GI News—December 2007

In this issue of GI News

• A cuppa tea quells BGLs
• Update on cinnamon (cassia)
• Prof Trim checks out glucosamine
• How to boost that slow metabolism
• Eating to beat cancer

If cookbooks for family and friends are on your Christmas shopping list, check out our top 10. We’ve picked our favourites from books reviewed in GI News with great recipes that will look after your body as well as delight your tastebuds. Also this month Dr David shares the secret of getting kids active; our chef Kate Hemphill has come up with two easy entertaining recipes with a Mediterranean flavour; and our pick of the crop for food for the month just had to be juicy, chin-drippy mangoes – we couldn’t resist. Enjoy this bumper issue for holiday reading.

Good eating, good health and good reading.



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

Food for Thought

You really can cut your cancer risk
Be as lean as you can within the normal range of body weight and be physically active for at least 30 minutes a day to reduce your risk of certain cancers are two key messages to come out of The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research report (November 2007).



Here, we have summarised their top tips for a healthy diet to reduce your risk of cancer. All we would add is opt for smart carbs for your meals and snacks to reduce the overall GI of your diet (see ‘The lowdown on reducing the GI of your diet’, GI News, November 2006), make sure you tuck into at least 2 serves of fruit and 5 of vegetables every day and get those good fats especially omega-3s by eating fish a couple of times a week and you’ll reduce your risk of type 2 diabetes and its complications and heart disease as well. A bit like going for the trifecta.

• Base your meals on plant foods like vegetables, fruits, legumes and wholegrains such as brown rice and wholemeal pasta. (GI Group: Although all wholegrains are healthy, nutritious foods, it’s only the low GI ones that reduce your blood glucose and insulin levels throughout the day and increase your sense of feeling full and satisfied because they are the ones that slowly trickle glucose into your bloodstream.)
• Opt for a colourful variety of vegetables and fruits every day. They are good sources of vitamins, minerals and phytochemicals and are linked to a reduced risk of several cancers.
• Limit your consumption of red meats (such as beef, pork and lamb) to less than 500 g cooked weight (about 700–750 g raw weight) a week. Why? Although red meat is a valuable source of several nutrients and can be part of a healthy diet, it also has substances that have been shown to damage the lining of the bowel. In fact the evidence linking red meat intake to colorectal cancer is more convincing than it was a decade ago. If you eat the recommended amount, the cancer risk is minimal, but beyond that the risk increases.
• Don’t bring home the bacon. Avoid processed meats such as bacon, ham, salami, corned beef and some sausages. Why? Well, processed meat is preserved by smoking, curing or salting or by the addition of preservatives. These methods of preserving meat can produce cancer-causing substances.
• Limit your consumption of salty foods and food processed with salt (sodium). Try to use herbs and spices to flavour your food and remember that processed food and breakfast cereals, can contain large amounts of salt.
• Avoid sugary drinks and limit your consumption of energy-dense foods (particularly processed foods high in added sugar, or low in fibre, or high in fat). Opt for water or unsweetened tea and coffee in place of sugary drinks.
• Watch what you drink. Convincing evidence links alcohol with a range of cancers, so if you want to reduce your risk, don’t drink it. There’s some evidence that small amounts of alcohol (1 standard drink a day) may have a protective effect on the heart, but the benefits only outweigh the risk in those particularly at risk of heart disease – men over 40 and postmenopausal women.

The report was based on the largest and most comprehensive study of cancer and diet to date –nine teams of scientists reviewed 7,000 studies on diet, exercise and cancer over five years. Download the report HERE.

News Briefs

Cuppa tea anyone?
‘There is no trouble so great or grave that cannot be much diminished by a nice cup of tea’ so the saying goes. Now it looks like that very same cuppa may help quell blood glucose spikes. A one gram cup of black tea may have the potential to stimulate an insulin response and reduce blood glucose levels, report Judith Bryans and colleagues from King's College London and the University of Central Lancashire in the Journal of the American College of Nutrition. Their findings suggest that black tea could blunt blood glucose spikes, keeping the body's blood glucose levels relatively steady throughout the day. They recruited 16 healthy volunteers for a randomised, crossover study and assigned them 75 grams of glucose in either 250 ml of water (control), 250 ml of water plus 0.052 g of caffeine (positive control) or 250 ml of water plus 1.0 gram (1½ teaspoons) of instant black tea. For the first hour after drinking the beverages the glucose concentrations did not differ much at all among the volunteers. However, after two hours tea drinkers’ glucose levels were significantly reduced compared with the controls. Tea drinking also showed elevated insulin concentrations at 1½ hours compared to the controls – the likely reason for the observed decrease in blood glucose levels. In a cautious conclusion the researchers point out that: ‘the physiological effects … were relatively small and were achieved under test conditions. Under normal tea drinking conditions before or after food, the presence of other phenolic compounds could potentially alter, or even enhance, the effects seen in our study.’
– Journal of the American College of Nutrition, 26 (5), 2007



Veggie fibre does it
If you want to reduce your risk of diabetes, eat a low GI diet and tuck into your veggies (especially legumes) say University of Sydney researchers writing in the November edition of Diabetes Care. The study which tracked more than 2,100 Australians over 10 years found that veggie fibre offers more protection against diabetes than fruit or cereal fibre reducing the risk of developing type 2 diabetes by 24%. Diets high in fruit or cereal fibre weren’t nearly as beneficial. In a separate analysis of people aged less than 70 years, diets with a high GI increased their risk of developing type 2 diabetes by 75%, compared with those eating a low GI diet.

Talking to GI News, the study leader, Alan Barclay, said: ‘vegetables, and legumes in particular, were probably delivering the best results because they were an ideal source of intact or natural fibre. Legumes like beans, lentils and chickpeas and vegetables like sweet corn, carrots and peas are eaten whole with their dietary fibre intact, which means they actually encapsulate the carbohydrate in the food. They therefore slow down the rate of digestion and absorption and have good flow-on glycemic effects on blood glucose. Cereal fibre was not so effective because it is now often added to products, rather than eaten in a natural form. And while fresh fruit fibre is often eaten intact, people probably just did not get enough from the fruit they eat to show a benefit.’
– Diabetes Care, Vol 30, No 11, November 2007


Source: Ontario Beans

What about fibre and GI?
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. The effect of fibre on a food’s GI depends on the type of fibre. Soluble fibres are the gel, gum and often jelly-like components of foods like oats, legumes and apples. Soluble fibre can lower your body’s glycemic response to a food by slowing down the time it takes for food to pass through the stomach and small intestine. Insoluble fibres are dry and bran-like and often referred to as roughage. All cereal grains and products made from them that retain the outer coat of the grain are sources of insoluble fibre. But not all foods containing insoluble fibre are low GI. Why? Insoluble fibres will only lower the GI of a food when they exist in their intact, original form, for example in whole grains of wheat. Here they act as a physical barrier, delaying access of digestive enzymes and water to the starch within the cereal grain.

Why do some high fibre foods have a low GI and not others?
Many processed grain foods that are rich in fibre such as wholemeal bread have a high GI. Why? It all comes down to the physical state of the fibre and the starch in the food. When wheat fibre has been finely divided as it is in wholemeal bread or breakfast cereals, it does little for either constipation or blood glucose levels. That’s why we say to choose your carbs carefully, and if your favourite wholegrain food has a high or moderate GI, combine it with a low GI food to reduce the glycemic load of your meal or snack.



The jury’s still out on cinnamon
Lab research has suggested that cinnamon (Cinnamomum cassia) may make body cells more sensitive to insulin. Some small studies have also shown that cassia cinnamon can reduce the blood glucose rise after eating. But it's too soon to recommend people with diabetes tuck into this spice and think it will steady their blood glucose levels naturally, according to researchers from University of Oklahoma in September Diabetes Care. In this latest study, 43 adults with type 2 diabetes were randomly given either cinnamon capsules or a placebo every day for three months. The cinnamon group took two capsules a day, each of which contained 500 milligrams of the spice. The placebo group took capsules containing wheat flour. In the end, there were no significant differences in glucose, cholesterol, A1C or insulin levels according to the researchers led by Dr Steve M. Blevins.

The reason for the conflicting findings from this and earlier studies may have to do with differences in the study groups according to Blevins and his colleagues. Most of the volunteers in the current study, for example, were on various diabetes drugs; in Khan’s 2003 study that found cinnamon reduced blood glucose levels, none of the participants were on any of these drugs. The researchers conclude that we need more studies to see whether factors such as diet, ethnicity, BMI, glucose levels, cinnamon dose and concurrent medication might affect cinnamon responsiveness. ‘Until then,’ they conclude, ‘cinnamon cannot be generally recommended for treatment of type 2 diabetes in an American population.’
– Diabetes Care 30:2236-2237, 2007

Food of the Month

Mangoes
Mouthwatering mangoes may be difficult to peel and messy to eat, but the effort’s worth it – they are one of the few tropical fruits with a low GI (51) so they’ll deliver sustained energy without spiking those blood glucose levels (in modest portions). That’s not all. They are also an excellent source of vitamin C, high in the soluble fibre pectin that helps in controlling blood cholesterol, a good source of vitamin E, rich in beta-carotene which the body converts to vitamin A, and loaded with compounds called polyphenols which have strong antioxidant properties protecting against heart disease and cancer. So you really don’t need an excuse to grab one.

Some mango lovers suggest that the best way to eat them is in the shower! But there are easier ways to enjoy a mango without the chin drips and messy hands. Simply slice the unpeeled mango lengthways down each side of the stone with a sharp paring knife. Score the fleshy cheeks into cubes in a criss-cross or diamond pattern (don’t cut through the skin), flip inside out, slice the dice into a dish and go for it.

Dried mango and mango juice have many of the nutritional benefits of fresh, but you are entering ‘a very little goes a long way’ territory here as they are substantially more energy dense. Keep these for occasional foods. A serving is 1 cheek fresh mango; ½ cup (125 ml) mango juice (no added sugar) or 30 g dried mango.

Low GI Recipes of the Month

Our chef Kate Hemphill develops deliciously simple recipes for GI News that showcase seasonal ingredients and make it easy for you to cook healthy, low GI meals and snacks. For more of Kate’s fabulous fare, check out: www.lovetocook.co.uk. For now, prepare and share good food with family and friends – we have chosen recipes that will serve six this month with the holiday season fast approaching.


Kate Hemphill

Pomegranate and parsnip chicken tagine
I find it hard to go past a lamb shank tagine, however that requires much longer cooking time. This one can be assembled, cooked and on the table within an hour of getting home. It also keeps well, and the leftovers are delicious next day. The sweet parsnips and tart pomegranate seeds complement the dish wonderfully. To remove pomegranate seeds, cut in half then pry seeds out in a bowl of water, then drain. This will stop the juice from flying everywhere! I use Herbies tagine blend. You can buy it online at www.herbies.com.au. When pomegranates are out of season, use 1 tablespoon pomegranate molasses for a similar flavour.

Serves 6



2 tablespoons tagine spice blend
6 skinless chicken thighs
2 tablespoons olive oil
4 small-medium parsnips peeled and diced (2.5 cm/1 inch)
1 long red chilli, sliced
1 large red onion (cut into 8 wedges)
1 clove garlic, crushed
1 pomegranate, seeds removed and set aside
400 g (14 oz) can chopped tomatoes
1 tablespoon tomato paste

To serve
Handful coriander leaves
Cous cous (made with 1½ cups/150 g instant cous cous)
Green salad tossed with vinaigrette dressing

• Pre-heat the oven to 180ºC (350ºF). Sprinkle 1 tablespoon of the tagine spice blend over the chicken pieces to coat and press into the flesh.
• Heat 1 tablespoon of the olive oil in a flameproof casserole dish on top of the stove and sauté the parsnips, chilli, onion and garlic (about 5 minutes). Add the remaining tablespoon of the tagine spice blend, three-quarters of the pomegranate seeds, the tinned tomatoes and the tomato paste – bring to the boil then reduce the heat and simmer gently for a further 5 minutes.
• Meanwhile, heat the remaining oil in a non-stick frying pan and gently brown the chicken pieces on all sides (about 10 minutes).
• Add the chicken pieces (but not the fat left in the pan) to the tagine plus a little water if necessary to make sure the chicken is mostly covered. Cover with a tight lid and cook in the oven for 30–40 minutes, or until the chicken pieces are cooked through. Just before the end of cooking time, prepare the cous cous following the packet instructions.
• Serve the tagine topped with the remaining pomegranate seeds and coriander leaves with cous cous and a crispy green salad.

Nutritional analysis per serving without accompaniments
1464 kJ/348 calories; 27 g protein; 19 g fat (includes 4.5 g saturated fat); 16 g carbohydrate; 4 g fibre

Lebanese Lamb Skewers
This marinade caramelises really nicely on the grill. You could also use the marinade on duck, or any cut of lamb. If you use wooden skewers, soak them in cold water for 2–3 hours to prevent them from burning when cooking under the grill or on the barbecue. You can buy baharat which is a Lebanese spice blend from Middle Eastern stores or online from www.herbies.com.au
Makes 12 skewers



1 kg (2.2 lb) lean lamb leg meat, cut into large cubes (you need 36 pieces of meat 2.5 cm/1 inch)

Marinade
3 tablespoons red wine
1 tablespoon pomegranate molasses
1 teaspoon baharat

• Combine the diced lamb with the marinade ingredients in a bowl and mix thoroughly. Cover and leave to marinate for at least 2 hours in the fridge.
• Heat a grill, barbecue or griddle pan to medium-high. Thread 3 pieces of lamb on each skewer and cook for 2 minutes on each of the 4 sides, then rest for 5 minutes before serving. The lamb should be pink and tender, but you can adjust cooking time for personal preference.

Serve with baba ganoush, tabouli and fennel seed flatbread. There are recipes for these on www.lovetocook.co.uk if you don't have your own.

Nutritional analysis per kebab (without accompaniments)
937 kJ/223 calories; 28 g protein; 11 g fat (includes 5.8 g saturated fat); 1.6 g carbohydrate

Good for You, Good for the Planet: Sue's Radd's Green Kitchen

3 ways to eat green at Christmas
Christmas is supposed to be the time for peace on earth and goodwill to men. Yet our frequently extravagant food expectations can result in the least eco-friendly meal of the year. Here are some tips to help you have fun but leave a softer ecological footprint so Santa continues to have a home in the North Pole – at least, for now.


Sue Radd

• Buy local, seasonal and organic produce to create your Christmas dinner. You may need to tweak your menu, but you will benefit by picking up fresher ingredients from urban gardens or Farmers Markets. You could also save mother earth the polluting effects of 49 000 food miles, the estimated distance Christmas food ingredients can travel to reach the dinner plate, according to the Soil Association in the UK.
• Feature more veggies and less meat on the menu. It takes 500 litres of water to produce 1 kg of potatoes but up to 100 000 litres to make 1 kg of beef! Vegetables also don’t burp like livestock, which contribute significantly to greenhouse gas emissions by producing methane.
• Waste not, want not. Plan your dinner requirements carefully and only buy what you need. Researchers from Australia estimate that a quarter of food purchased usually ends up in landfill. This is never more true than at Christmas time! It means a lot of ‘embodied energy’ – the fuel and water used in growing, harvesting, transporting and storing foodstuffs – is wasted. If you have leftovers, portion them into glass containers and freeze for a busy work week, when all your Christmases may not come at once.

If you have some great tips on how to make Christmas (and any other big celebrations) eco-friendly, please share them with us and other GI News readers by adding a post.

Dietitian Sue Radd is the author of The Breakfast Book and co-author of Eat to Live, acclaimed for showing how savvy eating can combat cancer and heart disease and improve wellbeing. Check out: www.sueradd.com

Busting Food Myths with Nicole Senior

I can’t lose weight because I’ve got a slow metabolism
Fact: Many people believe they have difficulty losing weight because they have a 'slow metabolism' implying this is outside their control when in fact this isn’t true. (An exception is poor thyroid function which slows metabolism and requires treatment with medication). Boosting your own metabolism is possible, but perhaps not in the ways you think.


Nicole Senior

What is metabolism?
The term metabolism (or metabolic rate) refers to the amount of energy the body uses each day – like a daily energy budget - and is measured as kilojoules/Calories. Spending more energy than your daily budget means you need to dip into your energy savings -body fat. Unlike a financial deficit, an energy deficit can be a good thing because it causes weight loss. Metabolism consists of three basic components: Basal Metabolic Rate; thermogenesis; and physical activity. There are ways you can boost spending on all three fronts.

Basal Metabolic Rate (BMR also called Resting Metabolic Rate or RMR) is the energy you spend to sustain basic physiological processes such as keeping your heart beating, your brain and nervous system firing and your liver and kidneys working. Your BMR is primarily related to your lean body mass, so developing and maintaining muscle is a great way to spend more energy (even when you’re sitting still!). There’s no need to sign up for Mr/Ms Universe, but ensuring you do some resistance (strength) training as part of your fitness regime is recommended. Remember not all resistance training is lifting dumbbells in a gym, you can also use your own body weight such as lunges, squats and push-ups, or therabands (large rubber bands used for resistance exercises). Many yoga and pilates exercises build muscle strength as well as flexibility. Talk to a fitness professional about a suitable resistance training program for you.

Thermogenesis is the energy you spend to digest and metabolise your food. Starving yourself actually lowers your energy budget as well as having the obvious negative physical and psychological consequences. Interestingly protein needs more energy to utilise and this one of the reasons higher protein diets seem to work. Ensure you eat enough food at regular intervals and include protein foods such as lean meat, skinless chicken, fish, eggs, dairy food, legumes and nuts in your meals and snacks. There’s no need to go to extremes with the protein and squeeze out smart carbs such as wholegrains, fruits and legumes, but simply balance your meals with some protein foods. For example, rather than just a salad sandwich on wholegrain bread, ‘beef’ things up a little by adding some lean meat, chicken, salmon, tofu or cottage cheese.

Physical activity is perhaps the most obvious way to increase your metabolism, and the more you do the more energy you’ll spend. You can start today and the effects are immediate. Before you say, “I don’t have the time to exercise” you need to know that just moving your body more can help. Being more active can mean sitting less and standing more, driving less and walking more for short trips (and always taking the stairs rather than the escalator), or taking time for active recreation such as gardening or visiting the park. If you do some high intensity exercise, you will continue to spend energy for hours after you stop exercising.

Boosting your metabolism is within your reach and one example of when spending up big is a good thing!


Click on the cover to purchase

Dietitian Nicole Senior is Nutrition Editor for Super Food Ideas and author of Eat to Beat Cholesterol. Check out: www.eattobeatcholesterol.com.au

Dr David’s Tips for Raising Healthy Kids

Walk the walk
There’s a pretty widespread belief out there that that we need bike tracks, parks and playgrounds to encourage people to exercise. That it’s the physical environment that encourages healthy behaviour. Not so says Johannes Brug, professor of epidemiology at VU University Medical Centre in Amsterdam. His review of 50 studies published in the journal Obesity Reviews found absolutely no association between aesthetics, weather and geographical influences such as beaches and bushwalks on levels of physical activity. It also found only a limited association between the availability, accessibility and convenience of recreational facilities and exercise. What works? Well, according to Brug parents setting an example of playing and exercising with friends are more likely to get people up and moving than the availability and convenience of recreational facilities.



It’s no surprise to learn that when parents get active, so do their kids. A number of studies have already shown that we learn our physical activity habits from our family. Researchers in France found that teens were twice as likely to take part in structured physical activities outside school when both parents played a sport. They also found that teenage boys were twice as likely to be highly inactive if both parents watched TV for more than 2 hours a day!

So what should you give the kids this Christmas? Well before you head off to the sports store for a baseball mitt or a basket ball hoop, how about a written promise to reserve at least one day each weekend dedicated to fun, family fitness stuff – things the whole family can enjoy together. Here are some ideas for starters: a bike ride, a hike or bush walk, tip or tag footie, a game of tennis or table tennis, swimming at the local beach or pool.

Please post your comments on what’s worked getting you and your family more active (and having fun) right here. Remember, active kids stay active for life. For more information, check out the OWL website.


Dr David Ludwig

– Dr David Ludwig is Director of the Optimal Weight for Life (OWL) program at Children’s Hospital Boston and author of Ending the Food Fight

Move It & Lose It with Prof Trim

Does glucosamine work?
Getting active can really be a pain for some people. Here’s a common question I get asked: ‘I’d love to become a bit more active and do my 30 minutes brisk walking a day, but I have troubles with knees and hips hurting. I’ve heard that glucosamine is good for arthritis and friends that say they have been helped by this. Is this true or is it all in the mind?’ Putting one’s facetious hat on, one could reply who cares if it is all in the mind – provided it works. But then that might be an expensive lesson. Now putting back the professorial hat, I can state the facts as they are now known.


Dr Garry Egger aka Prof Trim

Glucosamine has been found in some studies to have a better effect than placebo in reducing joint pain from arthritis. This has led medical practitioners working in the area from having a healthy scepticism, to actively promoting the product. However, since that happened, there has been one major meta-analysis (a combination of all the major studies done on the topic), to show that it may not be as successful as is often proposed. It is possible though that this is because of a wide variation in effect between different individuals.

The bottom line that comes out of this is that some individuals may, and do, indeed get significant relief from arthritis and joint pain from the use of glucosamine. Variations in the active ingredient in different formulations may make comparisons odious, so potential users are advised to seek reputable manufacturers. The combination of glucosamine and chondroitin is also thought to provide best benefits.

Another over-the-counter preparation with published benefits for joint pain, is a substance known as SAMe (s-adenysol methionine). This is promoted more as a mood enhancing substance – for which it also has some evidence – and is sold in products with names like ‘Mood Enhancer’ and ‘Mood Lift’. Again however, while there is reputable published support for SAMe, the results may be in the eye (or knee, or hip) of the beholder.

– Click for more information on Professor Trim.

Reviews

GI News top 10 cookbooks
Cookbooks have to be one of the most popular presents these days. There they are gorgeous and glossy and piled high on the tables at the front of the shop. It’s all too tempting. But if you you think these coffee table cookbooks may be making you (and your family) fat, spiking blood glucose levels and clogging arteries, turn away from the glittering tables because the recipes really do tend to be packed with more saturated fat, salt, added sugar and refined flour than you and your family need on a daily basis. These books and their recipes are in the keep for an occasional treat category.



For cookbooks that will look after your body as well as delight your tastebuds, check out some of our favourites that we have reviewed in GI News. There are delicious recipes packed with naturally low GI ingredients, good fats, and herbs and spices that certainly don’t disappoint in the flavour department. And they are all in print or available online because we have checked, so don’t let the bookseller tell you they aren’t available because he’s too lazy to order it in! In alphabetical order:

• Delicious Living – Peter Howard (available in Australia)
• Eat to Beat Cholesterol – Nicole Senior and Veronica Cuskelly (available
  in Australia and online from www.eattobeatcholesterol.com.au)
• Glycemic Index Cooking Made Easy – Jennie Brand-Miller et al (available
  in the US/Canada from Rodale
• Healthy Eating for Families (Healthy Eating for Australian Families)
  – Rosemary Stanton (available in the UK, US/Canada and Australia)
• Lighten Up – Jill Dupleix (available in the UK, US/Canada and Australia)
• The Low GI Diet Cookbook – Jennie Brand-Miller et al (available in the UK,
  US/Canada and Australia)
• Low GI Gluten-free Living – Kate Marsh (available in Australia)
• The Low GI Life Plan Jennie Brand-Miller & Kaye Foster-Powell with recipes
  by Lisa Lintner (available in UK, US/Canada and Australia)
• The Low GI Vegetarian Cookbook – Kate Marsh (available in the UK,
  US/Canada and Australia)
• Zest: The Nutrition for Life Cookbook Catherine Saxelby and Jennene
  Plummer (available in Australia or online from www.foodwatch.com.au)

Want to use herbs and spices to flavour your food instead of salt, then here are two books to help you get started:

• Spice and Herb Bible (Spice Notes in Australia) – Ian Hemphill with recipes by GI News chef, Kate Hemphill. (available in UK, US/Canada and Australia and online from www.herbies.com.au).
• Sticks, Seeds, Pods & Leaves – Ian and Liz Hemphill with GI News editor Philippa Sandall as co-author (available in Australia and online from www.herbies.com.au)

Why not combine a book with a gift certificate for cooking classes?


Lisa Lintner

• In Sydney, Lisa Lintner, who created the recipes for The Low GI Life Plan, runs classes that are all about enhancing your health and improving your cooking skills. Her seasonal, delicious and easy recipes incorporate low GI carbs with a wide variety of organic vegetables and fruit, lean protein and fish, nuts, grains and beans. For more details: www.lisalintner.com.au

• In London, our GI News chef, Kate Hemphill runs small lecture-style and private classes. Kate’s cooking and recipes are modern and relaxed. ‘For everyday cooking I like to be quite spontaneous and adventurous – and having grown up around herbs and spices, they are an intrinsic part of my cooking and recipe development,’ she says. For more details: www.lovetocook.co.uk

Your Questions Answered

Why are my blood glucose levels so high when I am doing all the right things?
This has to be one of the most common questions we get asked. And yes it can be very frustrating and worrying. But our answer has to be that since we don’t know you and what you are doing right or wrong, we suggest you see your doctor, dietitian, or diabetes educator and/or exercise specialist. We can only reiterate what you probably already know: lifestyle changes, including diet and exercise are an essential part of managing type 2 diabetes, along with any medication you need to take. Regular physical activity and improved eating habits really can reduce your blood glucose levels, improve how your body’s insulin works and reduce your risk of developing diabetes and its complications. Of course the key is knowing what to eat and the type and amount of exercise that will help.


Kate Marsh

So if you want to tune into some expert advice on managing diabetes, you may like to check out an audio CD that’s been put together by Accredited Practicing Dietitian and Diabetes Educator Kate Marsh and Accredited Exercise Physiologist Dr Adam Fraser. It covers everything you need to know about managing diabetes through lifestyle changes and all you have to do is pop it into your computer or download it to your iPod. It’s also helpful for anyone with pre-diabetes (impaired glucose tolerance) or insulin resistance who wants to reduce their risk of developing diabetes. Here’s what Kate says:


Play the Podcast above or download here

Kate and Adam have put together a special lifestyle changes audio CD for women with PCOS, too.

• Diabetes Made Easy AUD$55.00 including GST
• PCOS Made Easy AUD$55.00 including GST.

To order your copy, call Northside Nutrition and Dietetics on 612 9415 4845 or ORDER online.

Are chromium supplements advantageous for people suffering from type 2 diabetes, syndrome X or hypoglycemia.
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 number of studies have been done to see whether or not people with diabetes benefit from a chromium supplement. To date, there’s no compelling evidence for Australians or North Americans,’ says New Glucose Revolution for Diabetes author Alan Barclay. ‘There is one study from China that showed significant improvement in blood glucose levels when people took either 200 or 1000 micrograms of chromium picolinate each day for 4 months. But the Chinese food supply is very different from that of Australia or North America. We would suggest that differences in both the food supply and people’s food choices account for the difference in results of the various studies from around the world.’



In GI News in September 2006 we reported on a small double blind study by Julie Martin from the University of Vermont that was published in Diabetes Care. She 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 adults with diabetes 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. However, we would suggest caution re 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. When first diagnosed, it may be useful to take a multivitamin and mineral 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 (mcg) a day for women and 35 mcg a day for men. And it is found in many foods. Good sources are bran-based breakfast cereals and wholegrain breads and cereals; egg yolk, brewers yeast and yeast extracts (eg, Vegemite); cheese; fruits such as apple, oranges and pineapple; vegetables such as broccoli, mushrooms, potatoes with their skin on, tomatoes; muscle and some organ meats (eg, liver); peanuts; and some spices.

Is there a role for chromium supplements in treating certain types of mood disorders including atypical depression? I have read that chromium relates to the way insulin affects neurotransmitters including serotonin in the brain.
A few studies, which have included a relatively small number of people, have demonstrated improvements in mental health (generally depressive type illnesses) after taking around 600 micrograms of chromium a day for several months. The brains preferred fuel is carbohydrate, and given chromium’s role in carbohydrate metabolism, it is perhaps unsurprising that some people may experience improvements in organic brain function and mental performance if they are deficient in this essential mineral. More research is definitely warranted in this interesting area.



However, there is no evidence of widespread chromium deficiency in North Americans or Australians, so it would be irresponsible for health authorities to recommend widespread chromium supplementation as a routine therapy for depressive or other mental illnesses at this stage. The general recommendation to all people to consume a healthy balanced diet is perhaps the best way to ensure chromium deficiency is not a contributing factor to these kind of illnesses.

Your Success Stories

‘I finally got pregnant! And all because I stayed committed to a low GI diet so that my insulin levels wouldn’t rise too high.’ – Stephanie
‘I’m 29 and have PCOS (polycystic ovarian syndrome) – I was diagnosed in my early teens. My symptoms are irregular periods, infertility and excess of testosterone levels (hormone imbalance). I didn’t find out until this year that the main underlying problem was my insulin level. I did lots of research on my own about PCOS and if there was a way to reverse my condition because I wanted to start a family, and I found that being on a low GI diet was the ticket. I’m not overweight (that can be another side effect of having PCOS) but after only 3 months of being on a low GI diet, I lost 10 pounds and I and my cycles became regular. Then the shock of my life came when I found out that I was pregnant! After all these years of doctors telling me that getting pregnant would be a great challenge or that it won’t happen at all! And all because I stayed committed to a low GI diet, so that my insulin levels wouldn’t rise too high. I’ve finally learned that we can reverse our health conditions once we have the knowledge of what the “trigger” is and I believe in nature’s way of doing this. Knowledge is power and I’m staying on the low GI diet for as long as I can because I know I’ve seen the great results for myself.’



‘In late November 2006, I decided to commit to a regular exercise regime AND a low GI diet. I have lost approximately 10 kilos (22 lbs) in the process and I feel terrific.’ – Fil
‘I am writing this to you a little worse for wear after having completed the 14 km (8.7 mile) City to Surf run yesterday [this was sent to GI News on August 13] in Sydney. A little worse for wear is my way of saying that your body at 44 years of age lets you know when you push the boundaries after a workout like that. So today, my legs and knee joints in particular are reminding me of my efforts yesterday.

But the really good news is that I shaved almost 15 minutes off my time last year and am back at work the next day whereas this time last year, I was far too sore and sorry to leave my house. What has caused this transition? It is really simple. In late November 2006, I decided to commit to a regular exercise regime AND a low GI diet. I have lost approximately 10 kilos (22 lbs) in the process and I feel terrific. I can also sense that my body is more appreciative of the way I am treating it than ever before. I had follow up blood tests about 2 months ago which confirmed that all pre-diabetes triggers ( cholesterol, sugar levels, triglycerides etc) had fallen well below the acceptable limits which is a fantastic turn around based on earlier results some 8 months earlier.



Getting both medical and physical confirmation about the benefits of my new lifestyle changes has been such a positive experience and I can only say thank you to the whole GI team on providing me with the information I needed at the right time. I feel very fortunate to have been able to “reverse” some of the telltale signs associated with men in my age group and look forward to encouraging the rest of my family to embrace this lifestyle as well because the results simply speak for themselves. Bring on the 2008 City to Surf I say!’

GI Symbol News with Alan Barclay

With the New Year just around the corner, GI Ltd CEO Alan Barclay provides GI News readers with a peak at what’s in store for GI labelling in 2008.


Alan Barclay

Regulations
Food Standards Australia New Zealand is aiming to release a final draft of its nutrition, health and related claim legislation for (hopeful) incorporation into the Food Standards Code in 2008. The draft legislation includes provisions for GI claims that reference the Australian Standard, Glycemic Index of Foods AS4694-2007. This means that Australia will become the first country to introduce comprehensive legislation for regulating GI claims. This has generated considerable interest from regulatory agencies around the world looking to develop similar provisions.

The role of low GI diets in preventing lifestyle diseases
Hot on the heels of the release of the Cochrane Review: 'Low glycaemic index or low glycaemic load diets for overweight and obesity' in 2007, a comprehensive systematic review and meta-analysis for the role of low GI diets in preventing lifestyle-related diseases is due for publication in one of the world’s most prestigious nutrition journals early in 2008. This will add to the already powerful evidence for the benefits of low GI diets for long-term health and wellbeing.

Expanding the GI Symbol Program
GI Ltd is investigating opportunities to establish bases in key international territories in 2008, to promote the availability of healthy low GI foods around the world. Email Alan for more information.

Contact
Alan Barclay, CEO, Glycemic Index Ltd
Phone: +61 2 9785 1037
Fax: +61 2 9785 1037
Email: awbarclay@optusnet.com.au
Web www.gisymbol.com.au

The Latest GI Values

Where can I get more information on GI testing?

North America
Dr Alexandra Jenkins
Glycemic Index Laboratories
36 Lombard Street, Suite 100
Toronto, Ontario M5C 2X3 Canada
Phone +1 416 861 0506
Email info@gilabs.com
Web www.gilabs.com

Australia
Fiona Atkinson



Research Manager, Sydney University Glycemic Index Research Service (SUGiRS)
Human Nutrition Unit, School of Molecular and Microbial Biosciences
Sydney University
NSW 2006 Australia
Phone + 61 2 9351 6018
Fax: + 61 2 9351 6022
Email sugirs@mmb.usyd.edu.au
Web www.glycemicindex.com

New Zealand
Dr Tracy Perry
The Glycemic Research Group, Dept of Human Nutrition
University of Otago
PO Box 56 Dunedin New Zealand
Phone +64 3 479 7508
Email tracy.perry@stonebow.otago.ac.nz
Web glycemicindex.otago.ac.nz

See The New Glucose Revolution on YouTube

Making the Most of GI News

Subscribe - it's free!
To subscribe to GI News, simply click on the SUBSCRIBE link in the top right-hand column. Help us be sure our email newsletter isn’t filtered as spam. Add "gifeedback@gmail.com" to your address book to ‘whitelist’ us with your filter, helping future issues of GI News get to your inbox.

Your questions answered
If you have posted a question in GI News, 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 and questions on the site.

Want to search past issues of GI News?
Want to search the GI News Archive for a particular topic, food or recipe? Make the most of our search feature with Google. Simply enter the term in the space provided and press SEARCH.

Want to print a copy of this issue of GI News?
Download and print the PDF here.

Copyright
GI News endeavours to check the veracity of news stories cited in this free e-newsletter by referring to the primary source, but cannot be held responsible for inaccuracies in the articles so published. GI News provides links to other World Wide Web sites as a convenience to users, but cannot be held responsible for the content or availability of these sites. This document may be copied and distributed provided the source is cited as GI News and the information so distributed is not used for profit.

© ® & ™ The University of Sydney, Australia

GI News—November 2007

In this issue of GI News

• IDF targets post-meal blood glucose and endorses GI.
  
• Keeping blood glucose in check all day.
  
• Break through weight loss plateaus
  
• Does eating late at night make you fat?
  
• Jennie Brand-Miller responds to the Tufts research on GI variability

Diabetes is one of the fastest growing diseases in the world. In fact, it’s one of the largest epidemics humanity has ever faced. November 14 is World Diabetes Day and the focus is children and adolescents with diabetes. Read more about it in Food for Thought. Also this month Dr David alerts us to a potential epidemic – as many as one in three overweight children now have signs of fatty livers. There are also three delicious recipes from our chef Kate Hemphill (do try the Tuna, Bean, Olive & Fennel Salad); our pick of the crop for food for the month – mushrooms and how they can help you trim your waistline; new GI values for jarred sour pitted cherries; and of course our answers to your questions.

Good eating, good health and good reading.

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



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

Food for Thought

Let’s make sure kids with diabetes reach their full growth potential
Diabetes is one of the most common chronic diseases of childhood but often those closest to the child – family, friends, teachers – are unaware of the signs. Did you know that:

• Diabetes can strike children at any age.
• It is often diagnosed late, or it is misdiagnosed completely.

Don’t miss the signs!

• Excessive thirst
  
• Frequent urination
  
• Tiredness
  
• Blurred vision
  
• Leg cramps
  
• Always hungry
  
• Unexplained weight loss
  
• Skin infections, itching, cuts that won’t heal

To reduce the risk of complications and make sure kids with grow and thrive, early diagnosis and education are crucial. Here’s what diabetes dietitian Kaye Foster-Powell says: ‘It is absolutely essential to do everything possible to achieve and maintain optimal blood glucose levels in children from tiny tots to teenagers with type 1. This is because they are still growing and developing. Remember, you don’t get the chance to go back and try again. Poorly managed diabetes, particularly before puberty, can mean that a child doesn’t reach full growth potential.’

To do their bit for World Diabetes Day on November 16, publishers Hachette Livre Australia and Da Capo Lifelong Books are each giving away 6 copies of The New Glucose Revolution for Diabetes (The Diabetes and Pre-diabetes Handbook in Australia). This practical diet and lifestyle guide to living well with diabetes and pre-diabetes includes chapters on managing diabetes in children and adolescents including daily food guides and recipes, handling hypos and avoiding food battles. Specific sections cover:

• Managing type 1 diabetes in infants and toddlers
  
• Managing type 1 diabetes in school age children
  
• Type 1 diabetes and teenagers
  
• Type 2 diabetes in children

THANK YOU. WE HAVE BEEN INUNDATED WITH ENTRIES. THE GIVEAWAY IS NOW CLOSED AND THE WINNERS WILL BE ANNOUNCED ON WORLD DIABETES DAY
WE HAVE 12 COPIES TO GIVE AWAY
GI News has 6 copies of The New Glucose Revolution for Diabetes published by Da Capo Lifelong Books to give away to residents of the US or Canada only. The first six people to email will receive a free copy. Enter your name and address in the subject line of the email to be in the draw by clicking HERE.

And here are the winners, an even split between the US and Canada. From Canada the lucky recipients are Doug from Hawthorn, Joan from Verdun and Alheli from Calgary. From the US the lucky recipients are Amy from New York, Naomi from Moultonborough NH and Martha from Coffeyville KS.

We also have 6 copies of The New Glucose Revolution for Diabetes and Pre-diabetes published by Hachette Livre Australia to give away to residents of Australia only. The first six people to email will receive a free copy. Enter your name and address in the subject line of the email to be in the draw by clicking HERE.

In Australia the winners are: Amy, Kelly, Carol and Elise all from New South Wales, Val from Queensland and Warwick from South Australia.

GI News Briefs

Keeping blood glucose in check all day
In June GI News Prof Jennie Brand-Miller reminded us that breakfast is a great opportunity to ‘go for gold’ by selecting a low GI breakfast cereal or bread to reduce the GI of your diet overall. The findings of Anne Nilsson’s PhD dissertation presented at Lund University takes that low GI brekkie to platinum by adding some extra indigestible carbs. She found that ‘low GI in combination with the right amount of so-called indigestible carbohydrates, that is, dietary fiber and resistant starch, can keep the blood-sugar level low for up to ten hours, which means until after dinner.’ They can make it easier to concentrate for the rest of the morning too her research findings showed. Barley produced the best results of the four grains she tested and the whole grains were more effective in bread than in porridge.



What role do the indigestible carbs play? Because insoluble fibre and resistant starch are not broken down in the small intestine, they reach the large intestine where they provide nourishment for the intestinal bacteria. This triggers a fermentation process that produces various components such as short-chain fatty acids that can enter the blood and favorably affect the regulation of blood glucose and the feeling of satiety. They can also help alleviate inflammatory conditions in the body reducing risk of diabetes and cardiovascular disease.

We’ll bet there’s big demand from food manufacturers for Anne’s bread recipes!

– Lund University Dissertations Abstract
Eur J Clin Nutr. 2006 Sep;60(9):1092-9
Eur J Clin Nutr. Online publication 12 September 2007

For more information, please contact: Anne.Nilsson@appliednutrition.lth.se or Prof. Inger Björck: Inger.Bjorck@appliednutrition.lth.se

IDF targets post-meal blood glucose
Managing blood glucose is a numbers game. Until now, if you have diabetes you had two blood glucose (blood sugar) numbers to worry about: your A1c and your fasting glucose level. The first should be 6.5% or below and the second 5.6 mmol/l (100 mg/dl) or below according to IDF guidelines. They have now added a third target to the tally: to keep your post-meal blood glucose levels under 7.8 mmol/l (140 mg/dl) two hours following a meal. Why? Because mounting evidence is showing that reducing your post-meal glucose rises is at least as important as hitting your target A1c's when it comes to avoiding complications. The two-hour time frame for measuring glucose conforms to guidelines published by most leading diabetes organisations and medical associations.



In fact it's not possible to go too low to reduce complications according to the IDF. What should you do? Use your meters to get the information you need to help you achieve all three targets they say and focus on healthy eating, physical activity and weight control to manage your diabetes. But, they add, using the ‘GI can provide an additional benefit for diabetes control beyond that of carbohydrate counting’ because (their words):

• ‘Diets with a lower GI are associated with modest improvements in HbA1c.’
  
• ‘Nutritional plans based on the judicious use of the GI positively affect post-meal plasma glucose excursions and reduce cardiovascular risk factors.’
  
• ‘Diets with a high GI are independently associated with increased risk of type 2 diabetes, gestational diabetes and cardiovascular disease.’
  

– IDF Guideline for Management of Post-meal Glucose report and press release
Download the IDF report HERE.

GI values – getting the difference
The glycemic index is too variable a tool to be useful for people with diabetes according to researchers from the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University published in Diabetes Care (30:1412-1417, 2007). ‘Using glucose as the control food, previous studies indicate that white bread has a glycemic index of about 70,’ said corresponding author Alice Lichtenstein in reporting the results of their small study (only 14 healthy adults). ‘In our study the combined average was 71, virtually identical to the published value. However, quite strikingly, individual values ranged from 44 to 132. What is critical is to determine why there is such a wide range of responses among individuals.’


Jennie Brand-Miller

Professor Jennie Brand-Miller explains: The take-home message from the Tufts study is that the GI value of white bread is 70. That's nothing new: The same value has been found in dozens of other studies around the world.

What does a GI value of 70 mean? It means that on any given day, an exchange of white bread will have approximately 70 percent of the glycemic impact of an exchange of glucose sugar; that is, it will send sugar into the bloodstream 70 percent as fast as glucose sugar.

The authors of the Tufts study erroneously concluded that the GI value of the very same bread varied from 44 to 132. That's not correct. The bread didn't vary: Its GI value remained 70. The GI is a property of the food; the person is simply the instrument of measurement.

The Tufts researchers did not follow GI testing protocol, which is carefully designed to compensate for the variability inherent in using a person as a test instrument. As a result, all the Tufts study measured was the natural variation in individual responses to food at different times. Unfortunately, they mistook that for variation in the bread itself.

It's true that any one person's glycemic response varies from day to day and that glycemic response also varies from person to person. Nevertheless, the relative glycemic differences between foods are maintained. A person with diabetes can be confident that a high GI food (GI value of 70 or more) will produce a significantly higher glycemic response than a low GI food (GI value of 55 or less) 95 percent of the time. Just as the height of high tide and low tide varies from day to day and place to place, we still know that high tide will be higher than low tide on any one day at any one place. It's not the absolute level, but the difference, that's important.



Any one person's glucose tolerance may vary from day to day by as much as two-fold. (In people with diabetes, this variability is actually less than in normal subjects.) Why this occurs is not clear, but we can point to varying beta-cell responsiveness and insulin sensitivity, factors that are beyond anyone's control. The beta cells just work better on some days than on others. This variability among and within people must be managed carefully in order to detect true differences in the glycemic potential of the carbohydrates in different foods.

That's why GI testing has such a strict protocol. Ten subjects are used, each of whom is given the reference food (glucose) on three separate days. Each time, the overall fluctuation in their blood sugar is determined by testing their blood glucose eight times over a period of two hours. The findings from those three days of testing are averaged to find each person's usual response to the reference food, glucose. Next, his or her glycemic response to the test food is measured once, using the same two-hour testing protocol. Then each person's response to the test food is expressed as a percentage of their average response to the reference food. Finally, the relative responses of all ten subjects to the test food are averaged. This is the published GI value. The GI value of bread (70) means that the overall fluctuation in blood glucose after eating an exchange of white bread will be about 70 per cent of the effect of pure glucose (GI value of 100).

When it's done properly, there's nothing crude about GI testing. By taking the average of ten subjects, each of whom has undergone this painstaking process, we are simultaneously compensating for both within-subject and between-subject variability. If we were to test white bread over and over again using this protocol, we'd get the same result: a GI of 70.

The Tufts researchers did not satisfy the strict GI testing protocol. They repeatedly compared one test of the reference food (glucose) with one test of the test food (white bread). Inexplicably, they did this three times with three different groups of people. In a small sub-group of subjects who participated in all three groups (that is, who received the reference food on three occasions), the Tufts authors were able to calculate the GI according to the standard protocol. And lo and behold, they arrived at 70!

The Tufts study's within-subject variability was also heightened by the fact that it used venous sampling, not fingertip capillary sampling. Capillary testing is associated with much less variability than venous testing. We insist on capillary testing in the Australian Standard for GI testing (which is under review by the International Standards Organization).

The Tufts study uses the variability inherent in individual glycemic responses to criticise the GI. Were that a legitimate criticism, then that same variability could be used to denigrate carbohydrate counting as well. Can we be sure that 15 grams of carbohydrate in white bread will always give half the glycemic response of 30 grams? No, we can't. It will also vary for the same reason: day-to-day within-subject variability. Yet carb counting is considered a cornerstone of good diabetes self-care.

Meta-analyses show that a diet based on low GI carbohydrate foods (compared to a conventional low fat diet) will reduce A1c's by an average of 0.6 of a point, about the same amount as a serious exercise program. Other meta-analyses show that low GI diets improve blood lipids and weight control. Longer studies are still required, but long term prospective cohort studies indicate that diets with a low GI are likely to reduce the risk of chronic disease.
– also published online in Diabetes 3.health October 18, 2007

The world is fat – some food for thought from Prof. Barry Popkin


Prof Barry Popkin

• ‘The long-held philosophy of agricultural experts is that once a country produces enough grains and tubers, it should massively subsidise its livestock, poultry and fish industries. The result has been a major reduction in the prices of animal-source foods.’
  
• ‘The drop in the cost of vegetable oils and animal-source foods combined with the recent increases in personal incomes in China, India and other developing nations, has led to a consumer revolution. People are rapidly abandoning their traditional low-fat high fibre diets and switching to meals of calorie-rich fats, sweeteners and refined carbohydrates.’
  
• ‘The world is getting fatter, and the annual rates of increase are higher today than they were 15 years ago. Representatives of the food industry have long insisted that governments should not restrict an individual’s dietary choices. Their solution is to teach people how to control their diets and become more physically active.’
  
• ‘This strategy ignores the vast social, technological and structural changes that are pushing millions of people into debilitating lives of obesity. If left unchecked, the nutrition transition will cause horrendous increases in illness and devastating reductions in life expectancy.’
  

– Scientific American September 2007
Barry Popkin’s book, The World Is Fat is in press and due for publication May 2008 (Penguin Press).

Are we sleepwalking towards obesity
The technological revolution of the 20th century has led to weight gain becoming inevitable for most people, because our bodies and biological make-up are out of step with our surroundings, says the latest report from Foresight, the UK Government's futures think-tank.

‘Foresight has for the first time drawn together complex evidence to show that we must fight the notion that the current obesity epidemic arises from individual over-indulgence or laziness alone,’ said Sir David King, the Government's Chief Scientific Adviser and head of the Foresight Programme. ‘Personal responsibility is important, but our study shows the problem is much more complicated. It is a wake-up call for the nation, showing that only change across many elements of our society will help us tackle obesity. Stocking up on food was key to survival in prehistoric times, but now with energy-dense, cheap foods, labour-saving devices, motorised transport and sedentary work, obesity is rapidly becoming a consequence of modern life.’

The Foresight project was an in-depth two-year study by almost 250 experts and scientists to examine the causes of obesity and map future trends to help the UK Government plan effective policies both now and in the future.
– Department For Innovation, Universities And Skills News Release
Download the report: 'Tackling Obesities: Future Choices'

Low GI Food of the Month

Mushrooms
Mushrooms (which are fungi not veggies) have more going for them than you can imagine such as antioxidants (they up there with red capsicum and spinach), minerals like selenium and B vitamins including folate. They also have more protein than most vegetables. The GI isn’t relevant because they have almost no carbs although they are a very good source of fibre. Their big selling point is that they are one of the tastiest, nutrient-rich, low energy-dense foods around (providing you don’t serve them with butter and cream) with some100 kJ/24 calories in a 100 g/3½ oz serving of button mushrooms. These are the sorts of foods you need to make a bigger part of your life and your plate to lose weight and keep it off or simply to stay a healthy weight in the first place. Remember, it’s having excess weight, particularly that fat around your middle, that can make your blood glucose levels more difficult to manage because it contributes to insulin resistance.



What mushroom is that?

• Button mushrooms are perfect to use raw in salads or as finger food with dips, skewered on a kebab or tossed into stir fries and pastas.
• Cups can be used whole, halved, quartered or sliced in soups, stews and stir fries.
• Flats are almost a meal in themselves. Try topping them to make a ‘mushroom pizza’, use a patty in a burger or pan fry in olive oil with fresh herbs.
• Oysters are best cooked quickly (add at the end of a stir-fry) and partner perfectly with seafood, chicken, veal and noodles.
• Shiitake are ideal for braises, stir-fries, soups and sauces – or simply tossed on the barbecue or char grilled.
• Swiss brown have a rich, earthy flavour. Add to risottos, casseroles and pasta or marinate and pop on an antipasto platter.
• Portobellos are big (a larger flat version of Swiss browns) and ideal for grilling or roasting or served as part of a meatless burger.
• Enoki are best enjoyed raw in salads or sandwiches or used in soups, clear broths and stir fries and Japanese dishes such as shabu shabu or sukiyaki used in Asian cooking. Great for salads.

For more on mushrooms, check out the Australian Mushroom Growers cookbook: Quick Recipes for Fresh Mushrooms. You can order a copy from: www.oz-mushrooms.com.au

Busting Food Myths with Nicole Senior

Eating late at night makes you fat
In this day and age when everyone is busy, it’s difficult to live by the old adage ‘breakfast like a king, lunch like a prince, and dinner like a pauper’. The reality is many of us enjoy our main meal in the evening when the travails of the day are behind us. Is this making us fat? Looking at the science overall, the answer is no. When it comes to weight, the overarching principle is the balance between the kilojoules (calories) consumed versus the amount of energy used through physical activity. There are no studies to suggest that eating late at night causes weight gain, however there are possible reasons why big dinners and late night snacks might encourage it.


Nicole Senior

We know that our natural circadian rhythm prefers night for sleeping and not eating. Shift workers who turn their body clocks upside down tend to be heavier and at higher risk for cardiovascular disease. Studies in shift workers suggest that insulin levels are higher in the evenings and the effect of insulin in encouraging body fat storage is well known. While this may be a plausible mechanism for the idea that eating at night makes you fat, we just don’t have the studies to provide a conclusive answer just yet. But do we really need them? Many people find they sleep better and feel fresher the morning after a lighter evening meal – try it for yourself and see.

Practically speaking, eating less at night may help you eat less overall, and perhaps curb that late night TV and chocolate/biscuit/ice cream habit. Choosing the right foods at night can also help control blood glucose levels. Low GI foods at the evening meal can reduce the glycemic response to breakfast the next day, a phenomenon known as the ‘second-meal effect’. Eating less at night may also create a new desire for breakfast, considered the most important meal of the day. It’s a good thing to wake up hungry. Stoke your metabolic furnace with a low GI breakfast such as traditional rolled oats, natural muesli, grainy toast, or a fruit smoothie and you’ll experience better blood glucose levels and less hunger through the morning.

When it comes to your dinner, don’t get too tied up with timetables but rather, focus on eating lots of vegetables or salad, low GI carbs, and modest portions of lean protein (eg meat/fish/chicken). And ask yourself: do I really need dessert? Perhaps finish off with a piece of fruit or cup of herb tea. And remember humans are marvellously adaptable. Culture, tradition and lifestyle are powerful influencers on our eating habits – just ask the Spanish who frequently dine late at night and sleep in the afternoon!


Click on the cover to purchase

Dietitian Nicole Senior is Nutrition Editor for Super Food Ideas and author of Eat to Beat Cholesterol. Check out: www.eattobeatcholesterol.com.au

Low GI Recipes of the Month

Our chef Kate Hemphill develops deliciously simple recipes for GI News that showcase seasonal ingredients and make it easy for you to cook healthy, low GI meals and snacks. For more of Kate’s fabulous fare, check out: www.lovetocook.co.uk. For now, prepare and share good food with family and friends.


Kate Hemphill

Tuna, Bean, Olive & Fennel Salad
This is a lovely, nutritious meal, ideal for lunch or a light dinner – it’s even easy to pack in a container and carry to work. You can make the tuna ‘mash’ and serve as a dip, or just spread on toast. If you want to use fresh tuna, just sear it in olive oil, and continue with the recipe. The fats are mostly good fats, but if you want to cut back, halve the amount of oil you use in cooking the tuna and in the salad.

Serves 2



110 g (4 oz) can good quality canned tuna in oil (Ortiz or Sirena)
1 x 400 g (14 oz) can butter beans, drained
1 lemon, juiced (to make 3 tablespoons juice)
1/4 teaspoon smoked paprika
toasted sourdough bread, to serve

Salad
1 medium bulb fennel, shaved
1/4 butter or round lettuce, leaves torn
handful flat leaf parsley, roughly chopped
10 kalamata olives, pitted and halved
1 tablespoon extra virgin olive oil

• Put the tuna and oil from the can in a frying pan with half of the butter beans. Add 2 tablespoons lemon juice and the smoked paprika and heat gently, while mashing with a fork to bring together. Add salt and pepper to taste if you wish.
• In a bowl, mix the remaining butter beans with the fennel, lettuce, parsley and olives and toss with 1 tablespoon of lemon juice and 1 tablespoon extra virgin olive oil. Place the salad on plates, then spoon the warm tuna ‘mash’ on top, and serve with a slice of sourdough (to mop up the wonderful juices).

Nutritional analysis per serving without sourdough bread
1426 kJ/340 calories; 17 g protein; 23 g fat (includes 3 g saturated fat); 11 g carbohydrate; 8 g fibre

Vanilla Prunes
These are a great accompaniment to the muesli recipe below. I always have a container of them in the fridge and every time I use a vanilla bean in any other recipes I add the pod to the container for extra flavour.

Makes 12 serves

500 g (1 lb 2 oz) prunes
300 ml (1¼ cups) water
1 tablespoon orange or lemon juice
1½ teaspoons pure vanilla extract
1 vanilla bean

• Place the prunes, water, juice and extract in a saucepan and scrape the seeds from the vanilla bean into the pan and add the pod too. Simmer on low heat for 20 minutes, or until the prunes are very soft and most of the water has evaporated and you are left with a lovely syrup. When cool, transfer to an airtight container and keep in the fridge.

Nutritional analysis per serving
209 kJ/50 calories; less than 1 g protein; less than 1 g fat; 10 g carbohydrate; 2 g fibre

Macadamia Muesli
I keep seeing all these lovely, exotic mueslis in the shops and they cost a small fortune. It is so easy to make your own muesli, with all the bits and pieces you like. I don't add dried fruit to mine as I eat the muesli with fruit anyway. I also drizzle honey over it, so I don't like the muesli made too sweet. Play around with the recipe to suit your own taste and your family’s (yes, even the kids will eat this) and if you want to make less, just make half the quantity. If you are adding dried fruit, do so after you toast the muesli.
A serving is 1/3 cup (about 35 g)



1 kg (2 lb 4 oz) thick milled organic rolled oats
100 g (3½ oz) macadamia nuts, chopped
100 g (3½ oz) sunflower seeds
100 g (3½ oz) pumpkin seeds
50 g (1¾ oz) linseeds (flaxseeds)

• Preheat oven to 170ºC (325ºF). Mix all the dry ingredients and spread on baking trays (you might need 2 or 3) so that the muesli is no more than 1 inch thick.
• Bake muesli, stirring every 10 minutes. The nuts have a high oil content so you have to watch they don't burn. After 30 minutes, when there is light colour on the muesli, turn the oven off and leave the trays in there overnight, or until cool. Transfer to an airtight container. Serve with yoghurt, honey if desired and fruit.

Nutritional analysis per serving (35 g or 1/3 cup)
650 kJ/155 calories; 4.5 g protein; 7 g fat (includes 1 g saturated fat); 17 g carbohydrate; 2.5 g fibre

Your Success Stories

‘I have shared this website with my patients and the results have been amazing’ – family doctor from Canada
‘When I first encountered the concept of glycemic index, I was very curious. The rigorous testing and evidence presented on this site along with the information has impressed and convinced me of its validity. I have shared this website and the information with several of my patients and the results have been amazing. In my 16 years of practice, this has been the most immediate benefit that has come from half an hour of discussion with a patient who is struggling with obesity, polycystic ovarian disease or diabetes. My patients have returned with reports of having increasing energy, better sleep, no further cravings for sugar, improved mood and weight loss averaging 3-4 pounds a week. They are naturally moving towards increasing their activity level as they gain more energy.

• “I feel alive for the first time in years and my depression/anxiety symptoms are getting less” was a recent testimonial from a patient.
• “I have gone from a size 14 to a size 10 in four months, look at what my oversize bosom now looks like. I want the last eight years of my life back” was another recent comment from a patient.

I believe that a low GI/GL diet as an adjunct and when appropriate as an alternative to pharmaceutical management is leading patients towards managing diabetes like never before.’



‘My dietitian said I should be the poster child for the low GI diet’ – Carol from Colorado
‘I just came from a visit with my dietitian. I got a positive report. My A1c is at 6.7 and over all cholesterol is down from 195 to 161. Tryglerides 116 – down from 161; LDL 117 – down from 133. I was diagnosed with type 2 diabetes in July 2006, after a stroke. At 198 lb, and with a clotting disorder that is treated by coumadin therapy, it was a big adjustment for me to regulate my diet to accommodate both the glyberide and the coumadin. The up side to that is that I had changed my diet so drastically that I no longer needed the pill. I had lost 20 lb in the first 10 days. I continued to stay away from coffee, sugar (refined) or any processed food. I could not eat artificial sweeteners due to a history of seizures.

It was difficult to prepare my own meals. I received pointers from my dietitian and the general ADA stuff, but my daughter-in-law had done some low GI dieting and she pointed me in the right direction. So with some divine intervention about which foods to prepare, I was able to prepare and freeze meals for myself on the weekends. With my husband’s help, we prepared lunches that consisted of chicken (without hormones or antibiotics), green beans, great northern beans, brown rice, and I would finish off with a serving of peaches. For dinner it was chicken again with a baked russet potato (1/3 cup) and a pat of butter, peas, baby carrots and a plum. I would have a morning snack of cantaloupe with strawberries and a cheese stick and in the afternoon a few grapes or grapes and sweet cherries and a cheese stick. My breakfast consisted of shredded wheat, a boiled egg, 1/2 banana and a cup of milk.

After recommending the low GI Revolution books by Brand-Miller et al my dietitian saw me and remarked how well I had done. She said I should be the poster child for the low GI diet because with my evening snack, of plain yoghurt , strawberries and almonds I have incorporated six small frequent meals into my day. Oh, and I changed my breakfast to rolled oats with stevia. And in doing so I have dropped 58 lb and my body mass index (BMI) has gone from 35 to 25. I am no longer considered obese, and I am only 1 point away from a normal BMI). Only 5 more pounds!

Now with other tools, such as Dr Brand-Miller’s books, cookbooks and this website, I have many other options and I believe that it will get easier to add variety to my diet and help keep me on a healthy track. My next objective is to add some green leafy salad to my daily evening meal to help round out my diet. I will also take a multi-vitamin supplement. The trick is incorporating these into the coumadin regime. I am waiting for Dr Brand-Miller’s book entitled: Coumadin Therapy and the New Glucose Revolution (or How to balance your diet while maintaining glucose levels, weight, wellness, and vitamin K).’

Inspire others. Share your GI story.


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

Move It & Lose It with Professor Trim

Breaking through weight loss plateaus
Here’s something you won’t read about in the women’s magazines: Weight loss is not a linear process. In other words, you’re unlikely to lose a steady 1 or 2 kilograms per week until you get down to where you want to be. The truth is weight loss is a dynamic process. Change one thing (food or exercise), and your body changes other things (the rate at which you burn energy, your level of hunger, the rate at which your body converts food into fat) to make sure that you don’t disappear. Even someone starving to death will hit spots where weight loss stops for a while as the body adjusts to what is going on. What do we know about plateaus? The answer is not much. But here’s a few tips.


Dr Garry Egger aka Prof Trim

1. Everyone losing (or gaining) weight will hit a plateau (or several plateaus) at some stage.
2. There are big individual differences in the timing and lengths of plateaus probably dependent on things like how long someone has been overweight, age, gender and the actions taken to lose weight.
3. A plateau is natural and is a period of adaptation. The great Harvard Nutritionist Jean Mayer once said: “Like a wise man will reduce spending when his income is cut, the body reduces the amount of energy it expends when energy intake (food) is reduced”.
4. Change is likely to be the best weapon against plateau-ing. Adaptation of the body comes about largely through routine ie. eating, drinking and exercising the same in relation to food intake over time. Similarly a change to the routine in the opposite direction is likely to cause a breakthrough in adaptation and a drop off a weight loss plateau.
   

– Click for more information on Professor Trim.

Dr David’s Tips for Raising Healthy Kids

Children’s livers turning fatty
While it's known being overweight is a big reason for the rising number of children with type 2 diabetes, it's also increasing the prevalence of another dangerous condition: non-alcoholic fatty liver disease (NAFLD). This is a silent but dangerous epidemic. Just as type 2 diabetes exploded into our consciousness in the 1990s, so we at Children’s Hospital Boston think fatty liver will in the coming decade. Already it’s one of the most common yet least recognized complications of obesity – as many as one in three overweight children and one in two overweight adults have evidence of excessive fat accumulation in the liver. Fatty liver usually has no symptoms, but it can lead to hepatitis and sometimes progress to cirrhosis and liver failure.


Dr David Ludwig

We wanted to see if a high GI diet would cause fatty liver. Of course we couldn’t use children in such a study, so we fed either a high GI or a low GI diet to mice. The diets were equal in calories, fat, protein and carbohydrates. After six months on the diet, the mice in both groups weighed the same, but those fed the high GI diet had twice as much fat in their bodies, blood and livers. Our findings (published in Obesity, 2007;15) create a very strong argument that a high GI diet causes, and a low GI diet prevents, fatty liver in humans.

Here’s what happens. The glucose released into the blood after a high GI food ramps up insulin production, which tells the body to make and store fat. This process can be most dramatic in the liver because it is located just upstream from the pancreas, so concentrations of insulin can be extremely high in the liver after a high GI meal

A study on people living in Italy who ate high GI food showed they had fattier livers, but the study wasn't tightly controlled, whereas this study on mice shows that high GI carbohydrates can cause fatty liver in animals, regardless of other diet and lifestyle factors. We have now launched a clinical trial involving overweight children aged from 8 to 17 who will be randomised to either a high GI or a low GI diet. We hope to show that a low GI diet can reverse fatty liver in overweight children.

The current standard treatment for being overweight involves putting children on low fat diets, but that doesn't work for many children with fatty liver. Low fat diets could make things worse if they replace fat with high GI sugars and starches. Two low fat Twinkies, billed as a health food, contain the same amount of carbohydrate as an oral glucose tolerance test, which is used to determine whether someone has diabetes.
– Dr David Ludwig is Director of the Optimal Weight for Life (OWL) program at Children’s Hospital Boston and author of Ending the Food Fight