There are so many controversies surrounding the contribution of starchy foods such as cassava and many others to the incidence of diabetes mellitus. Since cassava is an important staple food that is consumed in various forms in Ghana which fufu is the base, I have decided to conduct a review on this to evaluates the health potential. Glycemic index (GI), a measure of blood glucose level as influenced by foods has become a concern due to the increasing cases of diabetes in Ghana. The GI of five Ghanaian staples: fufu (locally pounded), kenkey (Ga), banku, Tuo Zaafi (TZ), and fufu (Processed powder) were determined in a crossover trial among 10 healthy nondiabetics by Cophie et al 2017
Participants were given 50 g portions of pure glucose on two different occasions and subsequently the test foods containing 50 g available carbohydrates. The result demonstrates that Processed‐powdered fufu had the least glycemic response (31), followed by Ga kenkey (41) and locally pounded fufu (55), all recording low GI. However, Tuo Zaafi (68) had a medium GI and banku (73), moderately high GI. Meaning that fufu processed from cassava is good for diabetics. Also, a 1999 thesis by Shaban examines the impact of cassava products including fufu on blood and urine glucose levels. The study concluded that, as long as patients are on treatment, there appears to be no significant rise in blood and urinary glucose levels in adult diabetics who consumed cassava diets and products for a period of five weeks. Consumption of cassava and its products does not appear to worsen the condition of the adult diabetic as long as he/she is on hypoglycemic drugs.
Different Types of Cassava
There are basically two main varieties of cassava as we were told growing up in Suhum-Amrahia: The one eatable and non-eatable. Fufu is the major food in the village and I thought we were just eating for the sake of satiety. However, according to The Hong Kong’s Centre for Food Safety, cassava contains more than one form of cyanogenic glycosides — sweet and bitter:
“Different varieties of cassava are generally classified into two main types: sweet cassava and bitter cassava. Sweet cassava roots contain less than 50 mg per kilogram hydrogen cyanide on a fresh weight basis, whereas that of the bitter variety may contain up to 400 mg per kilogram” The leaves are also used for food and contain 100 times more protein than the root, but both must be cooked and the water discar4ded.
Ingredients in Cassava
The following nutrients are found in 3.5 ounces (100 grams) of boiled cassava according to Montagnac et al 2009.
- Calories: 112
- Carbs: 27 grams
- Fiber: 1 gram
- Thiamine: 20% of the RDI
- Phosphorus: 5% of the RDI
- Calcium: 2% of the RDI
- Riboflavin: 2% of the RDI
Studies on Cassava Health Benefits
Prostate and bladder cancer
One case report published in the Journal of Pharmaceutical Technology and Drug Research in 2013 revealed cassava ineffectiveness in controlling prostate cancer. ‘We report a patient with hormone-resistant prostate cancer whose serum PSA level continued to rise despite consumption of large quantities of boiled roots of cassava indicating its ineffectiveness in controlling the prostate cancer.
Though this is a single case, it provides guidance to health care workers who look after patients with castration-resistant prostate cancer in the absence of more comprehensive research on cassava and its effectiveness on prostate cancer.
“Linamarin, the main cyanogenic glucoside in manioc has been shown to cause toxicity to malignant cell lines”. A nested case control study conducted in India to identify the effect of dietary factors on causation of breast cancer using food frequency questionnaires has shown that consumption of tapioca is associated with a decreased risk of developing breast cancer.
“The cyanogenic glucosides (linamarin and lotaustralin) in cassava leads to the production of amygdaline or vitamin B-17 which is claimed to kill cancer cells by those who promote cassava as an anti-cancer agent. However, two case-control studies from India have shown that cassava consumption is associated with a higher risk of colorectal and pancreatic carcinoma. In addition, cassava may cause ataxic polyneuropathy, amblyopia and tropical pancreatitis as reported in several case reports from India and Nigeria. Therefore, it is prudent that we determine both the safety and efficacy of cassava in treating prostate cancer before it is promoted as a treatment.
Cassava and Colon cancers
Indonesian researchers have established the anti-cancer activity of cassava leaves against colon cancer cells. The researchers concluded: “Cassava leaves have anticancer activity against colon cancer cells. In addition, the boiling process does not reduce the anticancer activity on cassava leaves.”
Another important groundbreaking article is this one: Cassava or manioc root – one more magic cure for cancer | Holistic. sattvamji.blogspot.com/2014/10/78-cassava-or-maniok-root-one-more.html . Some published scientific works in the Western and a few Asian countries indicate that the incidence of cancer was less among the tapioca-consuming population in African countries. Indonesians were the first to reveal the anti-cancer properties of tapioca. Researchers from Nigeria had established that the leaf extract of tapioca could help to cure prostate and bladder cancer. Nigeria is the world’s largest producer of cassava, while Thailand is the largest exporting country of dried cassava.
Another study by Cesar et al in 2011 demonstrated that cassava leaves have potent anti-anthelmintic and anti-inflammatory activity. A similar study published in the Journal of Cancer Epidemiology demonstrates that cassava consumption has a protective effect on colon cancer in Nigerians.
Though, the American Cancer Society has said that “there is no convincing scientific evidence that cassava or tapioca is effective in preventing or treating cancer”. Dr. Cynthia Jayasuriya in Sri Lankan, a retired ENT specialist, advocates the use of manioc or other foods such as apricot which contains Vitamin B 17, to kill cancer cells in the body, leaving the afflicted person well again.
Dr. Jayasuriya cites the studies of Filipino Professor Manuel Navarro which affirms that manioc is an effective low-cost treatment to help reverse cancer growth.
He also said that it is not deadly “cyanide” and it is only Amygdaline (B-17) which is somewhat similar in formula to cyanide, but lacks an “h” factor of the cyanide formula. Amazingly, cancer cells being non-aerobic, do produce within themselves that missing “h” factor. Thus, only the cancer cells are poisoned as they touch the B-17! But all other cells are left untouched.
Pint-sized or no cancer
Research shows how to grow more cassava, one of the world’s key food crops
South American Indians living in the heights of the central mountain areas eat maize (corn) as their staple food. They never have cancer as corn contains large amounts of B-17. A Lankan doctor said that in places in Africa where tapioca is the staple food, there are no known cases of cancer, but deaths from AIDS are high.
Dr. Jayasuriya had had her left kidney and ureter (the tube which leads from the kidney to the bladder removed and part of her bladder was cut out. For seven and a half years she was well before cancer appeared again, necessitating surgery. At that stage, Dr. Jayasuriya, knowing that almond, the kernel of apricot is high in B-17 and used in treating cancer, searched the internet and found that manioc is also high in B-17.
Dr. Jayasuriya consumed about 100 grams of manioc, three times a day. In the morning, she ate it boiled and in the afternoon and night, like a curry. She advises that manioc should be boiled, covered with water to the top of the utensil, left open. Old manioc must not be used and ginger should not be consumed even as ginger biscuits eight hours before and after consuming manioc.
Dr. Navarro has said that his treatment of patients with Laetrile-amygdalin in cases of terminal cancer is comparable or superior to results obtained with the use of the more toxic standard cytotoxic agents, an extract from World Without Cancer by Edward Griffin.
Dr. Jayasuriya has been asked whether eating manioc when a patient is on chemotherapy or radiotherapy, or some other form of treatment is harmful. Her answer was that no tests had been carried out on any such harmful effects, but those who had dared to consume manioc while on such therapy had very good results.
Dr. Jayasuriya recounted some of the people she knew who had spent very large sums of money for the treatment of cancer with injections and other forms of therapy but they suffer and die.
Other Strange and Advantageous Benefits of Cassava
One aspect of cassava is that it’s one of several root foods defined by the Philippines’ Department of Science and Technology as having a low glycemic index (GI) and therefore good for diabetics.
“GI is a classification of food based on the blood glucose response to a food relative to a standard glucose solution. Low glycemic foods control the release of glucose into the bloodstream at a steady and sustained rate, keeping the body’s metabolic processes and energy levels balanced. People with low glycemic diets or [who] eat low glycemic foods are said to have a lower risk of getting coronary heart disease and type 2 diabetes. These food items that have low GI would benefit those who are already suffering from diabetes, since these would help in the proper control and management of blood sugar” Philstar Global Sept 30, 2010.
As a low-GI food, eating cassava can also help improve physical endurance because blood glucose levels are moderated instead of dropping when insulin is produced. Low-GI foods also may help control triglyceride and other lipid levels in your blood. Cassava has even been called a “weight loss wonder food” due to its ability to decrease appetite and decrease fat storage in fat cells (Chris Kresser August 2014).
Vitamins in Cassava
B-complex vitamins contained in cassava include folate, thiamin, pyridoxine (vitamin B6), pantothenic acid (vitamin B5), and riboflavin (vitamin B2). The root also includes a number of minerals that perform important functions throughout your body:
1. Iron helps form the two proteins responsible for transporting oxygen to your tissues
2. Zinc helps your immune system fight bacteria and aids cell growth and division
3. Calcium helps form strong bones and teeth
4. Magnesium optimizes mitochondrial function and helps regulate blood sugar
5. Potassium synthesizes proteins and helps break down carbohydrates
6. Manganese is vital for connective tissue and sex hormones, and repairing joints
7. Cassava also contains saponins that can ease inflammation, break down organic body wastes like uric acid, cleanse mineral deposits from your joints and help balance your gut flora.
Cassava fights Diabetics
Glycemic index is rated on 1 to 100. Foods that raise the blood glucose quickly after a meal are known as high glycemic index meals and they are assigned a value of 70 and above while foods that release glucose slowly into the bloodstream are known as low glycemic index foods and their values are 55 and below. Beidler reported an update on some of the studies done in this regard which include an article published in the journal “Acta Horticulturae, in 1994 by” AO Akanji which reported that cassava has been suspected of causing diabetes. However, several studies have shown a low incidence of diabetes in Africans who eat cassava regularly. In one study published in the December 2006 issue of “Fundamental & Clinical Pharmacology,” none of the 1,381 subjects had diabetes, even though cassava accounted for a full 84 percent of their caloric intake. A second study, published in the October 1992 issue of “Diabetes Care,” noted that Tanzanians who ate cassava regularly had a lower incidence of diabetes than those who rarely ate it.
If you’ve ever had tapioca, you’ve had a form of cassava, as tapioca is the starchy liquid extracted from the root; cassava is the ground root itself. The content is essentially pure carbohydrates, with negligible fiber, protein, or nutrients. In fact, one study called tapioca “nutritionally inferior.”( FoodNutr Bull. 2009 March;30(1):90-4)
One cup of dry pearl tapioca contains 544 calories, 135 grams of carbohydrates, and 5 grams of sugar. There are virtually no vitamins to speak of, other than a small amount of folate and pantothenic acid, but the same amount yields 13 percent of the recommended daily value in iron and 8 percent of the manganese (Nutrition Data Pearl Tapioca 2014)
Moisture is removed from the root either by evaporation or squeezing it out after being ground, leaving a fine, white powder. Dried, it’s often sold as flour or pressed into flakes or “pearls,” which should be boiled before you eat them; 1 part dry pearls to 8 parts water is a good ratio.
The product usually resembles small, translucent and gel-like balls with a leathery consistency that expand when moisture is added. Especially as a need for gluten-free options have emerged into the mainstream diet, tapioca is one of the best alternatives to wheat and other grains.
While tapioca starch provides energy with very little nutritional value, it’s gluten-free, which is worth its weight in gold to a growing number of people who are allergic or sensitive to gluten(Rubio-Tapia et al 2012).
It also has several uses in place of flour for both cooking and baking:
1. Tapioca makes a popular type of pudding made up of chewy, mildly sweet “pearls,” as well as bubble tea, an Asian concoction usually served cold.
2. Gluten- and grain-free bread made from tapioca is sometimes combined with other flours such as coconut flour or almond meal to improve the nutrition.
3. As a thickener, tapioca is excellent for bulking up the consistency of soups or stews, and it’s essentially flavorless.
4. Flatbread made from tapioca is most often found in developing countries because it’s inexpensive and very versatile.
5. Added to burgers and dough, tapioca is a binder that can improve the texture and moisture content in foods without becoming soggy.
Cassava: A Digestive-Resistant Starch
The Healthy Home Economist calls resistant starch “the healthiest starch for your gut:”
“Resistant starch is a type of starch that does not break down (it literally “resists” digestion), instead of being absorbed as glucose like most starches. Instead, resistant starch travels through the small intestine to the colon where it is turned into beneficial, energy-boosting, inflammation-squashing, and short-chain fatty acids by intestinal bacteria. The main reason why resistant starch is so beneficial is that it feeds the friendly bacteria in your colon, turns them into important short-chain fatty acids, such as butyrate (known to help reduce inflammation), and is extremely helpful in cases of autoimmunity, IBS, colitis, and allergies.”( The Healthy Home Economist 2016)
The Authority Nutrition (2012-2016) had this to say,
“Most of the carbohydrates in the diet are starches. Starches are long chains of glucose that are found in grains, potatoes and various foods. But not all of the starch we eat gets digested. Sometimes a small part of it passes through the digestive tract unchanged. In other words, it is resistant to digestion.”
According to Topping et al 2003, resistant starch can be very beneficial. As it feeds beneficial gut bacteria, it can reduce inflammation as well as harmful bacteria. It may also lower your blood glucose level after meals(Diabetes Care 2006, improve insulin sensitivity(Robertson et al 2005, help manage metabolic syndrome(Bodinham et al 2010 and possibly help you eat less(Raben et al 1994).
The four different types of resistant starches include (Authority Nutrition Resistant Starches 2012-2016):
1. Type 1, found in grains, seeds and legumes, resists digestion because it’s bound by fibrous cell walls.
2. Type 2 is indigestible starchy foods such as green bananas and raw potatoes which, when heated, makes them digestible.
3. Type 3 is created when starchy food is cooked, then cooled, turning some digestible starches, such as rice and white beans, into resistant starch through retrogradation(Science Direct March 2000)
4. Type 4 is a man-made substance using a chemical process and is not healthy for you.
Other Cassava uses:
Cassava is also known for many additional benefits, according to StyleCraze 2016:
1. Cassava made into a simple paste with water and used as a peel or scrub smoothes, brightens and hydrates your skin.
2. As a mask, wash your face first with warm water, smooth on a paste using water and honey, dry completely and rinse well with cold water.
3. Cassava roots and leaves can be made into a paste to nourish and soften your hair and remedy hair loss. Twice a week, apply coconut or olive oil, then cassava paste, wait one hour and rinse.
4. Traditionally, the roots and leaves were used to boost immunity, energy and brain function, heal wounds, de-worm, soothe headaches and fevers, aid digestion and rheumatoid conditions, lower blood pressure and balance stress levels.
5. In Ghana, it is the basis of our fufu!
Precautions Regarding Cassava
Cassava roots contain the toxic compound linamarin, which converts to hydrogen cyanide. Improper cooking of cassava root is associated with cyanide poisoning, which can cause symptoms of vomiting, nausea, dizziness, stomach pains, headache, irreversible paralysis from a disease called konzo(Nzwalo H and Cliff J. 2011 and even death.
“Cassava should never be eaten raw as the root composes small quantities of cyanogenic glycosides, especially hydrocyanic acid. Cyanide compounds interfere with cellular metabolism by inhibiting the cytochrome-oxidase enzyme inside the human body”( Nutrition and You 2016)
However, if the cassava is peeled and cooked, toxic substances are removed. It should be noted that the tapioca you buy at the store or prepare from a package does not contain harmful cyanide levels, so it’s perfectly safe to eat. Remember not to eat or drink ginger-containing food and beverages at least 8 hours after you eating cassava.
1. There is some compelling evidence on cassava and colon cancer prevention
2. As a resistant starch, cassava is good for diabetics, hence, fufu is good as well.
3. As it feeds beneficial gut bacteria, it can reduce inflammation as well as harmful bacteria.
4. Fufu from cassavas may also lower your blood glucose level after meals (Diabetes Care 2006, improve insulin sensitivity(Robertson et al 2005, help manage metabolic syndrome(Bodinham et al 2010 and possibly help you eat less(Raben et al 1994). Is this not impressive on cassava and all foods made from it?
DISCLAIMER: This post is for enlightenment purposes only and should not be used as a replacement for professional diagnosis and treatments. Remember to always consult your healthcare provider before making any health-related decisions or for counselling, guidance and treatment about a specific medical condition.
NB: The writer is on a mission to provide you and your family with the highest quality nutrition tips, scientific herbs and healthy recipes in the world.
The writer is an honorary Professor of Holistic Medicine-Vinnytsia State Pedagogical University, Ukraine, president, Nyarkotey College of Holistic Medicine and currently, LLB law student. He is also a Chartered Management Consultant, Canada. He is the formulator of FDA approved Nyarkotey Hibiscus Tea for Cardiovascular Support and wellness, Men’s Formula for Prostate Health and Women’s Formula for wellness. Contact: 0241083423/0541234556
Raphael Nyarkotey Obu, PhD, © 2020
Prof Raphael Nyarkotey Obu is an honorary professor of holistic medicine-Vinnytsia State Pedagogical University, Ukraine and the President of Nyarkotey College of Holistic Medicine, Tema Community 7, Post office.Column: RaphaelNyarkoteyObu