GI News—October 2005

In This Issue:

• Waist Not, Want Not.
• Just a Spoonful of Dressing …
• From Flab to Fab
  
• Is There More to Fibre than Crunch
• Low Sat Fat + Low GI = Prevention of Heart Disease

• ‘Cherries, Ripe Cherries’
• The Versatile Tortilla—Perfect for Wrapping, Scooping and Dipping
• Conchiglie with Pesto Balsamico
  
  
• What Makes My Blood Glucose Go Up and Down?
• Why do many high-fibre foods still have a high GI value?
• I was surprised to find that the American Diabetes Association has taken a position that is not supportive of your research. The comments I read in a Guest Editorial of their Sept 2005 issue of Diabetes Forecast suggest your approach may be more of a fad than a useful tool.
  

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‘People who eat three or four serves of fruit a day

(particularly apples and oranges)

have the lowest overall GI and the best blood glucose control.’

Jennie Brand-Miller

Food for Thought

Waist Not, Want Not— By Maggie Alderson
I can get my skinny jeans off without undoing them … This waistband revolution is the result of two months on the GI diet—which stands for ‘glycaemic index’, meaning how fast foods break down into sugars in your bloodstream. The lower the GI, the slower it breaks down - which is good, because you feel full longer.

In that time, following a diet I have found effortless—even enjoyable—to stick to, I have lost five kilos. That might not be much on a big bloke, but when you're just a little squirt like me, it means you're down a full dress size, a bra size and all your belt notches. More importantly, I am also down below the non-negotiable, crucial waist measurement which medical opinion now prescribes for women as being essential for long-term heart health: 88 centimetres.

… the thing that really inspired me to embark upon it - quite apart from general fashionista vanity and horror of the elasticised waistband - is that my dear old dad had his first heart attack at the age of 50. I am now at the stage in my own life when that birthday is no longer looking like something that only happens to other people. I can see it on the horizon now - without a telescope. And I was all too aware that I was carrying my excess weight in the worst place you can for heart disease risk; around the middle, like a lifebelt.

I was only 10 years old when Doug had that first heart attack and I remember it all too clearly. Characteristically, he was watching sport on TV at the time. Over the next few years he had several more and he was in and out of hospital - with that pitiless monitor going beep beep beep - his health gradually declining, until he died of heart failure at 63.

His last few years weren't that much fun for a man who used to play serious rugby union. So out of respect for his memory - and in the understanding that I have inherited his excitable ‘A-type’ personality, which is another heart-risk indicator - I felt I had to turn that apple-shaped abdomen into something more closely resembling a healthy violin. Or at least a cello.

And it's happened. I'm not Jessica Rabbit yet (I would like to lose another three kilos...) but, my goodness, I'm looking - and feeling - better than I did two months ago. But the real revelation of this diet journey for me—and I've been on every fad diet that has come out in the past 25 years - is that this is the only one of any of them that has actually lived up to all the breathless hype in the opening chapters.

You know where they all say: You won't feel hungry! You can eat delicious meals! The whole family can eat the same food and not notice! You can eat out in restaurants! You can break it occasionally for special occasions and carry on losing! You are going to want to carry on eating like this for the rest of your life! Well, for this diet, it's all true. A-m-a-z-i-n-g.

I'm not spruiking one particular diet book here—there are loads of different versions of the GI system on sale now and I have several. They differ in details, but the message is the same. And the message is some kind of a miracle. I commend it to you. I just wish it had been around when my dad was still alive.

—This piece is reproduced with permission of the author. It was first published in Good Weekend, the Saturday magazine of the Sydney Morning Herald and The Age, where Maggie Alderson writes each week. Her columns have also been collected into two books, Shoe Money and Handbag Heaven (Penguin). She's still doing well on the low GI diet ...


Maggie Alderson
Photo: Derek Henderson

GI News Briefs

Just a Spoonful of Dressing …
One of the biggest challenges to losing weight is ignoring that gnawing feeling in your gut. Hunger. To date, more than 20 studies around the world have confirmed the remarkable fact that low GI foods, in comparison to their nutrient-matched high GI counterparts, are more filling, delay hunger pangs for longer, and/or reduce energy intake for the remainder of the day.

Now Swedish researchers report in the European Journal of Clinical Nutrition that vinegar (acetic acid) may also help dieters eat less and reduce cravings brought on by sugar spikes after meals. They found ‘a direct relationship between increased acetic acid and satiety’ according to the study’s lead author, Elin Ostman from Lund University. After an overnight fast, volunteers were given vinegar diluted in water with a portion of white bread containing 50 grams of available carbohydrates. The reference meal was bread without the vinegar. Satiety was measured on a subjective rating scale at 30, 90 and 120 minutes after the meal. The more vinegar they consumed (up to 2-3 tablespoons), the more satisfied the volunteers felt. Olstrom notes that the study could explain why some people feel a benefit of drinking a glass of vinegar and water before a meal.



—Reported in the European Journal of Clinical Nutrition (vol 59, issue 9, pp983−988)

Alternatively, try a spoonful of vinaigrette dressing (2 parts red or white vinegar to 1 part oil) with salad. It can lower the blood glucose response of a meal by up to 30 per cent according to Brand-Miller and her co-authors in The New Glucose Revolution.

Is There More to Fibre than Crunch?
A recent Danish study reported in Diabetes Care, the official journal of the American Diabetes Association, shows dietary fibre, but not the glycemic index, is important in prevention of insulin resistance.’ Using baseline data from the Danish population-based ‘Inter99 Study’, Catherine Lau and her team estimated dietary intake (total carbs, GI, GL, fibre and sucrose) from self-administered food frequency questionnaires of 5,675 non-diabetic Danish men and women aged between 30 and 60. They conclude that: ‘the present study does not support the hypothesis that habitual intake of diets with a high glycemic index and high glycemic load is associated with insulin resistance.’ They also point out that ‘intake of simple sugars in itself is not associated with an increased insulin resistance.’ However, the authors don’t give the reader any idea of the average in GI or GL in this population. It’s possible that the range is just too narrow. Their findings contrast with those of the Framingham Offspring Study reported in Diabetes Care in 2004.

—Reported in Diabetes Care, Volume 28, Number 6, June 2005

From Flab to Fab
‘When you lose weight through severely restricting your food intake, you lose some of your body’s muscle mass. Over the years this form of dieting will change your body composition to less muscle and proportionately more fat, making weight control increasingly difficult. Your body’s engine requires less and less energy to keep it ticking over. In fact it is sad but true that most people regain the weight they lost. A good diet does not require a lot of sacrifice or discipline—it’s sustainable over the long term because it’s enjoyable,’ say Brand-Miller and her co-authors in The Low GI Diet.

A reduced energy diet, the traditional treatment for obesity, has been only partially successful, write Austrian researchers in Diabetes, Obesity and Metabolism. Poor adherence long term and a significant loss of lean body mass resulting in a decrease of energy expenditure are contributing factors. Based on the growing body of evidence of the benefits of low GI carbs, the research team undertook a 24-week feasibility study to evaluate the effect on weight loss, body composition changes and dietary compliance of a low-fat diet with unrestricted low GI carbs. They found that combined with advice by a dietitian and bi-weekly one-hour group meetings, the low-fat, low-GI diet led to a significant reduction (-15%) of fat mass but only a small decrease in lean body mass (just -5%). Not only that, 109 of the 120 patients who took part stuck to the diet losing an average 8.9 kg (that’s around 370 grams a week on average). Lead author Babak Bahadori says that the diet may have benefited patients ‘by promoting satiety; and by promoting fat oxidation.’

—Reported in Diabetes, Obesity and Metabolism, 7, 2005, 290–293

Low Sat Fat + Low GI = Prevention of Heart Disease
Reduce blood sugar levels and you’ll reduce the risk of coronary heart disease say US researchers in Archives of Internal Medicine. According to lead author Elizabeth Selvin, ‘… lifestyle modifications, such as increased physical activity, weight loss and eating a healthful, low-glycaemic index diet rich in fibre, fruit and vegetables, may not only help prevent diabetes, but also reduce the risk of heart disease.’ The research team reports that elevated hemoglobin A1c—a measure of long-term blood glucose level that hovers between 4% and 6% in most people—is an independent risk factor for CHD even in those without diabetes. Their study was based on a prospective analysis of 1321 adults without diabetes and 1626 adults with diabetes from the Atherosclerosis Risk in Communities Study. Assessing the relationship between HbA1c level and CHD during 8 to 10 years of follow-up, they found that heart disease risk was almost doubled in people with HbA1c levels of 6 per cent or higher compared with people with an HbA1c level below 4.6 per cent.

—Reported in Archives of Internal Medicine, September 2005 (165, pp1910-1916).

GI Values Update

‘Cherries, ripe cherries …’
Summer just wouldn’t be the same without juicy, cheerful cherries. Well supplied with nutrients—vitamin C, beta-carotene, potassium, a little iron and some fibre—they are also high in phytochemicals such as anthocyanins (the pigments responsible for the red and blue colours of fruits and vegetables). And quercetin, an antioxidant that may have anti-inflammatory properties making cherries (particularly cherry juice) of interest to people who suffer from gout.



There are numerous varieties, but two basic types: sweet cherries (Prunus avium) and sour (also called tart or pie) cherries (P. cerasus). Buy fresh sweet cherries with the stems intact and store unwashed and loosely packed in plastic bags in the refrigerator. They should keep for up to a week, but it is a good idea to check occasionally and remove any that have begun to go mouldy. You can extend the all-too-short cherry season by freezing them. Rinse and drain thoroughly, then spread the cherries out on a baking tray, freeze, then place the cherries in a plastic container or freezer bag. They should keep for up to a year.

Although you can find fresh sour cherries in produce stores and markets (usually without stems), commercially grown sour varieties are usually canned, dried or frozen for use in throughout the year.If you can’t find dried sour/tart cherries in your supermarket, look for them in specialist produce stores. They are not widely available in Australia, for example, but well worth tracking down. One supplier is Dry Ideas, an innovative fruit drying company based in Tasmania that’s been developing preservative free (no sulphur) dried sour cherries, blueberries and apricots for the past 10 years. For more information go to http://www.scientifichorticulture.com.au/. North American readers can check out availability at http://www.usacherries.com/ (Where To Buy).

Because cherries are a good source of carbohydrate, they can be glycemic index tested. The original GI for cherries (22) was based on an early European study that may not have been reliable. Later tests of red ripe Australian cherries, with 6 per cent glucose and 4 per cent fructose, produced a higher GI (65). Dried and frozen Montmorency tart cherries have recently been tested by Glycemic Index Laboratories in Toronto (www.gitesting.com) for the Cherry Marketing Institute in the US.

Montmorency tart (sour) cherries

• Frozen tart cherries GI 54
• Dried tart cherries GI 58

Fire-Roasted Corn and Cherry Salsa

Serve this medium-hot salsa from the Cherry Marketing Institute with grilled chicken, pork or fish. Use fewer or more chipotle chillies to make salsa milder or hotter. For more cherry recipes go to to http://www.usacherries.com/

Makes 3 cups



1 cup (180 grams/6 1/4 oz) dried tart cherries
1/2 cup (125 ml/4 fl oz) water
3 fresh corn ears, shucked
1 small red (Spanish) onion, chopped
1 tablespoon finely chopped garlic
1/4 cup (15 grams/½ oz) chopped coriander (cilantro)
2 to 3 whole chipotle chillies in adobo sauce, finely chopped
1/2 cup (125 ml/4 fl oz) lemon or lime juice
Salt, to taste

1) Heat the cherries and water in a small saucepan. Simmer for about 5 minutes, or until the cherries have plumped and water is slightly syrupy. Set aside to cool.
2) Meanwhile, roast each ear of corn directly over gas flame on the stovetop or over a gas grill or barbecue (just as you would for a roasted capsicum/pepper). Turn the corn until each ear is slightly charred all around. Set aside to cool. Cut corn kernels from cobs.
3) Combine corn, cherries with liquid, onion, garlic, coriander, chillies and lemon juice. Season with salt to taste and serve.

Cook’s Tips

• Use 2 or 3 dried chipotle chillies rehydrated in a little water if chipotle chillies in adobo sauce aren’t stocked at your local supermarket or corner store.
• Adobo Sauce is a spicy tomato sauce made with ancho (poblano) chillies, cumin, oregano, cayenne and tomato sauce. There’s a great recipe for it in The Wholefoods Market Cookbook.

Low GI Food of the Month

The Versatile Tortilla—Perfect for Wrapping, Scooping and Dipping
Tortillas are a flat (unleavened) bread traditionally made from corn (maize) flour. A staple of Mexican cuisine, they are quite different from the Spanish tortilla, which is a type of omelet. And when made in the traditional Mexican way, whether from corn or wheat flour, they have a low GI.


Photo: Ian Hofstetter, The Low GI Diet Cookbook

Almost any kind of food that does not contain too much liquid—beans, corn or chicken, chilli or salsa—can be placed on or wrapped in the versatile tortilla for a complete meal. Make the most of them with your favourite recipes for burritos, enchiladas, fajitas and quesadillas (but hold the creamy dips) or use as rolls, wraps or scoops. Corn tortillas are also a good alternative to bread if you are gluten intolerant.

To make bean and corn burritos, preheat the oven to 180°C (350°F/gas mark 4). Combine a 400 gram (14 oz) can of corn kernels, drained, a 400 gram (14 oz) can of red kidney beans, rinsed and drained, 2 large ripe tomatoes, chopped, 2 shallots, finely sliced and 75 g (2½ oz) prepared taco sauce in a bowl. Wrap four 15 cm (6-inch) white corn tortillas in foil and warm in the oven for 5 minutes. To assemble, spread shredded lettuce over a warmed tortilla, and top with the bean mixture and a little grated fat reduced cheese. Fold the bottom of the tortilla over the filling, and roll up to enclose. Serve immediately. Makes 4.

Low GI Recipe of the Month

Conchiglie with Pesto Balsamico
Dietitian, diabetes educator and author, Johanna Burani, cooked up this quick and easy pasta recipe especially for GI News! We wanted something simple and convenient and ‘very Italian’. ‘This pasta is nourishing, easy to prepare and something Italian cooks serve regularly to their families,’ says Johanna. Try it with salads on the side such as rocket and Parmesan, tiny vine tomatoes drizzled with good quality balsamic vinegar and a little olive oil.

Makes 4 servings


Photo: Jennifer Soo, The New Glucose Revolution Life Plan

250 g (8 oz) conchiglie (shell), farfalle (bowtie) or your favourite pasta shapes
1 cup (250 g) part skim ricotta cheese
2 tablespoons good quality pesto sauce
3–4 teaspoons good quality balsamic vinegar

1) Bring 2 litres (4 quarts) of salted water to a boil in a large pot. Add the pasta and stir. Cook approximately 12 minutes; the pasta should be al dente.
2) In the meantime, mix the ricotta and pesto in a small bowl until smooth. Set aside.
3) When the pasta is cooked, drain and return it to the pot. Quickly add the vinegar and mix well.
4) Pour the prepared sauce and toss. Serve immediately. Grated pecorino cheese is optional.

Per serve (1 cup)
1453 kJ (346 Cal) 11 g, 16 g protein, 45 g carbohydrate 2 g fibre

Johanna Burani MS, RD, CDE is a registered dietitian and certified diabetes educator in private practice in northern New Jersey. She counsels and lectures on healthful low glycemic eating. She particularly enjoys sharing recipes from her international background with her patients. She is the author of Good Carbs Bad Carbs and the American co-author with Prof Jennie Brand-Miller and Kaye Foster-Powell of The New Glucose Revolution Life Plan. She can be reached at: jburani@gmail.com

New Books

What Makes My Blood Glucose Go Up and Down?
In the foreword to the UK edition of What Makes My Blood Glucose Go Up and Down:
Sir Michael Hirst, Chairman, Diabetes UK (http://www.diabetesuk.org/) says:

‘One of the most challenging problems for people with diabetes, particularly the recently diagnosed, and their carers, is trying to maintain good glycaemic control. When my daughter, diagnosed with type 1 diabetes at the age of five, was younger, we were often mystified as to why her blood sugar levels varied for no apparent reason. There was often the suspicion that an unauthorised visit to the sweetie jar had taken place! More challenging still was to find out the effect of particular foods and drinks on blood glucose levels in the days when food labelling was very much less sophisticated. Such books and periodicals as we could access never really provided all the answers we wanted, and it was thus hard to add to our knowledge base.



‘This books provides a wealth of information to enable the patient, carer and family to be much better informed about the circumstances in which blood glucose levels vary. As such it is a vital support for self-management and an excellent reference book, not least for the parents of younger people with diabetes. As food and drink producers become more sensitive to the demand from the public—and not just those with diabetes—for the information on glycaemic index and glycaemic load and improved labelling on food and drink, an informed and independent guide, written for members of the public, is much to be welcomed.

‘Every professional involved in diabetes care, reinforced by a huge weight of clinical research evidence, knows that good glycaemic control is vital in maintaining continuing good health in the person with diabetes, and avoiding the serious, unpleasant and costly complications which can arise. In explaining the many reasons why blood glucose levels vary, and in offering related advice on diet and glycaemic control, care professionals will find this a most useful book to recommend to those who want to be, and remain, healthy.

‘What Makes My Blood Glucose Levels Go Up…and Down? is written in straightforward terms that patients and carers can readily understand and offers a lot of sound advice, by authors who have extensive knowledge and practical experience. From their separate standpoints as scientist, dietitian and person with diabetes, Jennie Brand-Miller, Kaye Foster-Powell and David Mendosa have covered all angles and have produced a definitive guide which is all the more helpful because it stands above the often conflicting welter of commercially inspired information about diets, blood glucose levels and health.’

UK: Vermillion
USA: Marlowe & Company
Taiwan: The Eurasian Publishing Group
Australia/New Zealand: Hachette Livre Australia

Feedback—Your FAQs Answered

Why do many high-fibre foods still have a high GI value?
Dietary fibre is not one chemical constituent like fat and protein. It is composed of many different sorts of molecules and can be divided into soluble and insoluble types. Soluble fibre is often viscous (thick and jelly-like) in solution and remains viscous even in the small intestine. For this reason it makes it harder for enzymes move around and digest the food. Foods with more soluble fibre, like apples, oats, and legumes, therefore have low GI values.

Insoluble fibre, on the other hand, is not viscous and doesn’t slow digestion unless it’s acting like a fence to inhibit access by enzymes (eg the bran around intact kernels). When insoluble fibre is finely milled, the enzymes have free reign, allowing rapid digestion. Wholemeal bread and white bread have similar GI values. Brown pasta and brown rice have similar values to their white counterparts.

After reading your book I thought the idea of finding and eating low GI carbs seems very logical. So I was surprised to find that the American Diabetes Association has taken a position that is not supportive of this research. The comments I read in a Guest Editorial of their Sept 2005 issue of Diabetes Forecast suggest your approach may be more of a fad than a useful tool.
Our response: We found this Guest Editorial rather odd because the American Diabetes Association has given cautious endorsement to the glycemic index. In its September 2004 Statement on carbohydrates one of the final recommendations is ‘the use of this technique can provide an additional benefit over that observed when total carbohydrate is considered alone.’ (Nancy Sheard et al. Diabetes Care 2004; 27: 2266).

Our advice? In Low GI Eating Made Easy, dietitian Kaye Foster-Powell says: ‘On a day-to-day basis, low GI foods can minimise the peaks and troughs in blood glucose that make life so difficult when you have diabetes. Since they are slowly digested and absorbed, low GI foods reduce insulin demand—lessening the strain on the struggling pancreas of a person with type 2 diabetes and potentially lowering insulin requirements for those with type 1 diabetes. Lower insulin levels have the follow-on benefit of reducing the risk of large blood vessel damage, lessening the chance of developing heart disease. There isn’t any one optimum diet for all people with diabetes. Whether you eat higher fat, low fat, high protein, high carb or whatever, certain characteristics are desirable. They are to eat:

• Regular meals and choose slowly digested carbs with a low GI
• Plenty of vegetables and fruits
• Only small amounts of saturated fat
• A moderate amount of sugar and sugary foods
• Only a moderate quantity of alcohol
• A minimum amount of salt and salty foods