GI News—December 2012

• Dr Alan Barclay on why healthy low GI food doesn't need to cost more; 
• Eating carbs mostly AFTER 5pm: are there benefits?   
• What would batman eat? Helping kids make healthier choices;   
• Kids prefer a colourful range of food on the plate;  
• Low GI emergency pantry;
• Coffee sobers you up: Nicole Senior investigates;
• Six recipes to enjoy including three fruity desserts for festive fare.

In Food for Thought Prof David Katz suggests we ‘embrace health as a kind of wealth. Investing in health and treating it as something of great and universal cultural value – something we raise our kids to aspire to as they aspire to being rich – is a true, potential game-changer for the future of food, ourselves, and our planet. 

Good eating, good health and good reading.

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

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Food for Thought

Embrace health as a kind of wealth.   
Heading into the festive season, we are bombarded with ideas for a ‘cracking’ Christmas feast which mostly seems to involve spending a lot of time, money and calories on a day’s good cheer. We thought that it might be timely to ponder Dr David Katz’s comment that the truly great hope for the future of food involves treating health more like wealth. The following is reproduced with his very kind (as ever) permission. 


Dr David Katz

‘In the beginning food was money and money was food. Food was the first currency, and modern currency is spoken of in terms of food – we are “breadwinners,” we “make dough,” and we “bring home the bacon.” We respect how money will affect the quality of our lives, but overlook it with regard to food. We invest in wealth, but generally, not health. Our time horizon for money is distant; for food, it’s only as far away as our next donut. We measure the value of food as calories per dollar, an obsolete metric in an age of epidemic obesity and caloric excess.

None of this is all that hard to fix. Our culture could embrace health as a kind of wealth. A cultural commitment to investing in health could be the normal expectation for any responsible adult. Experts who provide guidance toward better choices – dietitians, health coaches, and other qualified experts – could be valued universally as we value financial planners and investment counselors. And financial rewards for choosing better nutrition, courtesy of those with skin in the game, could put a high polish on the already luminous prize.

Food is a product of culture. The inertia of culture makes it tougher to turn than the Titanic. But the looming collisions (diabetes, obesity etc) are cause to get the job done -- and we can. The best way to predict the future ... is to create it. Unlike genes, culture is a medium of our devising. We created it – and we can update it. And by so doing, we can create the more nourishing future of food we would all like to predict.

So here’s a thought for the festive season and new year – investing in health and treating it as something of great and universal cultural value – something we raise our kids to aspire to as they aspire to being rich – is a true, potential game-changer for the future of food, ourselves, and our planet.

About Dr David Katz
Known internationally for expertise in nutrition, weight management, and chronic disease prevention, Katz is the founding director of Yale University's Prevention Research Center. He is the editor-in-chief of the journal Childhood Obesity, President-Elect of the American College of Lifestyle Medicine, founder and President of the non-profit Turn the Tide Foundation, and a blogger/medical review board member for The Huffington Post.
www.davidkatzmd.com
http://twitter.com/DrDavidKatz

What’s New?

Eating patterns in Canada – culture seems to count when it comes to obesity. 
Quebec has the lowest combined rates of overweight and obesity of any Canadian province. It now turns out that it is also the one province in Canada that truly maintains a true and distinct eating Culture (that is culture with a capital C). According to the 15th edition of Eating Patterns in Canada, Quebec households are less calorie conscious than other Canadians and take great pleasure in eating. The vast majority (82%) feel that it is important to enjoy full and regular meals each day, which compares to 60% of western Canadians and 63% of Ontarians. They are also less likely to skip meals. While some believe that breakfast is the most important meal of the day it is lunch and dinner that are of most significance. Most of these meals are prepared at home, with 6 out of 10 lunches and 6.5 out of 10 dinners in Quebec households being made from scratch. They also enjoy dessert with dinner more often – about 112 times a year compared with about 89 times in Atlantic Canada, 57 in Ontario and 55 on the west coast. And they are the least likely to snack.


Prof Arya Sharma

Prof Arya Sharma says: ‘While I am generally cautious about inferring cause-and-effect, I am also the first to support any move to improving eating culture. Improving eating culture in the rest of Canada requires a discussion of ‘values’ – and apparently, Quebecers place a higher value on home cooking, regular eating, and finding pleasure in food than the rest of us. Changing this culture will take more than taxing and banning foods. Indeed, I am confident that changing culture will eventually change consumer behaviour, which in turn will ultimately change supply. No easy task – but perhaps worth a wider discussion. In the mean time, perhaps more of us should enjoy our desserts.’
– 15th edition of Eating Patterns in Canada (EPIC). 

Eating carbs mostly AFTER 5pm at dinner reduces diabetes and cardiovascular risks.  
Eating carbs mostly at dinner (rather than throughout the day) could benefit people suffering from severe and morbid obesity according to new research published in two papers in Obesity and in Nutrition, Metabolism & Cardiovascular Diseases.‘The idea for this research came about from studies on Muslims during Ramadan, when they fast during the day and eat high-carbohydrate meals in the evening, that showed the secretion curve of leptin was changed,’ explained Prof. Madar.



Here's what the researchers from the Hebrew University of Jerusalem did. They randomly assigned 78 police officers to either the carbs-mostly-at-dinner diet or the control carbs-throughout -the-day diet for 6 months and measured the effects on the secretion of leptin, considered to be the satiety hormone, whose level in the blood is usually low during the day and high during the night; ghrelin, considered the hunger hormone, whose level in the blood is usually high during the day and low during the night; and adiponectin, considered the link between obesity, insulin resistance and the metabolic syndrome, whose curve is low and flat in obese people. The results showed that eating carbs mostly at dinner led to changes in daylight hormonal profiles in favor of the dieters whose:

• satiety hormone leptin’s secretion curve became convex during daylight hours with a nadir in the late day hunger hormone 
• ghrelin’s secretion curve became concave, peaking only in the evening hours 
• curve of adiponectin, considered the link between obesity, insulin resistance and the metabolic syndrome, was elevated. 

At the same time this dietary pattern led to lower hunger scores, and better anthropometric (weight, abdominal circumference and body fat), biochemical (blood glucose, blood lipids) and inflammatory outcomes compared to the control group. So much for the 'no carbs after 5pm brigade'.

A diet rich in slowly digested carbs reduces markers of inflammation in overweight and obese adults.  


Dr Marian Neuhouser

Among overweight and obese adults, a low glycemic load diet rich in slowly digested carbohydrates significantly reduces markers of inflammation associated with chronic disease, according to a new study by Fred Hutchinson Cancer Research Center published in Journal of Nutrition. In the study, the 80 participants (half normal weight and half overweight) completed a 28-day high glycemic load diet and 28-day a low glycemic load diet in random order. The diets were identical in carbohydrate content, calories and macronutrients. ‘This finding is important and clinically useful since C-reactive protein is associated with an increased risk for many cancers as well as cardiovascular disease,' said lead author Dr Marian Neuhouser. It also modestly increased blood levels of a protein hormone called adiponectin, which plays a key role in protecting against several cancers, including breast cancer, as well as metabolic disorders such as type-2 diabetes, nonalcoholic fatty liver disease and hardening of the arteries.

Higher dietary glycemic load diet linked to worse colon cancer survival.  
Lifestyle has been shown to play an important role in the development of colorectal cancer. Risk factors, such as obesity and physical activity have been shown to directly influence insulin levels and recent studies have shown a direct link between host factors that lead to hyperinsulinemia and cancer recurrence and mortality in colorectal cancer survivors; however, the influence of glycemic load and other related dietary intakes have on the survival of colon cancer patients is unknown. Researchers have now identified a link between higher dietary glycemic load and total carbohydrate intake and increased risk of cancer recurrences or death among stage 3 colon cancer patients, a finding that suggests that diet and lifestyle modification can have a role in improving patient survival, according to a study in the Journal of the National Cancer Institute.

Kid stuff.  



#1 What would Batman eat? Having trouble getting your child to make healthier eating choices at their favorite fast food restaurant? Priming them with the simple phrase: ‘What would Batman eat?’ may be the answer! In a recent field study by Brian Wansink and colleagues published in Journal of Consumer Research, 22 children in a summer camp were asked if they would like French fries or apple slices with lunch. On one day, they were shown pictures of real or fictional role models and asked what the role models would choose, before making their own decision. The use of this simple prime increased the amount of children who selected apple slices from 9.1% to 45.5%! Making the connection between eating healthy and being an admirable adult clearly helps children to make healthier eating decisions. So, next time you are at a fast food restaurant, be sure to ask them ‘What would Batman eat?’



#2 Should you plate food for your child the same way you do for yourself? In Brian Wansink and colleagues' study in Acta Paediatrica, pre-teen children and adults were shown 48 different photographs and asked for their preferences based on different dimensions of food presentation. These included the number of components and colors on the plate, the position of the main component, crowded plate versus an empty plate presentation, organizational levels and design. The results suggest amazing opportunities to encourage more nutritionally diverse diets among children. While adults prefer three components and three colors on their plates children preferred seven components and six colors, more than double the adult preference of three!

#3 Is childcare ‘making kids chubbier’? A Canadian study which followed children from 1.5 to 10 years old reports they were 65% more likely to become overweight if cared for in a nursery-style setting, than those cared for by a parent, and who had little exposure to other forms of childcare. Before you start feeling even guiltier as a working parent with a child in child care, check out what NHS Choices has to say. ‘…this interesting study raises more questions than it answers. It is unclear why childcare arrangements would be associated with weight gain, and the study cannot show a cause and effect relationship between centre-based childcare and obesity. The researchers speculate that some childcare centres may have ‘obesogenic’ features (those that promote weight gain). It’s also worth bearing in mind that the study was performed in Canada, and it may be that the results cannot be translated to the UK, or other countries. However, it serves to highlight the importance of good diet and plenty of physical activity for all children, regardless of where they are looked after.’

Get the Scoop

Preparing for an emergency is the smart thing to do. 

We originally ran this story early in 2011 after the catastrophic earthquake and aftershocks in Christchurch (NZ), the big freeze in Europe, blizzards in the US and disastrous floods in Australia, Brazil and Sri Lanka. Super-storm Sandy and its aftermath reminds us that you can be without electricity or gas for several weeks. It’s vital to have ready-to-eat food on hand to keep everyone fighting fit until the disaster has passed. And this is where canned foods come to the fore, enabling you to whip up a variety of healthy, tasty low GI meals in minutes. Opt for low(er) salt/sodium products when there is a choice and check use-by dates. Drain canned foods and rinse if you have clean water. Tip: Make sure you have a can opener! Because you can’t depend on refrigeration after cans or jars have been opened, buy sizes that you and your family can consume at one sitting. Here are our 10 top pantry picks.

1. Canned beans, chickpeas and lentils and bean dishes such as chilli beans, refried beans, lentil and pea and ham soups – OK cold but quickly heated on a camp stove 


2. Canned fish –such as tuna, salmon, sardines, crabmeat, prawns, mackerel, herrings 


3. Canned meats and meat dishes such as chilli beef and beans, ravioli, spaghetti Bolognese and broths (OK cold but quickly heated on a camp stove) 


4. Cans,  jars or tubs of fruit in natural juice; dried fruit such as apple, apricots, dates, peaches, pears, prunes, sultanas, fruit and nut mixes, fruit straps 


5. Cans and jars of vegetables such as artichoke hearts, asparagus, bamboo shoots, beetroot, cabbage/sauerkraut, capsicum, carrots, corn kernels, mushrooms, peas, tomatoes 


6. Nuts (not salted) and nut/seed mixes 


7. Dry cereals such as fruit and nut muesli (natural or toasted), muesli bars 


8. Grainy crackers and crispbreads, oatmeal biscuits and shelf stable flat breads and wraps such as white corn tortillas and reduced-carb wraps 


9. Powdered milk, small containers UHT milk, 


10. And if you have a heating source such as a camp stove or gas bottle barbecue, you can expand your options to include foods that don’t need much water to cook such as instant noodles and ready to eat basmati brown rice 

What to drink? Bottled water, single-serving-sized juice that doesn't need to be refrigerated, diet soft drinks.

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.

This December, we bring back an old favourite from Johanna’s kitchen as she hasn’t had time to create something special for us – she is out there on the front line helping survivors of super-storm Sandy in New Jersey.



Flourless chocolate hazelnut cake.
This cake isn’t an Italian recipe at all, but it was a huge hit in my household one Christmas in Friuli. It is built around rich and nutty tasting ingredients that melt in your mouth. White flour is replaced by fibre-rich, vitamin-and mineral-dense ground hazelnuts. The lasting mouth feel is the result of the primarily unsaturated fat in the nuts. This cake stands proudly on its own – no frosting or ice cream can add to its most satisfying taste. If you must, try just a slight dusting of powdered sugar on the top of the cake. Because of the amount of sugar, the GI will be moderate. Enjoy it for dessert when entertaining and special occasions like birthdays. It will feed a crowd. And if you are worried about the calories, just have a sliver instead of a slice! Serves 12

3½ cups ground roasted hazelnuts (approx. 375 g/13 oz)
1½ cups sugar
2 tbsp vanilla essence
¾ cup unsweetened cocoa (approx. 70 g/2½ oz)
12 egg whites



Preheat the oven to 180ºC (350ºF). Coat a spring-form pan with vegetable spray.
Mix the hazelnuts, sugar, vanilla and cocoa in a medium sized bowl. Beat egg whites until stiff and dry. Gently fold them into the chocolate nut mixture.
Pour the batter into the greased pan. Bake for 40–50 minutes or until an inserted toothpick comes out clean. Allow to cool before serving.

Per slice (when cut into 12 slices)
Energy: 1402 kJ/ 334 cals; Protein 9 g; Fat 20 g (includes 2 g saturated fat and 0 mg cholesterol); Carbs 34 g; Fibre 5 g

What about those 12 egg yolks? Here are some ideas from the ever-amazing chef and food writer Kate McGhie:

• Make mayo/hollandaise 
• Whisk through pasta (carbonara or alfredo) or stir fries 
• Poach the yolk and then chop and use in salads (potato is excellent) or on asparagus with salmon and a lemon-oil dressing 
• Use in custard or lemon curd. 
• Freeze. I pop a yolk into each cavity of an ice block tray, add a pinch salt for savoury use or sugar for sweet and freeze. When frozen I pop them into a freezer bag.

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 packed with fresh produce including these side dishes for festive fare – Sweetcorn and coconut salad from Kate McGhie’s Cook: recipes, stories and kitchen wisdom  and Kate McIntosh’s Sweet potato and pistachio quinoa.

Sweetcorn and coconut salad. 
A simple corn salad is ramped up with lively flavours and an unexpected burst of chilli heat. You can make this a day in advance and store, covered, in the fridge says Kate McGhie. Serves 4–6

3 cups fresh corn kernels
2½ cups milk
1 tsp butter
2 small red chillies, finely chopped
½ tsp ground cumin
2cm (1in) piece fresh ginger, peeled and grated
pinch turmeric
2 tbsp shredded coconut
6 sprigs coriander (cilantro), roughly torn



Place the corn and milk in a pan and simmer for 45 minutes or until reduced by three-quarters. Season to taste with a little salt if you wish.
Melt the butter in a pan and swirl the chillies, cumin, ginger and turmeric. Add to the corn mixture with the coriander and coconut. Stir well, cook for 2 minutes more and serve warm or cooled.

Per serve (for 6 people)
Energy: 760 kJ/200 cals; Protein 7 g; Fat 6 g (includes 4 g saturated fat and 14 mg cholesterol); Carbs 23 g; Fibre 3 g

Sweet potato and pistachio quinoa.
This dish can be served warm with lamb, chicken or fish such as mackerel and swordfish or served cold as a salad says Kate McIntosh. Serves 4–6 as a side dish

1 orange-fleshed sweet potato (about 400 g), peeled and cut into 2cm (3/4in) dice
200g (7oz) quinoa
3 cups light chicken stock (low sodium)
3 tbsp pistachios, chopped quite finely
1 tbsp chopped fresh mint
2 tbsp chopped coriander
2 tbsp chopped parsley
rind only 1 preserved lemon, finely chopped
2 tbsp olive oil
freshly ground black pepper, to taste

 

Preheat the oven to 180ºC (350ºF ).
Roast the diced sweet potato for about 20 minutes or until tender
Cook the quinoa following the packet instructions in 3 cups (750 ml) chicken stock, then drain.
For a warm dish, heat a large pan, add all ingredients and stir over low heat until warmed through. If serving cold, simply toss all ingredients together and season to taste.

Per serve (for 6 people) 
kJ/Cal 1269/302; Protein 8 g; Fat 12 g (includes saturated 2 g) Carbohydrate 38 g; Fibre 5 g

Three fruity desserts for festive fare  ...

Mango, passion fruit and lime fruit salad.  
Kate McIntosh’s dessert is absolutely delicious and truly made in minutes. Serves 2
 
2 medium ripe mangoes, peeled and cut into dice (about 2 cups mango dice)
2 ripe passion fruit

Dressing 
½ cup (125 ml) mango puree
pinch of ground ginger
1 lime, juiced



Combine the mango puree, ginger and lime juice in a small bowl to make the dressing.
Place the mango dice into a serving bowl. Scoop out the passionfruit pulp and seeds and add to the mango dice, then gently stir through the mango-lime dressing.

Per serve 
700 kJ/167 calories; 3 g protein; 0.6 g fat (includes 0 g saturated fat); 33 g carbohydrate; 6 g fibre

Baked spiced pears with zabaglione sauce.  
Johanna Burani’s pears with cinnamon and cardamom are a marriage made in culinary heaven. Serves 4

2 ripe Bosc pears
2 tbsp sugar, divided
¼ tsp ground cinnamon
¼ teaspoon ground cardamom
1 egg yolk
2 tbsp marsala wine



Preheat the oven to 180ºC (350ºF).
Peel, halve and core the pears. Place them cut side down in a rectangular baking pan with just enough water to cover the bottom of the pan.
Combine 1 tablespoon of the sugar with the spices, and sprinkle half of this mixture over the pears. Bake the pears for 5 minutes in the preheated oven. Turn the pear halves over, sprinkle with the remaining sugar-spice mixture and continue to bake for another 5 minutes. Pears are done when they are easily pierced by a fork but still hold their shape. Large pears may take a little longer to cook. Remove from the oven, place in individual dessert dishes and set aside.
To make the sauce, combine the egg yolk and remaining tablespoon of sugar in a very small saucepan and mix vigorously for at least 5 minutes with a wooden spoon. Slowly add the marsala and mix well. Heat over low heat stirring constantly for approximately 1 minute or until the mixture thickens WITHOUT COMING TO A BOIL. Pour the sauce over the pear halves and serve warm or at room temperature.

Per serve (Serving size: ½ pear with 2 tbsp of sauce) 
Energy: 416 kJ/ 99 cals; Protein 1 g; Fat 2 g (includes less than 1 g saturated fat and 55 mg cholesterol); Carbs 21 g; Fibre 2 g

Easy mango crumble.  
You can use fresh in season or canned or frozen mango cheeks or slices in Catherine Saxelby and Jennene Plummer’s deliciously versatile recipe (from Zest). It also works with other summery fruits and other nuts like pistachios or macadamias. Serves 4–6

100g (3½oz) almond bread or biscotti, roughly crushed
½ cup rolled oats
2 tbsp brown sugar
1 tbsp wheatgerm
2 x 400g (14oz) cans mango slices in syrup, drained, (reserve 2 tbsp of the syrup), or 8 frozen or fresh mango cheeks
1 tbsp chopped pistachio nuts
2 tbsp maple syrup low fat vanilla yoghurt and maple syrup to serve



Preheat oven to 180ºC (350ºF).
Combine the crushed almond bread, oats, brown sugar, wheatgerm and the 2 tablespoons of reserved mango syrup in a large mixing bowl.
Cut mango into chunks and arrange in a shallow ovenproof dish. Scatter over the crumble mixture and bake for 20–25 minutes until the topping is crisp and golden. Serve with yoghurt and a drizzle of maple syrup.   

Per serve
Energy 1260 kJ/ 300 cals; 17 g fat (includes 6 saturated fat g); 2.5 g fibre; 7 g protein; 28 g available carbohydrate

Busting Food Myths with Nicole Senior

Nicole Senior

Myth: Coffee sobers you up. 
Sorry, the only thing that sobers you up if you have drunk too much alcohol is TIME. It’s not a question of having a cup of strong black coffee to wake you up, nor a cold shower. It’s a question of getting the alcohol out of your body. And that takes time. If you have a large glass (250ml) wine, you need to allow about three hours for your body to break down the alcohol. So imagine how long a night on the town takes …



In fact, there are no hard and fast rules about how long the alcohol will stay in your body—it depends on your age and weight, whether you’re male or female, what sort of metabolism you have, how much food you’ve eaten, the type of alcohol over what period of time, how stressed you are and whether you are on any medication.

Downing a mug of coffee may be the worst thing you can do, according to a Temple University study (in mice) published in Behavioural Neuroscience. In the laboratory, caffeine made ‘drunk’ mice more alert but did not reverse the learning problems caused by alcohol, including their ability to avoid things they should have known could hurt them. The same results have been found in people who combine caffeine-loaded energy drinks with alcohol: the caffeine makes them more alert but their judgment is still impaired by the alcohol. In effect, the caffeine-alcohol combination makes you feel like you can, but actually you can’t: the potential for injury and misadventure is obvious.

The good news is that another study (in rats this time) has shown that a cup of coffee and an aspirin may help with the sore head the next day.

Key info: Coffee may make you feel more alert when you have drunk too much – but it doesn’t help you make better decisions or drive safely. Only time breaks down alcohol in the body.
Hungry for more? See http://rethinkingdrinking.niaaa.nih.gov and http://www.drinkaware.co.uk/alcohol-and-you/health.

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

Put your money where your mouth is 
This is a popular challenge in a variety of situations, but I have rarely heard it in the context of what we actually do put in our mouths. As Dr David Katz points out in Food for Thought ‘We respect how money will affect the quality of our lives, but overlook it with regard to food’.

‘Healthy food costs more’ is a popular tabloid headline along with hard-luck stories such as ‘I can’t afford healthy food’. But healthy food does not cost more. Not if you make the most of the inexpensive, filling and healthy staples that our parents and grandparents enjoyed. This includes naturally low GI foods like traditional oats; legumes such as beans, chickpeas and lentils (dried or canned) and split peas (channa dal), grain foods like barley (pearl), burgul, pasta, noodles and low or lower GI rices; starchy veggies like carrots, potatoes (Carisma and other lower GI varieties), taro, yams, parsnips and sweet corn; fresh green and salad veggies and fruit in season; and dairy foods like milk and yogurt (or the calcium enriched soy alternatives). For frugal low GI food know how, check out websites like food cents and Money Saving Meals (which has recipes packed with low GI ingredients).

And cooking healthy food doesn’t have to take longer. Check out Jamie’s 15-Minute Meals. This man knows how to make the most of a can of beans or a packet of pasta to create meals that will have the family coming back for more and the kids eating their greens. Possibly.

We do appreciate that some healthy low GI foods such as bread can cost a little more than the high GI alternatives. This is because the quality of the ingredients usually needs to be higher in order for the product to have a low GI, and processing techniques may also be different. However, quality really counts when it comes to your daily bread because for many of us, it is the number one source of glycemic carbohydrate in our diet. This is partly because it is such a versatile product – we can eat it for breakfast, use it to make sandwiches for lunch, and serve it with dinner all of which makes choosing a lower GI bread one of the easiest ways of lowering the overall glycemic impact of our diet. I realise for families, it's tempting to take advantage of supermarket price wars that drive prices down on staples like bread, but the cheap white stuff on offer is going to drive those BGLs up, and is not a good long-term investment.

So, invest your hard-earned cash in your health and buy healthy, low GI food and a low GI bread (it will also keep you feeling fuller for longer). In Australia and New Zealand, it is easy to find low GI breads – simply look for those that carry the GI Symbol:

• Bürgen® Soy-Lin GI 52 
• Bürgen® Pumpkin Seeds GI51
• Bürgen® Rye GI53 
• Bürgen® Fruit & Muesli GI53 
• Bürgen® Wholemeal Seeds GI39 
• Bürgen® Wholegrain & Oats GI51 
• Cripps 9 Grain Sandwich GI53 
• Tip Top Original 9-grain GI53 
• Tip Top 9 Grain Wholemeal GI53 
• Tip Top 9 Grain Mini Loaf Original GI53 
• Tip Top 9 Grain Pumpkin Seeds GI53 
• Tip Top 9 Grain 9 Seed GI53 

If you don't have the GI Symbol to guide you, look for quality breads like authentic sourdoughs, dense grainy breads and pumpernickel or rye bread. 

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.



Nutrition recommendations during lactation.
The energy cost of lactation depends largely on how much milk your baby is drinking. Assuming human milk provides about 3 kilojoules per mL, and that you are producing 1 litre a day, that’s a whopping 3000 kilojoules in the milk itself. But there’s a ‘tax’ in making all this milk, so in fact you need to ingest an extra 3700 kilojoules/day. However, most women have stored some extra fat during pregnancy which they want to lose during the first few months of their baby’s life. Allowing for this, the science suggests you need to get about 2000 extra kilojoules a day – about 20 per cent more than usual. Most women just eat more but some women do less physical activity than usual.

Losing weight: If you entered pregnancy being overweight, then now’s a good time to lose those extra kilos. You should do it slowly. Losses of approximately half a kilogram a week do not seem to affect milk production or your baby’s rate of growth. If you started pregnancy underweight, then make sure you eat three meals a day and are not losing weight. If your appetite is poor, then make an extra effort to eat small, energy dense healthy snacks (for example, nuts and dried fruit) between meals. During lactation, you’ll need an extra 15–20 g of protein a day – that’s relatively easy to obtain in our diet.

Nutrients that may be deficient in your diet while breastfeeding include folate, calcium, and vitamins E, D and B6.

• Folate: You’ll need about 130 micrograms more folate a day than you did pre-pregnancy. While a supplement is not necessary during lactation, make sure you are eating folate-rich foods – leafy green vegetables being one of the richest sources. 
• Calcium: There’s about 250–300 mg of calcium in a litre of human milk, equivalent to an extra serving of dairy or equivalent per day. 
• Vitamin D: Human milk provides small amounts of vitamin D, around 50 micrograms per litre. This is drawn from stores in your liver but these are depleted within eight weeks of birth. As it’s near impossible to obtain sufficient Vitamin D just from food (even with the ideal diet) so you need to expose your skin to brief periods of sunlight at appropriate times of the day. 

If you are struggling to find time to eat, preparing a snack and something to drink (a glass of water) ahead of time, so it is ready when you sit down to feed baby, is a good option. It also makes sure you are refuelling and rehydrating as baby takes his or her nourishment from you.

Top 10 breastfeeding snacks 

1. Wholegrain toast or raisin toast 
2. Wholegrain sandwiches 
3. Glass of milk or soy milk or a fruit smoothie 
4. Yoghurt 
5. Dried fruit and nut mix 
6. Wholegrain crispbreads with cheese or avocado and tomato 
7. Hummus or tzatziki dip with vegetable crudités 
8. Muesli or porridge with low-fat milk or soy milk 
9. Small can of baked beans or four-bean mix 
10. Roasted chickpeas  

This is an edited extract from my latest 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.



New GI values from SUGiRS: Nudie coconut water.
Coconut water has long been a popular drink (fresh, canned or bottled) in tropical climes, especially in India, SE Asia, Brazil, the Caribbean, Africa and many Pacific islands. It is simply the watery fluid inside the coconut, so it’s a type of juice (but from a nut not a fruit). Like other juices, it is low GI. Compared with say fresh orange juice, it has similar carbs per serving, more potassium, sodium, magnesium and calcium but not as much in the way of vitamin C. SUGiRS recently tested Nudie Coconut Water and here are the (rounded) results:

• ‘Straight Up’ Nudie Coconut Water (350ml bottle): GI 55, available carbohydrate 18g, fibre 1g, GL 10 

You can check out the nutrition information panel HERE.

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
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GI News—November 2012

• Bring on the beans; 
• Gut bacteria and diabetes;  
• Exploring how gut microbes react to probiotic yogurt;  
• Nicole Senior investigates the myth that most people can't digest milk;
• Prof Jennie Brand-Miller on diet and breast milk;
• Emma Stirling with the scoop on yogurt;
• Two low GI recipes to enjoy including one from Yotam Ottolenghi's new book: Jerusalem.

‘The 1.5kg (3.3 pounds) of bacteria that we carry in our intestines have an enormous impact on our health and well being. There is growing awareness that these resident microbes contribute to a wide array of critical body functions that can influence almost every aspect of our physiology from hormonal balance to metabolic rate, immune system function and inflammation. In this issue, we look at the growing body of evidence to suggest that disruptions to the normal flora of our GI tract may be implicated in a wide array of gastrointestinal and metabolic disorders including irritable bowel syndrome, obesity, metabolic syndrome and type 2 diabetes.

Good eating, good health and good reading.

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

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Food for Thought

The gut microbiota – a new piece of the obesity puzzle? 
Our GI (gastrointestinal) tract is home to a diverse collection of bacteria, viruses and archaea, collectively known as the gut microbiota. Patricia Lopez-Legarrea from the University of Navarra, Spain and Nicholas Fuller from The Boden Institute, The University of Sydney bring us up to date on recent research and describe a randomised controlled trial that they are undertaking to compare the effects of three different diets on microbiota composition.


Nicholas Fuller

It is estimated that a healthy adult’s gut consists of at least 100 trillion (10 to the power of 14), bacteria. It’s well known that these bugs are integral to our wellbeing – evolution has aligned our interests. ‘We are not just on friendly terms with our gut bacteria – the relationship is infinitely more intimate than that – we are married to them … we are colonised by bacteria from birth, and potentially in utero,’ writes Katrina Ray in Nature Reviews. ‘Indeed, our mothers play a vital part in providing the first building blocks for the development of our resident microbiota, jump-starting the stepwise colonisation of our intestines and the rest of the human body through skin-to-skin contact and breastfeeding. Once the gut microbiota becomes established and stabilised by age 2–3 years, these bacteria have a crucial role in nutrition and health … they have a fundamental role in synthesising vitamins and in helping to breakdown non-digestible products that provide energy to the human body.’

Recent research in humans and animals now suggests that changes to the gut microbiota composition are also related to metabolic disorders such as obesity, metabolic syndrome and type 2 diabetes.



Obesity Back in 2004, Backhed and colleagues observed that normal mice had 42% more adipose (fat) tissue compared with germ-free ones. Subsequently, they transplanted microflora from normal mice to the germ-free mice and observed that the germ-free mice had a 57% increase in their total body fat content in a period of two weeks. In 2005, Ley and colleagues observed interesting differences in the microbiota composition when they compared genetically obese mice to normal-weight mice. The obese mice showed a greater presence of bacteria with a higher expression of enzymes related to energy extraction, bowel fermentation and to the reduction in stool residual calories. In subsequent work, they transplanted the microbiota from obese mice to normal-weight mice and found that they developed obesity within two weeks. Translating the findings of these animal studies to people is now an important area of research.

Metabolic syndrome Researchers at the University of Maryland School of Medicine have identified 26 species of bacteria in the human gut microbiota that appear to be linked to obesity and related metabolic complications. These include insulin resistance, high blood glucose levels, increased blood pressure and high cholesterol, known collectively as the metabolic syndrome, which significantly increases an individual's risk of developing diabetes, cardiovascular disease and stroke. The results of the study were published in PLOS ONE. ‘We identified 26 species of bacteria that were correlated with obesity and metabolic syndrome traits such as body mass index (BMI), triglycerides, cholesterol, glucose levels and C-reactive protein, a marker for inflammation,’ says the senior author, Claire M. Fraser, Ph.D., professor of medicine and microbiology and immunology and director of the Institute for Genome Sciences (IGS) at the University of Maryland School of Medicine. ‘We can’t infer cause and effect, but it’s an important step forward that we’re starting to identify bacteria that are correlated with clinical parameters, which suggests that the gut microbiota could one day be targeted with medication, diet or lifestyle changes.’

What next? Dietary intake is considered one of the main factors that modify the number and variety of our gut bacteria. In this context, we and other researchers from The Boden Institute at the University of Sydney are currently carrying out a 12-month, randomised controlled trial to evaluate the effects of three energy-restricted diets (500 calorie (2100kJ) per day deficit) on the composition of gut microbiota. The diets are:

• Low fat/lower GI (less than GI 55)
• High protein/moderate GI (protein 25% total energy)
• Mediterranean/moderate GI (omega-3 consumption greater than 1.3g). 

Our study consists of a 6-month intervention period with one of the three diets, followed by a 6-month weight maintenance period with visits at 9 and 12 months. We will collect blood and stool samples to perform the corresponding analyses. It is hoped that the findings will both help to pinpoint those people who will respond to dietary treatment and will optimise dietary strategies. We will be reporting our findings in about a year’s time, so watch this space.

What’s New?

Bring on the beans.
In Archives of Internal Medicine, Dr David Jenkins and colleagues report on a study that found consuming about 1 cup (190g) of cooked legumes (beans, chickpeas or lentils) helped people with diabetes manage their blood glucose. It also lowered total cholesterol and triglycerides. The 3-month study with a group of 121 people with type 2 diabetes found that a daily dose of beans had a greater effect on reducing blood pressure as part of a low GI diet compared with a high wheat (insoluble) fibre diet. Even better, after three months, hemoglobin A1c levels had dropped from 7.4% to 6.9% in people eating beans, while it had fallen from 7.2% to 6.9% in those getting extra whole wheat. Even though the drops were not huge says Jenkins, they were impressive in part because the whole-grain comparison diet is a healthy one and in part because people in the study were already on diabetes and blood pressure medications. ‘We hope that this could be the point that allows a person with diabetes to delay medication use,’ he said.

What about wind? The study didn’t find any more gastrointestinal complaints in the legume group, although the comparison group also got a lot of fibre, which could have drowned out a potential effect.



It’s easy to boost your bean intake – home-cooked or canned – simply top some toast with baked beans for a light meal, serve dhal with that curry, add chickpeas to stir fries, red kidney beans to chilli, lentils to a ragu, a 4-bean salad to that barbecue menu, and enrich casseroles and soups with beans and lentils. Here are some flavoursome favourites from The GI News Kitchen to try:

• Shells with pinto beans and feta 
• Roasted beetroot and white bean salad with balsamic dressing
• Spicy Moroccan chickpea & lentil soup
• Zingy Italian white bean soup
• Split pea, watercress and goats curd salad 

Exploring how gut microbes react to probiotic yogurt.
No matter what the advertisements are, or are not, allowed to say, it would be good to know if probiotic yogurt, in addition to its nutritional value, has a beneficial effect on the gut. A parallel series of human (twin) and animal (mice) studies shows that daily consumption of yogurt does not significantly alter the gut’s bacterial makeup but does induce changes in the way bacteria metabolise carbohydrates. Jeffrey Gordon and colleagues took a closer look at the gut microbiomes of seven sets of twins and of mice who consumed a specific brand of yoghurt over a 4-month period. They analysed the bacterial composition and specific gene expression patterns of both human and animal gut microbial communities before, during and after consumption of the yoghurt. Although they found that in both humans and mice, consumption of yogurt did not change the species and gene content of their gut microbial communities, further analysis of gut bacterial gene expression and of substances called metabolites in the urine of mice revealed that yoghurt consumption incited marked changes in many metabolic pathways, especially those related to carbohydrate processing. Although it remains unclear whether eating a yogurt a day will keep the doctor away, the results show that probiotic foods may change our gut microbiomes in subtle, complex ways that warrant further investigation.



Dietitian Glenn Cardwell explains the difference between probiotics and prebiotics. 
‘You have probably heard of probiotics, healthy bacteria that help to keep your bowels in good health. They are often associated with yoghurts and supplements. Another term is prebiotics, compounds that are needed as food for the probiotics. Prebiotics naturally occur in bananas, asparagus, leeks, onions, garlic, chicory and wholegrains like wheat, rye, barley and oats. Asparagus, which is now in season in Australia, is one of the best dietary sources of inulin an important prebiotic that encourages the growth of healthy bacteria in the gut, which, in turn provides a barrier to gut infection. So support local produce and green your meals with fresh asparagus. Not only will you enjoy the flavour, you’ll be getting plenty of fibre and natural prebiotics to keep you healthy on the inside. Want help cooking up ideas? Check out the Australian Asparagus Council’s free recipes.’



Gut bacteria could cause diabetes. 
New research published in Nature shows that the composition of our gut bacteria could play an important role in the development of type 2 diabetes. Researchers examined the intestinal bacteria of 345 people from China, of which 171 had type 2 diabetes. The team identified clear biological indicators that someday could be used in methods that provide faster and earlier diagnosis of type 2 diabetes. The research, also demonstrated that people with type 2 diabetes have a more hostile bacterial environment in their intestines, which can increase resistance to different medication. Similar studies carried out on people with type 2 diabetes in Denmark also discovered a significant imbalance in the function of their intestinal bacteria and composition. ‘It is important to point out that our discovery demonstrates a correlation. The big question now is whether the changes in gut bacteria can affect the development of type 2 diabetes or whether the changes simply reflect that the person is suffering from type 2 diabetes,’ says author Karsten Kristiansen from the University of Copenhagen.

What’s new? 
www.eatgoodcarbs.com This website is dietitian Johanna Burani’s personal invitation to her virtual office. ‘Come in anytime. No appointment needed!’ she says. ‘By creating this blog, I plan on explaining how and why low glycemic good carbs prevent blood sugar highs and lows; help regulate blood fats; promote weight loss by suppressing hunger and cravings; increase energy and physical endurance.’ She also provides tips for food shopping and reading food labels for good carb ingredients, how to cook with good carbs, and how to find them when eating out. ‘Since I love to cook and spend a lot of time doing so in my homes in New Jersey and in Friuli (northeastern Italy), I’ll also share with you some of my original low GI recipes,’ says Johanna.

A regular contributor to GI News, Johanna is a Registered Dietitian and Certified Diabetes Educator with over 25 years experience in nutritional counseling. She is the author of the best selling Good Carbs, Bad Carbs, has co-authored five other books on glycemic index, and writes for mainstream diabetes magazines and websites as well as for professional publications. Although she loves to write and do research, her first love is her patients. A team player in an endocrine practice in Wayne, New Jersey, Johanna specialises in empowering people to improve their health with practical nutrition information that incorporates the concept of the glycemic index.

Seven ways to calm your upset stomach The medical term for persistent upper abdominal pain or discomfort without an identifiable medical cause is functional dyspepsia (indigestion) according to a new book from Harvard Medical School – The Sensitive Gut. Eating often triggers symptoms of functional dyspepsia. Sometimes the discomfort begins during the meal, other times about half an hour later. It tends to come and go in spurts over a period of about three months. Roughly 25% of the population is affected, and it hits men and women equally. If you suffer from indigestion (and you know it is indigestion and not an ulcer), here’s what they suggest you do to help get some relief.

• Avoid foods that trigger your symptoms. 
• Eat small portions and don't overeat; try eating smaller, more frequent meals and be sure to chew food slowly and completely. 
• Don't lie down within two hours of eating. 
• Avoid activities that result in swallowing excess air, such as smoking, eating quickly, chewing gum, and drinking carbonated beverages. 
• Reduce your stress. Try relaxation therapies, cognitive behavioural therapy, or exercise. An aerobic workout 3–5 times per week can help, but don't exercise right after eating. 
• Get enough rest. 
• Keep your weight under control. 

Glycosmedia App for iPhone and iPad UK-based Glycosmedia runs a website and free digital weekly diabetes news service that lists the latest research, reports and news in diabetes for healthcare professionals and people who want keep informed about diabetes. The new Glycosmedia App will present the latest diabetes information as soon as possible after publication saving busy professionals from having to spend time trawling through the plethora of information available. The Glycosmedia editorial team broadcast the information immediately on the App and on Twitter linking news item references to the original sources. The information on the home screen of the App is presented by date, or can be browsed by category via another screen. Interesting articles can be saved to your Favorites folder and/or shared with colleagues by email or via Twitter. The App can be downloaded free from iTunes. For more information or to provide feedback, contact Jim Young, Editor-in-chief, Glycosmedia jim@glycosmedia.com.

Get the Scoop with Emma Stirling

The scoop on yogurt.


Emma Stirling APD

Do you love yogurt? We do at GI News. Obviously it has a whole lot to do with yogurt’s low GI that makes it a perfect, portable snack to get you through the afternoon. But it’s the package of nutrients, versatility and huge range of offerings that sees us getting down with dairy at many a meal.

Know your ABCs When shopping around for a yogurt, make sure you fully investigate the probiotic or friendly bacteria cultures. They sometimes have long scientific names most of us can’t pronounce, like lactobacillus rhamnosus GG or LGG. The three most common names are acidophilus, bifidus and casei, but there are many different strains and only some are backed up by scientific research. Scientific evidence is needed to show that the strain survives the acidic environment of the stomach, arrives and multiplies in the gut and helps promote positive health outcomes like boosting your immunity or beating the bloat. Most reputable brands have their probiotic strains and clinical studies available on their website.

Build your bones Calcium content of yoghurt varies, so make sure you compare the amounts of this valuable bone building nutrient per 100 grams on the nutrition information panel. Go for at least 80mg of calcium per 100 grams, which is around 10% of the recommended dietary intake. And check out new yogurts also boosted with vitamin D which assists calcium absorption.

Take caution with portions With luxuriously smooth, creamy textures, full fat (more than 4g fat/100g) yogurts should be treated as a calcium-charged alternative to cream, sour cream or mayonnaise, not a daily snack choice. It’s fine to have a dollop on your muesli and summer berries but make sure you share the tub around, as these yogurts often have three times the calorie content as reduced fat versions. Also keep in mind some tubs are labelled as containing 2–3 serves so you need to double or triple the per serve figures if you eat the whole pot. As a rule of thumb, stick to around 500 kilojoules (about 120 calories) at snack time.

Waist not, want not A recent scientific review published in the 2012 International Journal of Obesity found that including dairy foods such as milk and yogurt in a weight loss diet can help accelerate fat loss, especially metabolically harmful belly fat linked to an increase risk of insulin resistance, type 2 diabetes and cardiovascular disease. The review concluded that including three to four serves of dairy foods as part of a kilojoule-restricted diet led to greater weight and fat loss, compared to a standard calorie restricted diet that didn’t include the same serves of dairy every day.

Get cooking For a healthy tang use natural low fat yogurt in pancake mixture instead of milk, whip into a marinade for chicken with fragrant cumin or mint for char grilled lamb kebabs. Did you know? Like cream, yogurt can curdle if over-heated. So simply stir natural or Greek style yogurt in just before serving or mix in a little corn flour before adding to a hot dish. Enjoy!  

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.



Caramelised autumn fruit with yogurt sauce – Italian style 
Italians prefer their fruit to showcase their natural sweetness and this recipe does just that. The spices and natural sweeteners blend harmoniously with the cooked fruit. You might never dream of adding vinegar to fruit but leave it to the Italians! The balsamic vinegar blends together all the flavors of this compote as soon as it hits the palate. Serves: 6 (approx. 3/4 cup of fruit with 3½ tbsp of sauce).

1 tbsp pinoli nuts – 54 nuts if you want to count them out!
3 tbsp (40g) sugar ½ teaspoon ground cardamom
2 medium apples
2 small pears
1 tbsp unsalted butter
2 tbsp (30ml) balsamic vinegar
1 cup fat free plain yogurt
2 tbsp (30ml) mascarpone (an Italian cream cheese)
2 tbsp (30ml) honey
½ tsp vanilla extract
3 tbsp freshly grated orange zest (or 2 Australian tbsp)

 

Lightly toast the pinoli in a small cast iron pan and set aside.
Mix the sugar and cardamom in a small dish and set aside.
Wash, halve and core the fruit and cut into thick slice and set aside.
Heat a large nonstick pan over a medium-high flame, add butter. When the butter has melted add the fruit slices and cook for 5 minutes, stirring frequently. Add the vinegar and mix well to coat the fruit. Continue cooking on medium-low flame for 2 minutes until the fruit is tender.
Sprinkle the prepared sugar mixture over the fruit, mix well. Cook another minute to allow the sugar to melt. When ready, remove the fruit from the heat and set aside.
Whisk the yoghurt, mascarpone, honey and vanilla in a small mixing bowl until smooth. Set aside.
Place the fruit slices on a serving plate. Drizzle the sauce over the fruit. Sprinkle the nuts and orange zest on top. Serve at room temperature or chilled.

Per serve 
Energy: 747kJ/178cals; Protein 2g; Fat 5g (includes 3g saturated fat and 13mg cholesterol); Available carbohydrate 32g; Fibre 4g

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 packed with fresh produce including this recipe from Yotam Ottolenghi and Sami Tamimi's new cook book: Jerusalem. It is published by Ebury Press and available from good bookshops and online. Be warned, the recipes are amazing. The book is addictive. Here at GI News we can't stop cooking from it. There's a large chapter on pulses and grains with countless low GI recipes you won't be able to resist trying ...

Na’ama’s fattoush
Arab salad, chopped salad, Israeli salad – whatever you choose to call it, there is no escaping it. Wherever you go in the city, at any time of the day, a Jerusalemite is most likely to have a plate of freshly chopped vegetables – tomato, cucumber and onion, dressed with olive oil and lemon juice – served next to whatever else they are having. It’s a local affliction, quite seriously. Friends visiting us in London always complain of feeling they ate ‘unhealthily’ because there wasn’t a fresh salad served with every meal.

There are plenty of unique variations on the chopped salad but one of the most popular is Fattoush, an Arab salad that uses grilled or fried leftover pita. Other possible additions include peppers, radishes, lettuce, chilli, mint, parsley, coriander, allspice, cinnamon and sumac. Each cook, each family, each community has their own variation. A small bone of contention is the size of the dice. Some advocate the tiniest of pieces, only a few millimetres wide, others like them coarser, up to 2cm wide. The one thing that there is no arguing over is that the key lies in the quality of the vegetables. They must be fresh, ripe and flavoursome, with many hours in the sun behind them. This fabulous salad is probably Sami’s mother’s creation; Sami can’t recall anyone else in the neighbourhood making it. She called it fattoush, which is only true to the extent that it includes chopped vegetables and bread. She added a kind of home-made buttermilk and didn’t fry her bread, which makes it terribly comforting. Serves 6

200g (7oz) Greek yoghurt and 200ml (¾ cup) full-fat milk or 400ml (1½ cups) of buttermilk (replacing both yoghurt and milk)
2 large stale Turkish flatbread or naan (250g/9oz in total)
3 large tomatoes (380g in total), cut into 1.5cm dice
100g (3½ oz) radishes, thinly sliced 3 Lebanese or mini cucumbers (250g/9oz in total), peeled and chopped into 1.5cm dice
2 spring onions, thinly sliced 15g (½oz) mint
25g (1oz) flat-leaf parsley, roughly chopped
1 tbsp dried mint
2 garlic cloves, crushed
3 tbsp lemon juice
60ml (¼ cup) olive oil, plus extra to drizzle
2 tbsp cider or white wine vinegar
¾ tsp coarsely ground black pepper
1½ tsp salt
1 tbsp sumac or more according to taste, to garnish

 

If using yoghurt and milk, start at least three hours and up to a day in advance by placing both in a bowl. Whisk well and leave in a cool place or in the fridge until bubbles form on the surface. What you get is a kind of home-made buttermilk, but less sour.
Tear the bread into bite-size pieces and place in a large mixing bowl. Add your fermented yoghurt mixture or commercial buttermilk, followed by the rest of the ingredients, mix well and leave for 10 minutes for all the flavours to combine.
Spoon the fattoush into serving bowls, drizzle with some olive oil and garnish generously with sumac.

Tip: Try to get small cucumbers for this as for any other fresh salad. They are worlds apart from the large ones we normally get in most UK supermarkets. You could skip the fermentation stage and use buttermilk instead  of the combination of milk and yoghurt.

Per serve
Energy 1260 kJ/ 300 cals; 17 g fat (includes 6 saturated fat g); 2.5 g fibre; 7 g protein; 28 g available carbohydrate

Busting Food Myths with Nicole Senior

Nicole Senior
Myth: Most people can’t digest milk.
The fact that milk is a commonly eaten food throughout the world suggests we can and do digest it. The story of how this came to be is fascinating, and I was introduced to it by Glenn Cardwell, dietitian and fellow myth-buster, via Gregory Cochran and Henry Harpending’s book, The 10,000 Year Explosion: How Civilization Accelerated Human Evolution. The authors reveal that the ability to digest milk in adulthood started around 10,000 years ago just after humans first started to keep animals for food. Geneticists believe by pure chance a mutation occurred that maintained lactase levels into adulthood and this mutation spread through the gene pool because it conveyed a survival advantage. That is, it provided an important source of nutrition that kept adults healthy and able to reproduce—and thus carry on the genes for digesting milk. This ability spread through Europe and India. A similar scenario was also happening in Arabia where the milk came from camels. It was so successful that fossilised human remains shows 80 per cent of Europeans were able to digest milk 7,000 years ago.

Lactose intolerance is when a person does not produce sufficient amounts of lactose-digesting enzyme (called lactase). Lactose is digested by the enzyme lactase found in the cells that line the digestive tract. All of us have sufficient lactase to digest lactose until three–five years of age, after which it undergoes a genetically determined decline in the majority of people. In fact, all mammals (including dogs, cats, rats, mice, etc.) show this decrease. An Australian review estimated that lactose maldigestion (poor digestion of lactose) affects as few as 4% of adult Caucasians. But figures are higher among people of Asian origin, Aboriginal people and African-Americans. The amount of lactose that can be comfortably tolerated varies from person to person, but generally people with lactose intolerance can digest small amounts of lactose (such as the amount in a small glass of milk) without symptoms, especially if consumed as part of a meal.



The amount of lactose in yoghurt is much lower because the bacterial cultures break the lactose down into lactic acid (giving yoghurt its characteristic tart flavour). Hard cheese contains negligible lactose. For the supersensitive there are lactose-free milks and yoghurts available, and even lactase enzyme powder you can add to milk to do the digesting for you.

There are also those with milk allergy who must stay well away from anything dairy-based or they become ill; however, this unlucky group makes up less than 1 per cent of the adult population.

Milk intolerance (which is different to lactose intolerance) also occurs but no data is available on the numbers of people affected, although it is expected to be higher those with milk allergy (food intolerance is notoriously difficult to diagnose, requiring an elimination diet and food re-challenge supervised by an experienced dietitian).

Getting enough calcium is important for healthy bones and the prevention of osteoporosis as you get older. You might think there are negligible consequences to avoiding dairy foods but a study published in the American Journal of Clinical Nutrition found people with self-perceived lactose intolerance had a much lower intake of calcium because they ate less milk, cheese and yoghurt.

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

Better heart health with a low GI diet 
These days, most people are aware of the importance of cutting back the saturated fat and choosing the good fats for heart health. What they are much less aware of is that being choosy about the carbs they eat can also help prevent heart disease.

Heart disease doesn’t just happen Your risk of developing it is determined by things you cannot change, such as genetic (inherited) factors and things you can do something about. Things you cannot change include: your ethnic background, being male, being older, having a family history of heart disease, being post-menopausal. Things you can do something about include: smoking, having high blood pressure, having high blood glucose levels, having high blood cholesterol, high triglycerides, and low levels of the ‘good’ (HDL) cholesterol, having high CRP (C-reactive protein) levels (a marker of low-grade chronic inflammation somewhere in the body), being overweight or obese and being sedentary.

 

That’s why public health programs around the world focus on encouraging you to quit smoking, be more active every day, lose weight, drop the salt (sodium) and cut back the saturated fat.

The saturated fat message, however, is a little more complicated than was first thought While eating less saturated fat – particularly from fatty processed meats – is prudent advice, we now know that what you replace it with is critical when it comes to preventing heart disease. For example, replacing saturated fats with quality unsaturated fats like olive, peanut and sesame oils and eating a handful of nuts can reduce your risk of developing heart disease by reducing the ‘bad’ LDL cholesterol and increasing the ‘good’ protective high-density-lipoprotein (HDL) cholesterol. On the other hand, replacing saturated fats with highly refined carbohydrate (sugars, oligosaccharides and starches) does not reduce your risk at all.

Carb quality counts A new systematic review by Mirrahimi and colleagues has added further evidence to the message that the quality and amount of carbohydrate you eat really counts. When they reviewed 12 population-based studies (230,000 people followed up over a period of 6–25 years and nearly 7,000 heart attacks) they found that women who ate a high GI (59) or GL (160) diet had a significantly increased risk (26% and 55%, respectively) of having a heart attack, compared to women who consumed a low GI (51) and GL (95) diet.

However, they found no association between GI or GL and risk of having a heart attack in men in these particular studies. Why? Well, apart from the fact that there were nearly three times more women than men in the combined studies and that women may report their dietary habits more accurately, we need to remember that part of the protection that women have from heart disease may be related to their normally high ‘good’ (HDL) cholesterol levels. As high GI and GL diets tend to reduce HDL cholesterol concentrations, this may disproportionately increase heart disease risk in women, especially after menopause. At the same time, high-GI diets may raise triglyceride levels, which may also increase women’s risk. Needless to say, more studies in men are of course needed to investigate this issue further.

The bottom line Routinely advising people to ‘eat less saturated fat’ may not be sufficient to reduce their risk of having a heart attack or stroke. Health professionals and heart health organisations need to encourage people to replace saturated fats with quality unsaturated fats and/or low GI carbs.

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 breastfeeding my baby. What’s the connection between my diet and my milk? 
In well-nourished women, there’s no real connection between your diet and your ability to produce milk. Most mothers will draw on stores built up during pregnancy to supply the building blocks of human milk. From day to day, whatever you eat, the major macronutrients – protein, fat, carbs – in your milk will remain surprisingly constant. Its energy yield will be about 250–300 kilojoules per 100 millilitres. But some vitamins and minerals will be influenced by the quality of your diet.

Protein Compared with the milk of other mammals, human milk has a very low protein concentration, less than 1 gram per 100 millilitres. By six months, it’s even less. The proteins in human milk supply all the essential amino acids for building new tissues, hormones and enzymes in your infant. They also protect against infection, help the synthesis of milk sugar (lactose) and carry some of the minerals your baby needs.

Fat This is the most variable component of human milk. It provides not only energy but also serves to carry the fat-soluble vitamins and hormones. In well-nourished women, fat averages 4 grams per 100ml. Interestingly, the higher the mother’s body fatness, the higher the level in their milk. What’s more, the nature of the fat in your diet is reflected in your milk. For example, if you consume the long chain omega-3 fats found in many fish, then your milk will also be high in these special fats.

Carbs The main carbohydrate in milk is a sugar called lactose that is similar in structure to table sugar (sucrose) but not as sweet to taste. Interestingly, human milk has the highest concentrations of lactose of any mammal’s, with around 7 grams per 100ml at peak lactation, almost double that of cows’ milk. One of the reasons for the high concentration may be the glucose requirements of our energy hungry brain. There is another form of carbohydrate in human milk that is often overlooked, even though there may be as much as 1 gram per 100ml (more than the weight of protein). Called ‘oligosaccharides’, they are complex sugars that remain undigested in the small intestine, but discourage pathogens in the small intestine and facilitate the growth of friendly bacteria in your baby’s large bowel. The beneficial bacteria produce substances that inhibit pathogens and encourage a healthy large intestine. The oligosaccharides in human milk may be another reason that breastfed babies suffer less gastrointestinal disease.

Vitamins and minerals The concentrations of water-soluble vitamins (vitamins C, B1, B2, B6, etc.) in your milk are directly linked to your current intake of these vitamins. It’s one of the best reasons to consume a healthy diet throughout lactation. The fat-soluble vitamins (A, D, E and K) are more constant, and mainly determined by your body stores. It means that any short-term deficits won’t affect the levels in your milk. The concentrations of minerals also appear to be unaffected by your short-term intake. However, it means that if you don’t eat well, your stores are being depleted as lactation progresses. Your next baby may not be as well off if you neglect your own needs during this important stage of life.

Next month I’ll look at the nutrition recommendations during lactation.

This is an edited extract from my latest 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.



New GI values from GI Labs in Toronto
Kit’s Organic Fruit & Nut Bar – New low GI snack bar. 



Clif Bar & Company is a privately owned American company based in Emeryville California that produces a range of organic foods and drinks for people on the go. Their latest product, Kit’s Organic Fruit & Nut Bar, is a gluten-free, soy-free and dairy-free fruit and nut snack bar that’s USDA-certified organic. ‘When I stepped back to think about what I’d want in a new snack, I knew it had to be organic, it had to be made with simple ingredients and it had to be delicious,’ says co-CEO Kit Crawford. ‘My appreciation for organic food began at a very young age, when my parents instilled in me the values of growing your own food and caring for the land.’ Available flavours include:

• Berry Almond: GI 33, available carbohydrate 22g, fibre 5g, GL 7 
• Cashew: GI 27, available carbohydrate 24g, fibre 3g, GL 6 
• Chocolate Almond Coconut: GI 29, available carbohydrate 20g, fibre 5g, GL 6 
• Peanut Butter: GI 26, available carbohydrate 21g, fibre 4g, GL 5 

Visit their website for nutrition facts and list of ingredients. 


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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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
Contact email (for questions or permission to reproduce stories from this newsletter): info@gisymbol.com for technical problems or faults please contact smb.ginewstech@sydney.edu.au

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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.’