GI News—September 2006

In This Issue:

• Food for Thought
  —Burning up
  
• GI News Briefs
  —The vegan advantage
  —High blood glucose linked to dementia
  —Not chubby by choice
  —The chromium question
  
• GI Values Updates
  —The latest GI values from SUGiRS: Ginger
  —The mystery of BR16
  
• Low GI Food of the Month
  —Low GI and gluten free
  
• Low GI Recipe of the Month
  —Thai-style pear and chicken salad
  
• Success Stories
  —Amy kills two birds with one stone
  
• What's New?
  —The Low GI Vegetarian Cookbook
  
• Feedback—Your FAQs Answered
  Joanna McMillan-Price and Alan Barclay answer this month’s FAQs
  
  1. I am 53 and not overweight, but I constantly feel tired and run down. And my mood can get low at times. Would low GI eating be of benefit to me?
     
  2. Does it matter if you eat less protein than is recommended in the 12-week action plan on The Low GI Diet?
     
  3. I heard people with diabetes should eat between meal snacks and supper before going to bed – is that true?
  4. Look it up in our A–Z: The GI Glossary continued
     

In late August we welcomed aboard the 20,000th subscriber to GI News. As a thank you, we have a special gift – a copy of The Low GI Diet Cookbook. At the same time we would like to thank all our subscribers who have helped to make the Newsletter a great success and whose comments and questions play a key role in shaping each issue.

The publishers of the New Glucose Revolution series, Hachette Livre Australia, Hodder Mobius UK and Marlowe & Company New York, have also agreed to give away a copy of The Low GI Diet Cookbook to every 1000th subscriber from now on. To subscribe, just click on 'SUBSCRIBE' at the top of the right-hand column.



GI News Editor: Philippa Sandall
Web Design and Management: Scott Dickinson

Food for Thought

Burning up
As you break out in a sweat over a bowl of chilli, think of the benefits. Not just reducing insulin demand as we reported in GI News in August, but helping you burn calories while you eat. Researchers from Maastricht University, Wageningen Centre of Food Science in Holland, and Laval University in Quebec have reviewed the evidence for capsaicin, black pepper, ginger and mixed spices with respect to energy balance and heat generation (thermogenesis). Reporting in a recent issue of Physiology & Behavior they conclude: ‘Consumption of spiced foods or herbal drinks often leads to greater thermogenesis … Therefore, it is suggested that these ingredients can realistically be considered as functional agents that could help in preventing a positive energy balance and obesity.’ For example:

• Capsaicin, the compound gives red chilli pepper its heat, has been reported by several studies to boost heat generation by the body, which means you burn more energy.
• This means that people who drank tomato juice with a little bit of red pepper added effectively consumed 10% less energy.
• Black pepper is also reported to stimulate metabolism.

– Physiology and Behavior, 30 Aug 2006, 89(1): 85-91


Dried Chilli

If you like it hot, try this recipe from Herbies Spices ‘Seriously Chilli Spice Kit’. For a vegetarian version, drop the bacon and add another 1/2 cup of mushrooms.

Mexican chilli soup
Serves 4

2 Ancho chillies
3 large tomatoes, thickly sliced
1 small onion, thickly sliced
1 clove garlic, chopped
4 cups (1 litre) chicken stock (home-made, or low-salt if purchased)
1 cup finely chopped mushrooms
½ cup chopped lean bacon (all fat removed)
1 tablespoon olive oil
1 tablespoon ricotta
fresh coriander (cilantro), to serve

1. Preheat the grill or barbeque griddle plate till very hot. Toast the whole chillies, turning often to avoid burning (blackening). Remove the chilli seeds and stems (veins) reserving them in case you want to increase the heat of the soup later. Soak the chillies in 1 cup of the stock for 10 minutes then blend the chilli and stock mixture until smooth in a food processor or blender.
2. Char the onion slices and whole garlic clove all over. Peel the garlic clove after cooling a few minutes. Char the tomato slices then chop roughly.
3. Blend the onion, tomato and peeled garlic clove with 2 cups of the stock until smooth and add to the chilli mixture.
4. Heat the tablespoon of olive oil in a pan then fry the chopped bacon. After a minute or two, add the mushrooms and cook for about 5 minutes. Blend (or pulse if you like a more textured soup) the bacon and mushroom mixture with the ricotta in the remaining cup of stock. Combine with the rest of the soup in a large pan and reheat for about 5 minutes. Serve garnished with the fresh coriander.

If you want to increase the heat of the soup, puree some of the chilli seeds and veins with the bacon and mushroom mixture. For more spicy ideas go to: www.herbies.com.au

Energy: 653 kJ/155 cals; Protein: 10.2 g; Total fat 9.8 g (saturated fat: 2.8 g); Carbohydrate: 5.6 g; Fibre: 2.7 g

GI News Briefs

The vegan advantage
For over a hundred years, people with diabetes have been given advice on what to eat. It was not until the 1970s that carbohydrate was considered to be a valuable part of the diabetic diet. Researchers found that not only did the nutritional status of patients improve with a higher carbohydrate intake, but their insulin sensitivity improved as well. Now a US and Canadian research team led by Dr Neal Barnard suggests that a high carbohydrate (favouring low GI carbs), low fat vegan diet treats type 2 diabetes more effectively than a diet based on American Diabetes Association (ADA) guidelines – especially in reducing the need for diabetes medications.


Neal D Barnard, MD

In the randomised, controlled pilot trial, 49 people with type 2 diabetes followed a low-fat vegan diet consisting of about 10% of daily calories from fat, 15% from protein, and 75% from carbohydrates. They avoided animal products and added fats and favoured low GI foods like beans and green vegetables. Portion sizes and total daily calories or food intake were unrestricted and they took a B12 supplement because people on a vegan diet are at risk for vitamin B12 deficiency.

The other 50 participants followed a low-fat diet based on ADA guidelines – 15%–20% protein, 60%–70% carbohydrates and monounsaturated fats (such as olive oil), and less than 7% saturated fats (such as animal fats and butter). Total cholesterol was also limited to 200 milligrams or less per day. Overweight participants in this group were also advised to reduce daily calorie intake by 500–1,000 calories per day.

Participants on both diets significantly improved their glycemic control and reduced unhealthy cholesterol levels; but the changes were even greater in the vegan group.

• 43% of those on the vegan diet reduced their need to take drugs to manage their diabetes compared with 26% of the ADA group.
• Weight loss averaged more than 14 pounds in the vegan group; it was less than 7 pounds in the ADA group.
• LDL ‘bad’ cholesterol dropped by an average of 21% in the vegan group compared with 11% of those in the ADA group who did not change their cholesterol drug use.

It’s early days, as the research team acknowledges concluding that ‘further research is necessary to establish longer term diet effect and sustainability.’ However, in a news release, Dr Barnard makes the point that: ‘The diet appears remarkably effective, and all the side effects are good ones – especially weight loss and lower cholesterol. I hope this study will rekindle interest in using diet changes first, rather than prescription drugs.’
– Diabetes Care 29:1777-1783, 2006


Photo: Ian Hofstetter

Want to try some delicious veg-based recipes? Check out The Low GI Vegetarian Cookbook reviewed in this issue – it features 80 vegetarian and vegan recipes along with 7-day menu plans for vegetarian and vegan adults, teenagers and children.

High blood glucose linked to dementia
A four-year study of post-menopausal women has found that chronically elevated blood glucose (glycated hemoglobin or HbA1c levels of 7% or higher) is linked with an increased risk of developing mild cognitive impairment or dementia. ‘We already know there’s a connection between diabetes and cognitive problems,’ says the study’s lead author Dr Kristine Yaffe of the University of California, San Francisco. ‘We were interested in what this measurement would tell us about a group of women with and without diabetes who were followed for four years. Nobody has really looked at that before.’

The four-year prospective study looked at 1,983 women whose HbA1c levels were tested at the beginning of the study. Over the course of the study, 86 women developed mild cognitive impairment or dementia – for every 1% increase in HbA1c, the women had a greater age-adjusted likelihood of developing mild cognitive impairment or dementia. Women with a HbA1c of 7% or higher at baseline were four times more likely to develop mild cognitive impairment or dementia than women who tested at less than 7%. Even when the researchers excluded the 53 women known at the outset to have diabetes, there was still a statistically significant association between elevated HbA1c and cognitive risk.

‘Type 2 diabetes is a very common and growing problem,’ says Yaffe. ‘The point is that now you can identify people who are at risk for mild cognitive impairment or dementia and monitor them closely ... I think we need to take these people who are at risk and see whether we can target them for trials or interventions for better blood glucose control.’
– Journal of Nutrition, Health, and Aging (10) 4.

What’s glycated hemoglobin?
Glycated hemoglobin, also known as HbA1c or simply A1c, measures the percentage of hemoglobin – the oxygen-bearing protein in red blood cells – that is bound to glucose. A result of 4 to 6% is normal. In people with diabetes, 7% or less indicates good long-term blood glucose control. Unlike a standard blood glucose test that measures your blood glucose at the moment of testing, HbA1c gives an indication of your blood glucose levels over the 2–4 months preceding the test.


Red Blood Cells

Not chubby by choice
The energy equation says energy intake and energy expenditure need to be in balance if you are to maintain a healthy weight. Simple isn’t it. So if you are overweight or obese you eat too much or exercise too little. And it is your fault. No, says Dr Robert Lustwig, professor of clinical pediatrics at UCSF Children’s Hospital. It’s not like that. Certainly not when it comes to children. They should not be blamed or expected to take personal responsibility for their diets when they are offered foods full of sugar and devoid of fibre. ‘The concept of personal responsibility is not tenable in children. No child chooses to be obese,’ he says.



In a comprehensive (and passionate) review of obesity research published in the August edition of Nature Clinical Practice Endocrinology & Metabolism, he concludes that changes in manufacturing processes over the past 30 years have made food ‘toxic’ and ‘addictive’, leading to obesity. ‘Our current Western food environment has become highly insulinogenic (elevates insulin levels),’ says Dr Robert Lustig, ‘as demonstrated by its increased energy density, high-fat content, high glycemic index, increased fructose composition, decreased fibre, and decreased dairy content.’ This upsets the balance of two hormones, which regulate how much we eat – leptin and insulin.

Here’s how it works. Insulin encourages eating in two ways. It blocks the signals that travel from the body’s fat stores to the brain by suppressing the effectiveness of leptin – and this leads to increased eating and decreased activity. It also promotes the signal carried by the chemical dopamine that seeks the reward of eating. So we want to eat for that pleasurable dopamine ‘rush’ – and this is the addictive bit.

Calorie/kilojoule intake and expenditure are normally regulated by leptin. When leptin is doing its job it ‘increases physical activity, decreases appetite, and increases feelings of well-being.’ When it is not, activity levels decrease, appetite increases and you get ‘leptin resistance’. Prof Lustig suggests that two factors which are promoting insulin production and making foods addictive are adding sugar to foods that never used to have it, and removing fibre in the processing.
– Nature Clinical Practice Endocrinology & Metabolism (2006) 2: 447–458


Robert H Lustig, MD

The chromium question
Chromium is an essential mineral that plays an important role in how our bodies metabolise carbohydrate, fat and protein. Current research suggests that it helps insulin work more effectively in the cells of the body, which in turn will help the body manage blood glucose levels better. So, if you have type 2 diabetes, will taking extra chromium as a supplement improve your blood glucose levels. To date studies have yielded conflicting results. A new, small double blind study by Julie Martin from the University of Vermont published in Diabetes Care in August found that ‘chromium picolinate supplementation in subjects with type 2 diabetes who are taking sulfonylurea agents significantly improves insulin sensitivity and glucose control’. The researchers tested whether chromium supplements were useful in combination with a sulfonylurea medication – an older class of diabetes drugs that often spur weight gain. They randomly assigned 29 diabetic adults to take either the medication plus 1,000 micrograms of chromium picolinate per day or the drug plus a placebo (sugar pill) for 6 months. In the end, study participants who took the supplement showed greater improvements in insulin sensitivity and blood glucose control. They also gained less weight and body fat than those on the medication alone.
– Diabetes Care 29: 1826-1832, 2006

GI Group: A word of caution about this interesting result – the researchers did not monitor the participants’ food or physical activity before or during the study. So it is not possible to say conclusively that the improvements were due to the chromium picolinate alone.

In addition, the body loses many vitamins and minerals (including chromium) in urine, and when urination increases, as it does with poorly managed diabetes, losses can be excessive and lead to a deficiency. Most people with type 2 diabetes can reverse this deficiency within a few months by achieving and maintaining optimal blood glucose levels. During this initial period, it may be useful to take a multivitamin supplement to boost the replenishment process. But once an individual is managing blood glucose levels and eating a healthy diet this should no longer be necessary. As for chromium, the body only needs only a minute amount – around 25 micrograms a day for women and 35 micrograms a day for men. And it is found in many foods. Good sources are bran-based breakfast cereals and wholegrain breads and cereals; brewers yeast; cheese; fruits such as apple, oranges and pineapple; vegetables such as broccoli, mushrooms, potatoes with their skin on, tomatoes; liver; peanuts; and some spices.

GI Values Update

The latest GI values from SUGiRS: Ginger
Valued the world over as a culinary spice, condiment and home remedy with beneficial properties that have long been recognised and recorded, ginger has made its presence felt and entered the language with phrases like ‘ginger up’ and ‘ginger group’. Although grown in Asia and India for hundreds of years, we don’t know exactly where it originally came from. But we do know it’s a great grower when you plant those juicy rhizomes in the right spot. Buderim, about 100 km (60 miles) north of Brisbane (Australia) is one such spot.


Ginger root

Not long before World War 1, some pieces of raw ginger found their way to Buderim where the comparatively high rainfall and humidity provided ideal growing conditions. During World War 2, when the supply from China was non-existent, five local farmers saw an opportunity and formed The Buderim Ginger Grower's Co-operative Association Limited with 25 pounds, two wooden vats and 14 tons of green ginger. Today, Buderim Ginger produces some of the world's finest ginger, and exports to 17 countries around the world (check their website to order online or find your nearest stockist: www.buderimginger.com). It also makes the world first GI-tested ginger products.

Buderim Ginger Divine Date Spread (mix of dates and ginger): GI 29
Buderim Ginger Original Ginger Marmalade: GI 50
Buderim Ginger Ginger Spread (no cane sugar): GI 10
Buderim Ginger Sucrose-free Ginger (looks like candied ginger): GI 10

For nominal serve sizes, available carbohydrate and GL, check out the GI database at www.glycemicindex.com

For more information about GI testing at Sydney University, please contact:
Fiona Atkinson sugirs@mmb.usyd.edu.au
Research Manager, Sydney University Glycemic Index Research Service (SUGiRS).
Human Nutrition Unit, Department of Biochemistry (GO8)
Sydney University, NSW 2006 Australia


Fiona Atkinson

The mystery of BR16
Many readers have asked where they can buy ‘Bangladeshi rice BR16’ a long-grain, white rice with a GI of 39 that’s posted in the GI database. First the bad news. We have checked with numerous international rice suppliers and sadly no one can identify a commercial branded product of this rice you can buy. Now the good news. In the next month or so, we will be publishing the results of a new low GI rice that carries the GI Symbol and will be available in supermarkets in Australia initially and then internationally. So watch this space.

Low GI Recipe of the Month

Thai-style pear and chicken salad
Versatile pears are an excellent source of fibre, and they are rich in vitamin C and potassium. Enjoy this low GI fruit juicy fresh as the perfect portable snack, in a salad or poached in red wine with a touch of cardamom. This tangy Thai-style low GI recipe from Horticulture Australia who have joined the GI Symbol Program makes a delicious starter or a complete light meal on its own.



Serves 1

1 pear, cut into wedges
1 Lebanese cucumber, sliced
100 g (3½ oz) skinless chicken breast, cooked and sliced
1 tablespoon chopped coriander
1 tablespoon chopped mint
Juice from 1 lime
1 teaspoon honey
1/4 teaspoon fish sauce
1 clove garlic (optional)

Combine the pear, cucumber, chicken, mint and coriander.
Mix together the lime juice, honey and fish sauce and garlic.
Pour the dressing over the salad, mix through and serve.

Recipe analysis
Energy: 1400 kJ/330 cals; Protein: 30 g; Total fat 8.5 g (saturated: 2.3 g; Carbohydrate: 31.4 g; Fibre: 6.3 g

Serving suggestions

• Serve in lettuce cups for an instant sang choy bau.
• Fill into softened rice paper for quick and easy rice paper rolls.

Low GI Food of the Month

Low GI and gluten free
Even on a wheat-free or gluten-free diet, you’ll find that there are many low GI foods you can enjoy. There is an ever-growing range of gluten-free products on supermarket shelves, and many foods that naturally have a low GI are also suitable for a gluten-free diet. So with a little extra care, you can still enjoy delicious and nutritious meals as well as keep your blood glucose levels within the optimal range. You’ll find low GI gluten-free foods in four of the five food groups:

• Virtually all fruits and vegetables
• Wholegrains in the bread and cereals group
• Legumes of all types in the meat and alternatives group
• Milk and yoghurt among the dairy foods.

We are currently developing a low GI gluten free fact sheet which we will be posting on our website later this year.



Not many special gluten-free products have been GI tested. It’s important to ask (hound!) the manufacturer of your favourite gluten-free foods to do this with an accredited lab. Hats off to Australian company, Freedom Foods. Many of their gluten-free products have been GI-tested – a great help for people who have both type 1 diabetes and celiac disease who have to eat a wheat free diet and keep their blood glucose on an even keel. Although Freedom Foods porridge oats are manufactured in an oat only environment, it is probably a good idea to trial a small portion first if you have celiac disease to make sure you can tolerate them. Here are the results their GI testing:

Cereals
Quick Oats Porridge GI 50
Mueslis
Gluten Free Wheat Free GI 50
Breakfast bars
Gluten Free Breakfast Bar GI 50, Omega BarGI 21
Slices
Strawberry Slice GI 58
Snacks
Chick Pea Chips GI 44
Fruit strips
Apricot & Apple GI 29; Plum & Apple GI 29; Peach & Pear GI 29
Pastas
Spaghetti GI 51; Rice Pasta GI 51
Flour shakes
Corn Fritter Mix GI 34; Pancake Mix GI 61
Fruit spreads
Apricot Spread GI 43; Strawberry Spread GI 29; Marmalade Spread GI 27; Raspberry Spread GI 26
Fruit and nut bars
Apricot & Almond GI 54; Macadamia & Pineapple GI 56; Yoghurt Coated Almond & Apricot GI 52; Simply Nuts GI 39

• Visit www.freedomfoods.com.au if you want to check out the ingredient list for these.
• For nominal serve sizes, available carbohydrate and GL, check out the GI database at www.glycemicindex.com

Your Success Stories

Amy kills two birds with one stone …
When I consulted dietitian Johanna Burani about my weight and my diabetes, I weighed in at 320 pounds and I am only 5 foot 7 inches (giving me a scary BMI of 50) – yes, I had trouble walking and even getting out of bed! My doctor was not optimistic about what the future held unless things changed as there's diabetes on both sides of the family. I really hoped there'd be a way to control it naturally. I am not a 'pills' person, and was already taking blood pressure medication and was not happy about that at all.



I knew I simply had to straighten out my diet and the big incentive was when my doctor told me I could come off Glucophage if I lost weight and kept it off. So I started walking for 45 minutes in my lunch hour and lost 36 pounds. But I always felt hungry and the temptation to grab a cake or donut or chocolate candies to snack on was constant, and all too often I gave in and raided my boss' candy dish in the afternoons. And all too soon the weight started coming back on.

So I decided to consult a dietitian. When I first saw Johanna, she asked me to construct a 24-hour food and drink diary. It's not as easy as it sounds! I had never really thought about portions. I just ate what I was served – or as much food as I felt like. But I am not a fussy eater at all and I love my fruits and vegetables. What did become clear was that I was eating far too many 'gushers' (high GI foods).

Johanna explained that she could probably 'kill two birds with one stone' – that is she could help me lose weight and control my blood glucose levels naturally! So we put together a game plan that I could stick to. Essentially all I had to do was exchange my quickly digested carbs for more slowly digested ones. This meant I had to decrease the high GI fruits and replace them with trickler fruits; breads had to be whole grain (with lots of grainy bits) and my evening meal would consist of smaller starch and protein portions with half my plate covered in vegetables.

Amazingly Johanna said that this might be all I would have to do (as well as some exercise and drinking lots of water). I have to say I couldn't believe it; but it was virtually all I had to do! I signed up at a women's only gym near where I worked doing both cardiac and resistance training for 45 minutes most lunchtimes and stuck to my low GI ‘trickler’ diet. In a little over a year I lost 118 pounds – and after the first 50 my doctor took me off blood pressure medication! My most recent bloodwork shows a 31 percent jump in my good HDL cholesterol; a 74 percent drop in triglycerides and a 26 per cent drop in mean glucose levels. So I got my wish – no medication and a nice bonus – no joint pain. I also got back my life. I workout six days a week and I really love my spinning classes. In fact I am thinking of becoming a spinning class instructor – part time of course.
– From Good Carbs, Bad Carbs by Johanna Burani, published by Marlowe & Company and reproduced with Amy’s and Johanna’s permission.

Send Us Your Success Story!


We'll send you a free copy of The Low GI Diet Cookbook if your story is published.

Books, DVDs, Websites: What’s New?

The Low GI Vegetarian Cookbook: 80 delicious recipes for vegetarians and vegans
Prof Jennie Brand-Miller, Kaye Foster-Powell and Kate Marsh with Philippa Sandall



Whether you are vegetarian, vegan, or simply want to eat a healthy balanced diet and find new ways to include more fibre-rich wholegrains and legumes in your diet, this book has a place in the kitchen. Illustrated with mouth-watering colour photography by Ian Hofstetter with food styling by Katie Holder, it really does show you how to combine the basics of a healthy vegetarian or vegan diet with the benefits of low GI carbs to successfully make the switch to the low GI way of eating.

Part 1, ‘The Healthy Vegetarian’, explains how vegetarians and vegans can get their diet into tip top shape with all the necessary vitamins and minerals including iron, zinc, calcium and vitamin B12.

• ‘What Should I Eat’ shows you how to build your diet around plant foods to give you all the nutrients you need
  
• ‘Why Choose Low GI Carbs’ –how vegetarians and vegans can choose the right kinds of carbs for their long-term health and wellbeing
• ‘The Healthy Veggie’ – six guidelines to help you make the most of fresh vegetables and fruit, wholegrain breads and cereals with a low GI, a variety of vegetarian sources of protein, plus nuts, seeds and the healthy fats including omega-3.
  
• ‘Six Healthy Veggie Menu Plans’ –seven-day menus for adults, teenagers and children

Part 2 includes 80 recipes for breakfast, lunch, dinner, snacks and desserts, like the ‘Shiitake, ginger and tofu hokkien noodles’ recipe illustrated here, making it deliciously easy to get all the nourishment you need from a healthy vegetarian or vegan diet.

ANZ edition: Hachette Livre Australia; Hachette Livre NZ now available
UK edition: Hodder Mobius to be published December 2006
US edition: Marlowe & Company November 2006

Feedback—Your FAQs Answered

I am 53 and not overweight, but I constantly feel tired and run down. And my mood can get low at times. Would low GI eating be of benefit to me? My doctor says I am healthy, I am just going through menopause. I do weight training and I am trying to walk more. I have a sister who is diabetic with high blood pressure and a sister and brother with high cholesterol. I don’t want to end up with these problems which seem to run in the family. I want to have a healthy middle to older age.
The Low GI Diet co-author, Joanna McMillan-Price says: ‘Yes we do believe a low GI diet would benefit you enormously. Carbohydrate-rich foods have been shown to be important in brain function and in improving mood, while low GI carbohydrates specifically can help you to maintain constant energy levels over the course of the day. They also help keep cholesterol levels down and there is increasing evidence to show they play an important role in preventing diabetes. Since you are also doing a moderate amount of exercise you will find that you need your carbs to keep you going. All up therefore a low GI diet sounds perfect for you. A low GI diet is not just important for those who need to lose weight, but for all of us for good health. The only difference will be in the quantity of food that you eat. Make sure you focus on consuming as many healthy foods as possible and use the GI as a tool to choose the best quality carbohydrates. You can use the database on our website www.glycemicindex.com to search specific foods or look to one of the Glucose Revolution books for more advice on how to put a low GI diet into practice. Since you don’t need to lose weight, perhaps Low GI Eating Made Easy is the one for you. Best of luck!’

Does it matter if you eat less protein than is recommended in the 12-week action plan on The Low GI Diet? A man of my husband's weight is supposed to eat 8 carb, 8 protein and 4 high fat serves. There’s only so much protein you can jam into a roll at lunch time so I’m having trouble fitting enough into the earlier part of his day. Do you have any suggestions on easy to make/handle high protein nibbles he can munch in the afternoon so he won't be tempted to go back to eating hot chips?
Joanna says: ‘Don’t get too caught up on trying to measure exact portions of carbs, protein and fat – it is there as a guide only. We recommend an increase in your protein intake in order to help in eating less overall – this is because protein foods are known to be satiating and keep you full and satisfied for longer. If your husband is not finding he is hungry between meals then his protein intake is absolutely fine. Remember the most essential part of your eating plan is to listen to your body and respond to your appetite cues. So long as he is not eating too much fat or resorting to carb-rich, high GI snacks to fill him up then all is well. If he is hungry between meals then you can try boosting his protein at meals or choose to snack on a low fat flavoured milk or yoghurt, a handful of nuts and dried fruit, carrot sticks with hummous or a low GI snack such as fruit.’


Joanna McMillan-Price

I heard people with diabetes should eat between meal snacks and supper before going to bed – is that true?
Alan Barclay from Diabetes Australia says: ‘Children with type 1 diabetes and people using some of the older types of insulin’s often need to have in between meal snacks and a supper to prevent them from going hypo. People with pre-diabetes or type 2 diabetes probably don’t need to snack. In fact, evidence is mounting that in between meal snacks lead to weight gain, which may in turn make your diabetes worse: aim to have three moderate size meals based around low GI carbohydrates to keep your blood glucose levels stable throughout the day. If you find you are still going low between main meals, ask your diabetes team to review your blood glucose lowering medications.’


Alan Barclay

Look it up in our A–Z: The GI Glossary (continued)



Ketones Our bodies need to maintain a minimum threshold level of glucose in the blood to provide energy for our brain and central nervous system. If for some reason, glucose levels fall below this threshold, (a very rare state called hypoglycemia) the brain will make use of ketones – a by-product of the breakdown of the body’s fat stores. Ketones are strong acids, and when they are produced in large quantities they can upset the body’s delicate acid-base balance. They are normally released into the urine, but if levels are very high or if the person is dehydrated, they may begin to build up in the blood. High blood levels of ketones may cause fruity-smelling breath, loss of appetite, nausea or vomiting, and fast, deep breathing. In severe cases, it may lead to coma and death. In a pregnant woman, even a moderate amount of ketones in the blood may harm the baby and impair brain development. Large amounts of ketones in the urine may signal diabetic ketoacidosis, a dangerous condition that is caused by very high blood glucose levels.

Ketosis is the metabolic state when the body is burning fat for fuel. Normally carbohydrates are the main source of fuel for your brain, heart and many other organs.

Kilojoule or kJ is the metric system for measuring the amount of energy produced when food is completely metabolised in the body. The Calorie is the imperial measure of energy, and can be calculated from the number of kilojoules by dividing by 4.2.

Lipids or fats are found in the blood and the walls of all of the body’s cells. The most common lipids are cholesterol and triglycerides (sometimes called triacylglycerols).

LDL cholesterol see Cholesterol

Millimole (mmole) is a unit for measuring the concentration of glucose, cholesterol, triglycerides and other substances in a certain volume of blood – usually 1 litre (L).
Mono-unsaturated fat is found in large quantities in olive and canola oil, and some nuts and seeds. Like all fats, mono-unsaturated fats are high in kilojoules. Mono-unsaturated help lower LDL cholesterol levels and are thought to help reduce the risk of heart attack and stroke.

Events

PCOS Conference
The Sixth Annual Conference on Polycystic Ovarian Syndrome (PCOS) will be held in Sydney, on Saturday September 30 at the Tattersalls Club in Sydney (181 Elizabeth Street). The conference is organised by the leading advocacy and support group for PCOS women, the Polycystic Ovarian Syndrome Association of Australia Inc (POSAA). While the event is aimed at PCOS patients, POSAA encourages family doctors and all health professionals who treat PCOS patients to attend. Registration costs start from $60 for POSAA members.

Further information about the speakers can be found by downloading a registration form from POSAA’s website.

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