1 July 2014

What's new?

ICEMAN and the blood glucose benefits of keeping cool.
Studies by endocrinologist Dr Paul Lee from Sydney's Garvan Institute of Medical Research have shown that people with plentiful brown fat stores tend to be lean and have low blood glucose levels. His recent ICEMAN study in Diabetes demonstrates that ambient temperatures can influence the growth or loss of brown fat in people. Cool environments stimulate growth, warm environments loss.

Dr Paul Lee

Brown fat, also known as brown adipose tissue, is a special kind of fat that burns energy to generate heat. It keeps small animals and babies warm, and animals with abundant brown fat are protected from diabetes and obesity. For the ICEMAN study, 5 healthy men were recruited and exposed to four, month-long periods of defined temperature – well within the range in climate-controlled buildings – at the NIH Clinical Centre. They lived their normal lives during the day, and returned each night to the centre, staying for at least 10 hours in a temperature-regulated room. Baseline temperature was established in Month 1 (24ºC), a “thermo-neutral” temperature at which the body does not have to work to produce or lose heat.

“What we found was that the cold month (Month 2: 19ºC) increased brown fat by around 30–40%. During the second thermo-neutral month (Month 3) at 24 degrees, the brown fat dropped back, returning to baseline. When we put the temperature up to 27 degrees during the fourth month, the volume of brown fat fell to below that of baseline,” says Lee. Among the metabolic benefits of increased brown fat was heightened insulin sensitivity. This suggests that people with more brown fat require less insulin after a meal to bring their blood sugar levels down.

"The improvement in insulin sensitivity accompanying brown fat gain may open new avenues in the treatment of impaired glucose metabolism in the future. On the other hand, the reduction in mild cold exposure from widespread central heating in contemporary society may impair brown fat function and may be a hidden contributor to obesity and metabolic disorders," Lee said. "So in addition to unhealthy diet and physical inactivity, it is tempting to speculate that the subtle shift in temperature exposure could be a contributing factor to the rise in obesity.”

It’s only a small, short-term study but we think the results are interesting and make sense. It would be good to see a larger, longer term follow up study.

Canola bread diet reduces BGLs and LDL cholesterol. 
A number of studies in recent years have linked low GI diets with a reduction in both type 2 diabetes and cardiovascular events, and have shown monounsaturated fats such as canola and olive oil reduced the risk of cardiovascular disease. A new study published in Diabetes Care puts the two together. The research team led by Dr David Jenkins, compared people with type 2 diabetes who ate either a low GI diet that included bread made with canola oil, or a wholewheat diet known to reduce the risk of cardiovascular disease. The volunteers on the canola bread diet experienced both a reduction in blood glucose levels and a significant reduction in LDL or “bad” cholesterol. “Even more exciting,” says Dr Jenkins, “was the finding that the canola bread diet seemed to have the most significant impact on people who needed help the most – those whose HbA1c test measuring blood glucose over the previous two or three months was highest.”

Azmina’s tips for safe fasting during Ramadan. 
People with diabetes who wish to fast need to be careful says leading UK dietitian Azmina Govindji. ‘The reason why you need to take care is that some drugs used to treat type 2 diabetes (e.g., sulphonylureas) and insulin can make your blood glucose level drop too low when you are not eating. Not drinking enough water can also make you dehydrated. Often the evening meal, Iftar, contains lots of carbs (starches and sugars) and perhaps sugary drinks. Because this is a time when families eat together to break the fast, the food is richer than you may be eating normally. And you may feel having fasted all day long you have an excuse to reward yourself. You need to be particularly strong willed at this time.’ Here’s Azmina’s checklist for safe fasting:

  • Seek the advice of your healthcare team before starting and at the end of the fast, since they may advise you to change the times or amount of medication you take.
  • Do not stop taking your medication.
  • Avoid eating lots of unhealthy foods as a reward!
  • Try and maintain a healthy eating pattern after you break the fast. Make sure that you have lots of fruit and vegetables and dal as these are slowly digested and help your blood glucose to rise more slowly too.
  • Remember to drink plenty of fluids.
  • Divide your daily food intake into two equal portions, one to be taken at Sehri and one at Iftar
  • Remember to check your glucose level regularly, at least once a day at different times of the day.
  • After the period of Ramadan, visit your doctor for a checkup. 
Here is an article Azmina recommends if you need more information. 

Warrigal greens: matching bush tucker with store-bought food. 
Over the next few months, Kerith Duncanson and the team from the Nutraditions project in Worimi and Biripi country on the New South Wales Mid North Coast (Australia) will look at some contemporary equivalents to traditional “bush tucker” foods in the Aboriginal diet.
    Warrigal greens

    Warrigal greens or New Zealand spinach (Tetragonia tetragonoides) is a sprawling groundcover with edible soft stems and light green, heart-shaped leaves that must be cooked or blanched in boiling water before eating because of their high oxalate content. (Don’t use the water – tip it out.) The leaves are rich in antioxidants, iron and in vitamin C (which helps us absorb iron from plants). This was the green “veg” that Captain Cook spotted, picked, cooked and pickled to help fight scurvy on HMS Endeavour; Joseph Banks took seeds back to Kew thus giving warrigal greens to the world; and early settlers used it as a substitute for spinach. You are unlikely to find them in the supermarket or local produce market, but they are very easy to grow in the right conditions (moist, reasonably drained soils in the sun or partial shade) – they don't require much water or attention. Propagate from an existing plant or pick up a packet of seeds for ground cover in a sunny garden that also provides a tasty, nourishing food source. The closest store-bought equivalent is Chinese cabbage, although rocket, kale, spinach and baby spinach have similar nutritional profiles.

    Use warrigal greens as an alternative to spinach or kale in soups, stirfries, frittatas and omelets and recipes such as warrigal greens pie, spinach and warrigal green gnocchi or whip up this dish of Warrigal Greens and Ricotta Cannelloni. 
    Ingredients: ½ small butternut pumpkin; 1 onion, finely diced; 2 tablespoons crushed garlic; 1 cup cooked and drained warrigal greens; 1 packet fresh lasagne or cannelloni sheets; 250g (½lb)  tub ricotta cheese; 500g (1lb) tomato pasta sauce; 1 cup grated light cheese
    Method: Chop pumpkin into 1cm (½in) thick slices and roast in a preheated oven on an oiled baking tray. When cooked, cool, remove skin and dice flesh • Sauté onion and crushed garlic in olive oil in a large pan. Add pumpkin and greens. Combine thoroughly • Lay out lasagne sheet and cut into 10cm (4in) wide strips • Spoon a heaped tablespoon of spinach mixture along the middle of the sheet. Top with a tablespoon of ricotta. Roll lasagne up and place in a baking tray. Repeat until mixture used up • Drizzle over the tomato pasta sauce and top with grated cheese. Cook in a pre-heated (180oC/350F) oven for 20 minutes or until done (most of the sauce will have evaporated). Serve hot or warm with salad. 
    Where to buy? Ask your fresh produce store if they can get them for you or check out local farmers’ markets. Alternatively, you can buy them online from bush food stockists such as Something Wild and Outback Chef.

    Healthy Kids Lunch Boxes: Baking Classes.  
    BakeClub Anneka Manning runs these demonstration classes three or four times a year. We were going to tell you about the one in July in Sydney (Australia), but it has already sold out. The next class is 18 October 2014. In these classes, Anneka compares store-bought muffins, muesli bars, biscuits and loaves with  home-baked, better-for-you versions, talks about the problem ingredients to look out for when packing lunches and shows you how easy it is to fill lunch boxes with healthy sweet and savoury alternatives, that also make great after-school snacks before the kids head off for sports practice.You can find out more about the classes and sign up for Anneka's free monthly newsletter here.