By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
If you ask the average 5- or 6-year-old kid about his or her favorite food, you’d rarely hear a mention of tomatoes—unless it’s in the form of ketchup (in which to dip a perennial kid fave—fries, of course). But as a boy, I loved tomatoes. They definitely topped my list of favorite foods.
I come from a big Italian family, and we often bonded in the kitchen over our shared love of cooking. It should come as no surprise that my grandfather and father both made an amazing homemade pasta sauce. To this day, I can still remember the intoxicating aroma of fresh tomatoes, garlic, and herbs wafting through the house as they created their culinary masterpiece.
As I got older, I remember my dad baking his famous ziti dish with tomato sauce for me and my fraternity brothers. The whole experience created a real sense of camaraderie between our two generations.
Today, my appreciation of all things tomato has not waned one bit. In fact, it’s gotten even stronger. Not only are they delicious, the benefits of tomatoes are almost too numerous to count.
Tomatoes haven’t always been viewed in a positive light. You see, they are part of the nightshade family, which contains an extensive list of toxic plants—including belladonna, known for its use as a poison. In fact, Colonial American gardeners grew tomatoes because they thought they were pretty to look at, but they were afraid to eat them because of how much they resembled belladonna.
It wasn’t until the 16th century that Europeans (including my Italian ancestors) began to accept them into the kitchen, and their popularity started to spread across the globe.
Compared to the number of inedible nightshades, the list of edible, nontoxic nightshades is actually quite short. In addition to tomatoes, it includes eggplant, white potatoes, and peppers (both sweet and spicy).
While most people can eat these nightshades with no problem, those with autoimmune diseases (particularly rheumatoid arthritis) may find that these foods exacerbate their symptoms. In these cases, they should be limited or avoided altogether.
If you ever wonder why so many people consider the tomato to be a vegetable even though it is a fruit (actually, technically, it’s a berry!), you can blame the Supreme Court for the confusion. In the late 1800s, tariff laws imposed a tax on vegetables, but not fruits.
One tomato importer argued that the tomato should be exempt from the tax since it is not a vegetable, but the court disagreed, therefore subjecting tomatoes to the tariff. Considering most people eat tomatoes with other vegetables (such as in salads) and as part of larger meals, the idea that tomatoes are vegetables just kind of stuck.
In this video, my son, Step, and I enjoy tomatoes in Easy Caprese Salad:
Fruit or vegetable, one thing is for sure: Tomatoes are excellent sources of nutrition. Not only are they low in calories (a medium-size tomato has about 25 calories), they’re high in vitamins, minerals, and phytonutrients.
Tomatoes contain robust levels of vitamins A (as beta-carotene), C, K, and various B vitamins. Vitamins A and C act as antioxidants in the body, neutralizing free radicals that cause cell damage and contribute to the development of diseases. Vitamin A plays a role in keeping eyes healthy and hair shiny and strong. And research has shown that robust levels of vitamin C may be linked to lower risk of cardiovascular disease—something this cardiologist takes very seriously! The B vitamins also help to protect the heart by regulating cholesterol and lowering blood pressure, while vitamin K is essential for healthy blood clotting.
Tomatoes are also rich in fiber as well as minerals like potassium, manganese, magnesium, chromium, and copper.
But nutritionally speaking, the main health benefits of tomatoes come courtesy of a phytonutrient called lycopene. Lycopene is actually a pigment that is responsible for the rich red color of tomatoes and the vibrant pinks seen in watermelon, pink grapefruit, papaya, and guava. You know how sometimes your cooking utensils end up stained a reddish-orange color after you make a pot of pasta sauce or some other tomato-based dish? That’s the lycopene!
But if this is lycopene’s worst attribute, I’ll take it…because its health benefits make all the stained spatulas and cutting boards totally worth it.
Load up on Lycopene
Lycopene is an extraordinary compound. It has been extensively studied for more than 80 years and has been the subject of thousands of published research papers for its ability to ward off problems ranging from gingivitis, asthma, osteoporosis, cataracts, cognitive decline, and ultraviolet-induced skin damage, to, most notably, cardiovascular disease and cancer.
From a cardiology standpoint, higher blood levels of lycopene have been associated with reductions in cardiovascular disease risk and it may even improve biomarkers linked to this condition. For example, lycopene prevents the oxidation of LDL cholesterol, which initiates a chain of events that ultimately can lead to heart disease.
A 2011 meta-analysis of 12 studies revealed that, “lycopene taken in doses ≥25mg daily is effective in reducing LDL cholesterol by about 10 percent, which is comparable to the effect of low doses of statins in patients with slightly elevated cholesterol levels.” Statins can be dangerous – they aren’t for everybody. I don’t recommend them for primary prevention, and would only prescribe them for select high risk patients (for more on this, read Types of Cholesterol). For everyone else, including patients with only moderately elevated cholesterol, I would much rather prescribe a bushel of tomatoes than a statin!
An even more recent analysis published in 2017 concluded that, “increasing the intake of [tomato products and/or lycopene supplements] has positive effects on blood lipids, blood pressure and endothelial function. These results support the development of promising individualized nutritional strategies involving tomatoes to tackle cardiovascular disease.”
Lycopene has shown promise in preventing a wide range of different cancers, too, including breast, lung, gastric, colorectal, and pancreatic. But of all the cancers, lycopene shows the most potential against prostate.
An early study published in 1995 that followed nearly 50,000 men showed that those with the highest levels of lycopene had about a 20 percent reduced risk of developing prostate cancer compared to the men with the lowest levels.
Since then, many studies have confirmed these results, including a 2015 meta-analysis that looked at 26 studies totaling just over 563,000 men. In it, researchers found that higher levels of lycopene significantly lowered prostate cancer risk, and the greater the consumption, the greater the protection (with total levels ranging between 9-21 mg per day).
On a final note – when it comes to cancer prevention, you want to pair tomatoes with broccoli. Eaten together, this dynamic duo acts synergistically, offering greater protection against cancer than when each is eaten alone.
Is Cooked Better Than Raw?
You know how with most fruits and vegetables, it’s advised that you eat them raw rather than cooked because heat destroys the nutrients? Well that’s absolutely not the case with tomatoes. In fact, it’s quite the opposite.
Cooking, heating, or processing tomatoes is what causes the lycopene molecules to transform and become more bioavailable—and therefore more easily absorbed and used by the body. So if you’re looking to naturally boost your lycopene levels, I encourage you to make some homemade tomato sauce. If you don’t have fresh tomatoes, even canned will do the trick! In fact, most canned and bottled tomato products—including store-bought pasta sauce, canned tomato products, and even ketchup—contain good amounts of lycopene. Just be sure to purchase organic tomato products to avoid pesticide residues (tomatoes are #10 on the Environmental Working Group’s Dirty Dozen list of conventional produce most contaminated with toxic pesticides).
This is not to say that raw tomatoes don’t do a body good. Really, there’s nothing better in the summertime than picking a ripe, juicy, organically-grown tomato right off the vine and taking a bite out of it right then and there. Tomatoes contain a lot of vitamin C, which actually is destroyed by heat—so if you want to boost your C with tomatoes, eat them raw. I love them in green salads, as well as Caprese Salad (sliced tomatoes with fresh mozzarella cheese and basil – see recipe link above).
Either way, you can’t go wrong. Tomatoes truly are nutritional gems!
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- Ried K and Fakler P. Protective effect of lycopene on serum cholesterol and blood pressure: meta-analyses of intervention trials. Maturitas. 2011 Apr;68(4):299-310. Last accessed March 20, 2018.
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- Giovannucci E, et al. Intake of carotenoids and retinol in relation to risk of prostate cancer. J Natl Cancer Inst. 1995 Dec 6;87(23):1767-76. Last accessed March 20, 2018.
- Chen P, et al. Lycopene and risk of prostate cancer: a systematic review and meta-analysis. Medicine (Baltimore). 2015 Aug;94(33):e1260. Last accessed March 20, 2018.
- Friedlander B. Italian chefs knew it all along: Cooking plump red tomatoes boosts disease-fighting, nutritional power, Cornell researchers say. Cornell Chronicle. Last accessed March 20, 2018.
© Stephen Sinatra, MD. All rights reserved.