1 August 2012

GI News—August 2012

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  • 4 steps to better blood glucose;
  • Prof Jennie Brand-Miller on why gestational diabetes is such a big deal;
  • Safe fasting during Ramadan;
  • The right diet (low GI of course) to fight malnutrition and help cancer patients combat their disease;
  • Emma Stirling with the scoop on avocados;
  • 3 avocado recipes including a simply sensational avocado pea mash.
High blood glucose levels pose a threat to your health even if you don’t have diabetes. In fact, elevated blood glucose levels within the ‘normal’ range can damage the blood vessels and circulatory system, increasing the risk of a heart attack, type 2 diabetes, weight gain and even certain types of cancer. This issue we focus on why keeping your BGLs on an even keel really matters. To help you achieve this we have tips on reducing the GI of your diet and low GI recipes to try.

Good eating, good health and good reading.

Editor
: Philippa Sandall
Web management and design: Alan Barclay, PhD
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Food for Thought

Why maintaining healthy blood glucose should be a lifelong goal.
High blood glucose levels pose a threat to your health even if you don’t have diabetes. In fact, elevated blood glucose levels within the ‘normal’ range can damage the blood vessels and circulatory system, increasing the risk of a heart attack, type 2 diabetes, weight gain and even certain types of cancer. It does so by increasing the production of damaging free radicals and creating oxidative stress and inflammation.

Over time, the effects of high blood glucose levels become even more noticeable. In people with poorly managed diabetes, problems may occur with the skin, leading to bacterial infections, fungal infections and itching. Nerves may be damaged, causing numbness, prickling, tingling, burning and aching sensations. There may even be a loss of nerve function so that a process like digestion is impaired. The narrowing of large blood vessels will slow blood flow and cause heart disease, stroke and the loss of circulation, which can lead to amputation. Small blood vessels may become damaged, which can cause problems that may include blurry vision, blindness and kidney disease.

4 steps to better blood glucose.
Switch to low GI foods These are the smart carbs your body slowly digests and absorbs, the result being that they produce only gentle rises and falls in your blood glucose and insulin levels.
Keep your carb portions moderate For most of us 30 to 60g carbohydrate at any one sitting is a good average to aim for. What does that look like? 2 to 4 slices of bread, 2/3 to 1 1/3 cups cooked rice or 2 to 4 medium (150g/5oz) potatoes. That’s 2 to 4 carbohydrate exchanges.
Eat more regularly Mealtime consistency matters. Enjoy three square meals a day or three smaller meals with some healthy snacks.
Exercise regularly Exercising muscles need fuel and the fuel that they prefer is glucose. Moving your muscles burns glucose, fat and consequently calories and lowers blood glucose levels. That’s what we call a win/win.

Tips for reducing the GI of your meals

  • Replace those high GI crunchy breakfast bubbles and flakes that spike your blood glucose and insulin levels with smart carbs like natural muesli or traditional (not instant) porridge oats or one of the lower GI processed breakfast cereals that will trickle fuel into your engine.
  • Swap your bread. Choose a really grainy bread where you can actually see the grains, granary bread, stone-ground wholemeal bread, real sourdough bread, soy and linseed bread, pumpernickel, fruit loaf or bread made from chickpea or other legume based flours.
  • Make your starchy staples the low (or lower) GI ones. Look for the lower GI rices like basmati, Doongara Clever Rice or Moolgiri medium grain rice, serve your pasta al dente, choose less processed foods and intact grains such as barley, buckwheat, bulgur, quinoa, whole kernel rye, or whole wheat kernels and opt for lower GI starchy vegetables like low(er) GI potatoes (Carisma or Nicola), parsnip, orange fleshed sweet potato, carrots and butternut pumpkin (winter squash).
  • Learn to love legumes – home-cooked or canned and add chickpeas to stir fries, red kidney beans to chilli, a 4-bean salad to that barbecue menu, and beans or lentils to casseroles and soups.
  • Combine high GI carbs with low GI tricklers to achieve a moderate overall GI. Lentils with rice, rice with beans and chilli, tabbouli tucked into pita bread, baked beans on toast or piled on a jacket-baked potato for classic comfort food.
  • Tickle those taste buds and slow stomach emptying with a vinaigrette with salads, yoghurt with cereal, lemon juice on vegetables like asparagus and sourdough bread.
  • Snack low GI with fresh fruit, a dried fruit and nut mix, low fat milk and yoghurt (or soy alternatives), fruit bread etc.
Tru at the rail

What’s New?

Eating well (low GI of course) to combat cancer.
The side effects of cancer and cancer treatments – a marked decrease in appetite, nausea, and a strong aversion to food (even foods once very much enjoyed) – make it more difficult for people with cancer to maintain a healthy diet, let alone get enough food to eat. In fact, according to the National Cancer Institute, 20–40% of cancer patients die from causes related to malnutrition, not from the cancer itself, and 80% of cancer patients develop some form of clinical malnutrition. Unfortunately, conventional medical advice suggesting a patient eat whatever they want, can actually feed the patient’s cancer, promote their malnutrition and contribute to the patient’s inability to tolerate treatment. In addition, if the malnutrition is not addressed, it can lead to a condition called ‘cachexia’, defined as a wasting syndrome that results in compromised immunity, weakness, and a loss of weight, fat, and muscle.

‘The current scientific consensus is that cancer cachexia results primarily from an underlying metabolic imbalance induced by the cancer, causing the body’s metabolism to speed up,’ explains Dr Keith Block . ‘The malignancy generates the production of low-grade inflammatory molecules that breakdown lean muscle, and can disrupt immune functioning. The heavy consumption of fats, refined flours and sugars found in the traditional American diet can increase this inflammation, contributing to a lack of appetite, more debilitating weight loss and actually promote the very disease the patient is trying to fight.’

Dr David Katz
Dr David Katz

It isn’t just severe malnutrition that will impact a cancer patient’s health. Even a relatively small degree of under-nutrition can be associated with a marked increased risk of hospital admissions and death. ‘Cancer may kill, in part, by causing starvation and conventional therapies may actually exacerbate this aspect of the disease,’ says Dr David Katz. ‘While these treatments can effectively attack the cancer, they also take a toll on the patient. There is thus a need to combine effective assaults on cancer, with effective nurturing, and nourishing, of the body. Optimizing nutrition during and following cancer therapy is unquestionably a vital element in overcoming the disease, and reclaiming good health.’

To fight malnutrition and help a people with cancer combat their disease Drs Block and Katz suggest shifting eating patterns to coincide with appetite. For example, eat the biggest meal of the day in the morning, if that’s what you are most inclined to do. At the same time it’s important to cut back on (or cut out) sugary beverages and high GI cookies, cakes, pastries, white bread, crackers and refined-flour baked goods and eat:

  • Plenty of fruits and vegetables.
  • Healthy low GI starchy carbs (see 7 tips for reducing the GI of your diet above) and lean protein foods.
  • Energy dense/nutrient dense good polyunsaturated (especially omega-3) or monounsaturated fats and oils such as canola, flaxseed (linseed), peanut and olive oil and foods like avocados, nuts/ nut butters and soy products. At the same time, reduce saturated fats and eliminate trans fats.
Safe fasting during Ramadan.
Ramadan is the holy month for Muslims, falling in the ninth lunar month in the Islamic calendar year. It is a period of worship, self-discipline, austerity and charity. The most important significance of Ramadan is that Muslims are required to observe fasting during daylight hours. During this month foods and fluids are only allowed at night so fasting extends from dawn to sunset. Despite being exempt, people with diabetes often wish to fast because of the status of Ramadan.

Most people with type 2 diabetes whose diabetes was well-controlled before Ramadan can safely observe Ramadan fasting is the finding of recent study. UK dietitian Azmina Govindji agrees. ‘It is possible to fast safely if you are careful about managing your diabetes,’ she says. ‘The reason why you need to take care is that some drugs used to treat type 2 diabetes (sulphonylureas) and insulin can make your blood glucose level drop too low when you are not eating. Not drinking enough water can also make you dehydrated. Often the evening meal, Iftar, contains lots of carbs (starches and sugars) and perhaps sugary drinks. Because this is a time when families eat together to break the fast, the food is richer than you may be eating normally. And you may feel having fasted all day long you have an excuse to reward yourself. You need to be particularly strong willed at this time.’

Azmina’s fasting checklist

Azmina Govindji
Azmina Govindji
  • Seek the advice of your healthcare team before starting and at the end of the fast, since they may advice you to change the times or amount of medication you take.
  • Do not stop taking your medication.
  • Avoid eating lots of unhealthy foods as a reward! Try and maintain a healthy eating pattern after you break the fast. Make sure that you have lots of fruit and vegetables and dal as these are slowly digested and help your blood glucose to rise more slowly too. Remember to drink plenty of fluids.
  • Divide your daily food intake into two equal portions, one to be taken at Sehri and one at Iftar
  • Remember to check your glucose level regularly, at least once a day at different times of the day.
  • After the period of Ramadan, it is essential that you visit your doctor to make sure that your blood glucose is being managed adequately and also to check whether your medication needs to be adjusted.
Healthy eating advice for new Mums can help cut child obesity.

Mother and child

Teaching new Mums about healthy eating and active play can help cut the risk of their child being overweight or obese, a study published on bmj.com finds. The study authors looked at 667 first-time mothers and their infants in Sydney (Australia). Specially trained community nurses visited the Mums eight times and the timing of visits was designed to coincide with early childhood developmental milestones. They looked at the children's BMI, feeding habits and television viewing time. Nurses taught the Mums healthy eating and exercise habits for their babies and toddlers using key messages such as:
  • Breast is best.
  • No solids until six months.
  • I eat a variety of fruit and vegetables everyday.
  • Only water in my cup.
  • I am part of an active family.
This study found that the first few years of a child's development are crucial in setting the foundation for lifelong learning, behaviour and health outcomes.

Eat to Beat Cholesterol
Now fully revised and updated, Nicole Senior & Veronica Cuskelly’s Eat to Beat Cholesterol is not just another diet or cook book. It can tip the balance towards a healthy heart and make healthy living a reality for you and your family. As well as recipes, eating plans and shopping and cooking tips, there are ‘quickies’—fast and easy ways to include super-heart food in your daily diet, all with nutritional information. Get a taste of what’s inside HERE.

ThyroidChange
This web-based initiative unifies the voice of the thyroid community (patients, organisations, groups, blogs, websites and physicians) to promote change and research in the diagnoses and care of thyroid disease. Their goal is optimal thyroid health. Their advocacy encompasses hyperthyroidism, hypothyroidism, auto-immune thyroid conditions, thyroid cancer and other thyroid issues of concern. Check it out HERE.

Get the Scoop with Emma Stirling

The scoop on avocados.

Emma Stirling
Emma Stirling APD

Do you love an avo? We do at GI News. Not that there is a huge GI story. In fact avocados are too low in carbohydrate to test for GI. We just adore their velvety texture, healthy fats and essential nutrients and all the fab ways you can add them to enhance your low GI meals throughout the day. Let’s take a look at some fresh research and show you clever ways to spread the love around.

Science scoop Avocados are a versatile, nutrient dense fruit, rich in mono and polyunsaturated fats, while naturally low in carbohydrate and sodium. Half an avocado can provide the average adult:

  • 5g of fibre (17% of adult fibre needs)
  • 36% of the recommended dietary intake (RDI) for folate
  • 31% of RDI for vitamin K
  • 24% of RDI for vitamin E
  • 15% of RDI for potassium
A recent literature review of avocados and health, in Critical Reviews in Food Science and Nutrition, has found that the addition of avocados to the diet may have a positive effect on heart health and other lifestyle conditions such as weight management and healthy aging. The review concluded that eight preliminary clinical studies have consistently demonstrated positive cardiovascular benefits from avocado consumption. Avocados may help promote healthy blood lipid profiles and enhance the bio-availability of fat soluble vitamins and phytochemicals within the avocado or other fruits and vegetables, naturally low in fat, that are consumed with avocados.

Smarter spread
The obvious place to start is to make a smart switch and use avocados as a replacement for your regular spread. Even though you may only take “a little butter for your bread” evidence suggest that our intake of saturated fat is too high and smart switches made on a daily basis can add up to big, health benefits.

Keep it real The second place most people reach for an avo is for guacamole dip. With the Mexican cuisine craze taking over Australia we’ve sourced this authentic recipe just for you below. But why not push your culinary creativity?

Niki Segnit, author of The Flavour Thesaurus, writes passionately about their versatility: “No wonder it’s hard to stop grazing on avocados: they taste like grass and have the texture of butter. Delicate avocado goes well with other subtly flavoured ingredients, such as mozzarella and crustaceans; the later love the light anise note in avocado flesh”. Try avocado in the obvious salads, dips and canapés, but also experiment. How about in a green smoothie with kale or spinach? An iced, avo gazpacho? Or as a butter replacement in baking? We have two more recipes to tempt you further down.

Victor Pisapia’s authentic guacamole

‘Superb guacamole depends on perfectly ripe, flavourful ingredients. The black, bumpy-skinned Hass variety is preferred because of its rich flavour’ says Victor of Victor’s Foods, Sydney. Serves 10–12

4 avocados
½ red onion (finely diced)
1–2 jalapeño chillies, stemmed, seeded and finely diced
3 tbsp chopped coriander
3 tbsp fresh lime juice
salt to taste
1 tomato, diced

Cut the avocados in half and remove the seed. Scoop the avocado flesh out with a large spoon and place into a mixing bowl. Mash the avocado with a fork until a very chunky mash is formed. Add the onion, chillies, coriander and lime. Mix with a fork to keep chunky. Taste and add salt or more lime to taste. Garnish with the diced tomato and serve with:
  • toasted corn or flour tortilla chips
  • julienne vegetables or jicama sticks
  • burgers, your favourite sandwich or eggs such as Huevos Rancheros
  • quesadillas, poultry, seafood, fajitas and wraps
  • cooked prawns and pico de gallo.
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.

[JOHANNA]

Mixed berry almond custard
More than a dessert after a meal, I serve this custard when I have the good fortune of having a few friends come over for an afternoon visit. Its wholesome goodness, however, qualifies it as an excellent choice any time of day or evening. For a special occasion, dust with confectioner’s sugar (icing sugar) if desired. Serves 8.

1 cup fresh strawberries, washed, drained, quartered
1 cup fresh blueberries, washed, drained
1 cup blackberries or raspberries, washed, drained
1 can (360g/12oz) evaporated fat free milk, well shaken
2 whole eggs
4 egg whites or 1/2 cup egg substitute
2 tbsp canola oil
1/4 cup amber agave nectar
1/2 teaspoon vanilla extract
1/2 teaspoon almond extract
1/2 cup almond flour
2 tbsp coarsely chopped toasted almonds (optional)

Blueberry-lemon buttermilk pancakes

Preheat oven to 180ºC/350ºF.
Evenly coat a 9½-inch (24cm) Pyrex pie plate with vegetable spray. Add all the berries and set aside.
Pour all remaining ingredients (evaporated fat free milk through almond flour) into a blender. Pulse approximately 20 times, or until all ingredients are well mixed. Pour mixture evenly over berries. Sprinkle toasted almonds on top if using.
Place pie pan on a cookie sheet and bake for 55 minutes. Custard is done when a knife comes out clean when inserted. Allow to cool thoroughly on a cookie rack then refrigerate for at least 1 hour before serving.

Per serve
Energy: 785kJ/187cals; Protein 8g; Fat 8g (includes 1g saturated fat and 53mg cholesterol); Available carbohydrate 19g; 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 these deliciously versatile recipes – Avocado pea mash and Avocado san choi bau from Australian Avocados Fresh Avocados Masterbook for Food Service

Avocado pea mash
Use frozen peas for this creamy mash that’s the perfect accompaniment for your favourite meat, chicken or fish. It’s also great to top toasted sourdough. Serves 4–6.

400g (14oz) green peas
1 tbsp chopped parsley
3–4 tbsp chopped mint
1 tbsp (20ml) avocado oil
2 tbsp (40ml) lemon juice
2 avocados, halved, peeled and chopped
sea salt and pepper to taste

Avocado pea mash

Boil peas for 3 minutes and drain.
Add peas, avocado oil, lemon juice and 1 avocado to a bowl. Using a stick blender, make a rough purée.
Fold in the remaining avocado and chopped herbs and season with salt and pepper. Taste for flavour and add more mint if needed.

Per serve
Energy: 1270kJ/300cals; Protein 7g; Fat 26g (includes 5g saturated fat and 0mg cholesterol); Available carbohydrate 9g; Fibre 6g

Kate McGhie’s avocado san choi bau
Serves 10.

Thai avocado salad
3 unripe avocados
1 cup fresh lime juice
½ cup fish sauce
20g (¾oz) shaved palm sugar
3–4 small red chillies (finely chopped)

Avocado prawn filling
250g (8oz) prawns, cooked, deveined and chopped
200g (7oz) water chestnuts, chopped
2 firm-ripe avocados, diced
20g (¾oz) coriander, roughly chopped
180g (6oz) Italian tomatoes (diced)
10 iceberg lettuce cups (trimmed)

Garnish
coriander sprigs

Avocado

To make the salad: Peel and coarsely grate the avocados into a bowl. Whisk together the lime juice, fish sauce, palm sugar and chillies. Taste and adjust the ingredients to obtain the harmony of hot, sour, salty and sweet. Pour over avocado and toss well. Cover and leave for 15 minutes.
To make the filling: Put prawns, chestnuts, avocado, coriander and tomatoes in a bowl and toss.
To serve: Spoon equal quantities of prawn mixture into each lettuce cup and top with a generous amount of avocado salad. Garnish with sprigs of coriander.

Per serve
Energy: 1330kJ/320cals; Protein 9g; Fat 28g (includes 6g saturated fat and 47mg cholesterol); Available carbohydrate 6g; Fibre 3g

Busting Food Myths with Nicole Senior

[NICOLE]
Nicole Senior

Myth: Meat causes cancer.
In some studies, eating meat has been flagged as a potential contributor to some cancers, but the scientific story is far from ending and is very complex. It may be too much meat, processed meat, charred meat or not enough protective plant foods, rather than meat per se that poses a risk. To say ‘meat causes cancer’ is an overstatement and scaremongering about a highly nutritious food.

What is the evidence? The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) recommend we limit intake of red meat and avoid processed meat because they have assessed the evidence as ‘convincing’ that red meat and processed meat increase the risk of bowel (colorectal) cancer. However, cancer researchers the world over concede the scientific evidence is hard to disentangle.

What is muddying the water? Meat is a complex food containing a variety of nutrients. The
nutritional composition can vary widely, depending on how it is grown, which cuts are eaten and how they are cooked. Fatty cuts of meat contain higher levels of saturated fat, so perhaps the cancer culprit is actually the fat rather than the lean meat—we’re advised to eat our meat lean anyway for reducing cholesterol and heart disease risk. The problem may be charring the meat—
carcinogenic compounds such as heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs) are formed when meat is charred.

Population studies of meat-eating have used vegetarian groups for comparison, including religious communities such as Seventh Day Adventists (SDA). It is very difficult to separate other factors in these communities when comparing them with meat-eaters from more diverse backgrounds. For example, SDAs do not drink alcohol and their religious beliefs compel them to live a healthier lifestyle in general—not just to be vegetarian. Their religious faith may itself be a confounding factor for health.

And then there is the big question of whether meat-eaters have less room on their plate for plant foods, which are considered protective. It may be a case of not enough vegetables, fruits, grains and nuts rather than eating meat.

How much meat? The WCRD & AICR don’t advise us to stop eating meat. Instead, they suggest limiting the amount of red meat to less than 500g (17.oz) cooked weight a week (70g/2.oz a day), and ensure very little —if any—of it is processed meat. This is bang-on the amount that government guidelines recommend for good health. The only arguments against this amount come from the meat industry, and especially from the smallgoods industry. The fact that well-loved foods such as bacon, ham and salami would pose a health risk has also been difficult for the public to swallow as well.

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

GI Symbol News with Dr Alan Barclay

[ALAN]
Dr Alan Barclay

Diabetes and cardiovascular disease: check out the common ground.
Did you know that healthy eating to prevent and manage diabetes will also help decrease the risk of heart disease, stroke and other cardiovascular diseases? This is because these diseases share a number of common risk factors including central obesity, high blood fats, high blood pressure, being inactive and smoking. High blood glucose levels normally associated with diabetes are themselves a risk factor for cardiovascular disease, particularly in people who already have diabetes. There is also some evidence that having highly variable blood glucose levels (high and low BGLs) can increase the risk of cardiovascular disease in people with type 2 diabetes.

The good news as regular readers of GI News know, is that there is very strong evidence from high quality randomised controlled trials that healthy low GI diets not only help you lose weight and keep it off, they help reduce your risk of diabetes and heart disease. How? By both reducing high blood glucose levels and most importantly by decreasing fluctuations in blood glucose levels – low GI foods and meals help keep your blood glucose levels on an even keel throughout the day.

Low GI also matters when it comes to cholesterol. Eating less saturated fat is a common way of reducing blood cholesterol levels. But what you replace the saturated fats in your diet with is vitally important. It's important to be aware that in some specially designed low fat foods you can find in the supermarket the saturated fat is replaced with refined carbohydrates (sugars and starches) with a high GI
and this certainly won't reduce your risk. To help reduce your risk of type 2 diabetes and cardiovascular diseases, you need to replace foods high in saturated fat (e.g. fatty and in particular processed meats) with unsaturated fats (e.g., soy bean oil, oily fish, etc) and/or low GI carbohydrate foods. In Food for Thought in this issue of GI News you can see our tips for lowering the GI of your diet.

But healthy eating is not just about fats and carbohydrates – the right type and amount of protein you eat matters as well.
There is growing evidence that consuming high quality protein (lean meat, poultry, seafood, dairy and alternatives) plays a key role in weight management. Recent evidence based on research in real people suggests at least 20% of our energy (kilojoules) should come from protein each day, although more research is needed. This is easy to achieve. Check out Nicole Senior's GI News story on getting enough of the quality protein you need HERE.

The GI Symbol, making healthy low GI choices easy choices


New GI Symbol

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.

Jennie

Gestational diabetes. Why such a big deal?
Gestational diabetes (any degree of ‘glucose intolerance’ diagnosed for the first time during pregnancy) is the most common medical problem encountered during pregnancy. The name is derived from the combination of having a raised blood sugar level, as occurs in people with diabetes mellitus, and being pregnant (gestational). While “blood sugar” is the commonly used term, it is actually a measurement of glucose in a blood sample taken from a vein. In practice, the terms are used interchangeably.

A diagnosis of gestational diabetes is important for many reasons. Firstly, it identifies women who may be at risk for developing type 2 diabetes later in life. The forewarning means they can make diet and lifestyle changes, for themselves and their family, to help reduce their chances. Some women, during and after pregnancy, may also be prescribed metformin, a drug that reduces insulin resistance and may prevent or delay the development of type 2 diabetes.

Secondly, women with gestational diabetes are more likely to have a large baby. While normal women without diabetes can also have big babies, the reasons are different and often genetically determined (e.g. both the mother and father are tall). Women with gestational diabetes have bigger babies because high amounts of glucose are converted and stored as fat around the baby’s abdomen. The increased size of the baby’s abdomen can be detected and measured on ultrasound.

A mother with a large baby, whatever the cause, is more likely to have a complicated delivery, with injury to both the baby and the mother. There is an increased rate of medical intervention (e.g. forceps delivery) and higher rate of both elective and emergency caesarean section. In many instances, the detection of a large baby will mean an earlier delivery is scheduled with induction of labour.

Women with gestational diabetes are also at increased risk of having a baby with a low blood glucose level after delivery. This is because of the sudden withdrawal of the mother’s high glucose supply and the baby’s relatively high insulin level. For this reason, together with additional concerns, the baby may need to be admitted to a special care nursery. These complications are directly related to the higher blood glucose levels in the mother. The good news is that they are highly unlikely if the diabetes is properly managed and blood glucose levels are kept relatively normal.

Finally, gestational diabetes is now a concern because of ‘programming’ in the womb and the potential for your baby to be more at risk of developing diseases in later life. What you eat during pregnancy affects the way the baby develops and the food choices that your baby will make later in life. It is not just your blood glucose levels that are important but all aspects of the diet. However, because carbohydrates are responsible for the rise and fall in your blood glucose levels after eating, carbohydrate foods are given special attention. Foods with a low GI will lead to a smaller rise and fall in the glucose levels and these gradual changes are passed through the placenta to the baby. Foods with a high GI will cause a rapid rise in your blood glucose and this glucose spike is passed through to the baby. For complex reasons related to the circulation of the amniotic fluid, this spike can have a sustained effect.

In September GI News, I’ll look at the risk factors for gestational diabetes.

This is an edited 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). I
n 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 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.

The Bump to Baby Low GI Eating Plan for Conception, Pregnancy and Beyond

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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