1 September 2012

GI News—September 2012

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  • Restoring physical activity into our computer-driven work, school and home environments;
  • Why too much sitting is bad for you;
  • Emma Stirling and the scoop on beetroot;
  • Do spicy foods boost your metabolism?
  • The winning edge: GI and sports performance. Dr Alan Barclay reports;
  • Prof Jennie Brand-Miller on the risk factors for gestational diabetes and what you can do about them.
Although the evidence that too much sitting is hazardous to health is now quite compelling, many of us sit longer than we sleep these days. So, this issue we focus on moving more and more often not necessarily by going to the gym or pounding the pavements, but by restoring physical activity into our computer-driven work, school and home environments. ‘We also need to be more creative in designing and transforming our work and home environments and even our whole communities into spaces where physical activity is not just the easy but perhaps even the only choice,’ says Prof Arya Sharma. We love his suggestion that ‘perhaps, it is time to establish building codes for “active” buildings in the same manner in which we now have building codes for environmental friendliness.’

Good eating, good health and good reading.

Editor
: Philippa Sandall
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Food for Thought

Why sports and exercise are barely relevant and what really counts is occupational and household activity.
Guest contributor Prof Arya Sharma discusses a paper that suggests why attempts to encourage recreational physical activity are largely doomed to fail.

Prof. Arya Sharma
Prof. Arya Sharma

There is no doubt that reducing sedentariness and increasing physical activity can have enormous health benefits. This is why public health policies and health promotion bombard us with messages on how to get more active – unfortunately, much of the advice focuses on increasing engagement in recreational and volitional sports and exercise.

A paper by Chuck Ratzlaff from Harvard University, published in the British Journal of Sports Medicine now suggests why attempts to encourage recreational physical activity are largely doomed to fail. This is simply not where most people’s physical activity happens – nor is it likely to happen. Most people simply do not like being physically active enough to want to do it – when given the choice, they’d much rather sit or lie down (which makes perfect evolutionary sense). It is therefore but natural, that about 80% of total daily physical activity in most people is associated with occupational and non-leisure (household chores).

Sporting activity formed a small fraction of overall physical activity compared with occupational and household activity (even more so in women) in Ratzlaff’s analysis of his recent population-based research measuring lifetime physical activity. If anything women have gotten even more physically active than before.

This not only means that most of us (even those, who do not seek out or participate in ‘recreational’ physical activity) are probably more active than generally assumed. It also means that perhaps the focus of public health measures to promote a more active ‘lifestyle’ may need to focus more on restoring physical activity in occupational and household settings.

Obviously, re-introducing physical labour into the workplace and household may prove far more challenging than simply appealing to people to go for a walk or run (to nowhere).

That workplaces, buildings and whole communities can be re-engineered to promote physical activity (whether you like it or not) is, for example, exemplified in the new Edmonton Clinic Health Academy at the University of Alberta, which incidentally, also houses our School of Public Health. Anyone entering this building is immediately faced with a wide open staircase (not stairwell!) – the elevators are rather hidden in a corner (and for some reason appear not to be accessible half the time). At any time there are people crowding the stairs. Most people will climb stairs when they have to – like it or not. (Simply putting up a sign pointing to the hidden stairwell on the other hand has little effect.)

The point is that we need to be more creative in designing and transforming our work and home environments and even our whole communities into spaces where physical activity is not just the easy but perhaps even the only choice. Perhaps, when it comes to building codes, it is time to establish codes for ‘active’ buildings in the same manner in which we now have building codes for environmental friendliness.

Despite all efforts (including tax breaks), we will probably not get the majority of the population to really ‘like and want’ to be physically active – most people would rather watch sports than do them (especially after a long day at work). This is why increasing occupational and household physical activity by 10% may have a huge population impact while increasing volitional sports and exercise by even 100% may do little (the multiple of zero is still zero!).

Check out Dr Sharma’s website HERE. You can also subscribe to his regular blog postings.

What’s New?

The extra benefits of exercise.
In an invited editorial in the British Journal of Sports Medicine accompanying Chuck Ratzlaff’s paper (discussed in Food for Thought), Profs Wendy Brown and Steven Blair remind us that although prevention of weight gain is extremely important for public health, ‘the benefits of physical activity are not restricted to weight-gain prevention or weight control.’ They highlight the extra benefits of participating in exercise and improved fitness, over and above those associated with weight control such as improved cognitive functioning, quality of life and sleep. They also make the point that: ‘in any consideration of the relationships between energy expenditure and health, both fitness and weight need to be considered. While occupational activity may contribute to energy expenditure, for most people, occupational activity is not at a level that will improve fitness. In today’s world, participation in activities that maintain and improve fitness are important for health; being overweight and fit is associated with better health outcomes than being healthy weight and unfit. In our view, exercise remains the best buy in public health.’

Stand up!
Did you know that the average adult spends 90% of their leisure time sitting down? Standing up more often may reduce your chances of dying within three years, even if you are already physically active, a study of more than 200,000 people published in Archives of Internal Medicine shows. The study found that adults who sat 11 or more hours per day had a 40% increased risk of dying in the next three years compared with those who sat for fewer than four hours a day. This was after taking into account their physical activity, weight and health status.

“These results have important public health implications,” said study lead author Dr Hidde van der Ploeg, a senior research fellow at the University of Sydney’s School of Public Health. “That morning walk or trip to the gym is still necessary, but it’s also important to avoid prolonged sitting. Our results suggest the time people spend sitting at home, work and in traffic should be reduced by standing or walking more.”

The results are the first landmark findings to be published from the Sax Institute’s 45 and Up Study, the largest ongoing study of healthy ageing in the Southern Hemisphere. The study’s size and focus on total sitting time make it an important contributor to the growing evidence on the downsides of prolonged sitting.

Why too much sitting is bad for your health.
Researchers at the Baker IDI Heart and Diabetes Institute in Australia who tracked the TV viewing habits of 8800 adults in Australia over 6 years report in Circulation that compared with people who watched less than two hours of television daily, those who watched more than four hours a day had a 46% higher risk of death from all causes and an 80% increased risk for CVD-related death. ‘It’s not the sweaty type of exercise we’re losing,’ says Prof. David Dunstan. ‘It’s the incidental moving around, walking around, standing up and utilizing muscles that doesn't happen when we're plunked on a couch in front of a television.’ In fact, the study participants typically reported getting between 30 and 45 minutes of exercise a day. What has happened is that a lot of the normal activities of daily living that involved standing up and moving the muscles in the body have been converted to sitting,’ he said. ‘People don’t move their muscles as much as they used to – consequently the levels of energy expenditure as people go about their lives continue to shrink. For many people, on a daily basis they simply shift from one chair to another – from the chair in the car to the chair in the office to the chair in front of the television. Even if someone has a healthy body weight, sitting for long periods of time still has an unhealthy influence on their blood glucose and blood fats,’ he said. Here are David's tips for moving more:

  • Switch off, stand up and get moving
  • Avoid prolonged periods of sitting – whether in front of the TV, a computer screen or on transport. At the very least get up and move once every hour
  • Limit your TV viewing to two hours a day
  • Use commercial breaks for household chores
  • Stand up and move around while answering the telephone

Associate Professor David Dunstan
Associate Professor David Dunstan walks the talk and quits the sit: he stands at his desk!

Quit the sit.
‘When we sit, we have muscle “dis-use” – our muscles are essentially “sleeping”. When we’re up and moving, we’re contracting muscles and it appears that these frequent contractions throughout the day are beneficial for helping to regulate the body’s metabolic processes says Prof David Dunstan. ‘The evidence that sitting is hazardous to health is now quite compelling. But for the vast majority of us who work in desk-bound sedentary jobs, our choice to sit appears largely out of our control. This prompted me to ask the question: How ridiculous is it that people now sit longer than they sleep and what, if anything, can be done about sitting for long periods? Current Australian occupational health and safety guidelines recommend desk-bound employees take a break from their computer screen every 30 minutes or so to reduce eye strain. We’d like to see these guidelines extended to encourage workers to take frequent breaks that involve some kind of physical movement.’

Feces fossils lend new insights into connection between Native-Americans, diabetes.
A common theory why Native Americans experience high rates of diabetes is that they possess fat-hoarding ‘thrifty genes’ left over from their ancestors – genes that were required for survival during ancient cycles of feast and famine, but that now contribute to the disease in a modern world of more fatty and sugary/starchy diets. A newly published analysis of fossilised feces from the American Southwest, however, suggests this ‘thrifty gene’ may not have developed because of how often ancient Natives ate. Instead, researchers said, the connection may have come from precisely what they ate.

The research suggests that the hunter-gatherer civilizations of the Southwest lived on a diet very high in fibre, very low in fat and dominated by foods with a low GI. This diet, researchers said, could have been sufficient to give rise to the fat-storing thrifty genes. ‘What we're saying is we don’t really need to look to feast or famine as a basis for (the genes),’ said Karl Reinhard, professor of forensic sciences at the University of Nebraska-Lincoln’s School of Natural Resources and the study's lead author. ‘The feast-or-famine scenario long hypothesized to be the pressure for 'thrifty genes' isn’t necessary, given the dietary evidence we’ve found.’

Natives have some of the highest rates of Type 2 diabetes of any group and are more than twice as likely to develop the disease as are Caucasians. To fully understand the basis of the high rates, Reinhard said, ‘one has to look at the best dietary data one can find. That comes from coprolites (the official term for fossilised feces). By looking at coprolites, we're seeing exactly what people ate.’ The coprolites are from Antelope Cave, a deep cavern in northern Arizona where, over several thousands of years, was home to various cultures. That includes the Ancestral Pueblan peoples, who are believed to have lived there seasonally for at least 450 years.

Antelope Cave, northern Arizona

Reinhard and Keith Johnson, an archeologist at California State University, Chico, studied 20 coprolites found in the cave and combined it with analysis from other sites. They found clues to a food regimen dominated by maize and high-fiber seed from sunflowers, wild grasses, pigweed and amaranth. Prickly pear, a desert succulent, was also found repeatedly in the samples. By volume, about three-quarters of the Antelope Cave coprolites were made up of insoluble fiber. The foods also were low on the glycemic index. The analysts' findings led them to deduce that the nature of the feast, and not necessarily its frequency, was enough to lock the ‘thrifty’ genes in place – and leave modern Natives more susceptible to diabetes as their diets evolved to lower-fibre, higher-GI foods.
Source: Eurekalert

Fish oil is not enough on its own.
Fish oil. The flavour of the month. What can’t it do? An animal study published in Am J Physiol Endocrinol shows that the total (‘background’ is the word they use) diet exerts a crucial influence on the ability of fish oil to protect against developing obesity and adipose tissue inflammation. (Evidence has suggested that low-grade chronic inflammation plays a crucial role in the development of obesity related insulin resistance). The authors show that sucrose (which is actually moderate not high GI) counteracts the anti-inflammatory effect of fish oil in adipose tissue and increases obesity development in mice. ‘To summarise’ they write, ‘it cannot be excluded that several additional beneficial effects of fish oil intake might be diminished or completely abrogated by a simultaneous intake of high-GI carbohydrates. If similar effects are found in humans, this is of great concern because the intake of refined sugars from sources such as soft drinks has increased dramatically during the last several decades.’ The bottom line: stick to low GI carbs.

Get the Scoop with Emma Stirling

The scoop on beetroot.

Emma Stirling
Emma Stirling APD

Did you enjoy the Olympics? We certainly loved all the talk about healthy eating and fuelling performance. When elite athletes are looking for that microsecond advantage it’s no surprise to hear that tailored sports nutrition is part of today’s solution. One of the most interesting tweets I read (from an in-the-know sports dietitian) was about the Kenyan marathon runners drinking copious quantities of beetroot juice at their training camp. Yes deep red, beetroot juice. Let’s explore.

Nitrate know how Recent research on beetroot and beetroot juice shows that there is more to this familiar vegetable than adding colour to a salad or zing to a hamburger. Many healthy eating recommendations focus on future health protection from your veggies, whereas it appears beetroot has benefits that may be immediate. You can just tell by the vibrant pigments in beetroots that they are bursting with phytonutrients and other bioactives. One of the most talked about components in beetroots is nitrate with beetroot being one of the richest plant sources of nitrate at 250mg per 100g. Other vegetables with a high nitrate content include spinach, radishes, lettuce, celery and Chinese cabbage. Nitrates are converted by your body into another compound called nitric oxide. Research has identified that increased nitric oxide levels may help:

  • Reduce blood pressure
  • Enhance endothelial function or the elasticity in blood vessels
  • Reduce platelet aggregation or blood clotting
  • Moderate blood glucose levels
  • Improve lung function and on today’s topic;
  • Improve performance and endurance when exercising
Can’t be beet A study on beetroot juice published in the 2011 Journal of Applied Physiology explored whether it was the nitrate content of beetroots that provided the previously observed exercise benefits. Subjects drank 500mL beetroot juice for six days and were compared with a control group that drank a juice that looked and tasted the same, but was depleted of nitrates. The researchers found that the beetroot juice drinkers reduced the oxygen cost of walking, moderate-intensity running and severe-intensity running. In addition the measure of time to exhaustion was increased by 15% for the severe-intensity running group. In other words the bodies of the group that drank beetroot juice, were able to work more efficiently when exercising and could train harder and longer. So it sounds like those clever Kenyan’s are on to a good thing?

Just beet it The taste of beetroot juice is not for everyone, so experiment with your culinary creativity and try blending with apple and fresh mint or carrot, ginger and fresh lime. It’s also wise to wear rubber gloves, an apron and avoid chopping anywhere near your pale cream, stone bench tops. While athletes can easily burn off two large glasses of beetroot juice each day, recreational exercises like you and I need to watch the liquid kilojoules. More research is needed so for now I’m sticking to freshly grated beetroot in salad. I’ve even tried to slip it in at the start of the day in this Scoop recipe for Fennel Beetroot and Corella Breakfast Salad.

Fennel Beetroot and Corella Breakfast Salad

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]

Beet greens frittelle.
Italians love to use every part of every vegetable plant they can. This recipe incorporates the slightly bitter-tasting leaves of the rootbeet in a simple, quick and wholesome vegetable side dish or entree. “Frittelle” translates as “fritters” but there’s nothing deep fried here! Serves 4 as side dish

7oz (200g) beet greens (15 leaves with stems)
1 tablespoon olive oil
¾ cup chopped red onion
1 large clove garlic, minced
½ teaspoon sea salt
freshly ground black pepper to taste
3–4 tsp lemon zest (yellow part only)
2 large eggs
2 egg whites or ½ cup egg substitute
½ cup freshly grated parmigiano-reggiano cheese
¼ cup flavored breadcrumbs (I used store bought)

Beet greens frittelle

Wash and pat dry beet greens. Coarsely chop and set them aside.
Heat a large nonstick pan over medium-high flame. Add the olive oil, onion, garlic, salt and pepper. Sauté for 1 minute, stirring frequently. Add in the greens, lower to medium heat and continue cooking for 5 minutes. Stir occasionally. Add in the lemon zest, mix throughly. Adjust seasonings. Set aside to cool.
In a mixing bowl whisk together the next 4 ingredients (eggs through breadcrumbs). Add to the vegetable mixture and combine well using a wooden spoon.
Over a medium flame heat a small cast iron frying pan, previously coated with vegetable spray. Drop ½ cup of vegetable mixture into pan, slightly flatten with the back of a fork and cook for approximately 2 minutes on each side. Continue until all the vegetable-egg mixture is cooked. Serve hot, warm or cold.

Per serve
Energy: 743kJ/177cals; Protein 14g; Fat 10g (includes 3g saturated fat and 93mg cholesterol); Available carbohydrate 10g; 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 salads from the Low GI Vegetarian Cookbook (Hachette Australia) and the California Walnut Commission.

Roasted beetroot and white bean salad with balsamic dressing.
Serves 4

600g (1lb 5oz) beetroot
120g (4oz) baby spinach leaves
3 cups cooked white beans (that’s two 2 400g/14oz cans, drained)
1 red onion, halved, thinly sliced
4 thick slices grainy bread, to serve

Balsamic dressing
1½ tbsp (30ml) balsamic vinegar
2 tsp flaxseed oil
1 garlic clove, crushed
salt and freshly ground black pepper

Roasted beetroot and white bean salad with balsamic dressing

Preheat oven to 180ºC (350ºF). Trim the beetroot leaves, leaving about 3cm (1in) of top attached. Do not trim bases as this will cause the beetroot to bleed and loose its colour. Wrap beetroot in a large piece of foil and place on a baking tray. Roast for 1½ –2 hours or until tender. Set aside to cool. Once cool, put on rubber gloves and peel the beetroot. Cut into thin wedges.
Place the spinach leaves, beans and onion in a bowl. Toss to combine. Add the beetroot and toss gently to combine.
To make the dressing, place the vinegar, oil and garlic in a small jug. Whisk well to combine. Season with salt and pepper. Pour the dressing over the salad and toss to combine. Serve immediately with the bread.

Tangy roasted beet and walnut salad.
This fibre-rich salad from the California Walnut Commission features roasted beets to highlight the flavour of fennel and oranges. Although this recipe is high in fat, it's the heart-healthy kind providing essential omega-3 and 6 fatty acids. Use a little less oil if it bothers you. Serves 6 (as an accompaniment).

Dressing
1 tbsp (15ml) orange juice
2 tbsp (30ml) white wine vinegar
1 tbsp (15ml) pure maple syrup
1/4 cup (50 ml) extra virgin olive oil
salt and pepper to taste

Salad
2lb (1kg) beets
2 bunches watercress or arugula
2 oranges, peeled and cut into sections
1 fennel bulb, thinly sliced
1 cup California walnut halves, toasted

Tangy roasted beet and walnut salad

Preheat the oven to 375ºF (190ºC). Place the beets in an 8in (20cm) square baking dish. Bake in the oven for about 1 hour, or until beets are tender (will depend on size of beets). Cool.
Whisk together the orange juice, vinegar and maple syrup in a medium bowl. Gradually whisk in the oil, taste and season with salt and pepper if desired.
Peel, slice and toss beets with 2 tablespoons (30ml) of dressing.
Gently toss watercress, oranges, fennel and walnuts in serving bowl. Top with beets and drizzle with remaining dressing.

Per serve
Energy 1445 kJ/ 345als; 26g fat (includes saturated fat 2.4g); 9 g fibre; 7.8g protein; 21g available carbohydrate

What about borscht?
Janet Clarkson’s, Soup. A Global History (Reaktion Books distributed in Australia by New South Books), contains an historical recipe for ‘Borschtch’ as described in On the Manners and Customs of the Ukrainians in Letters from the Ukraine, by a Russian Gentleman, published in 1807. ‘This being a national dish, the method of preparing it may not be uninteresting. They take a quantity of meat, and boil it in sirovetz, water made sour by letting some bread remain in it for several days; they add to it such vegetables as are in season, cabbage in autumn, beet root in winter, young nettle or sorrel in spring, and the tops of the beet root, or of young cabbage, in summer; after boiling the whole with a small quantity of millet, or flour, they mix with it cream, sour or fresh, as it suits their palate or fancy and eat it with bread cut small, previously dried in an oven.’

Tangy roasted beet and walnut salad

Busting Food Myths with Nicole Senior

[NICOLE]
Nicole Senior

Myth: Spicy food speeds up your metabolism
Many people believe they have difficulty losing weight because they have a ‘slow metabolism’. So it’s comforting to think that breaking out in a sweat over a bowl of chilli is boosting your metabolic rate, thanks to its capsaicin (the chemical compound that gives it the heat). Researchers have found that capsaicin can boost heat generation and thus your metabolic rate, which means you burn more energy. But it’s all pretty short term. And the studies are few and small (and some of them used supplements, not real food!). If you eat chilli often and don’t go back for seconds and say no thanks to the sour cream, the benefits may add up. But there’s no serious evidence that eating chilli (or black pepper or other spicy foods) work as long-term metabolic boosters that will help you burn excess fat.

Red chilli's

Look at real life. They eat a lot of chilli in Mexico and that country has a major problem with overweight and obesity—although maybe it would be a bigger problem without the chilli benefits.

The good news is that boosting your metabolism is within your reach, but there’s no quick fix. It’s the usual suspects: healthy eating (at regular intervals) and moving more, including some resistance exercise (yes, weights) to get yourself some muscle power.

Long story short Chilli and other spicy foods may briefly boost your metabolic rate, but for long-term benefits you’ve got to eat healthy, move more and build muscle.

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

The winning edge: using the GI to maximise performance.
Optimising the amount and type of carbohydrate you consume before, during and after an event can provide you with that winning edge. For most forms of physical activity, our muscles preferred source of fuel is glucose. This is because the carbohydrate we eat or drink, which is not used immediately for energy, is stored mostly in our muscles and liver as glycogen. When our muscles need fuel, our bodies quickly break down this glycogen into glucose for energy. That’s why, for optimal physical performance, it’s vital to consume the right amount and type of carbohydrate before an event to maximise glycogen stores. You can also improve your performance in an endurance event or a carnival, by carefully choosing the amount and type of carbohydrate you consume during and after the event.

The night before a morning event
Your evening meal the night before should contain more carbohydrate than normal to stock up your body’s glycogen stores. The carbohydrate should be low GI and the whole meal should be lower in fat, moderate in high quality protein and comfortable in quantity (don’t over eat or drink).

The morning of the event Make your breakfast a carbohydrate-based one that’s lower in fat and moderate in protein. Exactly what you eat depends on the time between breakfast and the start of your event. The following table provides a guide based on your start time. As with dinner, only eat a comfortable amount, otherwise you may regret it …

Table

Event foods
During the event choose high GI carbohydrates that are easily digested and absorbed like:

  • Gatorade or other isotonic sports drink
  • Goo or other gel/liquid glucose supplement
  • Jelly beans or other sugary lollies
  • White bread with regular honey
  • Scones with regular jam
Recovery foods
Aim to eat 1–2 hours after an event and your food and fluid choices should be low GI. Your body needs to replenish its glycogen stores, and delaying this replenishment can lead to fatigue and underperformance. The following suggestions will provide you with 75g available carbohydrate:
  • 5–6 slices of a low GI bread like Burgen or Tip Top 9 grain
  • 2½ cups Sustain cereal with reduced fat milk
  • 11 Ryvita biscuits
  • 1½ cups cooked basmati rice
  • 3½ cups 100% fruit juice
  • Milo or Sustagen
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.barclay@gisymbol.com
Website: www.gisymbol.com

GI Update with Prof Jennie Brand-Miller

Prof Jennie Brand-Miller answers your questions.

Jennie

Are you at risk of gestational diabetes?
All women should be tested for gestational diabetes in every pregnancy. Women with risk factors are more likely to have gestational diabetes but women with no risk factors at all can also have this problem. There are many different risk factors that predict the risk of developing diabetes during pregnancy. One or more of these may be operating in different women.

There are some risk factors that cannot be avoided:
Your genes. If there is a family history of type 2 diabetes, then there is likely to be a genetically-determined tendency to develop the problem. The average age of diagnosis in Australians of Caucasian or northern European origin is about 60 years. Thus a negative family history is not necessarily reassuring as many women in their pregnancy may not yet have a first degree relation who is old enough to have developed or been diagnosed with diabetes.

Your background. In Australia, gestational diabetes is more common in women who come from an ethnic background with a higher overall rate of diabetes or an earlier age of onset. This includes, but is not confined to women from the Pacific Islands, South East Asia, China and the Indian subcontinent.

Your age. With women now delaying their families often until their 30s, they are much further advanced towards the time when they potentially may develop type 2 diabetes in the future. Therefore under the stress of pregnancy this problem can be unmasked.

A previous adverse obstetric history. There is an increased risk of developing gestational diabetes in women who have had previous miscarriages, large babies and adverse pregnancy outcomes.

A previous history of gestational diabetes. Women who have had gestational diabetes in one pregnancy are much more likely to develop this again in subsequent pregnancies. However this is by no means inevitable and there is generally about a 50% recurrence rate. This rate can be reduced by careful attention to diet between the pregnancies, particularly with respect to reducing the intake of saturated fat.

Having PCOS. Women with PCOS have a much higher risk of developing gestational diabetes.

Risk factors that can be reversed or avoided:
Being overweight. Women who are overweight are much more likely to develop gestational diabetes. They are also much more likely to have large babies.

A poor diet, both before and during pregnancy. Women diagnosed with gestational diabetes who follow dietary advice are able to significantly lower their blood glucose levels. Thus it is likely that a less-than-healthy diet during pregnancy may unmask a tendency towards gestational diabetes.

Exercise. Women who exercise regularly are less likely to develop gestational diabetes. Women who are most active before pregnancy have less than half the risk of developing gestational diabetes compared to those who are least active, and those with the highest activity levels in early pregnancy reduce their risk of gestational diabetes by around 25% compared with those who are inactive.

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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