1 December 2013

GI News—December 2013

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  • Give prime position on the buffet table to healthy dishes; 
  • Does replacing sugar with isomaltulose improve BGLs?
  • Lower BGLs, better memory;  
  • Prof Jennie Brand-Miller on getting kids to like good foods;
  • Dr Alan Barclay on festive drinks;   
  • Nicole Senior enjoys deliciously low GI dates;
  • For festive fare try: Spiced date, nut and pomegranate loaf; Moroccan-style BBQ or roasted turkey with date stuffing; Almond meringues 
GI News 
Editor: Philippa Sandall
Web management and design: Alan Barclay, PhD
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Food for Thought

Health-by-design at the festive table
The holiday season is rapidly approaching and chief cooks in households around the world are starting to think about what festive fare to serve family and friends (of course the better organised ones have already made the Christmas puddings, mince pies and cakes). Serving the special foods that are part of your cultural traditions is part of the ritual and something everyone looks forward to. In my family, ensalada rusa (Spanish potato salad) will always be on the buffet table along with other traditional Spanish and Aussie Christmas fare. It’s all so tempting, it's hard not to overfill your plate ...

The big problem these days with our festive fare is that the holiday season seems to have spread way beyond that special Christmas eve dinner or Christmas lunch with parties and celebrations galore, each vying for your eating affections. However each time you overload your system with excessive food, it’s akin to metabolic assault: your blood becomes milky with fat (post-prandial lipaemia); glucose, insulin levels and inflammatory hormones rise; your blood vessels become less flexible (called endothelial dysfunction) and your blood becomes more likely to clot (or pro-thrombotic). Unfortunately for those with diabetes or pre-diabetes, these adverse effects are worse.

ensalada rusa

And did you know that rather than signalling the body to ease-off at subsequent meals, huge meals can actually increase appetite for the next meal perpetuating a vicious cycle of overeating (people often say their stomach has stretched). It’s no wonder hospital emergency rooms experience a rush of cardiac patients on Christmas and Boxing Day.

Surely it’s time to move on? The planet can no longer sustain such excess and our physical health is suffering as a result. Not to mention the moral affront of gluttony in a world where there is so much hunger, plus the environmental disaster of food waste.

  • If you are catering, be bold in offering healthier options and cook the right quantities to avoid waste. Don’t pressure guests to eat more than they need.  
  • If you’re on the receiving end of pressure to eat more than you want to, be kind but assertive. Your health and comfort need not suffer to please others. 
Of course, many of the adverse effects of overeating can be reversed by exercise, but it’s hard to throw a ball around when you’ve fallen into a postprandial stupor and can’t get out of your chair. Perhaps the best test of eating the right amount is having some get-up-and-go a few hours after getting up from the table? Some research conducted by Professor Brian Wansink from Cornell University might help. He found that placing the healthy items first on the buffet table helped diners fill their plates first with these better choices. I’m sure we could all could utilise a little health-by-design at our festive table to steer our guests towards more of the good stuff as well.

Sincere best wishes to you and yours for a happy and healthy festive season.

Nicole Senior is an Accredited Nutritionist, author and consultant who strives to make healthy food taste terrific. You can follow her on Twitter or Facebook or checkout her website

News and Reviews

Low GI diet in pregnancy reduces risk of excess weight gain 
Researchers in Ireland have found that giving women advice on a healthy low GI diet early in pregnancy can reduce the risk of excess weight gain and improve nutrition. Compared to women who received usual maternal care, those who were educated on a low GI diet in the first half of pregnancy had a lower energy intake, a higher intake of fibre and protein, and reduced their intake of high GI foods. They were also less likely to exceed pregnancy weight gain recommendations. Read more about the study here.

Pregnant woman

What’s better for your HbA1c — sugar or isomaltulose? 
Isomaltulose is a sugar (a disaccharide) found in minute amounts in honey and sugar cane. Compared with sucrose (aka regular sugar), it has a significantly slower rate of digestion and absorption because the bond linking the glucose and fructose molecules is harder to break down and this shows in the respective GI values – the GI of regular sugar is 65 (average); isomaltose is 32. A dietary intervention study in Diabetes Care reports that replacing 50 grams of sucrose a day with isomaltulose for 12 weeks was not enough to significantly improve HbA1c in people with type 2 diabetes. Triglycerides, however, were significantly lower in the isomaltulose group.

Lost your car keys? Lower BGLs and better recall 
A cross-sectional study in Neurology, has found that lower HbA1c and glucose levels were associated with better scores in delayed recall, learning ability, and memory consolidation. The authors conclude: “Our results indicate that even in the absence of manifest type 2 diabetes or impaired glucose tolerance, chronically higher blood glucose levels exert a negative influence on cognition, possibly mediated by structural changes in learning-relevant brain areas.”

Make room for mushrooms on the buffet table
Mushrooms are one of the tastiest, nutrient-rich, low energy-dense foods around with some100 kJ/24 calories in a 100g/3½oz serving. They are packed with, minerals like selenium and B vitamins including folate. They also have more protein than most vegetables. The GI isn’t relevant because they have almost no carbs although they are a very good source of fibre. What’s more, substituting a cup of white button mushrooms for red meat in three meals a week could be a useful strategy for enhancing and maintaining weight loss according to the findings of a randomized clinical trial reported in The FASEB Journal. At the end of the one-year trial, participants who substituted mushrooms for meat lost seven pounds, showed improvements in body composition compared to participants on the standard diet, and they maintained the weight loss. Looking for inspiration? Try Ian Hemphill’s Roasted Mushrooms with Ajowan.

Mushrooms

Ingredients: ½–1 tsp chilli powder; 3 tbsp olive oil; 8 large field mushrooms, stems removed; 2 cloves garlic, crushed; 2 tsp butter or margarine, cut into 8 squares; 1 tsp ajowan seeds; sea salt (optional); 4 handfuls wild rocket; cracked pepper, to taste
Method: Preheat the oven to 150°C (325°F) and lightly oil a baking tray or shallow ovenproof dish large enough to hold 8 mushrooms. Mix chilli with the olive oil and set aside to allow the flavour to develop while you prepare the mushrooms • Place a little crushed garlic and a tiny piece of margarine in the centre of each mushroom, then sprinkle each with just a pinch of ajowan and a little salt if using • Arrange the mushrooms face up on the baking tray and bake for 15 minutes or until heated through • Rinse the rocket well under running water; drain, gently pat dry and toss in the chilli oil. Place a mound of rocket on each plate, and serve with two mushrooms and cracked pepper.
What’s ajowan? These small, pale-brown seeds look like celery seeds and have a distinct 'thyme-like' flavour. Add them to vegetable curries, steamed cabbage, carrots, potato and pumpkin or use them in slow-cooked dishes when the flavour of thyme and a slight peppery spiciness is wanted. Want to know more? Check out Ian Hemphill’s Spice and Herb Bible.

What's New?
Produce pic 

Sweet red salad onions

Produce Sweet red salad onions
Pic Emma Sandall 
Purchased from Greg@Envy Horticulture, Bondi Beach Farmers’ Market
What to do? Slice and add to salads or gently caramelise in olive oil as an accompaniment or a filling for field mushrooms. How? Brush mushrooms on both sides with a little olive oil, place cavity-side up in a baking dish and bake in a preheated oven (180C/350F) for about 15 minutes. Serve warm topped with the caramelised onion, a dollop of labne (or a soft, mild feta), a sprinkle of lemon thyme and a scatter of chopped walnuts.
What makes them sweet? Catherine Saxelby says: 'Onions have a natural sweetness because they are high in natural sugars (around 5% – glucose, fructose and sucrose). They might make you cry, but they are a good source of antioxidants called flavonoids. There’s also some fibre and potassium but they are fairly low in vitamin C and minerals.'
Want to know your onions better? Penny Woodward is expert on all matters allium (garlic and onions).  

Soil sustainability matters 

Robert Edis

World Soil Day (December 5) recognises the benefits of healthy soil in sustaining plant life (and all life). In a recent terroir-for-produce series, “The good earth”,  Melbourne soil scientist Robert Edis profiled some of Australia's ancient soils and the flavours they bring to the produce table.

  • Boneo Leptic Tenosol and parsnips
  • Jasmine rice and Leeton Red Sodosol
  • Clare Hypercalcic Calcarosol and durum wheat
  • Green lentils and the Wimmera self-mulching Grey Vertosol
  • Thorpdale Red Ferrosol and chip potatoes
  • King Island cheese and Currie Yellow Kurosol
  • Buderim Red Ferrosol and ginger
  • Peaty Black Vertosol and asparagus
  • Kensington Pride mangoes Darwin lateritic Red Kandosol
  • Coonawarra Red Dermasol and cabernet sauvignon. 
Wine makers have long been telling us about the importance of terroir and the relationship between the flavour of a wine and its origin. In a new book, Barossa Shiraz (Wakefield Press $39.95), Thomas Girgensohn explains terroir – the concept of the vineyard’s site to the quality of the grapes and wine produced from it – in easy-to-understand terms.

Philippa’s bookshelf 
#1 You can’t turn a page in Rob and Sophia Palmer’s Colour of Maroc (Murdoch Books) without feeling the terroir. It’s very much a gift book, but you probably won’t want to give it away. Low GI picks for the buffet table? Try Barley and vegetable pilaf with cumin dressing; Roasted cauliflower salad with saffron and currant dressing; Fennel and blood orange salad; and Spinach and preserved lemon salad.

Colour of Maroc

#2 I heard Bruce Auld talking about A Traveller’s Flora recently. It’s his self published A to Z guide to familiar plants along roadsides, in fields and forgotten places in south-eastern Australia. It includes common roadside plants, crop plants, native plants and weeds. Many edible, it you know what you are looking for. I’ll never look at the ubiquitous canna (Canna edulis) the same way again. I discover it’s long been cultivated (dating back 2500 years in Peru) for its edible tubers which are usually baked. Here's what Crops for the Future have to say about it. ‘Never write off a minor crop! Once a staple in prehistoric Peru but going nearly extinct there because of the inconvenience for direct use (in particular extremely long cooking time), this root crop has bounced back in the last 50 years – not in its native range, but in Vietnam and Southern China. Gels made from canna starch have extraordinary tensile strength, making it the preferred raw material of popular transparent noodles. Currently grown on some 50,000 ha of marginal land in Vietnam and China, canna allows poor farmers to derive profit from minimal investments and from land unsuited for food crops.’ We guesstimate that those noodles will be low GI.

Canna edulis

Photo: Michael Hermann, Crops for the Future

Nicole's Taste of Health

It’s a date!
A friend brought along fresh dates to snack on the other evening and said they were as good as chocolate – high praise indeed. They were fabulous and had come all the way from California; my friend believes they grow the best she’s found. Food miles aside, I had to agree with her. I’m sure this will offend many other places that might lay claim to having the best dates, but speaks to the wide appeal of this fruit. Fresh dates have the perfect balance of flavour and sticky chewiness that really hits the palate ‘sweet spot’. And they are a fascinating fruit to boot.

The date palm (Phoenix dactylifera) is one of the few plants to thrive in the hot dry conditions of the Middle East and North Africa where it has been cultivated for at least 6000 years. Known as ‘the bread of the desert’ and ‘cake for the poor’, its fruit has long provided a local staple. It’s not surprising that date palms and hold religious significance for Judaism, Christianity and Islam. This ancient fruit denotes victory and peace and is included in Palm Sunday festivities celebrating Jesus’ triumphant return to Jerusalem. It is commonly the first food consumed for Iftar, after the day’s fasting during Ramadan. There must be nothing better than dates after a day of hunger, much like a cool drink after walking through the desert.

There are many varieties of dates in three main categories based on water content. The dates I know as ‘fresh’ are also known as soft or Medjool dates. Then there are semi-dry varieties such as Deglet Noor, and dry dates like Thoory. You’re probably more familiar with the dried version that is much easier to export around the world in this shelf-stable form. In early times dried dates sustained Arab sailors during their long voyages of trade and discovery.

Tomatoes

Photo: Ian Hofstetter, The Low GI Vegetarian Cookbook (Hachette Australia)

As well as being a key ingredient in the popular sticky date pudding, and date and nut bread Americans enjoy over the holidays (try Anneka’s recipe below), dried dates are very versatile and can be added to cakes, loaves muffins, cookies and scones (the English kind traditionally eaten with jam and cream). They’re also delicious added to breakfast cereal, muesli and in a nutty trail mix. I’ve even been known to throw a few on a peanut butter sandwich-yum. They also provide a lovely balance of flavours in savoury dishes together with meat and spices in tagines and other slow-cooked casseroles. Fresh dates are so good they need no accompaniment, although they enhance a cheese platter beautifully.

I was amazed at the myriad of ingredients formed from the humble date: a syrup (dibs), which is used as a sweetener similar to honey, powdered sugar, paste, sparkling juice, vinegar and wine; not to mention the creative stuffings used inside stoned (pitted) dates including cream cheese, nuts, candied citrus peel or marzipan. A healthy oil can even be pressed from the seed. What a clever fruit.

Dates are sweet, so it’s not surprising to learn they contain 70% sugars: a varying combination of sucrose, fructose and glucose, depending on the variety. All are low GI. They are high in fibre and also contain vitamins A, thiamine, niacin and riboflavin, and some iron, magnesium, calcium and potassium. They even contain selenium thought to be important for reducing cancer risk, and fluorine for strong teeth that resist decay – both elements are not found in many foods.

Dates are also high in natural sorbitol (a sugar alcohol or polyol) which makes them excellent for promoting bowel regularity, although those with an irritable bowel and sensitive to FODMAPS (certain sugars that can be poorly absorbed by the body) may want to give them a miss (poor them). The rest of us can make a date with dates over this festive season and rejoice in how sweet life has been to us this year. Season’s Greetings!

[NICOLE]

Nicole Senior is an Accredited Nutritionist, author and consultant who strives to make healthy food taste terrific. You can follow her on Twitter or Facebook or checkout her website

In the GI News Kitchen

Family Baking, Anneka Manning, author of Bake Eat Love. Learn to Bake in 3 Simple Steps and founder of Sydney’s BakeClub, shares her delicious ‘better-for-you’ recipes for snacks, desserts and treats the whole family will love. Through both her writing and cooking school, Anneka teaches home cooks to bake in practical and approachable yet inspiring ways that assure success in the kitchen.

 Anneka Manning
Spiced date, nut and pomegranate loaf 
This moist, fragrant date and nut loaf is studded with dried cranberries and hazelnuts. It has a little crunch and is mildly spiced to go perfectly with an afternoon coffee or pot of tea shared with friends. It is also great toasted and spread with fresh ricotta. The smell of the warm fruit and spices baking in your oven will get you in the festive spirit! Preparation time: 20 minutes (+ cooling time) • Baking time: 50–55 minutes • Makes: 1 loaf (Serves 20)

1¼ cups (300ml) freshly brewed black coffee
1 cup pitted dates, coarsely chopped
½ cup dried cranberries
½ cup currants
2 tbsp pomegranate molasses (see Baker’s Tips)
2 tbsp honey
slightly heaped 1/3 cup (90g/3oz) Logicane or raw sugar
1/3 cup sunflower oil or 75g (2½oz ) butter
1 orange, zest finely grated
2 tsp mixed spice
2 eggs, lightly whisked
50g walnuts, coarsely chopped, plus an extra handful, coarsely chopped, to decorate
50g hazelnuts, coarsely chopped, plus an extra handful, coarsely chopped, to decorate
2 tbsp sesame seeds
1½ cups wholemeal plain flour
2 tsp baking powder

Glaze
2 tsp pomegranate molasses
2 tsp honey
1 tsp water

Spiced date, nut and pomegranate loaf

Preheat the oven to 180°C350F. Grease a 21 x 10cm (base measurement) loaf tin and line the base and two long sides with non-stick baking paper.
Combine the coffee, dates, cranberries, currants, pomegranate molasses, honey, sugar, butter or oil, orange zest and mixed spice in a large saucepan. Bring to the boil over a medium heat. Remove immediately from the heat and set aside to cool.
Stir the eggs, walnuts, hazelnuts and sesame seeds into the cooled date mixture.
Sift the flour and baking powder together, returning any bran to the flour. Add to the date mixture and use a wooden spoon or spatula to stir gently until just combined.
Pour the mixture into prepared tin and use the back of a spoon to smooth the surface. Sprinkle with the extra nuts, pressing into the mixture slightly.
Bake for 50–55 minutes, or until the loaf is firm to the touch on the top and cooked when tested with a skewer. If it is browning too quickly, cover with foil after 40 minutes. Remove from the oven and stand in the tin for 10 minutes before turning out on a wire rack.
To make the glaze, combine the honey, pomegranate molasses and water in a small bowl. Brush over the top of the hot loaf. Set aside to cool before serving.

Baker’s tips 

  • Pomegranate molasses is available from specialty food stores and delicatessens. 
  • This loaf will keep in an airtight container in the fridge for up to 5 days. Serve at room temperature. 
  • If honey is firm or crystallised, heat it in the microwave for a few seconds to soften before using 
Per serve 
785 kJ/ 188 calories; 3 g protein; 8.5 g fat (includes 1 g saturated fat; saturated:unsaturated fat ratio 0.13); 24 g available carbs; 3 g fibre

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

[JOHANNA]

Almond Meringues
Northern Italy, where we have our home, does not have the best sweets, in my opinion. Meringues, however, is a dessert that everyone seems to enjoy. They show up in bakeries more than in homes. Makes 30 meringues.

4 egg whites at room temperature
1 tsp cream of tartar
2 tsp almond extract
½ cup (60g) confectioner’s sugar, sifted
30 cocoa roasted almonds

Almond Meringues

Preheat oven to 250F (120 C) Place parchment paper on 2 cookie sheets and set aside.
Add the egg whites, cream of tartar and almond extract to the bowl of a stand up mixer. Mix the ingredients on low speed for 1 minute. Start adding the sugar, 2 tbsp at a time, and gradually increase the speed of the mixer. The egg whites will start forming soft peaks. Continue to mix at the highest speed until the peaks are stiff and glossy. Total mixing time will be 8-10 minutes.
Using 2 tablespoons, drop the meringue into 30 mounds on the parchment-paper-lined baking sheets. Place one almond in the center of each meringue.
Bake for 1 hour or until the meringues are set and dry. Turn off the oven, leaving the meringues there for 1 more hour. Meringues may be stored in airtight tins for several days.

Per meringue
Calories: 18 (75 kJ) Fat: 0.5 g Saturated Fat: 0 g Saturated:unsaturated fat ratio: 0 Carbohydrate: 2 g Protein: 1 g Fiber: 0 g

Moroccan-style barbecued turkey 
This recipe and photo, kindly supplied to GI News by Steggles, can be adapted for oven roasting. Simply follow the same directions, but roast on the lowest shelf at 180C/350F (fan forced) preheated oven. Remove turkey from refrigerator 1 hour before roasting. They have turkey roasting tips on their website. Preparation time: 40 minutes • Cooking time: 3½–4½ hours (plus resting time) • Serves: 10 (depending on turkey size)

1 small turkey (2.8 kg)
¼ cup honey
5 small lemons, halved
2 tbsp dukkah
bay leaves, to garnish

Stuffing
1½ cups chicken stock
1¼ cups instant couscous
¼ cup olive oil
1 large red onion, finely chopped
1½ tsp Moroccan seasoning
¾ cup chopped pitted dried dates
½ cup coarsely chopped parsley leaves
½ cup coarsely chopped coriander leaves
1/3 cup toasted pine nuts
1 egg, lightly beaten

Moroccan-style barbecued turkey

Heat a hooded barbeque, hood closed, using indirect heat on medium setting. Or preheat oven. Remove neck from inside turkey. Pat turkey dry, inside and out, with paper towel.
Make stuffing. Place stock in a medium saucepan and bring to boil. Remove from heat. Stir in couscous, then cover and stand for 10 minutes. Fluff grains with a fork. Meanwhile, heat half the oil in small frying pan and cook onion until soft, stirring occasionally. Stir Moroccan seasoning, dates, parsley, coriander, pinenuts, onion and remaining oil through couscous. Stir in egg.
Loosely fill turkey with about two- thirds of the stuffing (this will depend on size of the turkey). Do not overstuff, as stuffing will swell. Close rear cavity with metal skewers. Tie legs together with kitchen string. Bend wings back and tuck under turkey.
Place in a large roasting pan. Cover completely with a foil tent. Place in the centre of the barbecue and roast, hood closed. • 40 minutes before the end of cooking time, open hood and remove foil. Cover ends of turkey legs with foil to prevent burning. Brush turkey with 1 tbsp honey. Place lemon halves around the turkey and close hood. Continue cooking for 40 minutes. Brush turkey with honey twice during this time. If the turkey appears to brown too quickly, loosely cover with foil. • 5 minutes before the end of cooking time sprinkle turkey with dukkah. Test the turkey is cooked by piercing the thickest part of the thigh – between the thigh and breast. The juices should run clear. If the juices are pink, cover turkey with foil and continue to barbecue until cooked.
Remove the turkey from the barbecue and cover loosely with foil for 20 minutes. Place turkey on a platter, reserving pan juices. Place lemons and bay leaves around turkey. Carve and serve.  

Per serve
1145 kJ/ 274 calories; 6 g protein; 11 g fat (includes 1.3 g saturated fat; saturated:unsaturated fat ratio 0.13); 36 g available carbs; 3 g fibre

We Are What We Ate

The New World bird that took over the Old World table 
Christmas – our biggest annual celebration – may seem like an age-old tradition, but travel back in time, and you will find it was typically a modest event for most people and, at times, a non event. England’s Puritan government cancelled Christmas in 1647, forbidding traditional expressions of merriment, ordering shops to open, and churches to close. The Plymouth Colony Pilgrims worked in the fields on their first Christmas day; while over in Massachusetts Bay, Puritans outlawed Christmas 1659–81, fining anyone caught celebrating it five shillings.

Today’s Christmas with its trees, cards, crackers, carols, decorations, gifts, feasting, entertainments, and wishes for peace on earth and goodwill to all men and women comes from Victorian England. 1843 is something of a seminal year with Henry Cole launching the world’s first commercial Christmas cards and Charles Dickens publishing A Christmas Carol and putting turkey with the trimmings in prime position on Bob Cratchitt’s table.

Turkey

Turkeys have been domesticated for some 2000 years or more. In America’s First Cuisines (written to highlight and celebrate the contribution made by the original inhabitants of the New World to the world’s food supply), anthropologist and food historian, Sophie D. Coe, tells us that the Aztecs had five domesticated animals: the turkey, the Muscovy duck, the dog, the bee, and the cochineal insect. By the sixteenth century, the number of turkeys the Aztecs raised was phenomenal. She quotes Motolinía, a Franciscan missionary who arrived in New Spain in 1524, who reports that “the market of Tepeyacac, just one of several suburban markets around Tenochtitlan, sold eight thousand birds every five days, and this all year round.”

According to Coe, the first actual evidence of turkey raising however, is in Maya territory. “The earliest bones of turkeys that could be considered domesticated were found in Tehuacan and date from between 200 BC and AD 700,” she writes. “Their use must have spread rapidly, because by the time the Europeans came exploring, turkeys seem to have been available beyond their natural range. Columbus may have brought them back from the islands on his first voyage, or perhaps he first saw them when he landed in Honduras on his fourth voyage. By 1511 the king of Spain was ordering every ship returning to Spain to bring back ten turkeys, five males and five females. It was one of the most rapid successes as far as the adoption of New World foodstuffs goes, speedily replacing the tough, stringy peacock as a spectacular dish for banquets.”
America’s First Cuisines, University of Texas Press, 1994.

GI Symbol News with Dr Alan Barclay

Alan Barclay
Dr Alan Barclay

Cheers 
Festive occasions tend to involve feasting. And when we eat, we tend to have something to drink. But apart from water, drinks usually come with calories. Research shows that on average, overweight adults in the US pack on and extra 5 pounds (2.3 kg) over the six-week Thanksgiving–New Year period.

But the temptation to over-consume as we stand around chatting is a considerable challenge. To minimise weight gain, we really have to plan ahead to make sure we balance healthy food with festive fare along with ensuring we maintain (or increase) physical activity. And we all have to watch what we drink. It’s not just alcohol that’s the problem; many festive beverages are high in calories.

The soft stuff Water is best and although not festive, it is a great in-between-drinks-drink to help you pace yourself on a night out. It doesn’t have to be Chateau Tap. Soda water, mineral water, diet soft drinks, and diet cordials are useful “watery” choices for special occasions with little or no carbohydrate or calories, so they won’t spike your blood glucose or contribute to weight gain. Vegetable juices are tasty choices with few calories and loads of nutritional goodies. Fruit juices are another story, being rich in carbs (natural sugars) they come with plenty of calories. You are better off enjoying them watered down with mineral or soda water. Most regular soft drinks have even more calories and carbs than fruit juice; the diet or reduced-sugar versions are better choices if you want something sweet.

The hard stuff Keep it moderate – no more than two standard drinks on any day. It takes the liver about an hour to metabolise a standard drink, so don’t down them too quickly. It’s also wise to have at least a couple of alcohol-free days each week (that’s where the planning comes in during the festive season). What’s a standard drink? It is much less than you imagine.

  • 100ml wine
  • 285ml regular or low carb beer 
  • 425ml low-alcohol beer 
  • 250ml cider 
  • 30ml spirits 
  • 60ml fortified wine 
Which alcoholic drink is best? Along with the taste, the amount of alcohol, carbohydrate and kilojoules/calories in alcoholic beverages are all important factors to consider when choosing a drink. Check out our at-a-glance tables to make better choices in the festive season – and throughout the coming year. (We have rounded all figures up/down.)

Drinks table

Drinking and diabetes If you are taking medication for your diabetes, alcohol can interact with the medication and cause hypoglycaemia. Either make sure you eat some carbohydrate foods while drinking to reduce your risk of a hypo, or have the drink just before a main meal (which includes some carbohydrate). Here are some good choices for snacks:
  • Low GI bread (e.g., Burgen) or grainy crackers with cottage cheese or hummus or salsa or dips 
  • Mixed nuts and seeds (not salted)
  • Fresh fruit platter 
  • Dried fruit 
  • Fruit and nut mix 
Cheers!

The GI Symbol, making healthy low GI choices easy choices

New GI Symbol

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

GI Update with Prof Jennie Brand-Miller

Prof Jennie Brand-Miller answers your questions. 

Jennie


I watch my sister struggling to get her almost 3-year-old son to eat fruits and vegetable, or any healthy food really. I am just about to introduce my baby to solids. I don’t want to go through what she is dealing with. Have you any tips to help me? 
Children have evolved to mimic their parent’s behaviour, and they are watching you more carefully than you would ever know. If you eat it, they will want to too. If you eat a balanced diet, they will too. Being a good role model applies to eating, exercising and all aspects of your behaviour, and food habits that are adopted early on, are difficult to alter later. If you flavour everything with salt, they will grow to prefer salty food. If you over-sweeten, then they expect food to taste extremely sweet. If you expect them to eat everything on their plate, then they learn to ignore internal satiety signals. They will learn to eat until they feel uncomfortably full. 

But it’s not easy in today’s world to confine your children’s food intake to only the healthiest foods. Children’s parties are common, family celebrations are occasions that call for special foods. The best way to handle these situations is not to deny your children, but to teach them that ‘party foods are for parties’. They should not be part of your normal pantry. Ice creams, soft drinks, cakes and biscuits, French fries and potato crisps are all indulgence foods. A little indulgence is a good thing, but make sure it’s just that – a little indulgence. 

Children cooking

One of the best ways of teaching your child to love healthy foods is to involve them in the preparation of the meal and even growing them in your garden. Young children can tear up various types of lettuce (and a little food sampling won’t hurt), and when they are old enough, they can help you draw a funny face with carrots, raisins and apple slices. Books dedicated to cooking with children can be a real delight. You’ll find it one of most enjoyable and rewarding ways of spending quality time with children. By the time they are old enough to be safe in a kitchen, you could insist that they prepare at least one family meal a week.
 

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) and in the US and Canada:  The Low GI Eating Plan for an Optimal Pregnancy (The Experiment). You can visit us 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
Phone + 61 2 9351 6018
Fax: + 61 2 9351 6022
Email sugirs@mmb.usyd.edu.au
Web www.glycemicindex.com

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1 November 2013

GI News—November 2013

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  • David Katz: 'Demonizing saturated fat never helped us much. Canonizing it now won’t help us any either'; 
  • Is the origin of type 1 diabetes in the gut?
  • Prof Jennie Brand-Miller on reducing the risk of type 2 diabetes;  
  • Dr Alan Barclay on the new American Diabetes Association guidelines for adults with diabetes;   
  • Nicole Senior on why it's OK to say 'Cheese Please';
  • Three delicious recipes to up your veggie intake: Breaded Cauliflower, Zucchini, Quinoa and Egg Slice and Spiced Little Carrots with Chickpea-Sauerkraut Puree. 
GI News 
Editor: Philippa Sandall
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Food for Thought

What’s for dinner? 
Food, choice and serving something delicious for dinner every night, is something many of us take for granted. Foodbank’s 2013 End Hunger Report is a timely reminder that a growing number of families are not so fortunate and have to turn to food relief to put something on the table. ‘Hunger in Australia affects more people than many realise, and families are increasingly relying on food relief due to difficult economic times,’ says Enzo Allara, Chairman of Foodbank Australia. ‘It only takes one unexpected cost or event to tip the balance.’ ‘Family circumstances have become the main driver for people turning to food relief,’ he says ‘with low income and single parent families the largest groups requiring assistance, especially for mealtime staples – cereals, fruit and vegetables, bread, meat and milk.’

These days, demand is outstripping supply. According to Allara, while Foodbank currently provides enough food for 88,000 meals a day, most welfare agencies say it’s not nearly enough as they don’t have sufficient food for the number of families who need their help. ‘Our traditional model of collecting surplus food from manufacturers and retailers is no longer able to meet growing demand, so we’re adopting new solutions, including arranging the manufacture of key staple foods and partnering with farmers for more fresh produce,’ says Allara.

We think it’s really heartening to see so many food companies providing generous support with dairy products, porridge oats, breakfast cereals, pasta, flour, bread, and meat – and good to see some nutritious, low GI staples like milk, oats and pasta on the list. But we gulped a little when we read that the major new beef initiative was designed to supply the charities with more than 130 tonnes of sausages a year.

Ask any doctor or dietitian and you’ll hear that a regular diet of sausages isn’t the best dietary choice for long term health and well being. It’s possibly one of the more disastrous choices. But sausages are something of a no-brainer in the charitable organisation ‘end-hunger’ scenario as they are cheap to make, popular with just about everybody, something of a comfort food and they come ready made so you just have to cook them, you don’t have to think what to do with them as you would with say, a packet of mince. But there’s still that big GULP. Tonnes and tonnes of sausages which are high in kilojoules (calories), saturated fat and sodium, linked to obesity and chronic diseases like diabetes and heart disease, are being given to people who are quite possible at risk already.

We absolutely agree that the first step is to put something on those dinner plates. We would like to see Foodbank and similar organisations take the next step, which is just as important, tell people the best way of cooking and serving them. We turned to our Taste of Health columnist, Nicole Senior for some sizzling tips to make sausages a healthier option for hungry families.

Sausages with vegetables

‘The best way to “healthify” the humble sausage is to reduce the amount per serve and fill out the meal with plenty of things we know are good such as vegetables, legumes and whole grains,’ says Nicole. ‘For example: add grilled sausage slices to pasta with vegetables and lentils; or vegetable and chick pea curry with brown rice; or vegetable noodle soup. Even serving a thin grilled sausage (or half a fat one) on a wholegrain roll with onions and coleslaw is a step up from the usual sausage sandwich. And of course you can cook sausages in ways that let much of the fat drain away, such as slicing them in half during cooking (grilling or barbecuing) and draining them on absorbent paper. And further up the chain, food companies need to reduce sodium and fat levels of sausages to reduce the effort and thought required to make them healthier. To improve the nutritional well being of everyone we need to make healthy choices easy choices’.

And if we could wish upon a star, we would wish that these many generous charities find the funds to teach their clients how to turn the food they receive into nutritious, balanced meals as well as ‘teach them to fish’ (so to speak), so that they are better able to feed and nourish their families on a budget when the crisis is over.

In the News

Scapegoats, saints, and saturated fats: old mistakes in new directions. 
A recent commentary piece in the British Medical Journal suggests that saturated fat is not really so bad after all. Is the author right? Is it time to absolve saturated fat? Not at all says Dr David Katz pointing out that it was never time to demonize it in the first place. ‘We vilified saturated fat, and were almost certainly silly to do so. Now, some seem on a mission to canonize it – and that is at least as silly. Diets can be lower, or higher, in saturated fat content and be crummy either way. There is no evidence of long-term health benefit from the wilful addition to the diet of saturated fat.’ In this edited extract of his Huffington Post piece (reprinted with permission) David Katz lays out his case that we are ill-served to think of saturated fat as either scapegoat, or martyred saint.

Ancel Keys was never really wrong.The case against saturated fat, its implication in the development of atherosclerosis, inflammation, and chronic diseases, notably heart disease, involves a vast expanse of research over many years by thousands of researchers around the world. Keys was among the first to emphasize the association between saturated fat intake and heart disease. He looked at rates of disease around the world and correctly noted that heart disease was more common in societies that ate more meat and dairy. His mistake may have been to look past that dietary pattern for the “active ingredient” in it, which led to the convictions of dietary cholesterol, saturated fat, and to a lesser extent overall dietary fat.

Ancel Keys wasn’t entirely right. Saturated fat is not one food component; it’s a category. Just as polyunsaturated fats include the anti-inflammatory omega-3s, and the pro-inflammatory omega-6s (and even that is over simplified), so does the saturated fat class contain a diversity of members. One of them, stearic acid, found in dark chocolate among other places, is now clearly established to be innocuous. Another, lauric acid, predominant in coconut oil among other places, may prove to be as well. But still others, such as palmitic acid and myristic acid, appear to be substantially guilty as charged, contributing to inflammation and atherosclerosis. The body of relevant evidence is expansive.

What this means is that even if there are harms attached to some saturated fats, summary judgment against the whole clan was never valid. The combination of parsing and over-simplification invites the devils in the details to run amok. That clearly happened here. If we focus only on cutting saturated fat, we can find new ways to eat badly. We have, over the years, done exactly that. Of note, we can do the same when cutting carbs, or gluten, or fructose, or sugar, or meat, or grains, or salt, or wheat, too. Diet never was, and never will be, a single ingredient enterprise. The whole recipe matters.

Demonizing saturated fat never helped us much. Canonizing it now won’t help us any either. All who share a concern for eating well and the health advances that can come from it must band together to renounce the perennial branding of this, that, or the other food component as scapegoat, or saint. It is, and always was, the big picture - the overall dietary pattern, and for that matter lifestyle pattern that matters. We could cut saturated fat and eat better, or worse, depending on what we eat instead.

A bounty of science along with an application of sense points very reliably to variations on the theme of optimal eating for Homo sapiens. We could all get there from here, and by so doing, add years to life, add life to years, and love food that loves us back. None of this will happen though if we replace the follies of history with old mistakes in new directions.’

Disease-Proof. DNA is not destiny.

 – David Katz’ latest book, Disease-Proof: The remarkable truth about what makes us well is available at bookstores throughout the US and Canada and online HERE.

Dr Alan Barclay says: "While it is wise to reduce the amount of saturated fat you consume, what you replace it with is vitally important. Either unsaturated fats or low GI carbohydrates are the best choice. To ensure the right balance of fats consumed, we recommend that for every gram of saturated fat you consume you eat 2 g of unsaturated fat (like those found in extra virgin olive oil, avocado, nuts, seeds, fatty fish, etc.), or in other words, your saturated fat : unsaturated fat ratio is less than 0.33. To help you achieve this, we are now including saturated: unsaturated fat ratios in all of the recipes published in GI News". 

Is the origin of type 1 diabetes in the gut? 
An in depth review by Outi Vaarala (Immune Response Unit, Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland) published in Current Diabetes Reports  looks at the role of the intestinal microbiota in type 1 diabetes. Here’s the Abstract:

Outi Vaarala

‘The role of intestinal microbiota in immune-mediated diseases, such as type 1 diabetes, has deservedly received a lot of attention. Evidently, changes in the intestinal microbiota are associated with type 1 diabetes as demonstrated by recent studies. Children with beta-cell autoimmunity have shown low abundance of butyrate-producing bacteria and increase in the abundance of members of the Bacteroidetes phylum in fecal microbiota. These alterations could explain increased gut permeability, subclinical small intestinal inflammation, and dysregulation of oral tolerance in type 1 diabetes. However, these studies do not provide evidence of the causative role of the gut microbiota in the development of beta-cell autoimmunity, yet. In animal models, the composition of gut microbiota modulates the function of both innate and adaptive immunity, and intestinal bacteria are regulators of autoimmune diabetes. Thus, prevention of type 1 diabetes could, in the future, be based on the interventions targeted to the gut microbiota.’

What’s new? 
The Bread And Butter Project. 
Bourke Street Bakery co-owner Paul Allam was inspired to set up The Bread And Butter Project following a trip to Mae Sot on the Thai-Burmese border, where at the invitation of a local orphanage, he taught a group of Karen refugee women how to bake bread and helped establish a social business to support these women and the orphanage.

The Bread And Butter Project

Back home, Paul along with his business partner and friend, David McGuinness, have used their baking skills and community spirit to set up a social enterprise bakery to empower the disadvantaged in Sydney – the current trainees are all refugees. If you live in Sydney, here’s where you can buy their sourdough bread.

Philippa’s cookbook shelf.
 #1 The Gentle Art of Preserving (Kyle Books): I picked this up because it has a whole chapter on fermenting including making water kefir, creamy yoghurt and labne (strained yoghurt). I was also curious to read what they said about preserving plums because when I was growing up we had four plum trees and my mother’s summer days were busy bottling plums and making jam and chutney. And although I would help her, I realised too late that I didn’t have her recipes. This book is a collection of Katie and Giancarlo Caldesi’s favourites including Italian cured charcuterie, jams and chutneys, pickling, fermenting, freezing and pressure canning.

#2 Smashing Plates (Kyle Books): I have always loved Greece and Greek food. A tag line ‘Greek flavours redefined’ was irresistible. What would Maria Elia do with traditional slow-roasted lamb (she marinates it with lemons, dill, cinnamon and cumin, wraps in paper and roasts for four hours). How easy is that? But it’s her salads and sides that will be crowd pleasers for GI News readers and her deliciously simple ways to up the veggie intake – Carrot Tabbouleh, a choice of Potato, Parsnip or Pomegranate Skordalia, Broad Beans and Mint Houmous, Lemon and Dill Braised Broad Beans, White Bean, Artichoke and Basil Houmous, Lemon and Oregano Roasted Tomatoes with Kefalotyri (or Pecorino) and Tomato Bulgar Pilau.

Nicole's Taste of Health

Say Cheese! 
It’s no wonder ‘cheese’ is the word most often used to make us smile for photographs: even the thought of it makes us happy. The story of cheese as a preservation method for milk through to artisanal masterpieces and myriad types, flavours, textures and culinary uses today, is a fascinating one.

The favoured theory of how cheese was born is that over 7,000 years ago, nomadic shepherds in the Middle East were carrying milk in a bag made from the stomach of a goat or sheep and the milk curdled. What they accidentally discovered was the milk reacted with the enzymes (rennet) in the stomach lining and caused the curd (solid), to separate from the whey (liquid), in a process used to this day to make cheese.

Four simple ingredients make up most standard cheese; milk, rennet, salt and lactic acid bacteria, which together create a wide range of flavour compounds which give cheese its unique flavour. In a kind of magical conjuring double-act between Mother Nature and cheese-makers; tweaking the type of bacteria added, salt, moisture levels and aging time can produce thousands of different types of cheese. To keep your cheese nice, store it loosely wrapped in wax paper inside a container or plastic bag to prevent trapped moisture causing mould, and to prevent the cheese picking up odours and flavours from plastic and other foods in the fridge.

Tomatoes
Photo: Ian Hofstetter, The Low GI Vegetarian Cookbook (Hachette Australia)

Cheese is one of the richest food sources of calcium that is highly bio-available, which makes sense when you consider it a concentrated form of milk. Many of us – especially women, children and teenagers – don’t get enough calcium so perhaps we should ‘say cheese’ more often. Until recently, the prevailing thought about cheese was one of a nutrition trade-off: sure, it’s rich in calcium, phosphorous, protein, vitamins A, B12, riboflavin and zinc, but what about all that saturated fat and salt?

Emerging research has been reassuring and points to the idea that there’s something about dairy – including cheese – that appears to offset the negative nutrients it contains. Population studies have found no association between cheese intake and risk of ischemic heart disease, but rather that eating cheese is associated with a REDUCED risk of cardiovascular disease, stroke and high blood pressure. Exactly why this is the case is not certain, although the fermentation process and perhaps calcium are implicated. Cheese and dairy foods are at the frontline of the paradigm shift taking place in the nutrition world that puts the whole food and not just its key nutrients at the centre of their effects on health.

Many kids could do with eating more cheese to get their daily calcium and to replace less nutritious snacks. While even your kids could tell you cheese is good for bones, cheese is also good for teeth. It inhibits tooth decay (is non-cariogenic), and provides a protective coating for teeth (cariostatic ) due to its casein (protein), calcium and phosphate which buffer plaque pH by reducing tooth enamel solubility and bacterial adherence. This tooth-friendly status makes it an excellent snack to eat away from home when they can’t brush their teeth. There’s no need to buy processed, packaged types: just take a slice off the old block and pop it into a container. It goes wonderfully well with cherry tomatoes, celery, carrot sticks and apple. As an after school snack, cheesy toast is easy-peasy (on wholegrain, low GI bread of course).

Typically the harder the cheese, the more calcium it contains: cheddar trumps gooey camembert and Swiss trumps stinky brie. Cream cheese is a mixture of cheese and cream so there’s less goodness to speak of; sadly, cream and butter are not blessed with the health benefits of milk, cheese and yoghurt. And processed cheese spread? Enough said. I’ve heard people say they are lactose intolerant as a reason for passing on the cheese plate however hard cheese has zero lactose, and softer cheeses contain very little: ricotta contains less than one tenth of one percent lactose (and you can check lactose content within the nutrition information panel – it will be the carbohydrate and/or sugars content).

Having said all this, we probably need to stop short of gay abandon in the cheese department. It is unlikely that ‘plastic’ cheese in a can (low calcium, high salt) sprayed over hot dogs (processed meat and high GI carbohydrate) is going to be of benefit to health, but there’s no need to ‘hold the cheese’ on your salad sandwich or miss out on the golden gooey goodness of melted cheese on your lasagne, or sprinkle of parmesan on your spaghetti. A little bit of cheese can go a long way to add flavour and protein to a meal or snack. The (newly revised) Dietary Guidelines for Australians sum up the situation by suggesting to limit cheese to 2–3 serves a week or choose reduced fat types, and warn against too much of the saltier cheeses such as fetta: sounds prudent and reasonable.

When all this cheese science is melted down, you’re better off (and always have been) eating a core food like cheese than consuming so-called ‘discretionary foods’ like sweets, soft drinks and fried savoury snacks. This reassurance about cheese is good news for those who prefer the cheese plate than the dessert menu but of course the biggest issue for us all is avoiding weight gain so perhaps we’d all be better off with herbal tea after dinner!

[NICOLE]

Nicole Senior is an Accredited Practising Dietitian and Nutritionist, author, speaker, consultant, and commentator with an interest in how we can learn to love good food that's good for us.

In the GI News Kitchen

Family Baking, Anneka Manning, author of Bake Eat Love. Learn to Bake in 3 Simple Steps and founder of Sydney’s BakeClub, shares her delicious ‘better-for-you’ recipes for snacks, desserts and treats the whole family will love. Through both her writing and cooking school, Anneka teaches home cooks to bake in practical and approachable yet inspiring ways that assure success in the kitchen.

 Anneka Manning
Zucchini, quinoa and egg slice.
This simple savoury slice makes a fabulous light meal accompanied by a green salad or a perfect snack – a nutritious addition to any school or work lunch box. Serves: 8 with salad as a light meal or 12 as a snack

1/3 cup white quinoa
1/3 cup water
1 tbsp olive oil
1 brown onion, chopped
100g (3½oz) shortcut bacon rashers, chopped
350g (12oz) zucchini (courgettes), coarsely grated
5 eggs, lightly whisked
40g (1½oz) finely shredded parmesan
½ cup coarsely chopped flat leaf parsley
Freshly ground black pepper, to taste
1/2 cup self-raising flour
75g (2½oz) feta, coarsely crumbled (optional)

Zucchini, quinoa and egg slice.

Preheat the oven to 180°C (350°F). Lightly grease an 18 x 28cm/7 x 11in (base measurement) shallow slice tin and then line the base and two long sides with one piece of non-stick baking paper.
Place the quinoa and water in a small saucepan. Bring to the boil over high heat. Reduce heat to low, cover the saucepan and simmer gently for 12 minutes or until all the water is absorbed and the quinoa is tender. Remove from heat. Meanwhile, heat the olive oil in a frying pan over medium-high heat and cook the onion and bacon, stirring occasionally, for 5–8 minutes or until the onion is soft and starting to colour.
Transfer to a large bowl. Add the quinoa, zucchini, eggs, parmesan, parsley and pepper to the onion mixture and stir with a wooden spoon to combine. Add the flour and stir to combine.
Spoon the mixture into the lined tin and use the back of a spoon to smooth the surface. Sprinkle with the feta if using.
Bake in preheated oven for 30 minutes or until cooked when tested with a skewer. Stand in the pan for 5 minutes before turning onto a cutting board.
Serve warm or cold with a salad for a light meal or as a snack.
Baker’s Tip This slice will keep in an airtight container for up to 2 days. 

Per serve
885 kJ/ 210 calories; 14 g protein; 12 g fat (includes 4 g saturated fat; saturated:unsaturated fat ratio 0.33); 12 g available carbs; 2 g fibre

Here's how you can 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 Spiced little carrots with chickpea-sauerkraut puree from Vedge.

Spiced Little Carrots with Chickpea-Sauerkraut Puree.
Serves 8

4 tbsp olive oil
1 tbsp Montreal Steak Spice Blend (see below)
2 tsp sherry vinegar
1½ tsp salt
½ tsp ground cloves
2 medium garlic cloves, 1 minced and 1 smashed
2 pounds (1 kg) young or baby carrots, tops removed, leaving 1 inch (2.5cm) of stem intact (substitute ‘baby-cut’ carrots if necessary)
2 cups cooked chickpeas or one 15-ounce (400g) can chickpeas, rinsed and drained
¾ cup bottled sauerkraut with 2 tbsp of its juice
2 tbsp minced fresh dill
2 tbsp Dijon mustard
1 tsp freshly ground black pepper

Spiced Little Carrots with Chickpea-Sauerkraut Puree.

Preheat the oven to 350°F/180C.
In a medium bowl, whisk 2 tablespoons of the olive oil, the steak spice blend, vinegar, ½ teaspoon of the salt, the cloves, and the minced garlic. Add the carrots and toss until combined.
Transfer the carrots to a sheet pan, cover with aluminum foil so that they will steam through, and roast until fork-tender, 15 to 18 minutes.Remove the foil and continue to roast until the carrots are soft, an additional 3 to 5 minutes. Remove the pan from the oven and allow the carrots to cool.
Meanwhile, to make the puree, combine the chickpeas, sauerkraut and its juice, dill, mustard, pepper, remaining 2 tablespoons olive oil, remaining 1 teaspoon salt, and the smashed garlic clove in a food processor. Process into a smooth, hummus-like consistency.
To serve, spread the bean puree onto a serving plate and arrange the carrots, either still warm or fully cooled, on top.

To make the spice blend, grind the following spices separately to achieve a uniform consistency: 2 tbsp coarse sea salt, 2 tbsp black peppercorns, 1 tsp caraway seeds, 1 tsp coriander seeds, 1 tsp cumin seeds and 1 tsp fennel seeds. Mix together with 1 tsp celery seeds.

Per serve 
765 kJ/ 180 calories; 4.5 g protein; 10.5 g fat (includes 1.5 g saturated fat; saturated:unsaturated fat ratio 0.14); 14.5 g available carbs; 7.5 g fibre

 – Recipe from Vedge: 100 Plates Large and Small That Redefine Vegetable Cooking, copyright © Rich Landau and Kate Jacoby, 2013. Reprinted by permission of the publisher, The Experiment.

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

[JOHANNA]

Breaded Cauliflower.
My grandmother, and hence, my mother and aunts, breaded everything. This recipe can work for a wide variety of vegetables (especially zucchini, eggplant, butternut squash, fennel, celery, etc.) and also for fish, chicken, beef and pork filets. Servings: (8 approximately 1-cup serves)

1 large head of fresh cauliflower
1/2 cup seasoned breadcrumbs
1/4 cup grated parmigiano reggiano
1/3 cup egg whites
1-2 tbsp extra virgin olive oil

Breaded cauliflower.

Cover the bottom of a 9x13in (22cm x 33cm) jelly roll pan with parchment paper or no-stick cooking spray. Preheat oven to 400 degrees F (200C).
Remove the outer leaves and stem base of the cauliflower. Separate florets into bite-size pieces. Place the florets into a steamer and cook for 5-8 minutes. Set aside to cool.
In a small bowl mix the breadcrumbs and cheese. Set aside.
Place the florets in a large shallow bowl. Pour eggs whites over them and mix well. Arrange the florets in the prepared pan.
Sprinkle the breadcrumb mixture on top, turning them over to cover both sides. Drizzle oil over the florets. Bake for 30 minutes, turning once. Serve hot.

Per serve
350kJ/ 85 calories; 5g protein; 3g fat (includes less than 1g saturated fat; ; saturated:unsaturated fat ratio 0.33); 11g available carbs; 4g fibre

We Are What We Ate

Trading cheese has a long tradition 
In her ‘Say Cheese’ piece in this issue, Nicole Senior reminds us of the pleasure of a good piece of cheese. It’s certainly a food that’s long had value and currency for consumers as the following extracts will show. First, here’s what Daniel Defoe wrote about cheese in his Tour Through the Whole Island of Great Britain

‘All the lower part of this county [Wiltshire], and also of Gloucestershire, adjoining, is full of large feeding farms, which we call dairies, and the cheese they make, as it is excellent good of its kind, so being a different kind from the Cheshire, being soft and thin, is eaten newer than that from Cheshire. Of this, a vast quantity is every week sent up to London, where, though it is called Gloucestershire cheese, yet a great part of it is made in Wiltshire, and the greatest part of that which comes to London, the Gloucestershire cheese being more generally carried to Bristol, and Bath, where a very great quantity is consumed, as well by the inhabitants of two populous cities, as also for the shipping off to our West-India colonies, and other places. This Wiltshire cheese is carried to the river of Thames, which runs through part of the county, by land carriage, and so by barges to London.

Again, in the spring of the year, they make a vast quantity of that we call green cheese, which is a thin, and very soft cheese, resembling cream cheeses, only thicker, and very rich. These are brought to market new, and eaten so, and the quantity is so great, and this sort of cheese is so universally liked and accepted in London, that all the low, rich lands of this county, are little enough to supply the market; but then this holds only for the two first summer months of the year, May and June, or little more. Besides this, the farmers in Wiltshire, and the part of Gloucestershire adjoining, send a very great quantity of bacon up to London, which is esteemed as the best bacon in England, Hampshire only excepted: This bacon is raised in such quantities here, by reason of the great dairies, as above, the hogs being fed with the vast quantity of whey, and skim’d milk, which so many farmers have to spare, and which must, otherwise, be thrown away.’

Want to know more about this ‘green cheese’? Here’s what Andrew Dalby says in his very readable Cheese, A Global History from Reaktion Books’ deliciously digestible Edible series.
green cheese
‘It was called green not from its colour but from its freshness, and this metaphor goes a long way back. In ancient Athens in the late fifth century BC, every month on the day of the new moon was held a fair called simply ho chloros tyros, “the Green Cheese”. We know this because of the advice reported in a lawsuit, that if one were looking for a man from Plataiai one would be sure to find him at this fair. Plataiai was a small hill town a few miles north of Athens: therefore we know that the economy of nominally independent Plataiai depended almost wholly on supplying fresh cheese to Athens. This is what big cities do to their neighbours. Ancient Rome liked its young Vestine cheese from the nearby Apennines: the best was from campus Caedicius, says Pliny. Nearly two thousand years later London and Bristol drew Wiltshire dairy farmers into producing green cheese to be dispatched in barges eastwards down the Thames and westwards down the Avon; and at the same moment Paris called on Viry, Vincennes and Montreuil for its fresh cream cheeses and on Neufchâtel and the Pays de Brie for fine cheese that required just a little longer to mature (ten days in the case of Neufchâtel).’

GI Symbol News with Dr Alan Barclay

Alan Barclay
Dr Alan Barclay

New American Diabetes Association (ADA) nutrition guidelines for adults with diabetes. 
The ADA has published its latest edition of the Nutrition Therapy Recommendations for the Management of Adults With Diabetes, the first major update in 5 years. Perhaps unsurprisingly, they are evolutionary rather than revolutionary. One of the more important aspects of the ADA guidelines is their Goals of nutrition therapy. While they importantly set targets for common diabetes complications risk factors, they equally importantly put these into the context of the cultural aspects of food, eating and mealtimes.

  • “To address individual nutrition needs based on personal and cultural preferences, health literacy and numeracy, access to healthful food choices, willingness and ability to make behavioural changes, as well as barriers to change.” 
  • “To maintain the pleasure of eating by providing positive messages about food choices while limiting food choices only when indicated by scientific evidence.” 
  • “To provide the individual with diabetes with practical tools for day-to-day meal planning, rather than focusing on individual macronutrients, micronutrients, or single foods.” 
After all, food is one of life’s pleasures whether you have diabetes or not – there is absolutely no point in avoiding any particular food or drink unless there’s good evidence to do so.

One of the most debated issues over the past few millennia has been how much carbohydrate (sugars and starches), fat and protein can or should a person with diabetes eat? In line with its broader goals, the ADA states that:
  • “Evidence suggests that there is not an ideal percentage of calories from carbohydrate, protein, and fat for all people with diabetes; therefore, macronutrient distribution should be based on individualized assessment of current eating patterns, preferences, and metabolic goals.” 
In practice, this means that a person with diabetes should work with their dietitian and other members of their health-care team to nut out what is best for them as an individual, rather than follow the latest fad diet.

Recommendations for saturated (less than 10% of kilojoules/calories) and trans fat (as little as possible) and sodium (less than 2,300 mg/day) are the same as those for the general population.

Importantly for readers of GI News, the latest ADA Guidelines now incorporate specific recommendations for use of the glycemic load (GL = GI x grams available carbohydrate per serve) for the management of diabetes. This means that all of the evidence-based recommendations for the management of diabetes from the major diabetes organisations around the globe now advise people to use of the GI or GL as part of the nutritional management of diabetes, including the Canadian Diabetes Association and Diabetes UK.

Although it is possible to lower the GL of your diet by either eating a low carb diet, or by eating a moderate or even high carb diet but with more low GI foods, the scientific evidence about the benefits of low GL diets is based on studies where people ate moderate amounts of healthy low GI foods – carbohydrates were about 40–50% of their total calories (kilojoules).

Here’s how you can enjoy a low GL diet. Simply use the low GI swap it approach. Choose the food/drink within each food group/category that has the lowest GI value (and that is a healthy choice overall, of course). Because foods within a group/category by definition have similar macronutrient (carbohydrate, fat and protein) contents, by choosing the food with the lowest GI, in most cases you are also choosing the food with the lowest GL. You can use our new Simple Low GI Swaps tool on our updated website www.gisymbol.com.

Swap it

The GI Symbol helps you identify healthy foods and drinks with both a lower GI and GL.

The GI Symbol, making healthy low GI choices easy choices

New GI Symbol

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

GI Update with Prof Jennie Brand-Miller

Prof Jennie Brand-Miller answers your questions. 

Jennie


I know that type 2 diabetes is one of the fastest growing chronic diseases worldwide. Do we know why this is so and what people like me (it runs in my family) can do to prevent getting it? 
The global increase in the prevalence of type 2 diabetes is being driven by the rise in overweight and obesity in all age groups. The reasons behind our weight gain creep are complex but include a simultaneous increase in global food abundance together with increased sedentariness and decreased physical activity during both work and possibly leisure time. Recent studies have also indicated that a deviation from the normal sleeping pattern of 7–8 hours sleep per night, particularly short duration of sleep, increases appetite and promotes obesity and its related diseases (e.g. type 2 diabetes and cardiovascular disease).

There are two ways to prevent type 2 diabetes: by preventing weight gain in the first place and by preventing people who already have pre-diabetes from progressing to diabetes with weight loss and maintenance. The main drivers in both situations are changes in dietary and physical activity patterns, but we also need to address disturbed sleep patterns and workplace stress. Unfortunately, despite convincing evidence from clinical trials that type 2 diabetes can be prevented or delayed through intensive lifestyle interventions resulting in weight loss, the reality is that weight regain and incremental weight ‘creep’ are very common. It is possible that this may jeopardise diabetes prevention and it remains to be seen the effect of a longer period of weight maintenance on prevention.

The recent Diogenes Study (Diet, Obesity and Genes) identified two dietary factors associated with shorter-term prevention of weight regain after prior weight loss: higher protein intake and lower glycaemic index (GI). The findings showed that overweight and obese participants assigned to the combination of modestly higher protein and lower GI ad libitum had significantly better completion rates and weight maintenance after six months as compared with the official dietary guidelines. Indeed, those consuming the high protein-low GI combination diet continued to lose weight during the weight maintenance phase and were twice as likely to have maintained a 5% weight loss compared to the other groups.

Here at the University of Sydney we are one of eight sites around the world taking part in the 3-year international PREVIEW Study. Its primary goal is to identify the most efficient lifestyle intervention pattern for the prevention of type 2 diabetes in people who are pre diabetic overweight or obese individuals (i.e. those at high risk of diabetes). The aim of this study is to find out the best methods (through diet, exercise and behavioural modification) of maintaining weight loss and keeping diabetes at bay. Individuals taking part in this study will have their own team of professionals dedicated to their weight loss and weight loss maintenance, all free of charge. We are recruiting participants now. If you are:

  • Between the ages of 25–45 or 55–70 years 
  • Overweight 
  • Have a blood relative with diabetes 
  • Been told you have pre-diabetes or impaired glucose tolerance you may be eligible to participate. 
This brochure will tell you about the study and how you can take part if you are eligible.

New GI Values from SUGiRS
Sustagen® Diabetic now has the GI Symbol 
Sustagen has been around a long time. It is a supplement designed for people finding it difficult to meet their nutritional requirements through regular food alone. There are a variety of products for specific purposes. Nestle Health Science have just launched Sustagen® Diabetic (vanilla flavour), specifically formulated to be low GI (34) for people with diabetes or pre-diabetes (type 1 or type 2) who are not eating well, or have a poor appetite, or are ill or recovering from illness. It provides essential nutrition without negatively impacting blood glucose levels. To be used under medical supervision.

Sustagen® Diabetic
  • To make 1 serving, mix 7 level of scoops with 210ml water (or milk), stir and serve chilled or warmed (210ml is about ¾ cup).
  • Nutrition information for 1 serving mixed with water: 25g carbohydrate and 8g fibre, 11g protein, 11g fat
  • Glycemic load (GL) 1 serving = 3 
  • For more information: www.sustagen.com.au 
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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1 October 2013

GI News—October 2013

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  •  Sleep and diabetes risk;
  •  Is insulin response more important than the GI value?
  • Tomato Magic with Nicole Senior;  
  • Four recipes including Wonton asparagus soup and Anneka's Baked eggs in nests with tomato and spinach;  
  • The difference in being rich or poor in gut bacteria;  
  • Dr David Katz new book: Disease Proof;   
  • China's diabetes epidemic, Dr Alan Barclay reports.    
GI News 
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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

Sugar, diabetes and why the state of our health is not about any one thing. 
Many of the nutrition studies we share with GI News readers are prospective studies. Looking at large groups of people over a period of time (usually many years), the researchers mine the data (rather like gold prospectors) looking for links between diet (e.g., consumption of fruit or vegetables or red meat or whole grains or sugar) and health. What you need to remember when you read (or watch) headline-hitting health stories featuring research findings from such studies is that the correlations or associations they find don’t actually establish causation. Prof David Katz comments on a recent study in Plos One using econometric models of repeated cross-sectional data of the association between sugar intake and diabetes around the world. Here is an edited summary of his Huffington Post piece reproduced with permission. 

Dr David Katz
Dr. David Katz

‘The study itself, published in the journal Plos One, is excellent overall. This kind of ecological evaluation – looking at an association between X and Y at the population level is certainly of some value. But it is absolutely not the “closest thing to causation” – in fact, it is among the least reliable forms of evidence. At the population level, the presence of a Bentley in the driveway, or a high-speed Internet connection in the home, is profoundly associated with reduced likelihood of malaria (or tuberculosis, or leprosy, etc.). This is absolutely not because Bentleys or the Internet protect against leprosy or malaria. Rather, affluent people with expensive cars and high-speed Internet access are much less likely to encounter malaria or leprosy than the poor for reasons having nothing to do with horsepower, or bandwidth.

Fundamentally, Dr Basu’s team found that the greater the availability of daily calories from sugar around the world, the more diabetes. I’m having some trouble figuring out what is supposed to be surprising about this. If people add sugar calories to their diets, they are getting both more sugar, and more calories, and those exposures alone and together are well known to contribute to diabetes risk. If they are adding sugar calories in place of other calories, then the percentage of total daily calories coming from sugar is going up, and the overall quality of diet is going down. Again, this pattern is pretty well linked to diabetes risk (and other chronic disease risk, for that matter) already.

To some extent, the Basu study was a self-fulfilling prophecy. It’s true the researchers looked at other associations between diet and diabetes. But consider that one food category was “meat,” which presumably lumped together everything from salmon to salami. Some such “meats” likely defend against diabetes, while others would likely increase risk. Lumped together, nothing much would be visible. Similarly, there was a category of “cereals,” but with no distinction between whole grains and refined starch. Putting everything from steel-cut oats to Cap’n Crunch in one category would not facilitate keen insights. The authors did not look at nuts and seeds, despite numerous studies – including one just published in the Journal of Nutrition – demonstrating that higher intake of walnuts and other nuts is associated with reduced diabetes risk.

Since Dr Basu’s methods involved looking at sugar dose available in the food supply per person per day, and the prevalence of diabetes in the population, there is nothing in the data to prove that those who ate the most sugar were most likely to develop diabetes – although one may infer that. Rather, as countries make more sugar calories available each day (i.e., become more like the US), their populations have more diabetes. Again, this is not terribly surprising.

But it’s more than a little wrong to conclude that since sugar intake contributes to diabetes risk, nothing else matters. In fact, Dr Basu and colleagues state explicitly that increasing sugar availability accounts for roughly one-quarter of the global rise in diabetes rates between 2000 and 2010. This clearly implies that something other than sugar accounts for almost 75 percent of that increase.

The reality, alas, is that the state of our health is not about any one thing. We can cut fat, and get fatter and sicker – by eating more starchy, sugary junk. We can cut carbs by switching from beans to baloney, and get fatter and sicker. And we can cut sugar and consume ever more artificially-sweetened, starchy, fatty junk – and get fatter and sicker. We clearly like little bits of truth we find easy to digest. But none of these is the whole truth, and when bits of truth are mistaken for the whole – they might just as well be falsehoods.’

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 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