Beans for All Ages

1. Beans for All Ages Donna M. Winham, DrPH Department of Nutrition Arizona State University Polytechnic Mesa, Arizona, USA July 22, 2008

2. My interests in beans • Do beans make a difference in health? (biomedical trials) • If so, how to keep beans in the diets of those who will benefit? 2

3. Topics for today • Review some of the known health benefits of beans • life cycle perspective • Suggest future research questions 3

4. Disclaimer • Use of word “beans” is meant to include other legumes such as peas and lentils

5. Life cycle perspective • What is it? • Long-term health effects of events and exposures in early life • In other words, recognition of the influence and effects of each life stage on later health

6. How does this relate to beans? • Diet and lifestyle effect • child growth • disease risk • length of life • Important: Behavior patterns in childhood continue as adults • Parents teach children food preferences and tastes 6

7. Want to increase bean consumption? • Focus on getting children to like them ... • Target parents to encourage beans with their children • Emphasize health benefits as appropriate for age & life stage

8. Health benefits of beans • Usually emphasis on middle-aged adults • Chronic diseases • Motivation • Benefits extend before - and beyond - middle age though

9. and Heart Disease

10. Reduction in Heart Disease Epidemiology studies of legumes and reduced risk of coronary heart disease Bazzano et al., 2001 NHANES I national data. Legumes eaten 4+ time per week associated with 22% lower risk of CHD over 19 yrs follow-up

11. Cholesterol Reduction Since 1980s, clinical studies have shown improvements in cholesterol mostly using baked beans, navy or white beans. Chickpeas similar effect (4%) Pinto beans more recent (~8%) BHA funded studies- ASU & USDA-ND Many other varieties & species not investigated

12. Reduction in cancer risk fruit & vegetable consumption linked with cancer reduction Seventh Day Adventist health study suggests that eating legumes >2x/week reduces colon cancer risk by 47% (Singh & Frazer, 1998)

13. Risk of type 2 diabetes Epidemiological data Low glycemic index foods may protect against type 2 DM (Schulze, 2004) Legumes are high-fiber, slow release carbohydrates with a low glycemic index 13

14. Beneficial effects of low glycemic index foods Low GI Foods may lower risk for developing type 2 DM Improve glycemic control Improve blood lipid profile Improve insulin sensitivity 14

15. Glycemic Index Reference is 100 GI values of individual beans low: Canned baked beans (48) Pinto beans (42) Split peas (32) Butter beans, lentils (29) Kidney beans (28) Black beans (20)

16. More research needed on GI of beans as part of a meal 

17. Health benefits of beans for preconception and pregnancy High fiber Weight control  Satiety  Constipation Folate  Birth defects Natural source 17

18. Health benefits of beans during childhood Folate, fiber, satiety, minerals Complex carbohydrate Higher nutrients than some foods, e.g. French fries Time to establish bean eating habit 18

19. Health benefits of beans- adolescence & early adulthood Quick and easy snack or meal Weight loss Vegetarianism Celiac Disease: beans are a gluten-free food 19

20. Multi-country study Japan – soy, tofu, natto, miso Sweden – brown beans, peas Mediterranean – lentils, chickpeas, white beans 7-8% reduction in mortality hazard ratio for every 20 gram increase in legumes per day Darmadi-Blackberry et al., 2004 Asia Pacific J Clin Nut Legumes linked to longevity

21. Health benefits for elderly • Folate intakes linked to  in Alzheimer’s disease • Beans are relatively  in folate • Synthetic folic acid may be associated with  rates of colon cancer in middle-aged to elderly Photo by William Utermohlen

22. Beans = good health + +

23. Actual Consumption • Despite 20+ years of the fruit and vegetable message, ...“Mean intakes of dark green vegetables, orange vegetables, and legumes are one third or less of recommended amounts...” Guenther PM, et al. J Am Diet Assoc. 106(9), Sep. 2006 23

24. Current Recommendations • Beans and peas are in two food groups in MyPyramid • Meat and Bean group • Vegetable group • 2005 Dietary Guidelines recommend that consumers triple their bean intake to three cups/week 24

25. MyPyramid suggests: “Vary Your Veggies” “Aim for this much every week:Dark green vegetables= 3 cups Orange vegetables = 2 cups Dry beans & peas = 3 cupsStarchy vegetables = 3 cups Other vegetables = 6 1/2 cups” 25

26. Mean daily intakes of fruit and vegetable subgroups, as a proportion of amounts recommended,* by adults age 31-50 years, estimated from the 1999-2000 NHANES * Total Fruits Dark Green Vegetables Orange Vegetables Starchy Vegetables Other Vegetables Legumes *Assuming 2 servings per cup Note: M = male and F = female Guenther PM, et al. J Am Diet Assoc. 106(9), Sep. 2006 26

27. How to increase? • Several directions to take to increase bean consumption • Education • Marketing • Personal health benefits • Inter-related to each other • (Not exclusive list)

28. Many people are unaware that beans are a vegetable Source: TNS telephone omnibus, September 2006, n=1,004 *Excluding green beans, baked beans and Pork & Beans 28

29. Education • Continue promotion of the ‘beans are a vegetable’ message • Not just consumers! Need to target dietitians, school lunch, nurses, MDs, other health professionals, etc.

30. Education • Name and food class issues – word ‘legume’ misunderstood as is ‘bean’ • Green bean consumption is good too, so should we care?

31. Substitute beans for a starchy vegetable White potatoes are the most common vegetable eaten by Americans – often as French fries Beans have similarities to potatoes Hot side dish Satiety factor Easy to prepare Convenient 31

32. Beans for White Potatoes at Meals? Beans offer more than potatoes for some key nutrients such as: Protein Fiber Folate Calcium ...and for about the same amount of calories and a lower glycemic index Plus beans have greater variety than white or red potatoes 32

34. Research on Beans and Flatulence Based on two BHA studies using the recommended serving size of ½ cup of pinto beans, we found that: 50% or fewer of the people ever experienced increased flatulence the first week By the 4th week of consumption, only 6-23% still had increased gas Too much worry? 34

35. Education • Address issues of flatulence openly with consumers • Research study needed on specific perceptions of flatulence from bean consumption by consumers • We did this, but secondary to study design

36. Education • Address (mis)perceptions about dried legume varieties • Length of time to cook – crockpot; microwave; faster cooking varieties, e.g. lentils • Negativity towards canned foods as ‘unhealthy’

37. Marketing • Must be scientifically sound and credible • Targeted across the life cycle to specific group needs • Multiple messages must not conflict

38. People want foods with health benefits U.S. Grocery Shopping Trends, Food Marketing Institute 2007

39. Selected research gaps • Cholesterol lowering effects of other legume varieties, ex: black-eyed peas, fava beans • Need documented individual effects before proposing a mixture of legume types • Dose response – is ½ cup 2 x day ‘better’ than ½ cup?

40. Selected research gaps • Legume effects on lowering the glycemic response or after meal rise in blood sugar in: • Normal people • those with diabetes • Is this solely a function of fiber or ?

41. Selected research gaps • Perceptions of beans by clinical and nutrition health professionals • Baseline data on opinions & knowledge • Education efforts • If not recommending, hard to boost usage by consumers

42. Selected research gaps • Legumes and athletic performance at several levels • Endurance athletes • Children’s sports teams, e.g. soccer, baseball

43. Global research gaps Beans in the traditional diet Each geographic area or culture has characteristic legumes Fava beans in Middle East Pinto beans in Latin America Black-eyed peas in Africa Lentils in India Soybeans in Asia 43

44. Global research gaps • Changes in traditional diets • Why does bean consumption decline? • Mexican women in Phoenix • Only 28% of recent immigrants surveyed eating beans 5-6 tx/wk! • 93% buy bagged beans • Canned brands - Rosarita, El Mexicano

45. Global research gaps • Iron deficiency anemia and low folate levels major health problems • Beans may improve levels • High in content, but may not be bioavailable • Further research needed because important opportunity to improve global nutrition

46. Increase/substitute beans as staple food • Many beans more nutritious than other staple food products such as cassava, taro, or rice. • Cultural acceptability of eating more beans or incorporating beans into current diet patterns

47. Summary High nutrient value and their role in reducing the risk of certain diseases been known for decades Yet bean consumption lags far behind recommended levels 47

48. Summary Innovative strategies needed to dispel myths and to close the consumption gap between recommendations and practice Further research to answer questions and substantiate health claims to promote bean consumption based on sound science. 48