Columnists are taken to task about non-starchy carrots

Q: I have picked up some tips from your column, but as a licensed dietitian, I was disturbed to see you repeating common misinformation about carrots. You said that people with diabetes should be cautious about carrots, as they are a starchy vegetable. This is incorrect; carrots are listed on the diabetic exchange list as a low-starch vegetable. Indeed, their effect on blood sugar as determined by the glycemic index (a measure of blood sugar rise after consuming a food) is in the low range. You also failed to mention that peas are considered a starchy vegetable, though they are not as likely to raise blood sugar as potatoes.

A: Thanks for an interesting observation. When we checked the glycemic index database at the University of Sydney, we found a wide range of values for carrots, cooked or raw.

Clearly, carrots are more healthful than high-starch vegetables such as potatoes. The American Diabetes Association lists carrots as non-starchy vegetables, along with pea pods and sugar snap peas.

People with diabetes or pre-diabetes should consult a dietitian for guidance on meal planning. Keep in mind, though, that individuals may vary in their response to certain foods (mSystems, Sep. 29, 2020). As a result, personal experimentation monitoring blood glucose after eating makes sense.

Q: You’ve written about melatonin maybe helping to restrict gastric juices from splashing back up into the esophagus. Can you give me a link to that article? I have an appointment with my gastroenterologist soon, and I would like to discuss the information with him.

A: A recent review article characterizes the evidence on melatonin to ease GERD (gastroesophageal reflux disease) as of moderate quality (Nutrients, Feb. 5, 2022). The full text is available without a payment, so both you and your doctor can read it.

There are some individual studies, including one that concluded melatonin plus certain vitamins and phytonutrients was better than omeprazole against heartburn symptoms (Journal of Pineal Research, October 2006).

Finally, this summary suggests that melatonin can prevent the worst outcomes of GERD (International Journal of Molecular Sciences, July 2018).

Q: As a physician, I am intrigued that aspirin has cardiovascular protective effects, while other NSAIDs are deleterious. Is this due to their effects on platelets?

A: It all starts with hormone-like chemicals called prostaglandins.

They are made by proteins called cyclooxygenases (COX-1 and COX-2).

Aspirin blocks COX-1, which produces a pro-clotting compound in platelets, the sticky part of blood. This inhibition reduces the risk for blood clots.

NSAIDs inhibit both COX-1 and COX-2, which can lead to elevated blood pressure and blood clots. These drugs also interfere with the production of nitric oxide, a natural chemical that helps blood vessels relax and dilate.

The bottom line is that aspirin can reduce the risk of heart attacks and clotting strokes while NSAIDs increase the chance of both. Both aspirin and NSAIDs can be irritating to the digestive tract, and aspirin may increase the risk for bleeding.

In their column, Joe and Teresa Graedon answer letters from readers. Send questions to them via www. peoplespharmacy.com.

DREAMSTIME The American Diabetes Association lists carrots as non-starchy vegetables, along with pea pods.