GI News—October 2012

• Dr Alan Barclay on single nutrient fad diets and why they can be high GI; 
• Discovering rice’ s GI gene; 
• The benefits of switching to a low GI diet in pregnancy;
• Prof Jennie Brand-Miller on pregnancy and optimal weight gain;
• Emma Stirling with the scoop on herbs;
• Three low GI recipes to enjoy.

‘Whether hot or cold, strong or weak, black or green, sweet or smoky, oolong or pekoe, with milk or lemon, bag or leaf, tea is the universal drink of countless millions.’ We asked Glenn Cardwell to bring us up to date on some recent studies and the benefits of taking a tea or coffee break while Nicole Senior busts the myth that a cup or tea or coffee will be dehydrating.

Good eating, good health and good reading.

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

Tea and coffee break.
‘Whether hot or cold, strong or weak, black or green, sweet or smoky, oolong or pekoe, with milk or lemon, bag or leaf, tea is the universal drink of countless millions.’ – Tea: A global history, Reaktion Books. We asked Glenn Cardwell to bring us up to date on recent studies and the benefits of taking a tea or coffee break. The following piece, reproduced with permission, first appeared on Glenn’s blog.


Glenn Cardwell

‘Humans have enjoyed tea and coffee for quite some time. Coffee was being drunk in Europe in the mid-17th century, while tea was supposedly consumed by the Chinese 4500 years ago, although this strongly disputed as the first mention of tea in a Chinese text was only 2000 years ago. Tea arrived in Europe around the same time as coffee.

The news is good I have said good things about tea and coffee over the years because I prefer a positive food story rather than the scare stories enjoyed by others. It is always comforting to have science on your side. A recent meta-analysis crunched all the research papers between 1966–2011, which included 140,000 coffee drinkers and came to the conclusion: “Moderate coffee consumption is inversely associated with the risk of heart failure, with the largest inverse association observed for consumption of 4 servings per day.” And it didn't matter whether you’re a boy or a girl. With 4 cups of coffee a day there was a 11% lower risk of heart failure. Any benefit was negated once you reached 10 cups a day. The analysis took account of body weight, alcohol consumption and smoking, as is always the way in making sense of research.

And then it gets better Some scientists who live just down the road from me at the University of Western Australia took a look at both tea and coffee and the potential risk of heart disease. They too were positive about a lower risk of heart disease in tea and coffee consumers after reviewing the published evidence. Tea seemed to improve the normal functioning of the arterial walls, lower triglycerides, inhibit inflammation and LDL-cholesterol oxidation (the latter two significantly contribute to atherosclerosis) and even lower the risk of stroke. Both tea and coffee are associated with a lower risk of type 2 diabetes. The association seems to be strongest with coffee, possibly due to the chlorogenic acids in coffee.

How much tea and coffee? Difficult to say precisely, but there is general agreement that 3–5 cups a day is having a useful effect on your health. They did emphasise that your genes could be playing an important role, meaning we can’t say that everyone will benefit from tea and coffee. For example, those with the polymorphism CYP1A2 in the P450 enzyme (that's laboratory clever people talk I think) are slow caffeine metabolisers, and actually have a higher risk of a heart attack with caffeinated drinks. All the same, it sounds very encouraging to me.

Is there a “yes, but”? Isn’t there always? Generally, the studies rely on self-reported tea and coffee consumption and only one point in time. If you believe that tea and coffee are “bad” then you will probably fib about how much you guzzle, and often people just plain “forget” how much they drink and therefore under-report. Or they may have changed drinking habits over time depending upon what they read in the paper. Association is not necessarily cause and effect. It could also be that the folk enjoying a brew three or four or five times a day might also eat more vegetables, watch only documentaries, cook proper meals, help their neighbours, give to charity, walk the dog and hug the kids. Nevertheless, when the numbers are given a thorough massage, it looks like moderate tea and coffee drinkers come out ahead in the health stakes,


1939 poster from the Empire Marketing Board

What does it all mean? If you drink tea or coffee, feel very comfortable with the habit. All the evidence suggests that up to 5 cups a day is fine and may even be a generous leg-up for your health. I suspect that even – 8 cups a day is OK. Twenty cups? I’m not so sure. Maybe worth considering a cut back. No-one is certain what specific compounds in tea and coffee are responsible for their proposed protection. There are many biologically active compounds, both known and unknown, in tea and coffee. Between you and me, 6 cups of tea a day find their way down my throat. They are big cups and I ain’t worried in the slightest. Hopefully, before I die, science will reveal why tea helped me live to 105.’

What’s New?

Using the GI in pregnancy.
‘In the long run, excessive weight gain in pregnancy has contributed to the current epidemic of obesity in women and children,’ says Prof Jennie Brand-Miller in her new book, The Bump to Baby Low GI Eating Plan (Hachette Australia). ‘A woman who gains too much during pregnancy gives birth to an overweight daughter, who in turn is more likely to be an overweight child and young adult, who is then more likely to gain excessive weight during her first pregnancy and give birth to a child with excess fat, and the cycle repeats itself.’ In this issue, we report on two recent studies suggesting long-term benefits of mum-to-be switching to a low GI diet.

1) A diet with a high GL increases the risk of excessive weight gain during pregnancy and post partum weight retention according to the Danish study in the British Journal of Nutrition. ‘The associations varied with the mother’s pre-pregnancy weight, and were more pronounced among the overweight and obese women. Even though only a modest effect on birth weight was observed, attention should be paid to the fact that the quality of carbohydrate in the diet may affect the birth outcome,’ the authors concluded.

2) Women who switch to a low GI diet during pregnancy are 20% less likely to experience excessive weight gain concludes the British Medical Journal. ‘This type of excessive weight gain during pregnancy is associated with an increased need for delivery by Caesarean section, a higher likelihood of post pregnancy weight retention, and a higher predisposition to obesity in later life,’ according to lead author, Fionnuala McAuliffe, professor of obstetrics and gynaecology at the University College Dublin School of Medicine. The study found that the 400 mums-to-be who changed their eating habits to the low GI diet gained an average amount of 12.2 kg during pregnancy, while the remaining participants put on an average weight of 13.7 kg.

Commenting on the overall GI of the women’s diet in the BMJ study Dr Alan Barclay points out that the women only achieved a mean daily average GI of 56 (down from 57.3 at baseline) and the difference in GI between the control and intervention groups was small – 1.7 units. ‘I believe an overall low GI diet should have an average dietary GI of around 45. There’s pretty compelling evidence from population health studies and clinical trials around the world that for long-term health and wellbeing this is the sort of figure we should aim for. It’s not as hard as it sounds to achieve this (around a fifth of the world’s population do). Choose less processed food most of the time and take the “this for that” option, that is you simply substitute healthy low GI carbs for high GI ones when shopping, cooking and eating out’.

Discovering rice’s GI gene.
As we have explained in GI News over the years, the GI of rice (brown or white; black or red) depends on its amylose content– a kind of starch that resists gelatinisation. When you cook rice, millions of microscopic cracks in the grains let water penetrate right to the middle of the grain, allowing the starch granules to swell and become fully ‘gelatinised’, thus very easy to digest. Greater gelatinisation of starch means a higher GI. Some varieties of rice have lots of amylose; others much less. There’s no easy way to tell. Neither the colour nor the length of the grain is a guide to the GI.

A research team from the International Rice Research Institute (IRRI) and CSIRO's Food Futures Flagship has now published a study in Rice which analysed 235 varieties of rice from around the world. They found that the GI ranged from 48 to 92 in the varieties they looked at. Importantly, they also identified the key gene that determines the GI of rice – a very useful achievement which offers rice breeders the opportunity to develop low or lower GI varieties.

Check out our Rice salad with fennel, orange and chickpeas (from the Forks Over Knives -- The Cookbook in the GI News Kitchen.

Do nonnutritive sweeteners really help you lose weight?
The sugar veto for people with diabetes or wanting to lose weight has helped create a huge market for alternative sweeteners from Aspartame (Equal/Nutrasweet) to stevia. Nonnutritive sweeteners provide few calories (kilojoules), carbs or any other nutrient. Typically they are hundreds of times sweeter than sucrose (table sugar), so you only need a minute amount. However, so that you can use them in a similar way to sugar (eg by the teaspoon), the manufacturer usually adds a bulking agent such as maltodextrin.



Nonnutritive sweeteners have virtually no effect on blood glucose levels and can help you cut back on your calories if you use them to replace equivalent amounts of sugar or honey etc. Their major drawback is that they aren’t as versatile as sugar and honey (and other nutritive sweeteners) because they tend not to be heat stable, they don’t brown or caramelise and they don’t add texture or bulk to food when used in baking. Gram for gram, they also tend to be much more expensive than their counterparts.

Reviewing the evidence, a Scientific Statement from the American Heart Association and the American Diabetes Association in Diabetes Care concludes that ‘when used judiciously, nonnutritive sweeteners could facilitate reductions in added sugars intake, thereby resulting in decreased total energy and weight loss/weight control, and promoting beneficial effects on related metabolic parameters. However, these potential benefits will not be fully realized if there is a compensatory increase in energy intake from other sources.’ They make the additional point that ‘At this time, there are insufficient data to determine conclusively whether the use of nonnutritive sweeteners to displace caloric sweeteners in beverages and foods reduces added sugars or carbohydrate intakes, or benefits appetite, energy balance, body weight, or cardiometabolic risk factors. There are some data to suggest that nonnutritive sweeteners may be used in a structured diet to replace sources of added sugars and that this substitution may result in modest energy intake reductions and weight loss.’

Nuts and olive oil for health.



Spanish researchers Prof Jordi Salas Salvado and Dr Emilio Ros presented the results of the long-term PREDIMED diet study (PREvencion con DIeta MEDiterranea – Prevention with the Mediterranean Diet) at the International Congress of Dietetics in Sydney. This comprehensive review of the Mediterranean diet is now in its ninth and final year. Nearly 7400 older adults at risk of cardiovascular disease, but with no symptoms, were randomly assigned to one of three diets (followed for five years on average). The three diets were:

• Mediterranean diet enriched with 30g (1oz) of mixed nuts per day (15g walnuts, 7.5g almonds, 7.5g hazelnuts)
• Mediterranean Diet enriched with virgin olive oil – 1 litre (4 cups) per family per week or 50ml (a little over 1½ fl oz) per day per study participant
• Low fat control diet – avoidance of plant and animal fats.

While the final five-year cardiovascular results are due later this year, the results to date report that a Mediterranean diet enriched with a 30g (1oz) handful of mixed nuts a day can:

• reduce the risk of diabetes by 52%
• reduce the risk of metabolic syndrome by nearly 14%
• reduce blood glucose levels, systolic and diastolic blood pressure and the LDL:HDL cholesterol ratio
• improve biomarkers of inflammation
• reduce obesity measures, such as BMI and waist circumference.

‘Our nine years of research has overwhelmingly demonstrated healthy diets rich in monounsaturated and polyunsaturated fatty acids provide long-term protection from health conditions such as heart disease, diabetes and obesity,’ says Prof Salas Salvado. ‘It’s time for people to forget the low fat hype and embrace good fats. We know there is a fear of weight gain surrounding foods high in good fats, like nuts, but this is absolutely unfounded. There are approximately 30 clinical trials that have demonstrated the beneficial effect of consuming nuts on diabetes, cholesterol etc, and none of these have observed any negative effect on weight. We recommend 30g (1oz) of nuts a day, which is around a handful, as this is the amount we have consistently demonstrated is beneficial for heart disease risk factors.’ For a summary on PREDIMED visit www.nutsforlife.com.au.

Get the Scoop with Emma Stirling

The scoop on herbs.


Emma Stirling APD

Do you love culinary herbs as much as we do? Basil, rosemary, parsley, coriander/cilantro, chives and more you’ll find them popping up all over our GI News recipes. They don’t factor directly in GI, but the growing health story has us skipping back down the garden path for more.

Getting to the roots of good health We don’t test herbs for GI – they get a 0 – as the amounts consumed are just too low in carbohydrate counts to affect blood sugar levels. And even though many herbs are high in vitamin C, you’re not going to get anywhere close to your daily needs with say a parsley garnish on a bowl of soup. Unless you’re into eating a bowl of tabouleh every day, an orange just seems a whole lot easier source of vitamin C. But is that the only way to assess the health benefits of herbs?

Nature’s flavour enhancer Nutritionists have often talked up herbs as nature’s flavour enhancers. With pungent aromatics they allow you to dial up the flavour and curb added salt and fat. Like rubbing roasted garlic on meat instead of adding gravy or combining dill and lemon juice on grilled fish, instead of a dollop of tartare sauce. But surely there is more, I hear you ask?

Growing stronger In more recent years the health benefits of culinary herbs have been under closer study. In fact a 2006 supplement to the Medical Journal of Australia titled Health benefits of herbs and spices: the past, present, the future called for culinary herbs to have greater prominence in our government food group recommendations. And the 2008 update to the Oldway’s Mediterranean Diet Pyramid saw the new inclusion of herbs and spices. Why? When you dig a little deeper and look at the phytochemicals in herbs, the grass may turn out to be a little greener. It seems that studies on the antioxidant capacity of culinary herbs show that they may have higher levels than medicinal herbs plus fruits and vegetables. Furthermore, adding phytonutrient rich herbs to other foods, like basil to a tomato salad, may enhance the overall antioxidant capacity of the carrier foods.

Fire up the grill? Everybody loves a barbie, but in more recent times concerns have been raised about the potentially cancer causing compounds that are formed when meat is grilled at high temperatures. However, in one study when meat was rubbed with antioxidant extracts of common herbs like rosemary, basil, oregano and thyme, the levels of harmful compounds known as heterocyclic amines (HA) were reduced. This effect was thought to be due to the powerful antioxidants in herbs soaking up these HA free radicals. So snip those herbs into salads and mix up that marinade, salsa or herb crust when you get set to BBQ. There’s no better place to start than with my Scoop Nutrition recipe for Kitchen Garden Salsa Verde.




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.



Spaghetti with parsley sauce.
No Italian household is ever without fresh parsley. It grows in the family vegetable garden or potted on a sunny terrace. Even in the dead of winter a vibrant bunch is kept at the ready in the refrigerated crisper. This simple sauce can be used with pasta, barley or rice, on crostini, in omelets, with chicken or fish. Your imagination is your only limitation. Here I’ve paired it with spaghetti. The recipe makes 1 cup sauce, but you only use ¼ cup for the 2 pasta portions served here so you have leftovers for another meal or two. Serves 2.

1 bunch fresh parsley, leaves only
2/3 cup extra virgin olive oil
2–4 large cloves garlic, minced
¼ tsp salt
2 tsp fresh lemon juice
½ cup freshly grated parmigiano-reggiano cheese
120g/4 oz spaghetti



Wash and pat dry the parsley leaves. Finely chop and set aside.
Combine the olive oil, garlic, salt and lemon juice in a medium-sized jar. Tighten the lid and shake to mix well. Add in the parsley and cheese, tighten the lid and shake again.
Cook the pasta according to package instructions until al dente. Drain the pasta and add ¼ cup of the sauce. Mix well and serve.

Per serve
Energy: 1696kJ/404cals; Protein 10g; Fat 21g (includes 4g saturated fat and 6mg cholesterol); Available carbohydrate 44g; Fibre 2g

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 including these recipes from The Modern Vegetarian by Maria Elia published by Kyle Books, London and from Forks Over Knives – The Cookbook by Del Sroufe published by The Experiment.

Spiced caramelised onion and beetroot bulgar pilau.
In this delicious recipe from Maria Elia’s The Modern Vegetarian, the earthiness and sweetness of beetroot blend perfectly with these spices and the bulgar and pine nuts add a unique texture. You could even try adapting it by sprinkling with pomegranates or a little pomegranate molasses. Serves 4.

3 raw beetroots
175g (6oz) bulgar
3 tbsp olive oil
3 onions, finely sliced
2 tsp cumin seeds
2 tsp ground cinnamon
1 garlic clove, finely chopped
pinch of chilli powder
1½ cups boiling water
pinch of sea salt
40g (about 1½ oz) toasted pine nuts
3 tbsp chopped mint
1 lemon



Preheat the oven to 190ºC/375ºF/Gas Mark 5.
Wash and scrub the beetroots, wrap in foil and roast until tender, about 30–50 minutes (depending on the size of the beetroot). Leave to cool, then peel and dice.
Tip the bulgar into a fine sieve and wash under cold water to remove excess starch.
Heat the olive oil in a large pan, add the onions and cook over a medium heat until caramelised, about 15 minutes, stirring frequently. Add the cumin seeds, cinnamon, garlic and chilli powder and cook for a further minute. Add the diced beetroot, bulgar and boiling water, then cover and simmer for 15–20 minutes, until the water has been absorbed. Season with sea salt, stir through the pine nuts, mint and a squeeze of lemon and serve hot or at room temperature.

Per serve
Energy 220kJ/ 400cals; 22g fat (includes saturated fat 2.5g); 10g fibre; 8g protein; 38g available carbohydrate



Recipe and image extracted with permission from The Modern Vegetarian by Maria Elia © (2012), $27.99, published by Kyle Books, London.

Rice salad with fennel, orange and chickpeas.
The mild anise-like flavor of fennel is well balanced by the citrus in this hearty salad. GI News tip: We saved time and made this with microwave brown basmati rice and a can of chickpeas. Delicious, and super quick. Serves 6.

1½ cups brown basmati rice (or 2½ cups cooked rice)
2 cups cooked chickpeas or one 15oz (420g) can, drained and rinsed
1 fennel bulb, trimmed and diced
1 orange, zested, peeled and segmented (zist and segments reserved)
¼ cup plus 2 tbsp (30ml) white wine vinegar
½ tsp crushed red pepper flakes
¼ cup finely chopped parsley


Photo copyright Cara Howe.

Rinse the rice under cold water and drain. Add to a pot with 3 cups cold water. Bring to the boil over a high heat, reduce the heat to medium and cook, covered, for 45–50 minutes or until the rice is tender.
Combine the chickpeas, fennel and orange zest and segments, white wine vinegar, crushed red pepper flakes and parsley in a large bowl while the rice cooks, and mix well. When the rice is cooked, fluff it up, add to the bowl and mix well.

Per serve
Energy 1170 kJ/ 280cals; 2.7g fat (includes saturated fat 0.5g); 7g fibre; 9g protein; 51g available carbohydrate

 
Forks Over Knives: The Cookbook published by The Experiment is available from bookshops and online. With over 300 recipes for plant-based eating throughout the year, it is companion to the hit documentary and the New York Times Number 1 best seller Forks Over Knives: The Plant-Based Way to Health.

Busting Food Myths with Nicole Senior

Nicole Senior

Myth: Tea and coffee are dehydrating.
Everyone assumes that caffeine-containing beverages such as tea and coffee dehydrate, but it’s an urban legend. Seriously high amounts of caffeine are needed before you lose more water than you drink in your cup of tea or coffee. Even if you had a really, really strong cup of tea or coffee, which is quite hard to make (and drink), you would still have a net gain of fluid. So the good news is that enjoying tea and coffee in moderation does contribute to your daily fluid quota. Dehydration is more likely if caffeine is taken in tablet form.



What’s moderation? For tea it’s around 3–4 cups a day. For coffee it’s around 2–3 cups of brewed coffee; if you have high blood pressure, cut that back to 1–2 cups. The key thing with coffee is to resist temptation to upsize. Use a regular cup and order regular-sized servings. If you make your own, use the single shot function on your espresso machine. Pregnant women and older children should try to stick to one to two cups of weak coffee or tea a day.

With tea and coffee watch the extras – the milk, sugar and biscuits or cake! Opt for low-fat milk and if you need the drink sweetened, add a little sugar, gradually using less – you may find you even prefer it without after a while.

Key info Tea and coffee are a source of essential fluids, as well as protective antioxidants that help look after heart and blood vessels. They are also social drinks that bring us together and
help us take time out. It makes sense to avoid caffeine drinks at night if you have trouble sleeping.

Long story short For good health you should drink plenty of water, but tea and coffee (in moderation) do count toward your total daily fluid intake. Water is essentially replacing fluid. Tea and coffee replace fluids and contain antioxidants, so they’ve got two things going for them.

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

Dr Alan Barclay

A diet of unintended consequences.
Whatever your health problem (being overweight/obese, or having type 2 diabetes or heart disease), what many fad diet solutions have in common, is advising you to severely limit or completely avoid the nutrient that is supposedly responsible for it.

Turning the clock back, carbohydrate was THE nutrient to avoid in the 1970s. In the 1980s and 90s, however, carbs lost the limelight as fats were fast-tracked to front position as THE dietary demon. Carbs in general made a brief comeback in the early years of the 21st century before THE problem (‘toxic’) nutrient of our time message zoomed in on sugars in general, and fructose in particular.

The problem with this One-Nutrient-At-A-Time approach, as I have discussed previously in GI News, is that we don’t eat single nutrients – we eat foods, that are usually a part of meals, and the meals we eat are at the very least partly determined by our social and cultural background. And this is why most people find it hard to stick to fad diets for prolonged periods of time – there are too many pressures from family, friends, and the societies we live in to consume a wide variety of foods. Enter our modern, high-tech food industry. They saw an opportunity and took it, creating low carb or low fat versions of our favourite foods when we asked for them.

The low fat boom The boom in low fat foods began in 1980s and continues today. We can choose low fat variants of everything from potato crisps to salad dressings. We can now have our proverbial cake and eat it. And because these were supposedly healthier versions of our favourite foods we could stick with this ‘diet’. We all know the consequences: rates of overweight/obesity and related conditions continued to rise.

The low carb boom When carbohydrate was subsequently re-anointed as THE problem nutrient to avoid at all costs, food industry again rode to our rescue producing low carb versions of breakfast cereals, pasta, cakes, cookies and more. Here at the GI Symbol Program, we measured the GI of several of these low carb alternatives and we were deeply concerned that they had values that were much higher than the regular counterparts, so much so that the glycemic load (or impact) was essentially the same: the lower carb content was counter-balanced by the higher GI. There were no net health benefits. Rates of overweight/obesity/type 2 diabetes continued to rise … and these foods didn’t help anyone manage their BGLs either.

The low sugar boom will be on your supermarket shelves soon Business is business. The food industry is now in the process of adapting our favourite foods to make them lower in sugars because it knows (through market research) that’s what their customers now believe is THE problem nutrient. The technology is there – most sugars can be relatively easily replaced by oligosaccharides and starches – perhaps with a non-nutritive sweetener like aspartame, sucralose or stevia thrown in to replace the lost sweetness. The net result will likely be of little nutritional benefit, however, as these oligosaccharides and starches are usually as equally refined, devoid of nutrients (other than kilojoules) and have a higher GI than the sugars they replaced. Like their low carb predecessors, they will likely be of no real health benefit. Based on the events of the past few decades, it’s highly likely that these ‘all new’ sugar free varieties will continue to contribute to the global obesity and type 2 diabetes epidemic just like their low fat and low carbohydrate predecessors. History has the strange tendency of repeating itself.

It’s time to stop the nutrient blame game - to stop ‘going on a diet’, and to start to focus on healthy eating patterns like the (higher fat, moderate carb) Mediterranean diet or (low fat, high carb) Japanese (traditional Okinawan) diet. Principles from these tried-and-true dietary patterns like eating minimally refined vegetables, fruits, grains, nuts, seeds, legumes, lean meats/fish, yoghurt and other fermented dairy products, and oils (olive/peanut) can be adapted to suit most people’s personal, familial and cultural backgrounds. Nutrients are by definition essential – it’s how we eat them (and how many of them we put on our plates) that ultimately counts.

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.barclay@gisymbol.com
Website: www.gisymbol.com

GI Update with Prof Jennie Brand-Miller

Prof Jennie Brand-Miller answers your questions.


I am 3 months pregnant. Should I monitor my weight? I don’t want to be left with ‘difficult-to-budge pounds after my baby is born. Well, not for too long!
As a routine part of care, your obstetric care providers will keep an eye on your weight gain but most will steer away from discussing it for fear of causing your embarrassment or needless anxiety. Of course, women often discuss the subject among themselves, especially if it’s faster and greater than they expected. Many will tell you that even after the birth they retained a few kilos, and found them difficult to budge.

While their experience is common, we want to assure you that weight gain during pregnancy is under your control and, indeed, it’s good practice for you to monitor it yourself, so that you gain the ideal, or optimal, amount. OK, so what’s ideal? The optimal amount of weight gain over pregnancy is one that results in a ‘desirable pregnancy outcome’. That means a healthy baby, born at full term (about 40 weeks, or 9 months + 1 week gestation) with a birth weight of 3–4 kilograms or 6 to 9 pounds (I have rounded the conversions for easy reading) In women from affluent countries like Australia and New Zealand, who start pregnancy weighing between 60 and 65 kilograms (132 to 143 pounds), the average weight gain over pregnancy is about 13 kilograms (28 pounds) and the average infant birth weight is 3.4 kilograms (7½ pounds). But these are averages only. You’ll be pleased to hear that there’s a range of weight gains that are considered ideal. The desired amount depends to a large extent on your pre-pregnant weight. For a woman who is underweight, a higher weight gain is desirable, while an overweight mum should gain less.

US Institute of Medicine guidelines for pregnancy weight gain (2009)
Your ideal total weight gain in kilograms
BMI less than 18.5 at the start of your pregnancy (underweight) – 13 to 18 kilos
BMI 18.5–24.9 at the start of your pregnancy (normal weight) – 11 to 16 kilos
BMI 25–29.9 at the start of your pregnancy (overweight) – 7 to 11 kilos
BMI 30 or more at the start of your pregnancy (obese) – 5 to 9 kilos

Your ideal total weight gain in pounds
BMI less than 18.5 at the start of your pregnancy (underweight) – 28 to 40 pounds
BMI 18.5–24.9 at the start of your pregnancy (normal weight) – 25 to 35 pounds
BMI 25–29.9 at the start of your pregnancy (overweight) – 15 to 25 pounds
BMI 30 or more at the start of your pregnancy (obese) – 11 to 20 pounds

Weight gain in pregnancy is an excellent predictor of the baby’s weight at birth. This, in turn, predicts how well your baby copes in the first days and months of life. That’s the reason for the proud tradition of announcing not only the baby’s sex but its birth weight as well. Like many things in life, however, there is a happy medium. If you gain too little, it can mean a small baby who has been born too lean with little body fat. Small babies, defined as those born weighing less than 2.5 kilograms (about 5 pounds), have a higher chance of having poor outcomes during and after birth. Paradoxically, they are more likely to become overweight as adults and have a great risk of high blood pressure and heart disease. On the other hand, a baby that grows too big or too fast also has poor outcomes. Excessive weight gain during pregnancy and high birth weight (greater than 4 kilograms/9 pounds) are both linked to complications at birth, such as emergency Caesarean delivery, physical injury and post-partum haemorrhage. Just as importantly, excess weight gain also predicts the future health of both mother and baby.

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). You can visit us HERE.

We are delighted to let GI News readers know that a US edition is on the way. The publisher is Matthew Lore of The Experiment. Matthew has published many of our books in the past and we are very happy to be working with him on this. We will keep you posted re publication details.



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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