GI News—December 2005

In This Issue:

• Energy to Burn for the Festive Season
• Children’s Growth Rate May Predict Future Problems
• You Can Enjoy a Pre-dinner Drink
  
• Potato Salad Anyone?
• A Matter of Endurance
• Vegans Lost Weight without Feeling Hungry

• Snack Bars
• Pears
• Garlic Prawns, Red Capsicum and Coriander (Cilantro) Pasta
  
  
• Susie, ‘43, but feeling like 29!’
• 2006 Shopper’s Guide to GI Values
• We use a lot sprouted breads and cannot find them in your database or books. Can you give us some information on how or if this affects GI numbers?
• Create an RSS News Feed for GI News

NEW FEATURE—YOUR SUCCESS STORIES: We receive a great deal of feedback from readers and visitors to our website about how a low GI diet has made a real difference to their lives along with some inspiring weight loss and blood glucose control stories. So, this month we are introducing a new feature: ‘Your Success Stories’ to share these stories with you. Each month from now on we will run one ‘success’ story in GI News. The stories will then be archived at glycemicindex.com for ready reference. If you feel you have a story that will inspire or help others and you are prepared to give permission for it to be published in GI News, please send it to us HERE with your name and a contact email address. We would like to thank Susie for volunteering to be our first contributor.

Your QUESTIONS answered. If you have posted a question in our newsletter, be assured that the GI Group will answer this as soon as possible. We welcome views about our articles and readers’ suggestions.

To PRINT ONE ARTICLE (ie. the recipe from the newsletter), simply click on the recipe or article name in the right-hand column under PREVIOUS POSTS. You will arrive at the page you have chosen. Select PRINT and you will find that you can print just the information you want.

To receive our FREE e-newsletter each month, click the SUBSCRIBE link in the right-hand column and send us an email. Your email address will be kept strictly confidential and you can unsubscribe at any time.

‘Aim for at least one smart low GI carb per meal.’

Jennie Brand-Miller

Food for Thought

Energy to Burn for the Festive Season
For the right fuel, fitness and stamina to make it through the non-stop demands of the festive season, try these energy-boosting tips.

Make breakfast a priority Fire up your engine with low GI carbs. A good breakfast recharges your brain, speeds up your metabolism after an overnight fast, and reduces those feelings of stress.

Don't skip meals Take a break to refuel at lunch time to maintain energy levels right through the afternoon. Hold back on the high GI carbs to minimise that post-lunch energy dip. And take time over one main meal every day to make sure you aren’t missing out on the vital vegetables you need.

Build your meals around low GI carbs For day-long (and night-long) energy, fuel your body with low GI carbs. Whether it’s a home-cooked meal or you are eating out, pick the 1, 2, 3 meal planner:
1. Start with a low GI carb
2. Add some lean protein
3. Plus a generous serving of vegetables



Pace yourself Eating and drinking in moderation will help you pace yourself on the social merry-go-round. If you are planning a big night out, don’t starve yourself beforehand. All that does is reduce your metabolic rate. Have a light breakfast and lunch, and before you head off to the party tuck into a quick and easy low GI snack such as a sandwich made with grainy bread and a glass of low fat milk or a tub of low-fat yoghurt and a dollop of fruit.

Be discerning with drinks Make water your first choice. Ask for some routinely, chances are you’ll drink it if it’s in front of you. Go easy on the sugary drinks (they tend to bypass satiety mechanisms) and drink no more than one to three glasses of alcohol.

Move it Cut stress in its tracks. Exercise helps to relieve stress (it releases the ‘feel good’ chemicals that negate energy and stress) and keeps your body strong. Get on your bike or into your joggers and get that heart rate pumping for at least 20 minutes a day.

Sleep tight Sleep sustains you when you are out and about night after night. Get seven or eight hours of sleep a night if you can. Plan for it. Make a date with yourself in your diary to catch up on some sleep.

GI News Briefs

Children’s Growth Rate May Predict Future Problems
Rapid weight gain after two years of age may be creating insulin resistant adults according to a study by Prof David Barker and his colleagues from Oregon Health and Science University (US), and the University of Southampton (UK) reported in the 27 October 2005 issue of the New England Journal of Medicine. ‘Our research shows that it is the rate of weight gain, not the degree of fatness at any one time, which is the main predictor of future problems,’ said Barker. According to Barker, slow early development and under-nutrition in the womb may program a ‘thrifty’ metabolism, which includes insulin resistance that becomes inappropriate with adequate or excess nutrition in childhood.

The researchers looked at detailed height and weight records for 8,760 people who were born in Finland between 1934 and 1944. The group’s growth had been closely tracked from birth to age 11. When the researchers then checked out hospital records, they found that 357 men, and 87 women from the group had been treated for or died from coronary heart disease. On average, those who had a coronary event had been small babies and tiny two-year-olds and thereafter put on weight rapidly to catch up to the average size of their age group by 11. The risk of coronary events was more strongly related to the rate (tempo) of childhood gain in body mass index (BMI) than to the BMI attained at any particular age. The researchers worked closely with Prof Johan Eriksson in Finland whose team examined 2003 of the group alive today, checking their glucose, insulin and cholesterol levels. The smallest babies and 2-year-olds tended to have higher blood pressure and levels of fasting blood sugar and insulin as adults.

The researchers say that the findings are likely a result of the impact of early weight gain on long-term insulin processing. Barker thinks the risk from this change in size is connected to body composition. ‘All children gain muscle as they grow. But a child's ratio of muscle to body weight is largely set by age two, barring serious exercise,’ he said. ‘So small children who catch up to average weight adding fat, ending up with a higher fat-to-muscle ratio that predisposes to diabetes and heart vessel disease.’
—New England Journal of Medicine 2005;353:1802–9

You Can Enjoy a Pre-dinner Drink
Many studies have linked moderate alcohol consumption (that’s 1, 2 or 3 drinks a day, depending on your gender and weight) with reduced risk of cardiovascular disease and type 2 diabetes. The question is ‘why’? Clinical trials have shown that alcoholic beverages, irrespective of type, increase your HDL or ‘good’ cholesterol levels as well as improve insulin sensitivity. There may be other mechanisms operating according to a paper presented at Nutrition Society of Australia. Researchers Kaniz Fatima and Chris Middlemiss from the School of Human Nutrition at the University of Sydney found that a pre-dinner drink (beer, wine and gin were used in the study) tends to reduce the blood-sugar response to the next meal. In three separate studies, 38 healthy, young, lean people drank two standard glasses of beer, or wine, or gin and tonic or water about an hour before eating then their blood glucose and insulin levels were measured. The researchers found the alcohol seemed to produce a ‘priming’ effect, kicking off the metabolism process and keeping blood-sugar levels low. ‘Realistic amounts of beer, wine or gin reduce postprandial glycemia but not insulinemia’ say the researchers in their conclusion. ‘This effect applies to drinks consumed alone in lieu of a starchy snack, or simultaneously with a meal, or as a pre-dinner cocktail.’
—Nutrition Society of Australia, November 2005



Potato Salad Anyone?
Boiled, mashed, steamed or fried, just about everybody loves potatoes. Unfortunately, a low GI variety of potato is hard to come by. The good news for potato lovers is that a potato salad made the day before with a vinegary vinaigrette dressing and kept in the fridge can lower the GI. Margareta Leeman and her colleagues at the University of Lund in Sweden in their report in the European Journal of Clinical Nutrition say that compared with freshly boiled potatoes, the GI of boiled cold-stored potatoes with vinaigrette, were reduced by 43 per cent. For the study, 13 healthy volunteers tucked into freshly boiled potatoes; boiled and cold-stored potatoes (8o°C for 24 hours); and boiled and cold-stored potatoes tossed in a vinaigrette dressing. (The dressing was made with 8 grams of olive oil and 28 grams of white vinegar at 6 per cent acetic acid.) All meals contained 50 grams available carbohydrate and were served at breakfast time after an overnight fast. Cold storage increased the potatoes’ resistant starch content from 3.3 to 5.2 per cent.
—European Journal of Clinical Nutrition, (2005) 59, 1266–1271



A Matter of Endurance
Athletes commonly consume high carb foods or drinks after exercise to replace their muscle glycogen stores as rapidly as possible—especially when they are training and competing on consecutive days. Dr Emma Stevenson and the Sport and Exercise Nutrition Research Group at Loughborough University compared the effects of high and low GI carbohydrate recovery diets in the 24 hours following prolonged heavy exercise. Nine active male athletes took part in two trials. On the first day they ran for 90 minutes at 70% VO2 max and then ate either a high or low GI recovery meal which provided them with 8 grams of carbohydrate per body mass. The next day after an overnight fast they ran to exhaustion. ‘The results of the present study show the consumption of a low GI diet in the 24 hours following prolonged running increased endurance capacity the next day beyond that which was achieved following the consumption of a high GI carbohydrate recovery diet. A higher rate of fat oxidation throughout the run to exhaustion in the low GI trial is a possible explanation for this increased endurance capacity,’ concludes the research team. Stevenson told GI News: ‘When the recovery period between exercise sessions is a day or more, low GI carbs may be just as effective for optimal recovery as high GI carbs and they will also promote the burning of fat as fuel as you exercise.’
— International Journal of Sport Nutrition and Exercise Metabolism, 2005, 15, 333–349



Vegans Lost Weight without Feeling Hungry
A high carb, low fat, vegan diet with no limit on portion size proved as effective as a 1200 cal a day reduced energy diet according to a study reported in the September issue of The American Journal of Medicine. Dr Neal Barnard, President of the Physicians Committee for Responsible Medicine with colleagues from Georgetown University Hospital and George Washington University conducted the study involving 59 overweight, postmenopausal women. ‘The study participants enjoyed unlimited servings of fruit, vegetables, whole grains and other healthful foods that enabled them to lose weight without ever feeling hungry,’ said Barnard. Animal products, added oils, avocados, nuts, nut butters and seeds were proscribed. The control group’s diet was based on (US) National Cholesterol Program guidelines. During the 14-week study, there were no limits on portion sizes and the women were asked not to alter their normal exercise patterns. They were given detailed nutrition guidelines for preparing their own meals or eating out and they attended weekly hour-long meetings with a physician and dietitian that included cooking instruction. ‘The low-fat, vegan diet was associated with significant weight reduction along with improvements in measure of glucose tolerance and insulin sensitivity … longer-term trials will determine the sustainability of the intervention diet’ concludes the report. For a copy of the paper, contact jeannem@pcrm.org
—The American Journal of Medicine

GI Group says: Competition is fierce in the race between the advocates of high protein versus vegetarian diets for weight loss. It’s clear that there’s more than one good diet. Humans can derive food energy in multiple ways and still be healthy specimens. The trick is to find a healthy diet that you can live with over the long term. For some, that will be high in lean animal proteins, for others it will be high in plant foods. Either way, low GI carbs are the way to go.

GI Values Update

Snack Bars
Healthy snack bars can be convenient and portable snacks for children (think lunch boxes or sport) and adults alike. And they definitely suit today’s busy, time-pressed, eating-on-the-go/in-the-car lifestyle. So, which one to choose? It pays to be fussy and check the nutrition panel as some are very high in fat. To give you an idea what to look for when choosing a snack bar, here’s the GI Symbol Program criteria:
FAT: less than total fat 5 grams per 100g or 5–10 grams per 100 grams if saturated fat is less than 20 per cent of the total fat
SODIUM: less than 400 mg per 100 grams
DIETARY FIBRE: more than 3 grams per 100 grams
CARBOHYDRATE: 35 grams per serve
ENERGY: less than 1500 kJ/357 Cal per 100 grams or les than 500 kJ/119 Cal per serve

Here are some products we know have a low GI that you can find on your supermarket shelves.

In Australia
Sunripe School straps are 100 per cent dried fruit bars
Sunripe School Straps Strawberry GI 40
Sunripe School Straps Wildberry GI 40
Sunripe School Straps Go Fruits GI 40
Sunripe School Straps Blackcurrant Sour Buzz GI 35

In Canada and USA
Solo GI Nutrition bars are specially formulated low GI snack bars. For more information, check out www.solo-gi.com
Solo GI Nutrition Chocolate charger Nutrition Bar GI 28
Solo GI Nutrition Berry Bliss Bar GI 22
Solo GI Nutrition Peanut Power Nutrition Bar GI 27
Solo GI Nutrition Mint Mania Nutrition Bar GI 23

For more details on snack bars, check out the database at www.glycemicindex.com or The New Glucose Revolution 2006 Shopper’s Guide to GI Values.

Granola Bars
For something seriously sustaining, try these low GI granola bars. The recipe is from The New Glucose Revolution.



Preparation time: 10 minutes
Cooking time: 14–20 minutes
Makes 12 bars

½ cup (75 g) wholemeal (whole-wheat) flour
½ cup (75 g) self-rising flour
1 teaspoon baking powder
½ teaspoon mixed spice
½ teaspoon ground cinnamon
1½ cups (135 g) rolled oats
1 cup (150 g) dried-fruit medley or dried fruit of choice, chopped
¼ cup (35 g) sunflower seed kernels
½ cup (125 ml) apple juice
¼ cup (60 ml) oil
1 egg, lightly beaten
2 egg whites, lightly beaten

1. Preheat the oven to 200°C/400°F)
2. Line a 20 cm x 30 cm (8 in x 2in) baking pan with parchment paper.
3. Sift the flours, baking powder, and spices into a large bowl. Stir in the oats, fruit, and seeds and stir to combine.
4. Add the apple juice, oil, and whole egg; mix well. Gently mix in the egg whites until combined.
5. Press the mixture evenly into the prepared pan and press firmly with the back of a spoon. Mark the surface into 12 bars using a sharp knife.
6. Bake for about 15 to 20 minutes or until lightly browned.
7. Leave to cool in the pan then cut into bars and store in a sealed cookie container.

Per bar
KJ/Cal 590/140, carbohydrate15 g, fat 8 g, fibre 3 g

Low GI Food of the Month

… And a Partridge in a Pear Tree
Juicy, sweet pears (GI 38) are one of the world’s most loved fruits—they’ve been immortalised in poetry, paintings and a Christmas carol! They are renowned as a non-allergenic food, thus a favourite when introducing babies to solid foods. An excellent source of fibre and rich in vitamin C and potassium, fresh pears have a low GI because most of their sugar is fructose.


Photo: Ian Hofstetter, The Low GI Diet Cookbook

Canned pears in ‘natural juice’ also have a low GI (44) because the fructose remains in high concentration during processing. Single-serve tubs and cans are also available. Again, look for those in natural juice. Although they are often hard when you buy them, pears will ripen at room temperature in a few days. Pack a pear for lunch or to snack on during the day—there’s no need to peel as the skin is a good source of fibre.

• Dip pear slices in lemon juice and serve with cheese and walnuts.
• Toss in salads—try pear, avocado, rocket or radicchio and walnuts.
• Poach or bake pears in a light citrus syrup, champagne and orange juice with a vanilla bean or in red wine with a touch of cardamom.
• Simmer four pears, peeled and quartered in 4 cups (1 litre/1 quart) water with a cinnamon stick, 3 or 4 cloves and a strip or two of lemon rind for 20 minutes and serve with grilled, bakes or barbecued pork fillet.
• Top a bowl of porridge with grilled pear slices and a drizzle of honey or some brown sugar.

—from Low GI Eating Made Easy

Low GI Recipe of the Month

Garlic Prawns, Red Capsicum and Coriander (Cilantro) Pasta
Lisa Lintner’s delicious recipe is a real crowd pleaser when entertaining family and friends—and it is a good source of omega-3 fats.

Serves 4
Preparation time: 8 minutes plus 10 minutes to marinate the prawns
Cooking time: 11 minutes

250 g/12 oz spinach fettuccine
500 g/1 lb green king prawns (giant tiger prawns), shelled and deveined (leaving heads and tails on if desired)
4 cloves garlic, finely sliced
1⁄4 cup (60 ml) extra virgin olive oil
salt and freshly ground black pepper
2 large red or yellow peppers, seeded and thinly sliced
1⁄2 bunch fresh coriander (cilantro), coarsely chopped

1. Heat a large pot of salted water.
2. Preheat the grill to moderately high.
3. Toss the prawns with the sliced garlic and olive oil in a large bowl, and marinate for 10 minutes.
4. When water boils, add the pasta and cooked uncovered for about 11 minutes. Stir occasionally.
5. Grill the marinated prawns for 2 minutes, coating them with the marinade, until cooked.
6. Grind salt and freshly ground black pepper over the prawns.
7. Drain the pasta and toss in 1 teaspoon of olive oil.
8. On a large serving platter combine the pasta, prawns, capsicum (pepper) strips and chopped coriander (cilantro).
9. Serve hot with crusty low GI bread.

Per serving
kJ/Cal 1367/326 , protein 23 g, fat 11 g, carbohydrate 44 g, fibre 3 g


Photo: Jennifer Soo, The New Glucose Revolution Life Plan

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 creating low GI recipes with 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

What's New?

Your Success Stories
Susie ‘43, but feeling like 29 now!’
June 2005: ‘I'd like to let you know that I purchased The Low GI Diet book three months ago, because I was diagnosed with pre-diabetes. I didn't know where to start or how to begin to plan my meals. With the help of your fabulous book I have managed to lose 1 stone (14 lb/6.3 kg) in weight. And of course the book has taken a lot of thinking out of planning meals. My husband also thinks its great and loves the recipes.’
October 2005: ‘I thought I'd give you an update as I emailed you in June, just to let know that I have now lost a total of 4 stone (56 lb/25.4 kg) in weight and am feeling so much better for it. I am at my target weight and have been for about two months now.'
November 2005: ‘I don't mind at all being your first true story, people like me needed a book like yours and it works. I did not feel like I was on a “diet” as such because I felt as though I was always eating. It took a bit of getting use to at first because I'm not a veggie person at all, but found using Balsamic vinegar with salads helped. And I did cheat with main meals by having gravy as I don't like dry food or veggies but I ate them. I guess if I had religiously stuck to the book I would probably be down to 9–9½ stone (126–133 lb/56.7–60 kg). But my weight has gone from nearly 14½ stone (203 lb/92 kg) to 10 stone (140 lb/63 kg). And I feel you needed to be told that your book worked for me. The other thing is I did do more exercise than the book said.’



Books, DVDs, Websites: What’s New?
Shopper’s Guide to GI Values 2006
This handy shopper’s guide to the GI values of around 600 foods will help you put those low GI food choices into your shopping trolley and onto your plate. To make an absolutely fair comparison, all foods included in the guide have been tested following an internationally standardised method. However, the authors remind readers that the GI is just one tool in the toolbox and should not be used in isolation. The overall nutritional value of the food needs to be considered, too. The authors remind readers that not all low GI foods are a good choice; some are too high in saturated fat and sodium for everyday eating. Foods that are high in saturated fat, for example are indicated.

The authors recommend that you use the GI tables to:

• identify the best carbohydrate choices
• find the GI of your favourite foods
• compare carb-rich foods within a category (two types of bread or breakfast cereal for example)
• improve your diet by finding a low GI substitute for high GI foods
• put together a low GI meal
• help you calculate the GL of a meal or serving if it is more or less than our specified nominal portion size

To give you the full picture of the glycemic impact of foods, the tables also include the glycemic load (GL) of average sized portions. Glycemic load is the product of GI and the amount of carbohydrate in a serving of food. Use the GL tables to find foods with a high GI but low carbohydrate content per serving. Remember: the GL values listed in the tables are ONLY for the specified nominal portion size. If you eat more (or less) of that food you will need to calculate another GL value.

If you can’t find the GI value for a food you regularly eat, the authors suggest that you check out www.glycemicindex.com—an international database of the latest published GI values that have been tested by a reliable laboratory. Alternatively, contact the manufacturer and encourage them to have the food tested by an accredited laboratory or to publish the values of their products.



The Shopper’s Guide to GI Values is published in:
Australia: Hachette Livre Australia (www.hachette.com.au/ngr.html)
New Zealand: (Hachette Livre New Zealand)
USA and Canada: Marlowe & Company (in store January 2006)

CORRECTION
Catherine Saxelby’s healthy eating and nutrition website is www.foodwatch.com.au

Feedback—Your FAQs Answered

We use a lot sprouted breads and cannot find them in your database or books. Can you give us some information on how or if this affects GI numbers?

The only sprouted bread we can find that has been GI tested is Silver Hills Bakery’s Balanced bread (GI ±57) that was tested by Glycemic Index Laboratories in Toronto. Ron Donatelli who is involved in research and development at Silver Hills Bakery says: ‘We don’t used refined flour. With sprouted grain breads the entire grain is used making it a true “Whole Food” rather than refined flour where most all of the bran, germ and endosperm is stripped away for shelf life and stability. At Silver Hills Bakery we sprout the whole organic grain and mash it up in its entirety.’ Ron says that the bread is ‘soon to be available in the Pacific Northwest in most major grocery chains.' Check their website for details: www.silverhillsbakery.com
‘Bread made from sprouted grains might well have a lower blood-glucose raising ability than bread made from normal flour’ says Jennie Brand-Miller and her co-authors in What Makes My Blood Glucose Go Up and Down? ‘Why’s that? When grains begin to sprout, carbohydrates stored in the grain are used as the fuel source for the new shoot. Chances are that the more readily available carbs stored in the wheat grain will be used up first, thereby reducing the amount of carbs in the final product. Furthermore, if the whole kernel form of the wheat grain is retained in the finished product, it will have the desired effect of lowering the blood glucose level. Physically limiting access of digestive enzymes to the starchy endosperm helps to reduce the rate of starch digestion.’
(Source: What Makes My Blood Glucose Go Up and Down?
USA: Marlowe & Company; UK: Vermilion; Taiwan: The Eurasian Publishing Group; Australia/New Zealand: Hachette Livre Australia)

Create an RSS News Feed for GI News
For those of you using Firefox [http://www.mozilla.org/products/firefox/start/] for your web browsing, there is a fantastic and free extension that can be added to the browser for creating easy access to what is known as ‘Really Simple Syndication’ or an RSS feed for short. RSS is a web standard for the delivery of news and other frequently updated content provided by websites. The extension that we recommend is called ‘Sage’. Sage not only gives you fast access to updates from our GI Newsletter as they occur on the first of every month but any of your favourite sites that support RSS can be added too. What’s more, Sage presents a summary of the new information in your browser window graphically.

To get started, you’ll need to download and install Sage [http://sage.mozdev.org/install/] while using Firefox. Once installed, quit Firefox and then restart to activate Sage. In the Tools menu, select Sage or just use the key-command Alt-S. A new Sage tab and column will appear on the left side of the browser window. Right-click in the top left frame and select New Bookmark. Give it a name (GI Newsletter for example) in the Name field and then paste the following address into the Location field:

http://feed.ginews.blogspot.com/atom.xml

That’s it! Now click on the new entry you created and a whole list of GI news entries will be generated in the lower left window frame. If you click on any of these entries, the corresponding story will appear in your browser window. Sage will automatically keep the list updated as new stories appear from GI News and any of your other favourite news sites.

Note: users of Mac OS 10.4 already have a similar feature built into the Safari web browser. Click on the blue RSS button in the right-hand side of the address bar when you are on the GI news site.

© ® & ™ The University of Sydney, Australia

GI News—November 2005

In This Issue:

• Unlock the Stairways and Step into Metabolic Fitness
• Tossing and Turning?
• GI and Weight Loss Benefits: Boost or Boast?
  
• A Little Resistance Goes a Long Way
• GI? GL? GR? IL? GGE? Getting the Measure

• ‘Wholegrain’ and Low GI Are Not the Same
• Juicy Pomegranates
• Porridge Power
  
  
• Michelle Trute’s Sweet Corn Loaf
• Paul Sacher’s From Kid to Superkid
• Catherine Saxelby’s Nutrition Website: www.foodwatch.com.au
• What about flour? If I make my own bread (or dumplings, pancakes, muffins etc) which flours, if any, are low GI?

If you have posted a question on one of the stories in our newsletter, be assured that the GI Group will answer this as soon as possible. We welcome your views about our articles and other reader’s suggestions. Please POST your comments on the site.

If you want to print a copy of just one article (ie. the recipe from the newsletter, simply click on the recipe or article name in the right-hand column under PREVIOUS POSTS. You will arrive at the page you have chosen. Select PRINT and you will find that you can print just the information you want.

To receive our FREE newsletter each month, click the SUBSCRIBE link in the right-hand column. Your email address will be kept strictly confidential and that you can unsubscribe at any time.

‘Everyone can benefit from the low GI approach to eating.

It is the way nature intended us to eat—

slow-burning, nutritious foods that satisfy our hunger.’

Jennie Brand-Miller

Food for Thought

Unlock the stairways and step into metabolic fitness
Exercise and activity speed up your metabolic rate (increasing the amount of energy you use) which helps you to balance your food intake and control your weight. Exercise and activity also make your muscles more sensitive to insulin and increase the amount of fat you burn. Best of all, the effect of exercise doesn’t end when you stop moving. People who exercise have higher metabolic rates and their bodies burn more kilojoules per minute even when they are asleep!

But you don’t have to run a marathon or join a gym to achieve ‘metabolic fitness’. Seemingly small actions add up to big health benefits that in the long run in conjunction with a low GI diet can reduce your risk of diabetes and heart disease.

It might not feel as if occasionally climbing a flight of stairs instead of taking the lift makes a difference. But it does. A recent study reported in the British Journal of Sports Medicine (2005; 39: 590–593) found that a group of healthy (but sedentary) 19-year-old female office workers who took just two minutes to climb the 199-step stairway in their office building with increasing frequency over an eight week period achieved a 17 per cent increase in aerobic capacity and an 8 per cent decrease in ‘bad’ LDL cholesterol. ‘Such exercise can easily be incorporated into the working day,’ says lead author, Prof Colin Boreham, Professor of Sport and Exercise Science at the University of Ulster, ‘and should be promoted by public health guidelines.’

Don’t despair if the stairways in your office building or apartment block are locked and alarmed and you have to take the lift. ‘Researchers have found that exercise of moderate duration and intensity—including walking—is associated with reduced risk of disease. While brisk walking is best, even slow walkers benefit! Ideally you should accumulate 30 minutes or more on most days of the week. The good news is you can do it in two 15-minute sessions or six 5-minute sessions. It doesn’t matter … To make a real difference to your health and energy, however, physical activity has to be regular and some of it needs to be aerobic. But every little bit counts—and, best of all, any you do that’s more than you are currently doing, is a step in the right direction,’ says Prof Jennie Brand-Miller in Low GI Eating Made Easy.


Photo: Ian Hofstetter, The Low GI Diet Cookbook

GI News Briefs

Tossing and Turning?
A small study by Sydney University PhD student, Ahmad Afaghi, reported in The Australian found a high-GI meal eaten four hours before bedtime cut the time needed to get to sleep. Afaghi presented his results at the Australasian Sleep Association Conference in October 2005. He found that the average was nine minutes for people who had eaten a high-GI meal, but 17.5 minutes for those who ate a comparable meal. ‘It makes sense from a physiological point of view,’ says Prof Jennie Brand-Miller. ‘Glucose levels affect the level of trytophan in the blood and therefore serotonin in the brain.’ However, it’s very early days and needs to be confirmed by larger, long-term studies before recommending people with sleep problems start experimenting with high GI meals.

GI and Weight Loss Benefits: Boost or Boast?
Researchers from the University of Minnesota set out to test whether reducing the glycemic index of a diet already low in calories would have any further weight loss benefit for obese adults. The small study reported in the Journal of Nutrition confirmed the benefit of lowering glycemic index on insulin sensitivity but not for additional weight loss.



The researchers randomly allocated a group of 29 obese adults to a high GI, low GI or high fat diet (there were about 9 or 10 people in each group). The kilojoule-restricted diet provided ~3000 kJ less than estimated energy needs. The team gave the 29 participants their food for the first 12-week phase and instructions (22 participants at this stage) for the second 24-week, ‘free-living’ part of the trial. At 12 weeks, they found significant weight changes from baseline in all groups, but no difference among groups, with weight loss ranging from 8.4 to 9.9 kg. All groups had improved insulin sensitivity. During the free-living phase, all groups maintained initial weight loss and continued to show improved insulin sensitivity, with both parameters independent of diet composition. The researchers conclude: ‘lowering the glycemic load and glycemic index of weight reduction diets does not provide any added benefit to energy restriction in promoting weight loss in obese subjects.’
—Journal of Nutrition, 135:2387-91

GI Group: What about fat loss? The study reports fat mass change (extrapolated from skinfold changes) for the first phase. People on the high GI diet lost 4.5 ± 1.9 kg (mean ± SEM) fat mass over 12 weeks; those on the low GI diet lost 6.9 ± 0.9 kg. If you are wondering why that's not significantly different, it's because they have only 9 or 10 subjects in each group. So the study was underpowered. Had they had more subjects and the difference was similar, it would be significant. To date, eight intervention studies have compared high and low GI diets for weight loss. All favour the low GI diet in one way or another, but in some cases (like the above study), the differences do not reach statistical significance. A meta-analysis can overcome these limitations.

A Little Resistance Goes a Long Way
Supplementing foods with resistant starch has the potential to improve insulin sensitivity—a crucial factor in the development of diabetes, report Keith Frayn and his colleagues from the Oxford Centre for Diabetes and INSERM-INRA in France in the September issue of the American Journal of Clinical Nutrition. Over four weeks, they gave ten volunteers 30 grams resistant starch, compared with a placebo. They say ‘Insulin sensitivity was higher after resistant starch supplementation than after placebo treatment,’ making the point that further studies in insulin-resistant people are needed.
—American Journal of Clinical Nutrition, 2005; 82 559–567

So, What is Resistant Starch? Most starches are digested and absorbed into the body through the small intestine. Low GI carbs, for example, are digested and absorbed slowly. Some carbs, however, are not absorbed at all. They resist digestion and make their way to the large bowel. Good bacteria in the large bowel ferment the resistant starch and in the process enhance your protection against bowel cancer. This type of starch is called resistant starch. Under-ripe bananas, cold cooked potato, pasta and legumes such as baked beans are all natural sources of resistant starch.

GI? GL? GR? IL? GGE? Getting the Measure
Where the end-game is about the multiple health benefits of improved insulin management and insulin sensitivity, should we be talking GI (glycemic index), GL (glycemic load), GR (glucose response), II (insulin index), GGE (glycemic glucose equivalents or something else? Azmina Govindji (co-author of The Gi Plan with Nina Puddefoot) explores the most accurate way of describing the glycaemic effect of carbohydrates in the summer 2005 issue of The Nutrition Practitioner. She concludes:

‘From the emerging evidence, it appears that the crucial element is the choice of slowly digested carbohydrates over those that are more rapidly digested. It is about the quality of carbohydrate, not quantity. GI refers to the rate of digestion; it is an intrinsic property of the food, reflecting its quality. GL is analysed from the original GI and reflects the quantity of carbohydrate in particular. Since the key is to choose low glycaemic carbohydrates, a low GL diet may not necessarily offer the glycaemic benefits of a low GI diet. For example, a low GL meal of a normal portion of pasta (a classic low GI food) could have the same GL as a small serving of mashed potato (a high GI food). However, small amounts of mashed potato have not been shown to offer the glycaemic benefits of low glycemic carbohydrate foods.

‘While GI is not a perfect measure and should not be used in isolation, it is currently the most familiar term with UK consumers and the use of an alternative term could cause confusion in the whole glycaemic concept. The science behind the benefits of lower GI is robust and means that this is not a short-term fad. As part of a balanced diet (that is low in sugar and saturates), GI can help consumers make more informed choices.

‘Here is the opportunity for healthcare professionals to fully make use of the media who, lets face it, have more impact on our patients than we could ever hope to achieve. In time, hopefully we will develop the best and most full explanation and terminology. But for now, it makes sense to work with what we have and indeed to take advantage of it. The time has come for us to distinguish between carbohydrates as we currently do for fat. It's about slow carbs, not low carbs. Carbs are fine, but it's the good carbs that really matter.’
—The Nutrition Practitioner (Vol 6 Issue 2, summer 2005)

‘Wholegrain’ and Low GI Are Not the Same
For most consumers, ‘wholegrains’ mean eating grains in nature’s packaging—or close to it—traditional rolled oats, cracked wheat, brown rice and pearl barley, for example. There are countless reasons to include more whole cereal grains in your diet, but it’s hard to go past the fact that you are getting all the benefits of their vitamins, minerals, protein, dietary fibre and protective anti-oxidants. Studies around the world show that eating plenty of wholegrain cereals reduces the risk of certain types of cancer, heart disease and type 2 diabetes. A higher fibre intake, especially from whole cereal grains, is linked to a lower risk of cancer of the large bowel, breast, stomach and mouth.


Photo: Scott Dickinson

However, when it comes to what manufacturers can put on the label, there’s no international definition of ‘wholegrain’. It can mean slightly different things in different countries. Food Standards Australia and New Zealand (FSANZ) have expanded the current legal definition for packaging labels to allow more foods including refined wholemeal foods to include ‘wholegrain’ on the label. A manufacturer can now label a food ‘wholegrain’ if ‘the intact grain or the dehulled, ground, milled, cracked or flaked grain, where the constituents—endosperm, germ and bran—are present in such proportions that represent the typical ratio of those fractions occurring in the whole cereal,’ says Lydia Buchtmann, FSANZ Communication Manager.

If you have diabetes or metabolic syndrome and low GI foods are an important part of your diet, what should you do? If there’s no GI rating on the label, follow our rule of thumb, if you can’t see the grains, then don’t assume it’s low GI. Why not follow up and encourage the manufacturers to have their products glycemic index tested?

Low GI Food of the Month

Porridge Power
For a high-energy breakfast that sticks to your ribs, warms you up on a crisp day and keeps you firing till lunchtime, it’s hard to go past porridge made with traditional oats—a good source of soluble fibre, B vitamins, vitamin E, iron and zinc. The GI value for porridge has been tested on a number of occasions and the published values range from 42 (for rolled oats made with water) to 82 (for instant oats).



Traditional rolled oats are hulled, steamed and flattened, which makes them a wholegrain cereal. The additional flaking to produce quick cooking or ‘instant’ oats not only speeds up cooking time, it increases the rate of digestion and the GI. This is why traditional rolled oats are preferred over instant in the low GI diet.

Porridge gourmets advocate steel-cut oats—the wholegrains are simply chopped into chunks. These oats may be hard to find but worth the hunt if you like a chewier porridge—and it has a low GI (51).

Follow the instructions on the packet (or use your favourite recipe) to make porridge. A fairly standard rule is one part rolled oats to four parts water. Cooking oats in milk (preferably low fat or skim) not only produces a creamy dish but supplies you with calcium and reduces the overall GI. Don’t skimp on finishing touches for perfect porridge. Choose toppings such as:

• chopped fresh fruit or mixed berries
• unsweetened canned plums or peaches in natural juice
• a tablespoon or two of dried fruit such as chopped apricots

—Source Low GI Eating Made Easy

GI Values Update

Juicy Pomegranates
Pomegranates are in the news thanks to the current focus on their health giving properties. Recent studies reveal an array of benefits from reducing the risk of heart disease and mediating high blood pressure to reducing the risk of certain cancers including prostate cancer. Jo Rogers in her invaluable resource What Food Is That? says that the pomegranate: ‘has excellent vitamin C, fibre and moderate iron. The pomegranate is slightly higher in kilojoules (calories) than most fruit but contains a wealth of fibre. One pomegranate supplies a quarter of the daily recommended requirement.’



POM Wonderful Pomegranate Juice (GI 67) was glycemic index tested in the US following standardised testing procedures and the results published on www.mendosa.com.

Pomegranates are about the size of a large orange. The leathery skin ranges from dusky pink to brilliant red depending on variety. The multiple chambers inside the fruit are filled with sweet nectar and small arils (seed sacs) bursting with crimson juice. Avoid the white membrane or pith as it is very bitter. Pomegranates are harvested ripe but check before buying as the heavier they are the more juice they will produce. Store them in the fruit bowl for a week or two if the weather is not humid. They can also be refrigerated for a few days. For best results when juicing, cut the fresh fruit in half as you would a grapefruit and use a hand press citrus juicer. If using an electric juicer care should be taken not to include any spongy membrane as the juice will taste tannic and bitter.

Pomegranate molasses is made from boiling the juice of the fruit until it is a thick concentrate, an excellent alternative when pomegranates aren’t in season. It can be purchased from Middle Eastern stores and specialist food shops.

• Add pomegranate juice to the blender with low-fat milk, a large banana, some slivered almonds and ice cubes. Add a teaspoon of honey and whiz for 30 seconds for a healthy morning shake.
• Try a simple marinade of equal parts pomegranate molasses and olive oil combined with fresh rosemary and crushed garlic and spread over baby lamb cutlets before barbequing.
• Add pomegranate seeds and chopped pistachio nuts to softened low fat vanilla ice-cream. Stir to combine and serve immediately with ripe strawberries.

—Thanks to Australian food writer, restaurant critic and passionate cook, Lynne Mullins, for these meal ideas. Lynne regularly contributes to Good Living and Sunday Life. She is a reviewer for the SMH Good Food Guide and has published two books: Noodles to Pasta, Harper Collins Australia (1999), Relish, New Holland (2001). Lynne presents the fortnightly food and produce segment on Channel Nine ‘Mornings with Kerri-Anne’.

French Green Beans with POM, Goat Cheese & Almonds
Thanks to POM Wonderful for this recipe and photograph—a great way to boost your fruit and veggie intake. It was developed and tested using POM Wonderful Pomegranates and 100% Juice. If you enjoy it, check out the POM website for more pomegranate recipes.



Preparation time: 20 minutes
Cooking time: 8 minutes cooking
Serves 6 as an accompaniment

1/3 cup (3–4 heaped tablespoons) arils (seed sacs) from 1 large pomegranate
2 tablespoons (30 ml) olive oil
600 g (1 1/4 pounds) fresh green beans, trimmed and cut diagonally into 2.5 cm (1 inch) pieces
1 teaspoon lemon or orange zest
1/2 cup (50 g) slivered or flaked almonds
freshly ground black pepper to taste
salt to taste (optional)
juice from 1 large pomegranate or 1/3 cup (80 ml) 100% POM pomegranate juice
115 g (4 ounces) goat cheese, sliced

1. To free the arils, score 1 fresh pomegranate and place in a bowl of water. Break open the pomegranate underwater—the arils will sink to the bottom of the bowl and the membrane will float to the top. Lift out the membrane then strain putting the arils in a separate bowl. Reserve ⅓ cup of arils and refrigerate or freeze the rest.
2. Place oil in a wok or large skillet and heat. Add the beans and stir-fry with the lemon zest for 6 minutes.
3. Add the almonds and stir-fry for 1–2 minutes or until beans are crisp-tender. Remove from heat. Season to taste with salt and pepper.
4. Toss beans with reserved pomegranate arils and pomegranate juice; turn onto a serving platter.
Arrange goat cheese slices over the top and serve.

Per 5.2 oz (about 140 g) serving
777 kJ/185 calories, 8 g protein, 14 g carbohydrate, 12 g total fat (5 g saturated), 295 mg sodium.

Low GI Recipe of the Month

Sweet Corn Loaf
Chef and ‘Cooking With Conscience’ founder, Michelle Trute, uses Australian Golden Circle canned products in her recipes. As an alternative, purchase the best quality canned corn kernels and creamed corn you can buy for maximum flavour for this sustaining light meal.



Preparation time 10 minutes
Cooking time 20 minutes
Makes 10 slices

400 g/14 oz can corn kernels
400 g/14 oz can creamed corn
1 medium sized onion, peeled and finely sliced
2 cloves garlic, crushed
2 egg whites, lightly beaten
1/2 cup/100 g/3 1/2 oz low fat natural yoghurt
55 g/2 oz reduced fat cheddar cheese, grated
2 cups/200g/7 oz rolled oats (not instant)
1/4 cup sunflower seeds

To serve
Fresh tomato salsa or a sweet tomato relish
Crispy green salad

Preheat the oven to 180C/350F
Grease and line a loaf tin.

1. Combine the corn kernels, creamed corn, onion, garlic, egg whites, yoghurt, cheese, oats and sunflower seeds in a large bowl and mix well.
2. Spoon the mixture into the prepared loaf tin and bake for 20 minutes or until cooked—a skewer will come out clean when inserted into the centre of the loaf.
3. Serve hot or cold with a crispy salad and vinaigrette dressing and a fresh tomato salsa or sweet tomato relish.

Per serving (1 slice)
909 kJ (216 Cal) 5.6 g total fat (1.3 g sat fat), 30 g carbohydrate 5.5 g fibre, 202 mg sodium

Award winning Executive Chef and international speaker, Michelle Trute, writes weekly for Queensland’s Courier Mail, and presents for ABC radio as well as television on healthy lower GI foods and recipes. Her books, Cooking with Conscience Book 1 and 2, are best sellers and available through her website.

What's New?

From Kid to Superkid: Set Your Family on the Path to a Junk-Food Free Healthy Future
by Paul Sacher with recipes by Kate McBain (Vermilion)

The advice here is based on Paul Sacher’s own experiences as an extra large lad plus his years of work as a specialist dietitian at Great Ormond Street Hospital for Children (London). Sacher doesn't advocate radical weight loss unless a child is particularly obese. He favours strategies that will keep children at the same weight until their height catches up. 'There's too much emphasis on weight today. What I'm trying to emphasise is raising healthy, happy children. You can be heavy and fit.’ The book is a practical, readable guide for parents and covers:

• The benefits of nutrition and diet, weight maintenance and using the GI to help regulate appetite
• The importance of making exercise fun along with ideas to help reduce sedentary pasttimes such as watching television or playing on the computer
• How to use rewards and goals to encourage positive, healthy behaviour and improve self-esteem and confidence.

Foodwatch
From fast food to fat loss, you will learn something new about the food and nutrition on Catherine Saxelby’s website: www.foodwatch.com.au–one of the first Australian sites devoted to healthy eating on the internet.

The site has been completely redesigned and a number of new features added so if you haven’t checked it out recently, why not drop by. You can sign up for the free monthly e-newsletter or download articles and fact sheets on how eating the right food will help you improve your vitality, boost your immune system, manage your cholesterol, delay the ageing process, enhance productivity and concentration, normalise your weight and more.

Catherine is a freelance nutritionist and accredited dietitian who is well known for her ability to cut through the clutter of nutrition information and her non-nonsense approach to the modern-day dilemma of healthy eating in a fast paced life. She is the author of seven books including Nutrition for Life, one of the most popular and enduring of nutrition books—the 20th anniversary edition will be published in January 2006 (Hardie Grant Books). She is Nutrition Editor for Australian Table magazine and has written more than 1,000 articles on all aspects of food, fat loss and special diets.


Photo: Michael Chetham

Feedback—Your FAQs Answered

I'm a very keen cook. Here's one burning question for me: what about flour? If I make my own bread (or dumplings, pancakes, muffins etc) which flours, if any, are low GI? There's some implication in the book that chickpea flour (baisen) is low GI. How about soy flour? Wholemeal flour probably isn't any better than white, judging by the results on commercial breads ...

To date there are no GI ratings for refined flour whether it’s made from wheat, soy or other grains. This is because The GI rating of a food must be tested physiologically that is in real people. So far we haven’t had volunteers willing to tuck into 50 gram portions of flour on three occasions! What we do know, however, is that bakery products such as scones, cakes, biscuits, donuts and pastries made from highly refined flour whether it’s white or wholemeal are quickly digested and absorbed.

What should you do with your own baking? Try to increase the soluble fibre content by partially substituting flour with oat bran, rice bran or rolled oats and increase the bulkiness of the product with dried fruit, nuts, muesli, All-Bran or unprocessed bran. Don’t think of it as a challenge. It’s an opportunity for some creative cooking. Here’s how we reduced the overall GI of our baking in The Low GI Diet Cookbook.

• These low GI ‘Cherry Oat Crunchies’ are made with fruit, nuts, oats and bran flakes. Just two delicious cookies will give you 2 grams of fibre. Preheat the oven to 180°C (350°F/Gas 4). Lightly spray two baking trays with olive oil. Put 55 grams (2 oz) soft brown sugar, 90 grams (3 oz) pure floral honey, 125 grams (4½ oz) reduced fat margarine or butter, 2 eggs, ½ teaspoon of bicarbonate of soda and 2 teaspoons of vanilla essence in a large mixing bowl. Beat on medium speed for 2 minutes. Fold in 150 grams (5½ oz) wholemeal flour, 200 grams (7 oz) rolled oats, 90 grams (3 oz) chopped dried apricots, 60 grams (2 oz) roughly chopped walnuts, 80 grams (2¾ oz) bran flakes cereal, crushed. Mix thoroughly. Drop spoonfuls of the mixture onto the prepared baking trays, spacing them about 5 cm (2 inches) apart. Bake for 15 minutes, or until light brown. Leave for 5 minutes before lifting off the tray and placing on a wire rack to cool. Store in an airtight container. Makes 42.

• To make low GI ‘Buckwheat and Buttermilk Pancakes with Berries’, combine 130 grams (4 1/2 oz) buckwheat flour, 35 grams (1¼ oz) wholemeal flour, 1½ teaspoons baking powder and 2 tablespoons of raw (demerara) sugar in a mixing bowl. Make a well in the centre and pour in 2 lightly beaten eggs, 250 ml (9 fl oz) buttermilk and 1 teaspoon of vanilla essence and whisk until smooth. Add a little more milk if the pancake batter is too thick. Heat a frying pan over medium heat and lightly spray with olive oil. Pour 60 ml (2 fl oz) of the mixture into the pan and cook for 1–2 minutes each side, or until the pancakes are golden and cooked. Repeat with the remaining mixture. Top the pancakes with a spoonful of yoghurt

Photo: Ian Hofstetter, The Low GI Cookbook, Buckwheat Pancakes

And remember, you don’t have to avoid all high GI foods. While you will benefit from eating low GI carbs at each meal, this doesn't have to be at the exclusion of all others.’ So enjoy baking your own bread or occasional treats. And if you combine high GI bakery products with protein foods and low GI carbs such as fruit or legumes, the overall GI value will be medium.

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.
  

If you have posted a question on one of the stories in our newsletter, be assured that the GI Group will answer this as soon as possible. We welcome your views about our articles and other reader’s suggestions. Please POST your comments on the site.

If you want to print a copy of just one article (ie. the recipe from the newsletter, simply click on the recipe or article name in the right-hand column under PREVIOUS POSTS. You will arrive at the page you have chosen. Select PRINT and you will find that you can print just the information you want.

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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

GI News—September 2005

In This Issue:

• The Low GI Diet—More Than Just “The Next Big Thing”
• Vegetarian Women Are Less Likely to Get Fat
• Whey to Health
  
• No Mixed Message About GI and Mixed Meals
• Added Risks

• Breakfasts That Sustain You Through the Morning
• Chickpeas
• Syrupy Oranges with Yoghurt
• The Low GI Diet Cookbook
  
  
• What connection is there between acne and GI?
• I have been reading What Would Jesus Eat? Would this be a low GI diet?

If you have posted a comment or question on one of the stories in our newsletter, be assured that the GI Group will answer this as soon as possible. Sometimes we need to do some research first, and this may take a little time.

If you want to print a copy of just one article (ie. the recipe from the newsletter), simply click on the recipe or article name in the right-hand column under PREVIOUS POSTS. You will arrive at the page you have chosen. Select PRINT and you will find that you can print just the information you want.

To receive our free newsletter each month, click the SUBSCRIBE link in the right-hand column and send us an email. Be assured that your email address will be kept strictly confidential and that you can unsubscribe at any time if you wish.


Jennie Brand-Miller

GI News Briefs

Vegetarian Women Are Less Likely to Get Fat
Vegetarian and vegan women are less likely to be overweight than meat-eaters even accounting for age, exercise and total kilojoule/calorie intake according to a new study. PK Newby and researchers at Tufts University report their study of 55,459 healthy, middle-aged and older Swedish women who were surveyed about their eating habits, weight and other health and lifestyle factors in the June issue of the American Journal of Clinical Nutrition. They found that 40 per cent of the women who said that they ate meat, poultry, fish, eggs and dairy products as well as plant-based foods were overweight or obese (a BMI of 25 or more) compared with 29 percent of the vegans (no animal products) and semi-vegetarians (dairy foods and fish occasionally). Lacto-vegetarians (dairy products but no meat, poultry, fish or eggs) were the leanest group with 25 percent identified as being overweight or obese. ‘In the present study, energy intakes were higher and fiber intakes were lower as more animal products were included in the diet,’ they said.

‘Notably, all the vegetarian groups had higher intakes of fruit, vegetables and fiber and lower intakes of fat and protein,’ the researchers write. ‘That vegetarians are leaner and have a reduced risk of overweight or obesity despite higher total carbohydrate intake points to the importance of differentiating between types of carbohydrate when selecting diets including weight-loss diets. Current fad diets that emphasize low carbohydrate intakes ignore the fact that whole and refined carbohydates evoke different metabolic responses. This study and others suggest that a high carbohydrate diet may be protective against obesity if the carbohydrates come from fiber-rich foods such as fruit, vegetables and whole grains,’ they said. ‘The advice to consume more plant foods and less animal products may help individuals control their weight.’
—Reported in American Journal of Clinical Nutrition (Vol. 81, No. 6, 1267–1274, June 2005)

Whey to Health
For people with type 2 diabetes, adding whey protein, not any old protein, to a high GI meal with rapidly digested and absorbed carbohydrates can stimulate insulin release and reduce blood glucose spikes after meals according to Dr Mikael Nilsson of Lund University, Sweden writing in the American Journal of Clinical Nutrition. In a small study, Nilsson and his team gave fourteen people with type 2 diabetes a high-GI breakfast (white bread) followed by a high-GI lunch (mashed potatoes with meatballs) both supplemented with either whey protein or ham. They report that when whey was included in the meals, insulin responses were higher, but the rise in blood glucose after the lunch was significantly reduced. In other words, whey protein had the same action as some of the drugs that are frequently added to diabetes therapy. Increasing insulin responses with whey protein ‘might improve glucose homeostasis in type 2 diabetic patients and could possibly postpone the introduction of medical treatment,’ states Nilsson.
—Reported in American Journal of Clinical Nutrition (Vol 82, No. 1, 69–75, July 2005)

No Mixed Message About GI and Mixed Meals
Because most GI testing involves single foods, the question is often asked whether the GI can be applied to mixed meals. ‘The GI concept can be successfully applied to mixed meals that would be consumed in a real life setting,’ report Dr Emma Stevenson, Prof Clyde Williams and Maria Nute in The British Journal of Nutrition. The Sport and Exercise Nutrition Group at Loughborough University investigated the effects of changing the GI of high-carbohydrate mixed meals. Nine recreationally active men took part in two randomised trials. For one they ate a low GI breakfast (GI 44) and lunch (GI 34); and for the other a high GI breakfast (GI 76) and lunch (GI 73). After a three-hour rest they did a 60-minute treadmill run. The researchers found not only that blood glucose and insulin levels were significantly lower after the low GI meals, but also that the utilisation of fat was greater during the 3-hour rest. This could have important implications for weight control.
—Reported in The British Journal of Nutrition (2005; 93, 885–893)

Added Risks
Insulin resistance is an important risk factor for congestive heart failure independent of diabetes, reports Dr Erik Ingelsson in the July issue of the Journal of the American Medical Association. Heart failure's main causes are high blood pressure and coronary artery disease. Smoking, obesity, high blood fat levels, diabetes, valve-related heart disease, and a thicker-than-normal left ventricle in the heart may increase the risk of developing heart failure. The new Swedish study adds insulin resistance to the risk factor list. Ingelsson of the public health and caring sciences departments at Sweden's Uppsala University and his team studied more than 1100 older men for about nine years, on average. The men were all at least 70 when the study started and none had congestive heart failure at the time. During the study, 104 men developed congestive heart failure. They found that insulin resistance predicted the incidence of heart failure independently of other established risk factors. ‘Our observations may indicate that the risk for congestive heart failure is already increased in the long subclinical phase of impaired glucose regulation that precedes clinically manifest diabetes,’ they write.
—Reported in The Journal of the American Medical Association (2005;294:334-341)

Food for Thought

The Low GI Diet—More Than Just “The Next Big Thing”
According to analysts at the market research/consumer intelligence company, Mintel International, American dieters are beginning to show interest in the glycemic index (GI) diet. ‘With the Atkins diet crashing financially, many consumers are in search of “the next big thing,”’ they report.

But encouraging people to adopt a low GI diet is not about being “the next big thing” for the weight loss industry or a best-seller list. For nutritionists and dietitians, it’s about encouraging people to adopt a way of eating that will make a real difference to their lives helping them to maintain long-term health and wellness and reducing their risk of developing chronic and crippling diseases such as type 2 diabetes and heart disease. The real reward is when someone with diabetes says that the GI has transformed their life—and you can see that it has.

Low GI eating not only has science on its side, it dovetails with the key dietary guideline of countries right around the world: ‘Eat a wide variety of foods.’ Low GI carbs are found in four of the five food groups. There are wholegrains and pasta in the bread and cereal group; milk and yoghurt among the dairy foods; legumes in the meat and alternatives group; and virtually all fruits and vegetables (with potato one notable exception) in the group we should eat the most of!


Photo: Ian Hofstetter, The Low GI Diet Cookbook

The low GI diet is not a restrictive diet. No one has to jump through a hoop or turn themselves inside out (or even buy a book) to adopt this back-to-the-future, commonsense way of eating that delivers taste, nutrition, satisfaction and wellbeing as we eat food closer to the way nature intended. It’s suitable for the whole family as it essentially encourages a ‘this for that’ approach to making some simple changes—such as swapping white bread for a grainy one or cornflakes for natural muesli or porridge.

What are the lifelong benefits?
Low GI eating:

• Reduces your insulin levels
• Lowers your cholesterol levels
• Controls blood glucose levels
• Halves your risk of heart disease and diabetes
• Helps control your appetite