence of GI illnesses, normal and stable intestinal mi-
crobiota and effective immune status (Bischoff 2011). Potatoes
contain a number of nutritional components which may play a
role in supporting “gut health”as defined by Bischoff, most
notably fiber and RS; however, the research is still based largely
on animal and in vitro studies. As previously mentioned, both
fiber and resistant starch escape digestion in the small intestine
and enter the colon where they can provide fecal bulk thus
helpingtomaintainnormalbowel function. In addition, results
fromasystematicreviewandmeta-analysis suggest that some
types of RS undergo colonic fermentation and may function as
a pre-biotic, supporting the proliferation of the colonic micro-
biota (Higgins and Brown 2013;Shenetal.2017).
Finally, potatoes are gluten free, thus they are a key source
of nutrient dense carbohydrates in the diets of those with ce-
liac disease and/or gluten sensitivity. According to the
National Foundation for Celiac Awareness, an estimated 1 in
133 Americans, or about 1% of the population, suffers from
celiac disease and would benefit from reducing or eliminating
foods containing gluten. However, eliminating foods with
gluten can predispose individuals to nutrient inadequacies.
Shepherd and Gibson (2013) examined dietary intakes from
55 men and women who had been following a gluten-free diet
for two years and found inadequate intakes of fiber and several
micronutrients, including thiamin, folate, magnesium, calci-
um and iron. Potatoes provide a number of those nutrients
and thus are a key food for someone needing or wanting to
follow a gluten-free or gluten-restricted diet.
Summary/Conclusion
The potato has been a dietary staple for centuries and remains
a popular and frequently consumed vegetable today. Potatoes
contribute important nutrients to the diet including potassium,
vitamin C and dietary fiber. Observational data indicate that
108 Am. J. Potato Res. (2019) 96:102–110

potato consumption is associated with an increase in overall
vegetable consumption and dietary nutrient density among
children, teens and adults in the United States. Research sug-
gests that potato nutrients and components may havefavorable
impacts on blood pressure, satiety and 412 gut health; howev-
er, data from observational studies examining the effects of
consuming whole potatoes on body weight and disease risk
remain controversial. There is currently a lack of experimental
data regarding the impact of potato consumption on obesity,
weight management and/or diabetes; thus, randomized con-
trolled intervention trials investigating the effect of potato con-
sumption on various health outcomes and disease states are
needed to better isolate potato consumption from other known
risk factors. Until then, dietary guidance should continue to
stress the importance of healthy eating patterns that consist of a
variety of vegetables, including nutrient dense potatoes.
Open Access This article is distributed under the terms of the Creative
Commons Attribution 4.0 International License (http://
creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
distribution, and reproduction in any medium, provided you give appro-
priate credit to the original author(s) and the source, provide a link to the
Creative Commons license, and indicate if changes were made.
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