In This Issue:
Don’t Get Carried Away with Glycemic Load
‘Glycemic index’, ‘glycemic load’ and ‘glycemic response’ are not the same write Alan Barclay, Prof Jennie Brand-Miller, and Prof Tom Wolever in Diabetes Care (Volume 28, Number 7, July 2005). ‘The evidence as it stands suggests that for preventing type 2 diabetes, we ought to encourage low GI carbohydrate foods but not those that simply have low “net carbs”, low GL or produce a low glycemic response.’
Glycemic load does not distinguish low carbs from slow carbs!
Low GI and low GL are not equivalent, ‘especially in preventing and managing diabetes and cardiovascular disease.’ This is because diets with a lower GL can be achieved either by lowering the GI of the carbohydrate or by reducing carbohydrate intake at the expense of consuming more fat or protein. So, going with GL on its own could mean someone is eating a decidedly unhealthy diet, too low in carbs and full of the wrong sorts of fats and proteins.
When you choose low GI carbs, you are getting a healthy, safe diet with an appropriate quantity and quality of carbohydrate.
When it comes to a low GI diet, however, the evidence to date shows that when people choose low GI carbs, they’re getting a healthy, safe diet with an appropriate quantity and quality of carbohydrate. In fact, they are often increasing their intake of nutritional powerpack foods such as beans, chickpeas, lentils and wholegrains.
In addition, the low GI ‘this for that’ strategy is also an easy option for most people whatever their cultural background or diet. Simply by choosing the low GI foods within a category (breads, breakfast cereals, grains etc) they are automatically choosing lower GL foods, too. Fruit and vegetables play a major role in a low GI diet and, bar potatoes, are not restricted. People are encouraged to eat around 7 serves of fruit and vegetables a day because they are not major contributors of carbohydrate even if, like watermelon, they have a high GI.
The bottom line
Reducing the Risk of Stroke
Replacing refined carbohydrates with high fibre, low GI carbs may help reduce the risk of hemorrhagic stroke in women according to researchers including Dr Walter Willett from Harvard University and Brigham and Women's Hospital in the American Journal of Epidemiology. Hemorrhagic stroke (also known as cerebral hemorrhage) occurs when a blood vessel in the brain breaks or ruptures. A high intake of refined carbohydrate may increase the risk of hemorrhagic stroke in women, particularly women who are overweight or obese. These results ‘may have implications for preventing stroke in Asian countries with a higher rate of hemorrhagic stroke and a higher intake of carbohydrate,’ say the authors.
—Reported in the American Journal of Epidemiology 2005; 161:161–169
Is It the GI That Makes the Difference to Weight Control (or Something Else)?
In human studies, it’s hard to control all aspects of a diet. When scientists change the GI of a diet, they often get more fibre and higher food bulk without trying or intending to. Animal studies allow better control of ALL the variables, making the interpretation easier. Harvard researchers report that low GI carbohydrate per se has implications for weight loss, body fat, and risk for diabetes and heart disease. Dorota Pawlak MNutrDiet, PhD and David Ludwig, MD, PhD, director of the obesity program at Children's Hospital in Boston set up experiments in which rats were fed to gain exactly the same amount of weight. After just 18 weeks, the rats on the high GI diet had 70 percent more body fat and 8 percent less lean muscle mass, compared with the rats on the low GI diet. The high GI group also had significantly higher blood glucose and insulin levels and higher triglyceride levels. When the low GI group was switched to a high GI diet they had greater increases in blood glucose and insulin compared with rats switched from a high to low GI diet.
—Reported in The Lancet (August 28, 2004; vol 364: pp 778–785).
Is Once a Day Enough?
‘It could be possible that only one meal a day needs to include low GI carbs for people to achieve improved glucose tolerance,’ reports the University of Nottingham’s Dr Emma Stevenson in the International Journal of Sport Nutrition and Exercise Metabolism. The study was designed to look at the effect of the GI of the evening meal on responses to a high GI breakfast the next day. The researchers found that when the men ate a low GI dinner their glucose tolerance was improved next day compared with when they ate a high GI evening meal. ‘If people can achieve improved glucose tolerance in the short term simply by eating just one low GI meal a day, rather than eating only low GI carbs this could make it easier for them to stick to a diet,’ said Stevenson.
—Reported in International Journal of Sport Nutrition and Exercise Metabolism, 2005 Vol 15 (3) 308-322. (The Effect of the Glycemic Index of an Evening Meal on the Metabolic Responses to a Standard High Glycemic Index Breakfast and Subsequent Exercise in Men; Emma Stevenson, Clyde Williams, Maria Nute, Peter Swaile, Monica Tsui)
Carrots and Sticks
One of the most repeated criticisms of the GI approach over the years has been the fact that carrots were being excluded from diets simply because of their high GI value. Note to GI critics—carrots were retested and the new values published three years ago (2002) in The New Glucose Revolution and on (www.glycemicindex.com), so you need to find a new stick. When carrots were first tested in 1981, the result was 92, but only five people were included in the study and the variation among them was huge. This was in the early days of GI testing and the reference food was tested only once. When carrots were assessed in 2001, ten people were included, the reference food was tested twice, and a mean value of 41 was obtained with narrow variation. It was clear that this result was more accurate and the other value should be ignored. This is a good example of the need for reliable, standardised methodology for GI testing. It is also another case for not using the GI in isolation. Carrots are rich in beta-carotene, a plant form of vitamin A or retinol, which we need to maintain normal vision (a deficiency in vitamin A produces night blindness—an inability to see in dim light). Carrots also provide some vitamin C and fibre, so add them to soups, salads, stir-fries, stews, casseroles, cakes and puddings or enjoy them as a crunchy snack.
Barley
GI 25 (pearl barley)
One of the oldest cultivated cereals, barley is nutritious and high in soluble fibre, which helps to reduce the post-meal rise in blood glucose—it lowers the overall GI of a meal. In fact pearl barley has one of the lowest GI values of any food that we have tested. Pearl or pearled barley (the outer husk and bran layers have been removed in the polishing process) is widely available and you will find it in the supermarket. Whole barley (sometimes called pot or Scotch barley) tends to be stocked in natural or health food stores and, rather like brown rice, takes much longer to cook. Barley flakes, or rolled barley, which have a light, nutty flavour, have a higher GI (66).
Use pearl barley instead of rice (or combined with rice) as a side dish, to make a warming breakfast porridge, a delicious risotto or lemon barley water—that old-fashioned favourite; or add barley to soups, stews and pilafs or grain-based salads.
Photo: Ian Hofstetter, The Low GI Diet Cookbook
If you cook a large batch of barley you can freeze what you don’t use for up to 6 months. Steaming pearl barley takes a little longer than steaming rice, but the method is similar. Place 1 cup (200 g/7 oz) well rinsed barley in a saucepan with 3 cups (750 ml) water and bring to the boil. Cover and reduce heat. Simmer gently for around 35–40 minutes or until the grains are tender but still a little chewy (al dente like pasta). Remove from the heat and leave to stand for a few minutes before fluffing the grains with a fork and serving. Serves 4.
—Dietitian, sports dietitian and public health nutritionist Penny Hunking of Energise Nutrition (www.energise.co.uk) is a great fan of barley and has provided the following recipes to whet your appetite.
Gingery Barley and Rice Salad
Fruity Beef and Barley Stew
Chargrilled Vegetables and Beans with Pasta
Serves 4
Preparation time: 15 minutes
Cooking time: 15 minutes
Make this satisfying pasta dish from The New Glucose Revolution Life Plan using your favourite pasta shapes and canned beans for a quick and easy supper.
Photo: Jennifer Soo, The New Glucose Revolution Life Plan
2 small Italian eggplants (aubergine), cut in half lengthwise
2 large red capsicum (peppers), seeded and cut into thick strips
6 Roma (plum) tomatoes, cut in half lengthwise
1 Spanish (red) onion, thickly sliced
4 cloves garlic, coarsely chopped
1 tablespoon olive oil
salt (optional) and freshly ground black pepper
1 x 400 g (14 oz) can borlotti or red kidney beans, rinsed and drained
250 g (8 oz) spirali pasta or your favourite shapes
½ bunch basil leaves, torn
1. Prepare the vegetables.
2. Brush the BBQ grill or a large chargrill hotplate on the cooktop with the olive oil, heat well and add all the prepared vegetables. Sprinkle with salt (optional) and a few twists of freshly ground black pepper and cook until the vegetables are golden brown, turning occasionally to make sure that they don’t catch or burn. Add the borlotti beans and toss through.
3. Meanwhile, boil 3 litres (quarts) of salted water and cook the pasta, uncovered, for about 4 to 5 minutes until al dente. Drain.
4. Arrange the pasta and vegetables on a large platter and scatter with torn basil leaves. Serve hot.
Nutritional analysis per serve
1533 kJ (366 Cal), 7 g fat (saturated 1 g), 14 g protein, 62 g carbohydrate, 11 g fibre, 140 mg sodium
The recipes for The New Glucose Revolution Life Plan were specially created by Lisa Lintner who runs the Lisa Lintner Cooking School in Sydney (Australia)—specialising in low GI, seasonal and locally sourced produce. The classes incorporate practical skills with tips for including low GI foods daily. Contact Lisa on 0412 800 880 or at lisalintner@bigpond.com for class programs and individual coaching.
The New Glucose Revolution Life Plan is published in:
Australia: Hachette Livre Australia (www.hachette.com.au/ngr.html)
New Zealand: (Hachette Livre New Zealand)
UK: Hodder Mobius
USA and Canada: Marlowe & Company
The Low GI Guide to Managing PCOS
Dr Jennie Brand-Miller. Prof Nadir Farid, Kate Marsh
Low GI foods play a vital role in addressing insulin resistance, the underlying cause of polycystic ovarian syndrome. PCOS affects up to one in five women in developed countries, yet only half those with the condition are aware of it. Often difficult to diagnose, the symptoms can include weight gain, difficulty conceiving, mood swings, hirsutism, acne, irregular periods and lack of energy. This new UK edition of The Low GI Guide to Managing PCOS is a practical diet and lifestyle programme. It has been written to help women beat the symptoms of PCOS, take control of their health and wellbeing and improve their insulin sensitivity with advice on switching to a low GI diet including menu plans and delicious recipes, exercise suggestions and information about medication. Endorsed by Verity, the self-help organisation for women whose lives are affected by PCOS (www.verity-pcos.org.uk).
UK edition published by Hodder Mobius
Also available in Australia (Hachette Livre Australia), New Zealand (Hachette Livre New Zealand), and in the USA and Canada (Marlowe & Company).
Empowering People with Diabetes and Pre-diabetes: The Healthy Shopping Tour CD-Rom
Diabetes Australia, New South Wales
‘There are around 20,000 different food items packed high on typical Australian supermarket shelves,’ says dietitian Alan Barclay of Diabetes Australia (NSW). ‘To make food shopping easier and help people with diabetes or trying to prevent diabetes choose foods that are tasty, affordable and healthy, we have created a virtual shopping tour. Before shoppers leave home they can check out products such as breads, breakfast cereals, milk, yoghurt, cheese, oils and snack foods from the convenience of their computer screen,’ he said at the launch in Sydney on 14 July of The Healthy Shopping Tour. The CD-Rom takes the viewer up and down the aisles demystifying manufacturers’ claims explaining how to read labels and what the Nutrition Information Panel and Ingredient List actually mean, and showing how much fat, carbohydrate, sodium and dietary fibre to look for in each food category. There’s a special section on understanding the glycemic index (GI) and how to choose foods with a low GI.
‘It is important to empower people, especially those with diabetes, to make wise food choices,’ said Prof Jennie Brand-Miller speaking at the launch. ‘Putting power firmly in the hands of the person with diabetes helps to improve the management of their condition. Diabetes Australia’s Healthy Shopping Tour is part of a total lifestyle solution. Lifestyle intervention for people with diabetes works when it's done well and this virtual shopping tour is another tool in the toolbox. And unlike drug interventions, there are no side effects to balanced nutrition choices and low GI foods. In addition,’ she said, ‘total lifestyle solutions hit more than one nail on the head—not just better diabetes control, but also better mental health, lower risk of heart disease, osteoporosis, arthritis, cancer etc.
Although designed for Australian shoppers, the CD-Rom would be useful for people in New Zealand where the regulations for Nutrition Panels and Ingredient Listing are similar. For ‘visitors’ from other countries, it’s still worth taking a look to help demystify manufacturers’ claims and check out how much fat, carbohydrate, sodium and dietary fibre to look for in each food category. For more information visit www.diabetesnsw.com.au
Why Is There No GI for Blueberries, Blackberries, and Raspberries?
Janey Berry, a spokesman for Waitrose reports that the UK’s ‘craze’ for the GI diet has boosted sales of berries, porridge and bananas, as people seem to have reposed their faith in the new diet rather than Atkins. Waitrose UK recorded a 264 per cent rise in demand for blackberries, while sales of breakfast oats rose 80 per cent. 'The GI diet has definitely had an impact on sales of berries, but there has been a return to old-fashioned fruit we had when we were kids,' she said.
However, what you really need to know is that apart from strawberries (GI 40), most berries actually have so little carbohydrate it’s difficult to test their GI. Their low carbohydrate content means their glycemic load will be low, so you really can enjoy them by the bowlful. They are a good source of vitamin C and fibre and some berries also supply small amounts of folate and essential minerals such as potassium, iron, calcium, magnesium and phosphorus. Eat them fresh, add them to fruit salads and frappés, use them in a delicious dessert, decorate cakes with them, or make them into jams, fruit spreads and sauces.
As for fresh strawberries, they are rich in vitamin C, potassium, folate, fibre and protective anti-oxidants. Because the average serve has very little impact on blood glucose levels, people with diabetes can eat them freely. So reap the health benefits as you enjoy them by the bowlful, but hold the cream! A word of warning: don’t eat too many strawberries in a single day. They can have diuretic and laxative effects if you overdo it.
From Low GI Eating Made Easy. Available in Australia and New Zealand (Hachette Livre); UK: December 2005 (Hodder Mobius); USA: January 2006 (Marlowe & Company)
I Have Type 2 Diabetes. How Can I Feed a Big Family with Cost-effective, No-hassle Low GI Foods?
Feeding a big family on a budget can be hard. But low GI eating often means making a move back to the inexpensive, filling and healthy staple foods that our parents and grandparents enjoyed. This includes traditional oats for breakfast porridge, legumes such as beans, chickpeas and lentils (available in cans), cereal grains like barley, and of course plenty of fresh vegetables and fruit, which naturally have a low GI. Some of these foods may take a little more time to prepare than high GI processed, packaged, and pricey ‘convenience’ foods piled high on supermarket shelves, but the savings will be considerable and the health benefits immeasurable. For a list of the top 100 low GI foods, check out Low GI Eating Made Easy. This book also includes plenty of ideas for using these foods in everyday meals. Or take the Diabetes Australia Healthy Shopping Tour (www.diabetesnsw.com.au). Your diabetes dietitian or educator will also have plenty of ideas for low-cost, low GI meals that the whole family will enjoy.
