GI News—July 2012

• Prof David Katz on the perils of a sugar-coated scapegoat;
  
• Might fructose actually be good for us?
  
• Why people with diabetes don't need special diabetic foods;
  
• The scoop on pasta with Emma Stirling;
  
• Nicole Senior explores the myth that humans don't need to drink milk;
  
• Can a low GI diet reduce the risk of birth defects? Prof Jennie Brand-Miller investigates.
  

‘For far too long, we have diverted public health from the benefits better eating would confer by bogging down in one-nutrient-at-a-time boondoggles,’ says Dr David Katz in Food for Thought. While Prof Winkler makes the point that our goal should be to make the healthy choice the cheaper choice. It’s hard to argue with such common sense. For Diabetes Awareness Week (8 to 14 July), Dr Alan Barclay reminds us that people with diabetes don’t need to splurge extra dollars that they can ill afford on special diabetic foods, as a healthy low GI diet will do the job.

Good eating, good health and good reading.

Editor: Philippa Sandall
Web management and design: Alan Barclay, PhD
Contact email (for questions or permission to reproduce stories from this newsletter): info@gisymbol.com for technical problems or faults please contact smb.ginewstech@sydney.edu.au

Food for Thought

Perils of a Sugar-coated Scapegoat.
It has been some time since Dr. Robert Lustig emerged as the messianic nemesis of added sugar – or perhaps specifically fructose. It has been some time since his meme took hold, engaging high-profile adherents and apostles. And it has been some time since I first started expressing my opposition to this ‘sugar is poison’ platform. Consequently, it has been some time since I started receiving a bounty of hostile correspondence that would make my mother pass out, my wife wince, and my children cry.


Dr. David Katz

Confronting fervour is ever perilous, and I likely owe the filter of cyberspace for the fact that I have only suffered rhetorical violence. The fainting, wincing, and weeping notwithstanding, I am sticking to my figurative guns. Excess dietary sugar is harmful, and among the salient liabilities of the modern food supply. Sugar is not poison, however. And yes, I think the distinction matters enough to keep fighting for it. Here’s why.

1) The follies of history. I am convinced a fixation on sugar (or fructose) as poison will result in net harm to public health – and quite possibly a lot of it. I am equally convinced that process has already begun. This is not because we don’t consume a large excess of sugar; we do. It’s not because that large excess doesn't contribute mightily to our prevailing public health ills; it does. It’s not because there are no metabolic differences between fructose and sucrose; there are some, although I don't think they matter all that much in the real world. And it's not because I own stock in Sugar Smacks, or because the sugar cartel is holding my first-born hostage; I don’t, and they aren't. It’s because when the truth gets too hyped-up and too dumbed-down, it ceases to be the truth. It turns, instead, into propaganda – or at least fodder for the flames of propaganda. And the food industry will be only too happy to stoke those flames, as history has shown us.

What history? We decided oat bran was good for us – and saw a wild proliferation of products (including potato chips!) with trivial essence of oat bran in the ingredient list, but great big banner ads about it on the front of the package. This no doubt convinced a lot of shoppers they could have their donuts and Danish and eat their oat bran, too – but it was all marketing hype, exploiting a narrow fixation on a particular nutrient.

The history of our fixation on dietary fat is even more notorious. We didn't start eating more fruits and vegetables – we started eating SnackWell cookies and the like, and all got fatter and sicker.

So we switched to a fixation on cutting carbs, and along with throwing out the baby with the bathwater we fell victim to the same capacity of the food industry to leverage our tunnel vision. We got low-carb brownies rich in trans fat, and guess what? Since the advent of low-carb eating, obesity and diabetes rates have gone up.

There are many other examples of the dangerous liability of focusing on any one nutrient property at a time – but that should suffice. It is, alas, a well-trod path. In my opinion, there is a comparable and very grave danger in focusing preferentially on sugar, and that much more so by focusing preferentially on fructose, as our current dietary concern. Perhaps you have already seen some soda and/or ketchup ads noting ‘now made with pure sugar!’ as if sucrose is trading up from high-fructose corn syrup. It is not.

Sucrose is a 50/50 mixture of glucose and fructose; high-fructose corn syrup is, at most, a 45/55 mixture of the same monosaccharides. The notion that a 5 percent differential in fructose content has much of anything to do with current public health ills is more than a little far-fetched. The net effect of sugar excess is detrimental, no matter the sugar.

As for pure fructose – it doesn’t have a big role in the food supply. The only places one tends to find it is in fruits (which all concerned acknowledge are NOT the problem, but let’s recall that fruits did get tossed out of diets at the height of the low-carb, low-glycemic frenzy, and we could find ourselves there again if we aren't careful) – and in juices made from fruits. Juices are, arguably, a small part of the obesity problem. But I really don't know anyone inclined to blame epidemic obesity or diabetes on orange juice.

If we now focus public health concerns preferentially on fructose, we will surely see the dawn of the ‘FRUCTOSE-FREE!’ banner ad era, as such proclamations populate the packages of innumerable processed foods that are in many cases new versions of old junk. People getting the message that fructose is bad, and seeing those banners will be led right down the old garden path, through no fault of their own. They’ll think they are trading up, while making a lateral move.

And that may not be the whole story. Perhaps we’ll see a whole new crop of artificially sweetened starchy foods, boasting they are ‘now sugar-free!’ and belying the facility with which our bodies turn starch into sugar. And maybe, feeling virtuous about eschewing sugar, we'll eat twice as much – and get fatter and sicker.

As someone who has worked in nutrition, public health, medicine, and the media for decades – trust me, the food industry is salivating over the ‘fructose is poison’ message. If we get the public totally mesmerized by one nutrient concern at a time, we’ve created a gaping loophole for a whole battalion of new, high-profit, low-nutrient, just-what-you've-been-asking-for foods. They are already on the assembly line. My job is to defend against that, and I intend to keep doing it – no matter the weeping, wailing, and wincing. Excess sugar intake – and not just fructose – is one of the great liabilities of the modern diet. But it’s just one of them. Until we devise campaigns that leave the industry with no loopholes so their only option is to make and market foods that are actually better for us, and until we educate ourselves to demand the same, we will keep getting fatter and sicker, and the sellers will keep getting richer, presumably while laughing at us.

2) The dose makes the poison. Iron, oxygen, cholesterol, and sugar – in the form of glucose – all circulate in the blood. All are essential for life. In the absence of any one of them, we die. And the body manufactures some of them, sugar included. When sugar levels in our blood dip, our body manufactures glucose in one of two ways. It breaks down a fuel called glycogen, stored in muscle and liver, directly into glucose in a process called glycogenolysis. If glycogen stores are depleted and sugar levels dip, the body manufactures sugar out of any other fuel source – carbohydrate, protein, or fat [glycerol from triglycerides]– in a process called gluconeogenesis.

Iron, which is essential for carrying oxygen, is vital to life – but highly toxic in excess. It, too, might be called a poison – except that we die of oxygen deprivation at the cellular level without it. And for that matter, oxygen, in excess, is far more virulently toxic than sugar. The harms of excess fructose intake accumulate over years. Exposure to 100 percent oxygen is lethal within hours to days, and this is of practical concern in the hospital setting. But it does not induce us to call oxygen poison; if so inclined, try getting along without it.

Delivery vehicles for fructose include blueberries and cherries. We really can't have it both ways. If fructose is a poison, blueberries are poisonous. If blueberries are not poisonous, fructose is not a poison. Rather, the dose makes the poison – of fructose, or any sugar, or oxygen. Why fuss about the difference? For the reasons above. The well-travelled path that leads through the garden of dietary good and evil doesn't lead us any place we want to go.

For the many disciples of Dr. Lustig, I hasten to note that his focus on the harms of excess sugar intake did real good up to a point. He was directly involved in getting the American Heart Association (AHA) to count sugar among its concerns, something I for one felt was long overdue. I have long railed against the one-nutrient-at-a-time (ONAAT) fallacy, and the AHA and cardiologists have been perpetrators of it. They worried about saturated fat, while sugar calories were driving an epidemic of obesity that was driving an epidemic of diabetes that was in turn a major driver of trends in heart disease. It made no sense for the AHA to ignore sugar, and thanks in part to the efforts of Dr. Lustig, they no longer do.

But the fact that sugar should be ON everyone’s list of dietary concerns is a long way from saying that sugar – let alone fructose – should BE everyone’s entire list of dietary concerns. That leads us right back to the ONAAT fallacy, just through a different door.

For far too long, we have diverted public health from the benefits better eating would confer by bogging down in one-nutrient-at-a-time boondoggles. For far too long, we have created monstrous loopholes for a food industry only too happy to tell us what we say we want to hear, while inventing new variations on the theme of junk food. The costs of this have been high,
as the costs of looking for a single scapegoat rather than owning the full scope of our issues are always high. Sometimes, calamitously high.

Added sugar is among the more salient liabilities of the modern food supply, and this requires a remedy. But the ills of modern eating are not due to just one misaligned star, but to a whole constellation of factors we have aided, abetted, invented, and condoned. We must look to ourselves and muster the resolve to fix this comprehensively. Turning one of many dietary concerns into a scapegoat for all threatens to substitute the propaganda and procrastination we’ve seen with past follies for the genuine progress we urgently need. Let’s not go there ... again.

Dr. David L. Katz
www.turnthetidefoundation.org
For more by David Katz, M.D., click here.

What’s New?

Could fructose actually be good for us?

A new study in Diabetes Care by researchers at St. Michael's Hospital suggests that fructose may not be as bad for us as previously thought and that it may even provide some benefit. ‘Over the last decade, there have been connections made between fructose intake and rates of obesity,’ said Dr John Sievenpiper. ‘However, this research suggests that the problem is likely one of overconsumption, not fructose.’ The study reviewed 18 trials with 209 participants who had type 1 and 2 diabetes and found fructose significantly improved their blood glucose control. The improvement was equivalent to what can be achieved with an oral antidiabetic drug. Even more promising, Dr. Sievenpiper said, is that the researchers saw benefit even without adverse effects on body weight, blood pressure, uric acid (gout) or cholesterol. In the trials reviewed, diets with fructose had the same amount of calories as the ones without and the fructose was incorporated or sprinkled on to test foods such as cereals or coffee.


Adrian Cozma

‘Attention needs to go back where it belongs, which is on the concept of moderation,’ says Adrian Cozma, the lead author and a research assistant with Dr. Sievenpiper. ‘We’re seeing that there may be benefit if fructose wasn’t being consumed in such large amounts,’ Cozma said. ‘All negative attention on fructose-related harm draws further away from the issue of eating too many calories.’ Although the results are encouraging, longer and larger studies are still needed say the authors.

Damning fructose: what’s the evidence?


Dr Bettina Mittendorfer

‘Rather than damning fructose, efforts should be made to promote a healthy lifestyle that includes physical activity and fresh fruits and vegetables while avoiding intake of excess calories until solid evidence to support action against fructose is available,’ write Dr Luc Tappy and Dr Bettina Mittendorfer in their comprehensive review that evaluates the evidence that that fructose may be toxic and involved in obesity, diabetes and even cancer in Current Opinion in Clinical Nutrition & Metabolic Care. ‘Public health is almost certainly to benefit more from policies that are aimed at promoting what is known to be good than from policies that are prohibiting what is not (yet) known to be bad.’

Make the healthy choice the cheaper choice.



‘Taxes on “bad” foods are the dish du jour in nutrition policy,’ says Prof J.T. Winkler in an editorial in the BMJ commenting on a new study whose authors though recognising that most taxes are small, based on flawed evidence and have limited, even negative, effects propose more taxes – just a bit higher. ‘These are unlikely to be adopted and would be ineffective if they were,’ writes Winkler who makes the point that the goal should be to make the healthy choice the cheaper choice. And who can argue with this? He suggests a range of options to achieve this including agricultural policy, government catering and corporate margins.

Getting the facts to make the healthy choice …


Catherine Saxelby

These days, most of us head for Google for the seemingly endless amount of nutrition information just a click away. But as you trawl one site after another, it’s very easy to become confused by all the conflicting information along with a fair amount of total rubbish. Who can you trust? What’s the real deal? How can you sort fact from fiction? One of our regular contributors, Catherine Saxelby (author of the best-selling Nutrition for Life), has just published a comprehensive, 400-page A to Z guide on all the popular food and nutrition topics from acai and additives to zeaxanthin and zinc. So, if you want to have on hand a resource you can trust with all the up-to-date evidence, check out Catherine Saxelby’s Complete Food and Nutrition Companion HERE.

A plant-based diet – good for us and for the planet.


Rosemary Stanton

Nutritionist Dr Rosemary Stanton, who reviewed the evidence in a series of papers produced by the Medical Journal of Australia, has provided us with a summary of the findings. ‘Most people are aware of the vital roles that vegetables, fruits, wholegrains and nuts can play in a healthy diet. And yet, meat eaters get prickly and many doctors and dietitians tack warnings onto any discussion of vegetarian diets. Are fears of nutritional adequacy for plant-food based diets valid? After reviewing the papers, I wrote an accompanying editorial. I’m not a vegetarian but I acknowledge the wealth of evidence supporting the healthfulness of plant foods. In my current work, I’m also aware of their vital role in reducing our ecological footprint. And as a lover of good food, I don’t understand why we neglect so many great tasting plant foods.

So how does the evidence stand up? In a general sense, a well-planned plant-based diet turns out to be associated with a lower incidence of cardiovascular disease, bowel cancer, type 2 diabetes and obesity. For Australians, the bowel cancer aspect is particularly relevant because it’s a disease for which we score gold medal status. The World Cancer Research Fund’s band of unconflicted experts now rates the evidence as ‘convincing’ that red meat increases the risk of bowel cancer. Some plant foods, by contrast, are protective. The MJA papers show that we can also drop our warnings about deficiencies of protein, iron and zinc.

When writing textbooks in the 1970s, I spent hours poring over lists of amino acids in foods, adding up data to find combinations of plant foods that would equal the protein in meat. Modern biochemistry shows the body can take the amino acids from foods over a day or more and we can stop fussing over which seed goes with which cereal.

Warnings about iron and zinc deficiency are ubiquitous and certainly relevant in countries where people struggle to find enough to eat. In Australia and other western countries, vegetarians can relax because they are no more likely to suffer iron deficiency than meat eaters. It’s true that the haem iron in meat, poultry and seafood is absorbed better than the non-haem iron in plant foods. However, those who need more iron absorb more non-haem, iron with absorption increasing as high as almost 60% absorption during pregnancy. Old studies checked iron absorption after only a single meal taken by meat eaters. Zinc is found in abundance in grains, legumes and nuts, but many nutritionists have been concerned about competition for absorption caused by levels of compounds called phytates in the plant foods. Here the news is also good because of the way we prepare our foods, Adding yeast to breads, soaking legumes and roasting nuts decreases the effects of phytates.

The one relevant warning for plant-based diets is vitamin B12. This vitamin is found naturally only in animal products – although that does include dairy products and eggs. Those who avoid all animal foods will need a supplement or one of the soy foods with added B12.’

Get the Scoop with Emma Stirling

The scoop on pasta.


Emma Stirling APD

I’ll never forget the night my (misguided) girlfriend on a low carb diet, ordered a spaghetti marinara with a blithe, “hold the spaghetti”. I thought the Italian waiter would keel over. Pasta is often tainted as a “carb culprit” but did you know that it has a low GI? Check the database at www.glycemicindex.com (or The Shopper's Guide to GI Values) for the GI of your favourite brands. To enjoy pasta, manage your BGLs and have a healthy weight too, just follow my four step guide.

Step 1 - Go low GI Somewhat surprisingly, most pasta in any shape or form has a relatively low GI value (35–60). In the early days of GI research, it was assumed that pasta's low GI value was because the main ingredient was semolina (durum or hard wheat flour), and not finely ground wheat flour. Subsequent research has shown, however, that even pasta made entirely from plain wheat flour can have a low GI value. The reason for the slow digestion rate and subsequent low GI value is the physical entrapment of ungelatinised starch granules in a sponge-like network of protein (gluten) molecules in the pasta dough.
Top tip:

• Canned spaghetti in tomato sauce and packet mix macaroni cheese are not low GI — they have medium to high GI values.
  

Step 2 - Harness wholegrains You can also boost nutrient intakes by choosing a product from the increasing range of wholemeal and wholegrain pasta options including the spelt and kamut pasta options.
Top tip:

• Wholegrain pasta lends itself beautifully to a lunchtime salad with vegetables or legumes, nuts, seeds, canned fish and fresh herbs.

Step 3 - Keep portions moderate While the GI results are great news for pasta lovers, portion size is very important. It's crucial to keep your portion to around ½-1 cup cooked pasta to keep the GL (glycemic load) moderate. Remember, if you eat too large a portion of even a low GI food the glucose load becomes too large.
Top tip:

• Instead of piling your plate, why not pad out your pasta with a sauce laden with vegetables, lean meat or fish and seafood? this way you’ll turn one cup of cooked pasta into a satisfying volume of food and a complete meal.

Step 4 - Cook like an Italian Al dente ‘firm to the bite’) is the best way to eat pasta — it’s not meant to be soft. It should be slightly firm and offer some resistance when you are chewing it. Although most manufacturers specify a cooking time on the packet, don’t take their word for it. Start testing about 2–3 minutes before the indicated cooking time is up. Overcooked pasta is very soft and swollen in size and will have a higher GI.
Top tip:

• Adding egg to the dough lowers the GI further by increasing the protein content.

Buon appetito!



Emma Stirling is an Accredited Practising Dietitian and health writer with over ten years experience writing for major publications. She is editor of The Scoop on Nutrition – a blog by expert dietitians. Check it out for hot news bites and a healthy serve of what’s in flavour.

In the GI News Kitchen

American dietitian and author of Good Carbs, Bad Carbs, Johanna Burani, shares favourite recipes with a low or moderate GI from her Italian kitchen. For more information, check out Johanna's website. The photographs are by Sergio Burani. His food, travel and wine photography website is photosbysergio.com.



Blueberry-lemon buttermilk pancakes
We have beautiful fresh blueberries now (a month earlier than past years), so I was inspired to put them in pancakes. Italians don’t eat pancakes. They eat something similar, called ‘frittelle’ which may be savory and served as a light main course, or sweet and served for dessert. I’ve noticed that it doesn’t take too long for my Italian house guests to adjust their morning palates to the scrumptious taste of this favorite American breakfast food. These are quite hearty pancakes and very filling. You can easily double the milk and make thinner, less cake-like pancakes. Because of the flour, the GI is probably moderate.
Makes 6 pancakes.

For the coulis
2 cups fresh blueberries, washed and pat-dried
1/3 cup sugar (use low GI LogiCane in Australia)
1 tablespoon lemon juice

Blend all ingredients in a food processor for approximately 2 minutes. Warm before use.

For the pancakes
½ cup unbleached all purpose flour
½ cup whole wheat flour
1 teaspoon baking powder
¼ teaspoon baking soda
½ teaspoon nutmeg, freshly ground
1 egg
¼ cup egg substitute or 2 extra egg whites
½ cup fat-free buttermilk
1 teaspoon vanilla
½ cup part-skim ricotta cheese
1 tablespoon lemon zest
½ cup blueberries, washed and pat-dried



Mix the flours, baking powder, baking soda and nutmeg in a small bowl.
Whisk the egg, egg substitute, buttermilk, vanilla, ricotta cheese and lemon zest in a medium bowl. Gently stir the dry ingredients into the egg mixture until just mixed.
Prepare a large skillet (frying pan) with vegetable spray and place over medium heat.
Pour 1/3 cup of batter into the skillet and add a few blueberries on each pancake. Cook for 1½–2 minutes or until the edges appear brown then flip and cook the other side for another 1½ minutes.
Place 1 or 2 pancakes on each serving plate topped with a little of the warmed blueberry coulis.

Per pancake with a little coulis
Energy: 873kJ/204cals; Protein 8g; Fat 4g (includes 1.5g saturated fat and 44mg cholesterol); Available carbohydrate 34g; Fibre 3g


Cut back on the food bills and enjoy fresh-tasting, easily prepared, seasonal, satisfying and delicious low or moderate GI meals that don’t compromise on quality and flavour one little bit with our Money Saving Meals recipes including Smoked salmon and dill pasta salad from The Low GI Diet Cookbook (Hachette Australia and Da Capo Press in the US) and tips on making pasta salads from Money Saving Meals (Hachette Australia).

Smoked salmon and dill pasta salad
This works just as well with canned salmon and tuna and is a delicious way to add some omega-3 to your life (so much tastier than a fish oil capsule!). If you like you can replace some or all of the onions in the salad with roughly chopped marinated artichoke hearts. To make a meal of it, pop a big salad of mixed green leaves on the table. Serves 4.

Salad
250g (9oz) penne rigate (or your favourite shape)
100g (3½oz) smoked salmon cut into strips
6–8 cherry tomatoes (about 100g) halved, or quartered if large
4 medium spring onions (scallions), thinly sliced, diagonally (including the green tops!)
1 small red (Spanish) onion cut into thin rings, slices separated

Dressing
1/3 cup extra virgin olive oil
3 spring onions (scallions), chopped
juice of ½ a good juicy lemon
½ cup chopped dill
freshly ground black pepper



To make the dressing, combine oil, onions, lemon juice and dill in a food processor and puree until smooth. Season with pepper.
Cook the pasta in plenty of boiling water until al dente following packet instructions for timing. Drain well then rinse under a stream of cold water and leave to dry. Return to the pan in which it was cooked.
Pour the dressing over the pasta. Add the salmon, tomatoes and spring onions, stir gently to combine and serve.

Per serve
1,800kJ/430cals; 21g fat (includes 3g saturated fat); 4g fibre; 14g protein; 45g carbohydrate

Making a success of pasta salads
A pasta salad can sometimes taste a bit bland despite all your creativity, no one eats it and you end up throwing it out. Here’s how you have a no-waste, sure-fire success on your hands.

• Be creative but keep it in the family rather than opting for fusion confusion. Combine the tried and true ingredients that go with pasta and suggest the Mediterranean. The same goes for Asian-style noodle salads. Stick with the culture and cuisine.
• Proportion matters too – you need plenty of other ingredients (vegetables, legumes, mushrooms, meats or seafood) to combine with the pasta for flavour, colour and texture. Allow around 50–60g (2oz) dried pasta per person
• Boost flavour by making the most of stronger tasting ingredients – feta or Parmesan cheese, herbs, finely sliced spring onions (scallions), chopped red onion, capers, sun-dried tomatoes or capsicum, olives, a little spicy salami, toasted nuts. A little goes a long way.

Busting Food Myths with Nicole Senior

Nicole Senior

Myth: Humans don’t need to drink milk
Dairy foods (milk, yoghurt, cheese) are rich in nutrients and have assumed such importance in our diet as to warrant their own food group. This is because they are nutrient-dense and provide a package of nutrients that are not found in the same amounts in other foods. This means that health experts and governments around the world have reviewed the evidence and concluded our health and wellbeing are enhanced by including dairy foods in our diets.


WPA Art Program poster for Cleveland division of Health 1940

There is a lot to recommend dairy foods. They are high in calcium needed for healthy bones and provide the majority of calcium in the diet for most people. Dairy foods also contain a bunch of other essential nutrients, including protein, phosphorous, potassium, magnesium, zinc, riboflavin and vitamin B12. They have a low GI and help lower blood pressure when consumed in a diet with plenty of vegetables and fruits. Regular milk drinkers have a lower risk of heart disease and stroke, and emerging research is discovering beneficial ‘bio-actives’ in dairy such as lactoferrin which enhances bone and immune health.

With so much to recommend them, why are there so many ‘dairy-free’ claims on food these days? Why do naturopaths seem to routinely suggest people avoid dairy foods? Why are there websites devoted to the ‘dangers of dairy’?

Even though whole dairy foods do contain mostly saturated fat, this is easy to avoid by choosing low-fat versions, and limiting hard cheese. Although some still believe milk is fattening, studies have demonstrated dairy foods may actually help with weight loss. The World Cancer Research Fund-American Institute of Cancer Research conclude that the evidence suggesting milk and dairy products increase prostate cancer risk is limited, and consuming milk probably reduces the risk of bowel cancer and may reduce the risk bladder cancer.

Milk allergy affects up to 5 per cent of children at most (and more likely 2 per cent), and 1 per cent of adults. Lactose intolerance is an issue for a lot more people worldwide; however, complete dairy avoidance is not usually necessary. The anti-dairy argument is hard to reconcile with the idea that humans have been eating dairy foods for thousands of years – the Masai tribes in Tanzania still live principally on milk, blood and meat.

What’s the alternative? If you cannot, or choose not, to eat dairy products there are alternatives such as soy milk and rice milk with added calcium. There are also soy yoghurts (check that these have added calcium), soy cheese as well as fun foods such as dairy-free frozen desserts. Life can go on when you’re dairy-free, but it is a little more challenging to ensure your nutritional needs are met, and the taste can take some getting used to. For those who have chosen the dairy-free path, I’m sorry to say there are a plethora of websites also attacking the safety and goodness of soy milk.

Nicole Senior is an Accredited Practising Dietitian and Nutritionist and author of Food Myths available in bookshops and online and from www.greatideas.net.au


Woman milking a cow from a medieval bestiary

Editor: If you want to know more about milk and how, when and why humans began to drink it past weaning, turn to Hannah Velten’s Milk, A Global History from Reaktion Books’ deliciously digestible Edible series of small format, fully illustrated books on food and drink. It’s packed with fascinating snippets and perfect to dip into for a quick read or check out when you want something a little more tantalising than The Oxford Companion to Food or Wikipedia.

GI Symbol News with Dr Alan Barclay

Dr Alan Barclay

Why you don’t need special ‘diabetic foods’
Browse through your average diabetes magazine and you will find a special range of biscuits and cookies, cakes, ice cream, chocolate, lollies and candies that are sugar free or have no added sugar prominently advertised for people with diabetes. As our stalwart myth-buster Nicole Senior says: ‘If you ask anyone walking down the street what they think a diet for people with diabetes should include, chances are the first thing they’ll say is “no sugar”. It’s one of the most pervasive and persistent myths about diet and health ever, I reckon. Yet it is a myth.’ Where did it start?

Back in the 1920s, research by Dr Fred Allen on pancreatomised dogs (very unfortunate dogs whose pancreases were removed) led to the conclusion that glucose was more rapidly absorbed than starch. Not long after, this principle was expanded to include all sugars. Based on this research, low sugar diets were recommended to people with diabetes throughout the world for most of the remainder of the 20th century and doctors began recommending high fat diets for their diabetic patients, because they knew that fat didn’t break down to become blood glucose. Unfortunately, most of the fats that were commonly used were animal fats – high in saturated fat and cholesterol that only hastened the development of heart disease, the most frequent cause of death among people with diabetes. But that’s another story.

Back to diabetic foods, a growth industry. In order to make these foods taste sweet, manufacturers use a range of nutritive sweeteners (e.g., maltitol, mannitol, xylitol, etc...) and non-nutritive sweeteners (e.g., aspartame, sucralose, stevia, etc...). Indeed, with careful formulation they can make these products taste much the same as the regular sugar-sweetened alternative. And to be fair some of them do contain less kilojoules/calories than their counterpart, but usually at a cost – a dollar cost or because they have side effects like wind, bloating diarrhoea, or unpleasant after tastes and unusual textures.

Most diabetic foods, however sweetened, should be saved for special occasions just like other special occasion foods. Just because a food is low in sugar or contains no added sugar does not automatically make it a healthy choice. In fact, many of these foods are still high in kilojoules, saturated fat and highly refined starches, so they will still contribute to weight gain, elevated blood cholesterol and glucose levels just like their regular biscuits/cake/cookie counterparts if eaten regularly and/or in excess.

In terms of both your health and mental wellbeing, it makes much more sense to enjoy a small amount of traditionally sweetened food on an occasional basis and to really enjoy its full flavour and texture, than consuming large amounts of a poorer quality substitute on a regular basis. The most recent food and nutrition position statement from the American Diabetes Association says ‘… intake of sucrose and sucrose containing foods by people with diabetes does not need to be restricted because of concern about aggravating hyperglycemia [high blood glucose]. Sucrose can be substituted for other carbohydrate sources in the meal plan or, if added to the meal plan, adequately covered with insulin or another glucose lowering medication.’

What to do? Read the ingredient list and remember Michael Pollan’s key food rules: ‘Don’t eat anything your great grandmother wouldn't recognise as food (rule 2); Avoid food products containing ingredients no ordinary human would keep in the pantry (rule 3); Avoid food products containing ingredients a third-grader cannot pronounce (rule 7).’


The GI Symbol, making healthy low GI choices easy choices



For more information about the GI Symbol Program
Dr Alan W Barclay, PhD
Chief Scientific Officer
Glycemic Index Foundation (Ltd)
Phone: +61 (0)2 9785 1037
Mob: +61 (0)416 111 046
Fax: +61 (0)2 9785 1037
Email: alan@gisymbol.com
Website: www.gisymbol.com

GI Update with Prof Jennie Brand-Miller

Prof Jennie Brand-Miller answers your questions.



Can a low GI diet reduce the risk of birth defects?
Moderation is a good thing and that applies to glucose levels in the blood. Very high glucose levels are toxic to cells. That’s why people with diabetes, who are not properly controlled by diet or medications, develop complications such as blindness, kidney failure, nerve damage and cardiovascular disease. High glucose levels are also implicated as one of the causes of a birth defect called a neural tube defect. This is an opening in the spinal cord or brain that should have closed during development. Normally, in the second week of pregnancy, specialised cells begin to fuse and form the neural tube. By week four, the neural tube closes but if it does not close up completely, a neural tube defect develops. In some instances, the brain and/or spinal cord are exposed at birth through a defect in the skull or vertebrae (back bones), a condition known as spina bifida. Unfortunately, neural tube defects are one of the most common birth defects, occurring in approximately one in 1000 live births.

Foremost among the causes of a neural tube defect is a relative deficiency of the vitamin folate. Many women don’t consume the recommended amount of folate as part of a normal diet, and this is the reason why folic acid supplements are routinely recommended for pregnancy.

Diabetes, a condition characterised by high blood glucose levels if not properly managed, is also associated with a having a higher risk of baby with a neural tube defect. For this reason, a woman with type 1 diabetes who is planning to have a baby should do her best so make sure she has optimal glucose control before she conceives.

The concern is well justified because of the known toxic effects of excess glucose in the blood of the mother on the embryo. At this early stage, the embryo has no beta cells and is unable to secrete insulin or regulate their own glucose levels. Studies have confirmed that markedly elevated glucose concentrations contribute to the development of birth defects.



This is an extract from my new book (with Dr Kate Marsh and Prof Robert Moses), The Bump to Baby Low GI Eating Plan for Conception, Pregnancy and Beyond (Hachette Australia). In the book we share the latest science to help women enjoy a healthy pregnancy while safeguarding their baby’s future wellbeing. It’s available from bookshops and online in Australia and NZ and as an eBook from Amazon, iTunes etc. We now have a website too, where you can visit us, learn more about our book (and look inside), find pregnancy friendly recipes, keep up to date with the latest news about the importance of lifestyle for pregnancy and preconception, download information and weight charts, contact us and link to other useful information. Visit us HERE.

New values from GI Labs
Going to the Nth Degree
Specially created for endurance, performance and energy, Nth Degree Low GI Performance Drinks were launched in May 2012. Unlike many sports drinks with high GI values (70–100), this new range with no artificial colours, flavours or preservatives has a low GI thanks to the use of isomaltulose (Palatinose) a slow-release sweetener derived from sugar beets. The drinks are also fortified with B vitamins and a balance of electrolytes such as sodium (sea salt), potassium, magnesium and calcium. Available flavours include Orange, Raspberry, Lemon Citrus & Fruit Punch.

• The actual GI value of these drinks hasn’t been released for publication, but they are certified low GI by GI Labs in Toronto who carried out the clinical testing.
• The 20oz (600ml) bottle delivers 37g carbs. To keep the GL low (under 10), stick to a standard serving of 1 cup (8oz).

During exercise, sports drinks are an ideal way of providing fuel to the working muscle as well as helping with that vital rehydration. In addition, a key benefit of a low GI post-exercise beverage or meal if you are exercising primarily for health, fitness or for weight loss is that it may help your body maintain a higher rate of fat burning (oxidation). For more product information on this new range visit: www.nth4u.com.

GI testing by an accredited laboratory

North America
Dr Alexandra Jenkins
Glycemic Index Laboratories
20 Victoria Street, Suite 300
Toronto, Ontario M5C 298 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

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