Do we know beans?

1. Do we know beans? 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) Cholesterol reduction Glycemic response or blood sugar control How to keep beans in the diet? Low-income minorities, Hispanics, AA General consumer beliefs 2

3. Topics for review Review some of the known health benefits of beans Suggest future research directions Possible funding sources Potential collaborations 3

4. 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

5. 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 5

6. 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

7. Health benefits of beans Usually emphasis on middle-aged adults Chronic diseases Motivation Influential group for their children, grandchildren, and their elderly parents

8. 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

9. 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

10. Cholesterol Reduction Many other varieties & species not investigated Will they be same? Maybe – but need to investigate – black beans, red kidneys for P. vulgaris sp. Other species? Black-eyed peas; favas; lentils, peas!

11. 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)

12. 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. 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)

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

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

16. Health benefits of beans for preconception and pregnancy High fiber Weight control  Satiety  Constipation Folate  Birth defects Natural source 16

17. Health benefits of beans during childhood Folate, fiber, satiety, minerals Higher nutrients than some foods, e.g. French fries Time to establish bean eating habit 17

18. Health benefits of beans- adolescence & early adulthood Quick and easy snack or meal Weight control Vegetarianism Go ‘green’ 18

19. Legumes linked to longevity 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

20. Beans = good health + +

21. 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 21

22. 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 22

23. 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” 23

24. 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 24

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

26. 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 26

27. 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.

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

29. 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 29

30. 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 30

32. 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? 32

33. 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

34. 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’

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

36. 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?

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

38. 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 ?

39. 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

40. Selected research gaps Legumes and athletic performance at several levels Endurance athletes Children’s sports teams, e.g. soccer, baseball Moms want what is good for their children and sports are important to many communities

41. 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

42. 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 in all situations Further research needed because important opportunity to improve global nutrition and child outcomes

43. 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

44. Getting research done • Government programs • USDA – Multiple programs • Private foundations • Pfeiffer Foundation • Community organizations • American Heart Association • American Diabetes Association

45. Getting research done • Change your angle to fit available funding • Beans – good quality food • Match to the health needs and/or media topic • Results in increased sales • Sound science, sustainable growth

46. Who can help with research? • Broaden contacts – not just agricultural scientists • Local university • Nutrition • Public Health • Anthropologists • Ethnic studies • Public Health agencies • State and county health departments • Women, Infants, Children (WIC) • Food Assistance program directors

47. Check credibility and reliability “New” researchers should be given a chance to prove themselves Be alert to track record of researchers though – benchmarks for quality research – peer review If sounds too good to be true, it probably is!

48. 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 48

49. Summary Qualitative and survey research needed to define myths and design strategies needed to dispel them Will aid in closing the consumption gap between recommendations and practice Further research to answer questions and substantiate health claims to promote bean consumption based on sound science. 49

50. Summary Look for research opportunities that benefit industry and communities as well as sales