Panini, Diverticulosis, and Whole Wheat

Q: How do panini rate nutritionally?
Q: Is the plant-based diet recommended to prevent cancer appropriate for someone with diverticulosis?
Q: What is the best way to use whole wheat flour instead of white flour in a recipe?

Karen Collins, MS, RD, CDN
American Institute for Cancer Research

Q: How do panini rate nutritionally?
A: Panini are grilled, pressed sandwiches made from a small loaf of bread. As with most foods, nutritional quality varies with how panini are made. The panini available at most restaurants tend to be high in calories and fat. Some panini with particularly low-fat ingredients may contain about 450 calories and 12 grams of fat, but many restaurants’ versions range from 575 to 925 calories, with much of that coming from 26 to 53 grams of fat. The top end of that range is over three-quarters of the recommended total day’s worth of fat for a person who eats 2,000 calories a day. The high fat content comes from oil used for cooking, as well as a combination of high-fat cheese and perhaps a high-fat meat or flavoring such as pesto. A healthful panini could be made using whole grain bread and reduced-fat cheese or poultry, limiting fat in cooking, and adding flavor from roasted vegetables or fresh herbs.

Q: Is the plant-based diet recommended to prevent cancer appropriate for someone with diverticulosis?

A: Absolutely. More than half of Americans over age 60 have diverticulosis, though most are unaware of it. Pouches, called diverticula, form in the colon due to the pressure of moving waste through the digestive tract. For about 10 to 25 percent of people with this condition, the pouches become infected. Doctors may recommend a low-fiber diet while the colon heals. But once the colon has healed, a high-fiber diet is important. A high-fiber diet may also prevent or treat less severe diverticulosis. Fiber makes softer stools that are easier to pass, reducing pressure and decreasing the odds of more pouches forming. Whole grains, bran, dried beans, fruits and vegetables each supply different types of fiber that can help. In one study of more than 47,000 men, those who ate about 32 grams of fiber a day developed 42 percent less diverticulosis than men who consumed 13 grams of fiber daily (a typical amount in the United States). Another advantage of plant-based diets comes from restricting red meat. Limited evidence links high red meat consumption with diverticulosis, perhaps because red meat may promote the growth of colonic bacteria that may lead to the formation of diverticula. In the past, physicians commonly advised patients with diverticulosis to avoid raw vegetables, spicy food and salad dressings. This advice is not supported by current research. A recent medical review noted that avoiding nuts and seeds is common advice given to diverticulosis patients but it is also not based on supporting research.

Q: What is the best way to use whole wheat flour instead of white flour in a recipe?
A: To use whole wheat flour, substitute one cup of whole wheat flour minus one tablespoon for every one cup of all-purpose white flour. You can make recipe transitions more gradual by changing a recipe that calls for white flour with half whole wheat and half white flour. Over time, you can increase the proportion of whole wheat flour. Since whole wheat flour provides more fiber, vitamins, minerals and natural plant compounds, the greater the proportion of whole wheat flour, the better. If you prefer a lighter texture than typically comes with using all stone ground whole wheat flour, you might keep on hand whole wheat pastry flour. White whole wheat flour is another option that has a slightly milder flavor.

Reprinted with permission from the American Institute for Cancer Research www.aicr.org

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