1 March 2008

Your Questions Answered

I thought salt was salt, but have just bought a recipe book that tells me to use kosher salt and I now notice my supermarket has shelves groaning with packets of different types and colours of salt. Is there any difference? Are some better than others? How much is OK?
You are right. Salt is salt. It is a compound called sodium chloride of which about 40% is sodium. We turned to Canadian food consultant, Norene Gilletz, who is a certified Culinary Professional with the IACP, a leading authority on kosher cooking and author of Norene’s Healthy Kitchen (reviewed last month in GI News), for some tips on the types of salt you find on your supermarket shelves.

[TABLE SALT]

  • Table salt is the one in most salt shakers. It is fine-ground, refined salt typically from rock salt and usually with some additives to keep it free flowing (anti-caking agents such as sodium silicoaluminate or magnesium carbonate).
  • Iodized salt is table salt with a minute amount of potassium iodide, sodium iodide or iodate added. The iodine is added to help reduce the chance of iodine deficiency which commonly commonly leads to thyroid problems such as goitre.
  • Sea salt is produced by the evaporation of seawater and comes in flakes and crystals. It usually has no additives.
  • Kosher salt is additive free and coarse grained. It’s readily available in North America.
Whether you opt for table salt, iodised salt, sea salt or kosher salt, there’s little difference in the sodium content by weight. The key difference is taste and texture, and iodine content. Many chefs and gourmet cooks prefer to use the coarser kosher and sea salts. If you opt for a ¼ teaspoon of a coarse grained salt like sea salt or kosher salt, you’ll find that less will fit on a spoon so you’ll get less sodium. But that’s about it when it comes to benefits.

As for how much is enough? ‘We don’t need much at all,’ says Foodwatch nutritionist, Catherine Saxelby. ‘The body needs less than 200 mg of sodium a day, but the average Western diet supplies from 2300–4600 mg of sodium a day (which is equivalent to 6–12 grams of salt or around 1–2 teaspoons salt). The problem with too much sodium is that it attracts and retains fluid inside the body. The evidence is compelling that cutting back on salt will make a big difference to blood pressure in most cases, and for any condition where fluid retention is a feature.’

Most experts these days recommend between 1500 and 2300 mg sodium a day for healthy adults. So, how do you cut back your salt intake?

‘The big problem is not so much the salt shaker, says Catherine. ‘It’s those everyday foods even if they don’t taste salty – cheese, deli meats, butter and margarine, fast foods, sauces and spreads. In fact around 75 per cent of our salt intake comes from processed foods, which is why buying salt reduced and no added salt foods will have the biggest impact on your intake.’

Download Catherine’s tips on cutting back on sodium HERE.

I’ve heard that coffee is good for diabetes. Is that true?
The jury is still out on this one. Occasional coffee drinking may actually decrease insulin sensitivity, but drinking coffee or other high caffeine foods or beverages on a regular basis does not appear to have any detrimental effects on people with diabetes in the long run. Coffee (regular and decaffeinated) contains lots of antioxidants and magnesium which may improve insulin sensitivity. Our take-home message as ever is moderation. Here are the findings of a couple of studies.

[COFFEE]

A small study reported in February 2008 Diabetes Care however suggests that daily consumption of caffeine in coffee, tea or soft drinks can increase blood glucose levels for people with type 2 diabetes. Dr James Lane of Duke University tracked 10 people with established type 2 diabetes who drank at least two cups of coffee every day and were trying to manage their diabetes through diet, exercise and oral medications, but not extra insulin. Each had a tiny glucose monitor embedded under their abdominal skin that continuously monitored their glucose levels over a 72-hour period. The participants took capsules containing caffeine equal to about four cups of coffee on one day and then identical capsules that contained a placebo on another day. Everyone had the same nutrition drink for breakfast, but were free to eat whatever they liked for lunch and dinner. The researchers found that when the participants consumed caffeine, their average daily sugar levels went up 8%. Caffeine also exaggerated the rise in glucose after meals: increasing by 9% after breakfast, 15% after lunch and 26% after dinner. Cathy Moulton, care advisor at Diabetes UK, said: ‘Although this is interesting research, the study only examines a sample of 10 people taking pure caffeine capsules (not real coffee) for a 72-hour period, which proves very little. More research is needed before we ask people with diabetes to stop drinking coffee. The best way to control glucose levels is through healthy eating and exercise.’

A study of the dietary habits of more than 125,000 people in the US over 20 years (Annals of Internal Medicine January 2004) found that men who drank more than six cups of caffeinated coffee a day reduced their chances of getting type 2 diabetes by more than 50% compared with men in the study who didn’t drink coffee. Among the women, those who drank six or more cups a day reduced their risk of type 2 diabetes by nearly 30%. These effects could not be accounted for by lifestyle factors such as smoking, exercise or obesity. Decaffeinated coffee was also beneficial, but it had less effect than regular coffee. The researchers noted that caffeine, the best-known ingredient in regular coffee, is known to raise blood sugar and increase energy expenditure in the short term, but its long-term effects are not well understood. Coffee (both regular and decaffeinated) has lots of antioxidants like chlorogenic acid (one of the compounds responsible for the coffee flavor) and magnesium. These ingredients can actually improve sensitivity to insulin and may contribute to lowering risk of type 2 diabetes.

9 comments:

Saundra said...

I am very confused again about coffee consumption. I was told to avoid all caffeine after my gastric bypass. But I have developed HYPOGLYCEMIA after 5 years of a low fat, no sugar and no caffeine diet. i have collapsed, I have to check my blood sugar 6 times a day now. I did fine for 5 years and kept my weight off. So do you drink coffe or not with Hpyopglycemia. This is a precurser for diabetes. Gastric by pass is no answer for weight loss. You still have to follow a strict diet, on now with the onset of the HYPo problem I am ravenous all the time. So wouold coffee or tea help me??????? Very frustrated!!!!

PKPontious said...

Hi Saundra,

As I read your post, I remembered what the Dr. said at a seminar on gastric surgery. He said that this operation 'cures' diabetes 99.9% of the time within months after surgery. Did you have the surgery 5 years ago, or more recently? I am considering bypass surgery when I can get to health insurance. Please let me know about this matter. Thanks patience@efn.org

GI Group said...

Hi Saundra, really sorry but we can't give you specific advice on this one. If your doctors told you to avoid caffeine, then that's the way to go. We can only keep people informed about the latest studies. However, perhaps it's time to have a chat to a dietitian who knows about low GI eating (not all do) that will deal with those hunger pangs. No one needs those! Nor the hypos.

Ron said...

Hi Sandra
I had gastric bypass 4 years ago and have kept all 110 pounds off. We were told to stay away from coffee and tea because it flushes water out of your system. We were also told if we do drink coffee that we must also drink 3 cups of water for every cup of coffee. They don't want us to become dehydrated.

Anonymous said...

Hi, I think the data related to prevention of t2 diabetes and coffee consumption is somewhat stronger than what you imply -- in my view.

Benefits may not apply to people with diabetes of course.

Anonymous said...

You have overlooked an error in your article regarding salt. The text says ‘The body needs less than 200 mg of sodium a day, but the average Western diet supplies from 2300–4600 (equivalent to 6–12 grams or around 1–2 teaspoons of salt).'

I think you will find that 2300 mg = 2.3 gm = 1 tsp. -keith-

GI Group said...

Thanks for pointing it out. We left off a couple of words and have fixed it now. One level teaspoon (or 5 grams)of salt has approximately 2300 mg sodium.

Anonymous said...

Does anyone know anything about greeen tea consumption and effect on diabetes or pre-diabetes? There are several articles out there touting the benefits of drinking green tea on blood sugar uptake, at a level of 4-6 cups per day depending on which article you read -- but nowhere mentioned in any of those articles whether the tea is/was/or should be caffinated or decaf. This is the first article I've seen that mentions both caf and decaf coffee and provides stats -- so I thought I'd ask here. :) Thanks!

GI Group said...

Hi,

A recent 2006 study in Japan examined the relationship between consumption of coffee, green, black, and oolong teas and risk for diabetes. The study included 17,413 persons (6727 men and 10,686 women) who were 40 to 65 years of age; had no history of type 2 diabetes, cardiovascular disease, or cancer at baseline.

During the 5-year follow-up, there were 444 self-reported new cases of diabetes in 231 men and 213 women.

Consumption of green tea and coffee was inversely associated with risk for diabetes after adjustment for age, sex, BMI, and other risk factors.

Total caffeine intake from these beverages was associated with a 33% reduced risk for diabetes. These inverse associations were more pronounced in women and in overweight men.

CONCLUSIONS: Consumption of green tea, coffee, and total caffeine was associated with a reduced risk for type 2 diabetes.