GI News - December 2017

GI News is published by the University of Sydney, School of Life and Environmental Sciences and the Charles Perkins Centre

Publisher: Professor Jennie Brand-Miller, AM, PhD, FAIFST, FNSA
Editor: Philippa Sandall
Scientific Editor/Managing Editor: Alan Barclay, PhD
Contact GI News: glycemic.index@gmail.com

Sydney University Glycemic Index Research Service
Manager: Fiona Atkinson, PhD
Contact: sugirs.manager@sydney.edu.au

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FOOD FOR THOUGHT

EYE PROTECTION
Back in July GI News we focused on our eyes because protecting our eyesight is one of the most important things we can do for the quality and enjoyment of life. Evidence to date says the ayes have it for a good diet with plenty of veg (good carbs and leafy greens) rich in lutein and zeaxanthin.” We recently came across some kids’ lutein and zeaxanthin supplements that claim to “guard” or “shield” their young eyes from harmful blue light. We asked ophthalmologist Dr Shanel Sharma to tell us about blue light, whether such a supplement could guard kids’ eyes from it, and what tips she has for parents to protect their kids’ eyes to ensure their enjoyment of life.



Blue light refers to the light at the blue end of the visible spectrum. Most of the blue light that enters our eyes comes from the sun and the blue light we absorb from digital devices is very low in comparison to that. That said, it is worth noting that there is no evidence to date to suggest that blue light is harmful to human eyes. Despite this, parents are often made to feel guilty that their child is exposed to blue light from the digital devices that have now become a part of everyday life.

What about the blue light science? Retinal surgeon Dr Daniel Polya reports: “There is some evidence that taking a plate of rodent retinal cells in a lab and exposing them to high intensity blue light can cause damage to those cells. However, the doses of light in this study are not reflective of real life situations, and thus the clinical relevance of these studies has to be questioned.”

What this shows is that while it is possible to create artificially a situation in which high intensity blue light can cause damage to exposed retina cells, this doesn’t reflect the real world. For example, the intensity of the blue light used in these experiments is much higher than we would be exposed to in real life, regardless of how long a person is exposed to digital devices. Therefore, using this type of experiment to “prove” the need for blue light protection is misleading.

In terms of taking supplements such as lutein and zeaxanthin to protect our eyes, the truth is that our bodies are very well equipped to absorb these from our food, and in fact over supplementing might have a negative effect. Associate Prof Wilson Heriot from Melbourne University says: “Eating a healthy diet, which includes green leafy vegetables, tomatoes, carrots, capsicum and oranges is all we need for a natural source of these vitamins. Our body is extremely efficient at absorbing lutein and zeaxanthin from the gut. Flooding the gut with alternatives such as carrots or beta-carotene supplements decrease the efficiency of lutein and zeaxanthin uptake.”



As an ophthalmologist, I have particular concern regarding supplements that include beta-carotene in the formula as scientific evidence demonstrates that beta-carotene is associated with an increased incidence of lung cancer in smokers. I would be concerned about children being given beta-carotene, particularly those exposed to second hand smoke. In particular, I would not recommend taking vitamins for which there is no evidence from randomised controlled trials, as the possible toxicities of any particular combination of supplements in children is unknown at this stage.

Parents should feel comfortable allowing their children to spend some time on devices, particularly as so much homework is now on computers. However, it is important that the use of devices is limited, and children are encouraged to play outside.

While blue light has not been shown to damage eyes, it has been shown to affect sleep patterns. Also, time spent playing outside can help children in keeping fit and absorbing important vitamins from the sun. I would stress that it is much more important to protect children’s eyes from UV sunlight damage than to be concerned about the low intensity blue light from digital devices because there is a lot of evidence that UV sunlight damages the eye and surrounding structures. “Studies show that UV damage to eyes occurs in childhood and is linked to eye disease later in life, including cataracts, pterygium, solar keratopathy, and skin cancer of the eyelids and around the eyes” says Dr Alina Zeldovich, eye surgeon and clinical lecturer at Sydney University.

Ophthalmologists have seen a sharp increase in the number of children presenting with eye damage caused by UV exposure (most of that damage occurs before 18 years of age). This is not surprising because UV levels have increased dramatically over recent decades. “The level of eye protection needed now is much greater than it was in the past, and so parents and schools need to be even more vigilant in ensuring that children’s eyes are protected. Children should wear suitable hats and sunglasses whenever they are outdoors” says Zeldovich.

How can you protect your children’s eyes? Ophthalmologists recommend you ensure they wear broad brimmed hats, sunblock and sunglasses that are rated Category 3 of the Australian Standards for UV protection when outdoors.



The sunglasses should have:

• A wraparound frame, designed to minimise unfiltered side light entering the eye 
• Polarised lenses with UV 400 protection, and 
• Lens coatings to block reflected light from entering the eye.

WHAT’S NEW?

NUTS TO YOU
At the start of The Hitchhikers Guide to the Galaxy, the every-resourceful alien Ford Prefect buys six pints of beer, ostensibly as a relaxant, as the world is about to end … To his beers Ford Prefect also added several packets of salted peanuts from the bar. Most bars have nuts. Some are also edible. But their true purpose remains shrouded in mystery.

Eating small, protein-rich snacks (like nuts) before take-off in an aeroplane can reduce motion sickness. This may be because protein, more than any other nutrient, triggers regular, slow and smooth stomach contractions. These keep it busy and act to suppress rapid convulsive contractions associated with feeling sick, and ultimately vomiting. At the same time, when we eat, stomach emptying is slowed down due to the presence of food, meaning the rate at which alcohol levels rise is also slower. So it takes slightly longer (and more alcohol purchases) to get drunk when we are eating nuts.

Adding to the conspiracy theory, some argue that the addictively salty nuts are only there to make us thirsty, so we’ll have to buy more drinks. But this is not true. Pound for pound salty nuts don’t make us drink more than if we ate unsalted ones. Actually, the conspiracy works in reverse. It seems alcohol promotes snacking. It is no coincidence that most nuts and pretzels are displayed at just an arm’s length behind the bar. Given the plenty of calories in most beverages we shouldn’t be hungry or need to eat. But with a little disinhibiting alcohol on board, we can’t help ourselves.


This is an edited extract from Prof Merlin Thomas’s The Longevity List – Myth Busting the Top Ways to Live a Long and Healthy Life available from www.exislepublishing.com. Thomas is a physician, scientist and author who uses the cutting-edge science and research to help people live better, longer and healthier lives. He has been featured in many of the world’s leading medical journals, and is the author of Understanding Type 2 Diabetes, and Fast Living, Slow Ageing.

PEANUT ALLERGY PATCH TRIAL SHOWS PROMISE 

People allergic to peanuts might soon be able to breathe easier, as peanut patches designed to help those with allergies to become less sensitive have shown promise in a recent US clinical trial. The patch provides continual exposure to controlled amounts of peanut proteins and doesn't pose the risk of triggering the allergy that actually eating peanuts would. The trial used patches with low, intermediate and high doses of peanut protein; compared to the placebo, those given the high dose patch reacted less when given real peanuts to eat.

Study 

• Effect of Varying Doses of Epicutaneous Immunotherapy vs Placebo on Reaction to Peanut Protein Exposure Among Patients With Peanut Sensitivity 

NEW HIGH PROTEIN, LOW FAT, LOW GI ICE-CREAM 


Ice-cream is usually considered a treat. But it’s worth remembering it’s a useful source of bone-building calcium plus the protein and vital vitamins found in milk. The GI of regular ice cream (37–49) is generally a little higher than milk or yoghurt because of the added sugar.

ProYo have recently launched a better-for-you, low-fat ice-cream that’s higher in protein than regular ice-cream and has a lower GI (25–39, depending on the flavour). What’s in it? According to the ingredient list for vanilla: “Skim Milk, Whole Milk, Whey Protein Concentrate, Xylitol (Natural Sweetener), Cane Sugar, Inulin, Natural Flavors, Ground Vanilla Beans”. Before you ask … inulin is a fructan, a type of soluble dietary fiber found in agave, artichokes, asparagus, bananas, carrots, chicory root, garlic, Jerusalem artichokes, jicama, leeks, onions, wheat, and yacon. The food industry’s main sources are chicory root and Jerusalem artichoke. Xylitol is a polyol (sugar alcohol) that may be good for your teeth.



We asked two dietitians to comment. “What a great product this is for nursing homes where the frail elderly need palatable foods they enjoy eating that will give them the calories, protein and calcium they need and that are easy to swallow,” says dietitian Nicole Senior.

“ProYo delivers balanced nutrition and real ice cream flavor and texture,” says registered dietitian Carrie Gabriel who makes the point it’s also versatile. “You can put a 4oz (115g) scoop in your morning smoothie to get 10g of protein; use it instead of milk to make baked goods; or enjoy a scoop as a delectable dessert,” she says.

PERSPECTIVES WITH DR ALAN BARCLAY

NUTS ABOUT CALORIES? 
Despite the excited claims of the latest fad diet, the proportion of carbohydrate, fat and protein in your diet really doesn’t make much difference when it comes to weight loss. Research has repeatedly demonstrated that provided “the diet” provides less energy (Calories/kilojoules) than what you were consuming before, you will lose weight. This is the simple reason why most fad diets work in the short-term. You are eating less.



To help us to keep an eye on our total energy consumption, the energy content of most commonly eaten foods and drinks is now readily available on food packages, restaurant menu boards, in books, apps and government databases.

However, have you ever stopped to think how they calculate (estimate) the Calories/kilojoules in a food or drink?

Over 100 years ago, in the USA, carbohydrates, fats, proteins and alcohol were obtained from a wide range of commonly eaten foods and burnt in what is known as a bomb calorimeter to see how much they heated up a fixed volume of water. A Calorie is the amount of energy that is required to raise 1 gram of water one degree Celsius at normal (one atmosphere) pressure. Because a gram is a relatively small amount, we typically use 1000 grams of water and correspondingly the kilocalorie, or Calorie with a capital C. The average Calorie values for the macronutrients are: 

• Carbohydrates (available) - 4 Calories / 17 kJ per gram
• Fats - 9 Calories / 37 kJ per gram 
• Proteins - 4 Calories / 17 kJ per gram 
• Fibres - 2 Calories / 8 kJ per gram
• Alcohol - 7 Calories / 29 kJ per gram

Commercially, most food companies measure the amount (grams) of water, fat, protein dietary fibre, alcohol and ash in food, and what is left over, they call available carbohydrate. They then multiply the amount (grams) of carbohydrate, fat, protein, fibre and alcohol by their respective energy factors (Calories or kilojoules) and add them all together to estimate the average energy content of a serve (and in Australia and New Zealand 100g) of food.

While the method is considered the best currently available, it may not be so accurate for individual foods however. Almonds are a good example. A recent small study fed 18 healthy adults either 9, 42 or 84 grams of almonds a day for 9 days, and collected all urine and feces from all participants. Based on this, the researchers estimated that the average energy content of almonds was 4.6 Calories (19 kilojoules) per gram. Using the bomb calorimeter method, almonds are estimated to contain 6.05 Calories (25 kilojoules) per gram – a 32% difference.

When you think about how well an average person is able to chew nuts like almonds, this may not come as a big surprise. If you ate a teaspoon of almond paste that had been prepared in a steel-bladed food processor, you would probably obtain the full 6.05 Calories per gram, but masticating a handful of nuts in our mouth is not as efficient – we don’t all have perfect dentition, salivary flow and chew each mouthful 30 times before swallowing!

So while we may need to take the Calorie/kilojoule content of whole almonds with a grain of proverbial salt, we should keep in mind that overall, Calorie counting is sufficiently accurate for the planning of weight reduction diets.

 
Alan Barclay, PhD is a consultant dietitian. He worked for Diabetes Australia (NSW) from 1998–2014 . He is author/co-author of more than 30 scientific publications, and author/co-author of  The good Carbs Cookbook (Murdoch Books), Reversing Diabetes (Murdoch Books), The Low GI Diet: Managing Type 2 Diabetes (Hachette Australia) and The Ultimate Guide to Sugars and Sweeteners (The Experiment, New York).

FOOD UN-PLUGGED

CONFUSED ABOUT BOOZE?
With Christmas just around the corner, there is a sleigh full of alcohol myths (and hopes) flying about. Don’t be confused about booze. Here, we answer common questions to ensure you’re armed with the facts this party season.

Do alcohol calories really count? Some people believe that because alcohol is toxic, the liver burns it for energy rather than storing it as fat, so the calories don’t count. Sorry, no; while your body is busy burning the calories from your tipple, any unused calories from your food will be stored as fat. We may be stating the obvious, but if you are trying to lose your beer belly, drink less beer (and same goes for cider, wine, spirits and the rest).

Are low-carb beers healthier? Beer were never high in carbs (sugar) to begin with. Your typical lager-style beer generally contains 2% carbohydrate by volume, that’s just 7.5g carbs in a 375ml can. While the empty calories from added sugar should be limited, those seeking our low-carb beers are missing the point. Alcohol is the real calorie contributor here, contributing to around 75% of the total energy content of beer. If you are looking for a healthier option, choose a lower alcohol beer instead. Ciders are very popular and they do contain more carbs. A standard apple cider contains 6.5% carbs; or 23g per 355ml bottle, however they do vary according to style (dry vs sweet). Sweet style mixed drinks known as ‘alco-pops’ (approx 4-5% alcohol) and spirits with mixers are available in no-added-sugar varieties and these represent a significant kilojoule saving, however take care as their sweetness makes them easy to over-consume.

What about lower alcohol wines? Some people think that lower alcohol wines are not a good option because they are laden with sugar. As an aside, alcohol is higher in calories and certainly worse for your health than sugar. However, we had a look at a New Zealand 25% lower alcohol Sauvignon Blanc and found that one glass (150mL) contained only 0.2g more sugar than your average white wine. More importantly, it also contains around 25% fewer calories! If you are watching your weight, lower alcohol wines are a better option.

Is red wine healthier than white? Many people believe the antioxidants in red wine make it a healthier option. In reality, both red and white wines contain antioxidants and a similar kilojoule and alcohol content. For your health it doesn’t matter much what you drink, but how you drink it. Where wine may have an edge is because it is typically consumed with food, whereas beer and spirits aren’t – it may be wine drinkers have better diets overall.

Is alcohol good for you? There are some cardiovascular benefits of drinking alcohol, but it very much depends on drinking in moderation, your age and your overall health profile. Drinking alcohol also increases cancer risk, particularly cancers of the liver, bowel and breast. As the benefits of drinking alcohol are not as certain as the risks, don’t start drinking for your health.

Does giving alcohol to teens teach responsible drinking? Alcohol is not safe for children. It is a common belief that introducing alcohol to children teaches them to drink responsibly. In fact, it appears to have the opposite effect; early exposure in children appears to increase the risk of unsafe drinking as an adult. Also, don’t forget that alcohol can also affect the development of the brain during the teenage years.

Does mixing your drinks worsen your hangover? We need more studies to find out if mixing alcoholic drinks worsens a hangover, although many people have personal experiences suggesting it does. We do know that even if the alcohol content is the same, some drinks affect your hangover more than others. This is because alcohol is not the only factor at play; you also need to consider the congeners in your drink. These are chemicals that give your drink colour. As a general rule, lighter coloured drinks such as white wine, vodka or gin contain fewer congeners. Darker drinks such as brandy and red wine contain more congeners, making the hangover worse.

What is the best hangover cure? Sorry to be the bearer of bad tidings, but there is no such thing as a hangover cure. However, there are a few things that you can do to make it more bearable:

• Eat a meal before drinking to delay alcohol absorption. 
• Don’t push natural limits. Generally, your liver can process one standard drink per hour. Larger people can handle a little more alcohol while smaller people can handle less. 
• Alcohol is dehydrating which will worsen your headache the next morning. Drink a glass of water between each alcoholic beverage. 
• To combat low blood glucose levels, drink some fruit juice before bed and first thing when you wake up. 

The un-plugged truth 

• Alcohol is high in kilojoules/ calories and can contribute to holiday weight gain. 
• If you want a lower calorie option, choose lower-alcohol drinks. 
• There is no such thing as a hangover cure; prevention is everything. 
• For long term health, men and women should drink on average no more than 2 standard drinks a day. 
• To minimise short-term risk, drink no more than 4 standard drinks in one sitting (more than 4 is classified as binge drinking). 
• Aim for at least 2 alcohol-free days per week.

Thanks to Rachel Ananin AKA TheSeasonalDietitian.com for her assistance with this article.

 
Nicole Senior is an Accredited Nutritionist, author, consultant, cook, food enthusiast and mother who strives to make sense of nutrition science and delights in making healthy food delicious. Contact: You can follow her on Twitter, Facebook, Pinterest, Instagram or check out her website.

KEEP GOOD CARBS AND CARRY ON

GET CRACKING 
Nuts are popular nibbles that pack a nutritional punch with their protein, fibre, unsaturated fats, vitamins, minerals, trace elements and phytochemicals. As a bonus, they are also rich in substances considered protective for the heart: an amino acid (building block of protein) called arginine; vitamin E, folate, copper (a mineral) and plant sterols. Did you know studies show that: 

• Enjoying a handful of nuts 5–7 times a week can halve your risk of developing heart disease. Even people who eat nuts once a week have less heart disease than those who don’t eat any nuts. How come? It’s possible the unique combination of healthy fats, fibre, antioxidants, arginine and plant sterols all working together give nuts their heart healthy benefits. 
• The arginine in nuts helps insulin work more effectively. It can also improve the overall health of blood vessels, helping prevent complications of diabetes. 

What about peanuts and nut allergy? Processed peanuts are quality-controlled for the presence of fungus that produces a toxin called aflatoxin. Because peanuts in the shell are not screened, throw away any mouldy ones. Peanut allergy is an increasingly common food allergy especially in children. One-third of all peanut-allergic people are also allergic to tree nuts such as brazil nuts, hazelnuts, walnuts, almonds, macadamia nuts, pistachios, pecans, pine nuts and cashews.

What about blood glucose? Most nuts contain relatively little carbohydrate which is why they either don’t have a GI or have a very low GI and will have negligible impact on blood glucose. In fact, nuts can reduce the GI of starchy foods eaten with them in a mixed meal. For example if you eat nut butter on a slice of high GI fluffy white bread the overall GI of the sandwich will be lower.

 

What about activated almonds? Dietitian Nicole Senior explains: “Essentially, activated almonds are soaked overnight, rinsed and slow roasted on a low heat for several hours. Enthusiasts say this process deactivates enzyme inhibitors in the outer layer making the almonds more digestible and their nutrients more available. Looking at the science it becomes clear this is more a good story to justify charging a lot more money for them. Enjoy them by all means but I think I’ll stick to the regular lazy almonds.”

Are cakes made with almond meal better for you? Nicole Senior says: “Making cakes with almond meal gives a delightful moist texture and great flavour, and that’s a great reason to use it. Using almond meal instead of flour also adds fibre and good fats, and allows cakes to be gluten-free which is good news for those with celiac disease. Make an almond meal cake even healthier by adding fruit (citrus is divine) and using oil instead of butter.”

10 tasty ways to get more nuts into your day 

1. Sprinkle nuts over wholegrain breakfast cereal or porridge 
2. Toss cashews through a stir fry 
3. Roast nuts and toss through a salad 
4. Chop walnuts or Brazils and add to a dipping sauce 
5. Crumble pecans into yoghurt and serve with fruit 
6. Sprinkle chopped, roasted hazelnuts or almonds over low-fat ice cream 
7. Top grilled fish with a nutty crumble 
8. Add roasted pine nuts to pasta dishes 
9. Blend pistachios or macadamias with fresh herbs, parmesan and a little olive oil for pesto 
10. Partner sweet potato, beetroot, pumpkin, baby spinach, avocado and mango with roasted macadamias

IN THE GI NEWS KITCHEN

STICKS, SEEDS, PODS and LEAVES 
Kate Hemphill is a trained chef. She contributed the recipes to Ian Hemphill’s best-selling Spice and Herb Bible. You will find more of her recipes on the Herbies spices website. Or you can follow her on Instagram (@herbieskitchen). Kate uses Herbies spices and blends, but you can substitute with what you have in your pantry.

CASHEW GUACAMOLE WITH PASILLA PEPITAS
With the addition of cashew nuts and pepitas, this creamy avocado dip can be a meal in itself with vegetables such as carrots and capsicum for scooping. Makes: approx 2 cups guacamole. • Prep time: 10 mins • Cook time: 5 mins • Total time: 15 mins

½ cup raw cashew nuts, soaked in boiling water for 10 minutes
2 avocados, peeled and stone removed
½ red onion, chopped
juice of 1 lime
½ tsp ground cumin
¼ cup pepitas (pumpkin seeds)
pinch Herbie’s Ground Pasilla Chilli
pinch Herbie’s Ground Cumin
coriander, to serve



Drain cashew nuts and place in a food processor with avocados, onion, lime and cumin. Blitz until smooth and adjust seasoning to taste. • Toss pepitas in a hot pan with pasilla chilli, cumin and a drop of olive oil for a few minutes until crisp. • Serve guacamole with spiced pepitas and coriander and the dipping vegetables of your choice.

Per serve (¼ cup dip/150 g) 
1360kJ/325 calories; 7g protein; 29g fat (includes 6g saturated fat; saturated : unsaturated fat ratio 0.29); 5g available carbs (includes 2.5g sugars and 2.5g starches); 5.5g fibre; 10mg sodium; 618mg potassium; sodium : potassium ratio 0.02

ANNEKA MANNING’S BAKE CLUB 

Through cooking school and her new book, BakeClass (Murdoch Books), Anneka teaches home cooks to bake in practical and approachable yet inspiring ways that assure success in the kitchen. You can follow her on Twitter, Facebook or check out her website.

GLUTEN-FREE MANDARIN ROASTED ALMOND CAKES. 
These cakes are a play on the original (and wonderful) classic Middle Eastern orange cake from the one-and-only Claudia Roden. The ground roasted almonds give a lovely ‘toasted’ flavour but you can substitute pre-ground almond meal. To roast and grind the almonds, spread on an oven tray and place in an oven preheated to 180°C/350°F for 8-10 minutes or until aromatic. Cool on the tray before processing in a food processor until finely ground. Makes: 12 • Prep: 20 minutes (+ 30 minutes simmering and 15 minutes cooling time) • Bake: 15–18 minutes

2 large mandarins (about 110g/3½oz each)
olive oil spray, to grease
½ cup instant polenta
80g natural almonds, roasted, finely ground
½ tsp baking powder
3 eggs, at room temperature
¾ cup raw caster sugar
2 tsp natural vanilla essence or extract
icing sugar, to dust (optional)



Put the mandarins (skin and all) in a small saucepan and cover with water. Bring to the boil and simmer for 30 minutes or until very soft when tested with a skewer. You may need to place a small saucer over the mandarins to keep them submerged. Remove from the water and set aside to cool slightly. • Meanwhile preheat the oven to 180°C. Brush a 12-hole 80ml (1/3 cup) muffin tin with the melted butter to grease. • Combine the polenta, roasted almond meal, and baking powder in a medium bowl and mix well to combine evenly. • Quarter the mandarins and remove and discard any centre core or seeds. Puree in a food processor or blender until smooth. • Put the eggs, sugar and vanilla in a medium mixing bowl and use an electric mixer with a whisk attachment to whisk until very thick and pale and a ribbon trail forms when the whisk is lifted. Add the mandarin puree and use a spatula or large metal spoon to fold in until just combined. Add the polenta mixture and fold together until evenly combined. • Divide the mixture evenly among the muffin holes (pouring the mixture from a jug or using a ladle works well). • Bake in preheated oven for 15-18 minutes or until the cakes are firm to the touch on the top and cooked when tested with a skewer. Remove from the oven and cool in the tin for 10 minutes. Use a palette knife to ease the cakes out of the tin and transfer to a wire rack. Serve warm or at room temperature dusted with a little icing sugar if you wish.

Per cake 
Energy: 560kJ/130cals; Protein 3.5g; Fat 5g (includes 1g saturated fat; saturated : unsaturated fat ratio 0. 25); Available carbohydrate 18.5g (includes 15g sugars, 3.5g starches); Fibre 1g; Sodium 40mg; Potassium 95mg; sodium to potassium ratio 0.42

GOOD CARBS COOKBOOK 
Good Carbs Cookbook by Dr Alan Barclay, Kate McGhie and Philippa Sandall (Murdoch Books, RRP $39.99) Photography by Alan Benson'



BANANA AND PEANUT ICE CREAM
Blitzed frozen bananas make this one of the easiest and amazing ice-cream recipes ever. Kate says a powerful blender will do the job better than a food processor. They go from crumbly and gooey to looking a bit like oatmeal and finally achieve the consistency of a soft serve ice-cream. If you like, replace the chopped roasted peanuts with ½ cup blueberries. Preparation time: 15 minutes + freezing • Serves: 6

4 large ripe bananas, peeled cut into chunks and frozen
¼ cup crunchy peanut butter
¼ cup runny honey
⅔ cup natural yoghurt
⅓ cup chopped roasted peanuts

Put the frozen banana into a blender and blitz until smooth and creamy. (Because the bananas are frozen solid this is a noisy process.) When the mixture is smooth add the peanut butter, honey, yoghurt and peanuts then pulse-blend. Pour the mixture into a freezer-proof container with a lid and freeze.

Per serving 
Energy: 1125kJ/270cals; Protein 8g; Fat 11g (includes 2g saturated fat; saturated : unsaturated fat ratio 0. 22); Available carbohydrate 34g (includes 30g sugars, 2g starches); Fibre 3.5g; Sodium 50mg; Potassium 470mg; sodium to potassium ratio 0.11

PLUMPED WALNUT PRUNES WITH ORANGE IN SPICED PORT
Prunes are a basic ingredient on an international roster of classic dishes. Here they are steeped in port until they become plump and luscious. Although a lot of the alcohol from the port will evaporate when it is simmered, use all orange juice if you prefer. Preparation time: 20 minutes Cooking time: 3 minutes Serves: 6

18 walnut halves
18 large pitted prunes
½ cup orange juice
1⅔ cups port wine
2 strips orange zest
1 cinnamon stick
2 whole star anise
1 cup vanilla bean yoghurt
Seeds from one pomegranate

Push a walnut half into each prune through the opening created by the stone being removed. Place filled prunes in a heat-proof basin. • Put the orange juice (freshly squeezed is best), port, orange zest strips, cinnamon stick and star anise in a pan and bring to a gentle simmer. Simmer 3 minutes with the lid on and then pour over the prunes. Cover the bowl with cling wrap and leave at room temperature to cool. If not using immediately refrigerate. • Serve with a spoonful of yoghurt decorated with pomegranate seeds.

Per serving 
Energy: 1185kJ/285cals; Protein 5g; Fat 6g (includes 1g saturated fat; saturated : unsaturated fat ratio 0. 20); Available carbohydrate 29g (includes 28g sugars, 1g starches); Fibre 6g; Sodium 40mg; Potassium 485 mg; sodium to potassium ratio 0.08

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Nutritional analysis To analyse Australian foods, beverages, processed products and recipes, we use FoodWorks which contains the AusNut and Nuttab databases. If necessary, this is supplemented with data from www.calorieking.com.au and http://ndb.nal.usda.gov/ndb/search.

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GI News - November 2017

GI News is published by the University of Sydney, School of Life and Environmental Sciences and the Charles Perkins Centre

Publisher: Professor Jennie Brand-Miller, AM, PhD, FAIFST, FNSA
Editor: Philippa Sandall
Scientific Editor/Managing Editor: Alan Barclay, PhD
Contact GI News: glycemic.index@gmail.com

Sydney University Glycemic Index Research Service
Manager: Fiona Atkinson, PhD
Contact: sugirs.manager@sydney.edu.au

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FOOD FOR THOUGHT

THE AMAZING STORY OF BIG CHICKEN

How did chicken take over the world’s diet? Industrial farming is a big part of it. But secret sauce is 63,000 tons of antibiotics every year. This insight comes from Maryn McKenna in her new book – Big Chicken. Before those innovations, hens were just leftovers from egg production and “a chicken in every pot” was an empty political promise reports ConscienHealth’s Ted Kyle.

When you put antibiotics in a chicken’s food, they grow big and fat. So farmers can make an abundant supply of plump chickens on an industrial scale. Now, Americans eat far more chicken than any other meat. And farms dump millions of pounds of antibiotics into the environment. Most of it goes into chicken manure, which in turn becomes fertilizer for plant crops. The circle of farm life has become a circle of antibiotics. McKenna tells the story of Acronized® chicken from the 1950s. American Cyanamid promoted – and trademarked – its chicken soaked in antibiotics for a longer shelf life: They dipped all the chicken in the US in a bath of antibiotics and sealed it up in packages and thought it would last for a month on the shelf and people could eat it and be fine? Were they crazy? To me that story was really the purest distillation of this uncomplicated belief that science was going to make our lives better.

The problem goes beyond antibiotic resistant superbugs. Dumping all these antibiotics into the environment raises the possibility of contributing to the rise of obesity prevalence. Lee Riley and colleagues explained this theory in a 2013 paper. They estimate that as much as 18 million pounds of antibiotics from animal farming go into the environment. They describe evidence for how antibiotics can move from environment and into the food chain. And thus, they explain the possible link to obesity: “We propose that chronic exposures to low-residue antimicrobial drugs in food could disrupt the equilibrium state of intestinal microbiota and cause dysbiosis that can contribute to changes in body physiology. The obesity epidemic in the United States may be partly driven by the mass exposure of Americans to food containing low-residue antimicrobial agents.”

Ultimately, McKenna sees hope in the story of big chicken and antibiotics. Business, economics, and regulators might have failed. But consumers are succeeding. People are demanding chicken produced without antibiotics. McDonald’s is making a big move in that direction. In turn, it’s exerting a big influence on the rest of the industry.

The move away from antibiotics in chicken can be a case study for beef and pork production. Consumer demand for antibiotic-free meat is growing. Even in China, government is pushing for changes in meat production. It’s a work in progress. 

• ConscienHealth 
• How antibiotics beefed up the chicken industry: Maryn McKenna interview 
• McDonald's expands its move away from antibiotics in poultry 
• How can we reduce antibiotic use in animals? 
• Ten facts you need to know about the chicken and eggs on your table: The Conversation

WHAT’S NEW?

CAN CHICKEN SOUP CURE A COLD? 

Of all the homemade winter cure-alls, chicken soup is the best known and most loved. In fact, the term “chicken soup” has become idiomatic for all things restorative; benefiting every possible problem from the head to the soul. In many different cultures, chicken soup is a traditional treatment for symptoms of the common cold.

Chicken soup is widely known as “Jewish Penicillin”. Some of this may reflect the traditional use of chicken soup as a Sabbath meal and the perceived importance of piety in affecting health outcomes. Nonetheless, it’s a staple among Jewish grandmothers and their snotty grandchildren, worldwide.

Even before the Olympics, Greek grandmothers may also claim they invented Chicken soup for the common cold. Avgolemono (Αυγολέμονο) is a thick egg and lemon (chicken) broth widely administered for the symptoms of cold and flu, or for their prophylaxis on wet winter evenings. Although a quintessentially Greek dish, it is likely that its therapeutic use has its earliest origin in Sephardic tradition. Adding the “all important” lemon may have been the Greek contribution.

Not to be outdone, most Chinese grandmothers are ready and primed to produce chicken soup at the first sign of a sniffle. In traditional Chinese medicine, illness is perceived as a state of imbalance between yin and yang. Yin represents the darker cooling forces, while yang embodies the lighter, warmer forces. In this paradigm, the treatment for cold is obviously yang, and chicken soup is a prime example: restoring the yang forces and balancing the cold of yin.

There have been a few attempts to definitively establish these cold-busting effects in clinical studies. One 1978 study found that sipping hot chicken soup increased the velocity of nasal secretions (runny noses) in healthy volunteers. This could be a good thing for clearing a blocked nose but the study showed it only worked for a few minutes and wasn’t any more effective than hot water.

Beyond the steam, there is no chemical or biological reason for having chicken soup when we are sick with a cold. However, the psychology of chicken soup can’t be overlooked. Chicken soup is a comfort food on a day when we would really like some comfort. With the expectation of efficacy, the succour of being cared for, the taste of home on an otherwise dull day. There’s a good reason for chicken soup for the soul.

Study 

• Effects of drinking hot water, cold water, and chicken soup on nasal mucus velocity and nasal airflow resistance 
• “Chooks in the garden” watercolour by Helen Sandall. 

This is an edited extract from Prof Merlin Thomas’s The Longevity List – Myth Busting the Top Ways to Live a Long and Healthy Life available from www.exislepublishing.com. Thomas is a physician, scientist and author who uses the cutting-edge science and research to help people live better, longer and healthier lives. He has been featured in many of the world’s leading medical journals, and is the author of Understanding Type 2 Diabetes, and Fast Living, Slow Ageing.

BREAST MILK SUGARS FOUND TO FIGHT BACTERIA

The most prominent infection that affects newborns is called Group B Streptococcus (GBS), which can lead to babies developing sepsis or pneumonia before their immune systems are strong enough to fight off the bug. While GBS can be deadly, most newborns don't get infected. Researchers have now found that although the pathogen can be transmitted to infants through breastfeeding, some mothers produce protective carbohydrates in their milk that could help prevent infection. They also report that the carbohydrates can act as anti-biofilm agents, which is the first example of carbohydrates in human milk having this function. “This is the first example of generalised, antimicrobial activity on the part of the carbohydrates in human milk,” says chemist Steven Townsend. “One of the remarkable properties of these compounds is that they are clearly non-toxic, unlike most antibiotics.”

Curious as to how GBS was infecting these young infants in the first place, researchers about 10 years ago found cases in which the bacteria were transmitted through breast milk, despite milk's known immunologic benefits. But because most babies do not become infected with group B strep, Townsend and others wanted to see if some women's breast milk contained protective compounds that specifically fight that bacteria.

“As carbohydrate chemists, we knew from previous research that milk carbohydrates are protective against other bacteria, so we figured there would be a chance they would be active against group B strep, too,” says Townsend, who is at Vanderbilt University. To test this hypothesis in a pilot study, his lab gathered five samples of breast milk from donors, isolated the complex sugars, also called oligosaccharides, and grew GBS in the presence of the sugars. The women's GBS status was unknown.

“When bacteria want to harm us, they produce this gooey protective substance called a biofilm, which allows them to thwart our defense mechanisms,” Townsend says. “In the initial study, the oligosaccharides from one mother's milk killed nearly the entire colony. Another milk sample was moderately effective, while the remaining three showed diminished activity.”

In the current study, his team members are testing more than a dozen additional milk samples to see if they can replicate their first round of results. So far, two samples have shown activity against both bacteria and biofilms; two just worked against bacteria but not biofilms; and four helped fight biofilm formation but not bacteria. Six were relatively inactive against both. Preliminary data also suggest that some mothers produce milk carbohydrates that make the bacteria more susceptible to common antibiotics, including penicillin and erythromycin. If these results bear out through future studies, these carbohydrates could potentially become a part of an antibacterial treatment for infants or adults. They could also help reduce our dependence on some common antibiotics, Townsend says. “The great thing about these carbohydrates," he adds, "is that if they're safe for babies, they should be safe for everyone.”

Study 

• Human milk oligosaccharides exhibit antimicrobial and anti-biofilm properties against Group B Streptococcus 

BUILT ENVIRONMENTS AND OBESITY 

Are we building places that harm our health? Yes, unequivocally, yes we are according to distinguished professor Jim Sallis opening a survey of the young science of built environments and obesity at the National Academy of Sciences.

Well into the 20th century, big cities and small towns alike were built for people. Mixed uses meant that neighbourhood businesses served the needs of people who lived nearby. Workplaces and schools often blended into neighbourhoods. People used the streets. By the end of the century, most cities and towns were built for cars. Zoning laws separated homes from businesses. Strip malls and fast food evolved around cars. Pedestrians became second-class citizens at best. Driving to work, to shop, and to school became a big part of daily routines. Public transit faded and frayed.

Did these profound shifts in our environment play a role in the rise of obesity? That was a question rarely studied until the 21st century, said Sallis. Rodrigo Reis, Karen Glanz, and Daniel Rodríguez provided excellent overviews of what we know about this question. Especially in Glanz’s presentation on the food environment, two things were clear.

First, we certainly have good reasons to suspect that we’ve built our world in a way that promotes obesity. But second, the evidence remains thin to pinpoint the critical factors and single out solutions. When tested, assumptions often prove to be false. Considerable money and effort, for example, went toward planting supermarkets in food deserts. But those efforts, by themselves, didn’t move the needle toward better nutrition.

Likewise, efforts to control fast food outlets haven’t yet produced impressive results. Glanz made an important point. These are early days. Maybe the problem is that our methods are weak for studying these questions. Maybe the strategies need refinement. Implementation, intensity, and time are all important factors. Or maybe some of our assumptions are wrong. The time is right for asking what we really know. Which beliefs about the built environment are indeed factual? Which are presumptions? And which of them are simply myths?
—Thanks to Ted Kyle of ConscienHealth for this report.

To read more 

• For slides and a video recording of the proceedings, click here. 
• For perspective on studies of the built environment and health, click here and here. 
• For a systematic review of the relationship between local food environments and obesity, click here. 
• Photo: Ted Kyle

PERSPECTIVES WITH DR ALAN BARCLAY

DIABETES. IS AN EGG A DAY OK? 

The answer is a qualified yes. Here’s why. Eggs are popular. They are delicious and convenient and easy to cook. There’s also a steady stream of scientific research looking at whether we can enjoy them as part of our daily fare, or whether we should limit them. Two recent systematic reviews help explain the evidence and provide an answer for people with type 2 diabetes and those at risk. It’s worth remembering, eggs are a highly nutritious food. One hard-boiled egg is: 

• A good source of protein and vitamins – B (B12, pantothenic acid, riboflavin, folate), A, E, and is one of the few food sources of vitamin D 
• A relatively good source of iodine, iron, zinc and phosphorus 
• Rich in omega-3 fatty acids and cholesterol, and is a source of saturated, poly-unsaturated, and mono-unsaturated fats, with a saturated : unsaturated fat ratio of 0.48 (the ideal ratio is less than or equal to 0.5 so they squeeze in). 

The systematic review that looked at egg consumption on cardiovascular risk factors for people with diabetes included all randomised controlled trials where people consumed either 6–12 eggs per week compared to a control group that consumed no eggs or few eggs (less than 2 eggs a week), for 12 to 20 weeks. In a total of 6 studies, the authors found that consuming 6 to 12 eggs per week had no impact on total cholesterol, LDL (“bad”) cholesterol, triglycerides, fasting blood glucose (sugar), or insulin and that HDL (“good”) cholesterol increased in 4 of the 6 included studies. While these results are encouraging, the study authors noted that “...the studies varied in diet composition aside from the addition of eggs.” Indeed, most of the studies were reduced energy (kilojoules/calories), and had beneficial ratios of saturated : unsaturated fats.

The second review looked at all of the data from observational studies and the risk of developing type 2 diabetes and found that from a total of ten studies (5 in Europe, 4 in the USA and 1 in Asia), consuming 1 egg a day was associated with a 13% higher risk of developing type 2 diabetes. However, they determined that risk was strongly influenced by where you live, with people in the USA consuming 1 egg a day having a 47% increased risk, and people living in Europe and Asia having no increased risk. The authors noted that “...in the US studies, egg intake is often associated with smoking or lower physical activity or higher intake of red meat, whereas this is generally not observed in studies outside the USA.” and that “Food preparation methods (e.g. boiled or fried eggs, whole eggs or only egg whites) or concurrent consumption of other foods that may increase diabetes risk (e.g. home fries, bacon) may also account for a part of the differences, but such information is not available in these studies.”

So yes, it is ok to eat an egg a day if you are at risk of or have type 2 diabetes – provided you enjoy them as part of a healthy balanced diet, rich in other quality proteins (lean poultry, meats and seafoods), minimally refined low GI carbohydrates, and healthy fats (e.g., Canola, olive, peanut, or sesame oil; nuts and seeds). It’s the overall eating pattern that counts. And poach don’t fry.

Declaration of interest. My family loves eggs. We keep chooks and enjoy meals made with their fresh eggs every week.

Studies 

• Impact of Egg Consumption on Cardiovascular Risk Factors in Individuals with Type 2 Diabetes and at Risk for Developing Diabetes: A Systematic Review of Randomized Nutritional Intervention Studies 
• Egg consumption and risk of incident type 2 diabetes: a dose-response meta-analysis of prospective cohort studies

   
Alan Barclay, PhD is a consultant dietitian. He worked for Diabetes Australia (NSW) from 1998–2014 . He is author/co-author of more than 30 scientific publications, and author/co-author of  The good Carbs Cookbook (Murdoch Books), Reversing Diabetes (Murdoch Books), The Low GI Diet: Managing Type 2 Diabetes (Hachette Australia) and The Ultimate Guide to Sugars and Sweeteners (The Experiment, New York).

FOOD UN-PLUGGED

PROCESSED VEGAN FOODS 
The vegan diet is exclusively plant-based and excludes meat, fish, eggs, dairy products and honey. People choose to follow a vegan diet typically do so for a combination of reasons: ethical (not killing animals), environmental (a smaller environmental footprint), and health (a plant-only diet is better for you). Fruits, vegetables, legumes, wholegrains, nuts and seeds are nutritious options, no question. But like many food and diet trends, when opportunity knocks, the market answers with a myriad of processed products of varying nutritional quality. This month we take a closer look at the nutritional profile of some good and not-so-good vegan foods.

GOOD 
Quorn sausages – Quorn is the brand name for an interesting meat alternative composed of mycoprotein, which is a kind of stringy fungus (similar to mushrooms) that is compressed into more familiar food products such as “mince” and sausages. Quorn sausages contain more fibre per 50g serve than beef sausages, but unfortunately they don’t contain added Vitamin B12. Vitamin B12 only occurs in animal foods, so adding this essential vitamin to vegan products helps fill this dietary gap.

Chickpea and Sesame Seeds Vegetable Burgers – These contain less than half the protein of a beef burger but are packed with fibre. They are much lower in saturated fat than regular beef burgers.

Soy milk with added calcium – Soy milk is a good source of protein and is fortified with calcium and vitamin D. Note that not all plant milks (e.g. rice, oat, and nut “milks”) are fortified and generally have little protein, vitamins or minerals.

NOT SO GOOD 
Tofutti Cream Cheese – is soy-based and contains less than half the fat of regular cream cheese, but also less than half the protein. There are 13+ ingredients including added sugar, salt, thickening agents, emulsifiers and preservatives. To be fair, regular cream cheese is not a healthy choice either but generally comes with far fewer additives.

Choc Chip Cookies – are gluten-free, egg-free, dairy-free and yeast-free, but they are made with refined flours, chocolate, sugar and salt. Like any cookie (vegan or not) these are high kilojoule/calorie treats best eaten sparingly and in small amounts.

Dairy-Free Chocolate – chocolate without the dairy is still chocolate, just because it is vegan doesn’t give you a free pass to eat it in unlimited amounts.

Unsweetened Coconut Milk – this brand is better than regular coconut milk because it is has half the fat and some calcium added (not all coconut milks have calcium added so check the label). However, it has 16 times less protein than regular milk from regular cows, and has lots of additives.

Protein Snack Bar – this is a highly processed caramel and chocolate bar made according to the label with “real plant-based food ingredients.” There’s a lot of them (we counted around 50). Consider it an occasional treat and opt for an apple or an orange or a handful or nuts for a regular snack food.



Chocolate Frozen Dessert – This soy-based frozen dessert is lower in saturated fat than regular ice cream as the fat predominantly comes from vegetable oils (not cream). However, it’s no lower in calories (kilojoules) and the main ingredient is added sugar. Like ice cream, it’s an occasional treat.

The un-plugged truth 

• A “vegan” label does not guarantee a healthy product. 
• Highly processed foods vegan foods can be high in calories (kilojoules) saturated fat, salt and added sugars and are likely to have a large environmental footprint. 
• For the healthiest vegan options stick to minimally processed plant foods, including products fortified with essential vitamins lacking in vegan diets.

Thanks to Rachel Ananin AKA TheSeasonalDietitian.com for her assistance with this article.

   
Nicole Senior Nicole Senior pulls the plug on hype and marketing spin to provide reliable, practical advice on food for health and enjoyment. She is an Accredited Nutritionist, author, consultant, cook, food enthusiast and mother who strives to make sense of nutrition science and delights in making healthy food delicious.    
Contact: You can follow her on Twitter, Facebook, Pinterest, Instagram or check out her website.

KEEP GOOD CARBS AND CARRY ON

CARROTS 

Carrots are one of the most popular vegetables in our kitchen and for good reasons says dietitian Nicole Senior. For a start, they are very versatile: they are delicious raw or cooked, and can blend in to most dishes whether it is a stir fry, casserole, grill or salad. It’s really no wonder you’ll find them in most people’s refrigerator. One of my favourite ways to eat this sunshine-y root vegetable is roasted whole with a short length of stem still on (wash thoroughly, then just brush with a little oil and bake). With the water content reduced by the oven, the caramelisation of the natural sugars creates a kind of magic in your mouth and one of the many reasons I shall never be a raw foodist! Which reminds me of another favourite way to enjoy them: with a drizzle of extra virgin olive oil and honey (and a sprinkle of cumin if you like a little spice). I love them in soup too and marvel how well they go with chicken and chickpeas, or in the slow cooker with beef and lentils.

There’s another kind of magic that happens when carrots are cooked long and slow and turn to velvet but still hold their shape: so comforting. But of course, carrots also shine in summer salads and the trick to a super salad is to slice the carrot in long slender strips or ribbons. You can do strips or batons with a sharp knife but you’ll look like a pro if you use a julienne blade on a V-slicer that produces willowy, regular lengths that look gorgeous and perform a texture tango in your mouth. Another very modern idea is to use a spiralizer to make long curly carrot noodles (‘coodles’ anyone?) or vegetable peeler to slice long ribbons. If you do the same with zucchini you can create a two-colour ribbon salad that only needs your favourite chopped herbs and a knockout vinaigrette dressing.

Aside from all this, carrots are really good for you. They even give their name to a family of phytochemicals called carotenoids: carrots are rich in a particular type called beta-carotene that gives them their orange colour. But carrots were purple or dull yellow 5000 years ago in Afghanistan where they are thought to originate, but these ‘heirloom’ varieties are now available again and look simply spectacular on your plate. Being root vegetables, carrots of any colour are high in fibre for digestive health. They also have impressive amounts of vitamin K for healthy bones, vitamin C for immunity and potassium to maintain ideal blood pressure. And if that wasn’t enough, munching on carrots is good for the teeth and gums too because they massage the gums and increase production of saliva which rinses out the mouth and helps to protect against decay.

Raw or cooked, carrots won’t send your blood glucose on a roller coaster ride either. Why? Well, not only are they low GI (39), they have very few carbs. In fact, to get a hefty portion of carbs (38 g) from carrots you’d have to crunch through at least 5 cups or 750g (about 1½lb) raw at a sitting – a pretty awesome achievement even for carrot lovers.

IN THE GI NEWS KITCHEN

CARROT GLUT
This month we are making the most of Sydney’s carrot glut in the kitchen with Kate Hemphill’s roast carrot humous with carrot top pesto, carrot and date wholemeal muffins, some classic carrot soup and salad recipes from Elizabeth David and Jane Grigson and Barbara Solomon’s chicken and barley soup from the Monday Morning Cooking Club.

STICKS, SEEDS, PODS and LEAVES 
Kate Hemphill is a trained chef. She contributed the recipes to Ian Hemphill’s best-selling Spice and Herb Bible. You will find more of her recipes on the Herbies spices website. Or you can follow her on Instagram (@herbieskitchen). Kate uses Herbies spices and blends, but you can substitute with whatever you have in your pantry.

ROAST CARROT HOMMOUS WITH CARROT TOP and MINT PESTO 
Instead of throwing away the tops of lovely fresh carrots, make this versatile pesto with the leafy ends. Makes approx 2 cups of hommous and 1 cup of pesto.



1 bunch carrots, with tops, washed and cut into 5cm (2in) pieces
1 tbsp olive oil ½ tsp ground cumin
400g (14oz) can chickpeas, drained
2 tbsp tahini
1 small clove garlic
Salt, to taste
2 tbsp lemon juice
75ml (2½fl oz) olive oil

Pesto 
2 cups carrot tops, loosely packed
1 cup flat leaf parsley, loosely packed
3 sprigs mint, leaves picked
1 clove garlic
40g (1½oz) parmesan, grated
30g (1oz) pine nuts
100ml (3½fl oz) olive oil

Preheat the oven to 180C (350F). Toss carrots in olive oil and cumin and roast for 40 minutes until soft and browned. • To make hommous, combine cooked carrots with chickpeas, tahini, garlic, salt and lemon juice in a food processor. Blend while pouring in oil and blitz until smooth. • For the pesto, pulse carrot tops, parsley, mint, garlic, parmesan and pine nuts in a food processor to break down, then add oil while blending. Season to taste.

Per serve (75 g)
740kJ/175 calories; 3.5g protein; 15g fat (includes 2.5g saturated fat; saturated : unsaturated fat ratio 0.2); 5g available carbs (includes 1.5g sugars and 3.5g starches); 3g fibre; 125mg sodium; 185mg potassium; sodium : potassium ratio 0.68

CARROT and CASSIA DATE MUFFINS 
The mashed carrot gives a wonderful moist texture and the dates give a natural sweetness to this tasty, better-for-you, lunchbox treat. Prep: 15 mins • Cook: 30 mins • Makes: 12



500g (1lb 2oz) carrots, peeled, boiled until tender, and drained
100ml (3½fl oz) vegetable oil
1 cup semi-skimmed milk
2 eggs, lightly beaten 400g (14oz)
wholemeal self-raising flour
1 tsp ground cassia or cinnamon
75g (2½oz) soft brown sugar
100g (3½oz) pitted dates, chopped

Pre-heat oven to 190°C (375°F). Grease or line a 12-hole large muffin pan or two 12-hole mini muffin pans • Mash or blitz carrots to a smooth puree and combine in a bowl with the oil, milk, and eggs. • Combine the flour, sugar, cassia and dates in large bowl, then add the carrot mixture, stirring until well combined. Spoon the batter into greased or lined muffin pan holes and bake for 20–25 minutes until golden. • Remove from oven and allow muffins to cool on a wire rack. Once cooled, muffins will keep in an airtight container for 3 days.

Per muffin (or 2 mini muffins) 
1105kJ/265 calories; 6g protein; 9.5g fat (includes 1g saturated fat; saturated : unsaturated fat ratio 0.12); 36g available carbs (includes 15g sugars and 21g starches); 6g fibre; 255mg sodium; 330mg potassium; sodium : potassium ratio 0.77

CLASSIC REVIVAL


We have been seduced to look for new recipes in the latest cookbooks by the hottest chefs with the most gorgeous photographs. Frankly, if you want a simple vegetable soup or salad, turn to the time-tested classics: the books of Elizabeth David and Jane Grigson. The writing is good. The food fabulous.

POTAGE CRECY 
Elizabeth David’s classic carrot soup from French Provincial Cooking. Why Crecy? It’s reputed to have the best carrots in France and as David says, “It’s important to have very good quality carrots”.

375g (¾lb) carrots, 1 large potato, 1 shallot or half a small onion, 30g (1oz) butter, 600ml (1 pint) veal, chicken or vegetable stock, or water if no stock is available, seasoning, parsley and chervil if possible.

Scrape the carrots, shred them on a coarse grater, put them together with the chopped shallot and the peeled and diced potato in a thick pan with the melted butter. Season with salt, pepper, a scrap of sugar. Cover the pan, and leave over a very low flame for about 15 minutes, until the carrots have almost melted to a purée. Pour over the stock, and simmer another 15 minutes. Sieve (blend), return the purée to the pan, see that the seasoning is correct, add a little chopped parsley and some leaves of chervil. Enough for three.

CARROT SALAD 
From Jane Grigson’s Vegetable Book, the go-to book for the definitive guide on the selection and cooking vegetable. Still.

Grated raw carrots, dressed with an olive oil and lemon juice vinaigrette and plenty of chopped herbs – either fennel or tarragon, or chives and parsley mixed. Chill well and drain off any surplus liquid before serving.

CARROT SALAD WITH RAISINS
As above, but instead of herbs use seedless raisins and split (slivered) almonds. The flavour is improved if you toast the almonds.

MONDAY MORNING COOKING CLUB
Monday Morning Cooking Club started back in 2006 when six Jewish women who live in Sydney came together on a Monday morning to share recipes and talk about food. What they started as an idea to raise money for charity, grew into a project to document their community’s somewhat obsessive relationship with food, and has become a series of beautifully photographed books.

CHICKEN AND BARLEY SOUP
Barbara Solomon’s totally, totally delicious soup from the Monday Morning Cooking Club (their first book) may not cure a cold but it sure nourishes body and soul. Use leftover roast chicken, or pick up half a chicken from the takeaway and shred the flesh, discarding the skin and bones. Makes 8 servings.

2 tbsp olive oil
2 onions, chopped
2 carrots, peeled and chopped
2 stalks celery, sliced
2 garlic cloves, crushed
400g (14oz) can diced or crushed tomatoes
8 cups chicken stock (home-made is best, but a bouillon cube is fine)
1 cup pearl barley
2 cups shredded chicken meat (no skin)
2 tbsp chopped parsley



Heat the olive oil in a large saucepan and cook the onions, carrots and celery until soft. Add the garlic to the pan and cook for a further 2 minutes, then add the tomatoes and stock and bring to the boil. • Add the barley and reduce the heat to a simmer, then cook for about 50 minutes (no lid) or until the barley is tender. Add the chicken and parsley, and stir to heat through. Season well and serve.

Per serving (based on making 8 servings) 
Energy: 885kJ/210cals; Protein 12g; Fat 8.5g (includes 1.6g saturated fat; saturated : unsaturated fat ratio 0. 23); Available carbohydrate 20g; Fibre 4.5g

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GI News - October 2017

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FOOD FOR THOUGHT

DON’T CONFUSE CORRELATION WITH CAUSATION 
In an entertaining and informative piece in The Conversation, Jon Borwein and Michael Rose look at the dangers of making a link between unrelated results. “Here’s an historical tidbit you may not be aware of,” they write. “Between the years 1860 and 1940, as the number of Methodist ministers living in New England increased, so too did the amount of Cuban rum imported into Boston – and they both increased in an extremely similar way. Thus, Methodist ministers must have bought up lots of rum in that time period! Actually no, that’s a silly conclusion to draw. What’s really going on is that both quantities – Methodist ministers and Cuban rum – were driven upwards by other factors, such as population growth. In reaching that incorrect conclusion, we’ve made the far-too-common mistake of confusing correlation with causation.”



As we are reporting on a number of large prospective studies and their correlations (otherwise known as associations) in this issue of GI News, we thought we would kick off with an extract from a post by Prof Arya Sharma (Even Correlations Based on Billions of Data Points Do Not Prove Causation, Obesity Notes, August 23, 2017) reminding us of the very serious limitations of such studies.

Even Correlations Based on Billions of Data Points Do Not Prove Causation 
Readers may have already heard about a recent study by Tim Althoff and colleagues from Stanford University, published in Nature, that analyses physical activity data collected from smart phones consisting of 68 million days of physical activity for 717,527 people, in 111 countries (only 46 of which were included in the study). As one may expect, not only do activity levels vary widely across countries but also substantially within countries (which in general terms, the authors refer to as “activity inequality”). It turns out that activity inequality and not actual levels of activity predict obesity rates (based on BMI).

The authors discuss [in their paper] various limitation of their study but fail to mention the biggest limitation of all, the simple fact that correlations, no matter how strong or how large the data set, simply cannot prove causality.

Thus, while the data does prove the point that you can do all sorts of interesting analyses when you have large data sets, it simply does not prove that activity levels (or activity inequality for that matter) actually has much to do with obesity at all. Indeed, one could think of a number of confounders that would otherwise differentiate countries with high activity inequality that happen to have high obesity rates from countries that have low activity inequality and low obesity rates (let’s not even mention reverse causality).

Thus, as nice as the figures presented in the paper may be, it is really hard to follow the authors’ conclusion that, ‘Our findings can help us to understand the prevalence, spread, and effects of inactivity and obesity within and across countries and subpopulations and to design communities, policies, and interventions that promote greater physical activity.’

This is not to say that designing communities, policies, and interventions would not be of substantial health benefits – given all of the known benefits of physical activity. Unfortunately, whether or not, these policies would do anything to prevent or reverse obesity is another matter altogether and remains as unclear after this study as before. 

• Dr Sharma’s Obesity Notes 
• Large-scale physical activity data reveal worldwide activity inequality 
• Clearing up confusion between correlation and causation

  
Dr Sharma is Professor of Medicine and Chair in Obesity Research and Management at the University of Alberta, Edmonton, Canada. He is also the Clinical Co-Chair of the Alberta Health Services Obesity Program. He has authored and co-authored more than 350 scientific articles and has lectured widely on the etiology and management of obesity and related cardiovascular disorders and is regularly featured as a medical expert in national and international TV and print media and maintains a widely read obesity blog at www.drsharma.ca.

WHAT’S NEW?

PROTEIN AND THE PROSPECT OF DIABETES 
There have been a couple of prospective studies or what we are now going to call “Methodist ministers and Cuban rum” studies recently on protein intake and risk of type 2 diabetes.

• The findings of the University of Eastern Finland study in the British Journal of Nutrition suggest the source of dietary protein may play a role in the risk of developing type 2 diabetes. The researchers found that replacing animal protein with plant protein was associated with a lower risk of type 2 diabetes. 
• The findings of a prospective study and meta-analysis of the Melbourne Collaborative Cohort published in the American Journal of Clinical Nutrition showed that higher intakes of total and animal protein were both associated with increased risks of type 2 diabetes, whereas higher plant protein intake tended to be associated with lower risk of type 2 diabetes. 

What the researchers have found are actually correlations not “findings” in the sense of answers or causation. Certainly, diets high in plant protein such as wholesome whole foods like beans, chickpeas and lentils seem to be protective of a number of chronic diseases including type 2 diabetes. They are also generally low GI. Diets rich in animal protein don’t seem to convey the same advantage and numerous prospective studies over the years show this. Perhaps the saturated fat in meat has something to do with it. Saturated fat does contribute to insulin resistance making the poor old pancreas work harder pumping out more insulin. It’s also worth remembering that the Insulin Index of Foods published in the American Journal of Clinical Nutrition showed that any type of meat (beef, chicken, and pork) produced substantial insulin secretion.

What next? Prospective studies like these are useful for developing hypotheses that can then be put to the test with randomised controlled trials.

The studies 

• Intake of different dietary proteins and risk of type 2 diabetes in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. 
• Dietary protein intake and risk of type 2 diabetes: results from the Melbourne Collaborative Cohort Study and a meta-analysis of prospective studies. 
• An Insulin Index of Foods (full PDF) 

SUGAR’S SWOON IS GOING GLOBAL 
A new industry analysis by Rabobank suggests sugar’s swoon appears to be passing a tipping point reports ConscienHealth’s Ted Kyle. Food marketers are bowing to consumer pressure and driving sugar out of products, even in developing markets. For more than a decade now, the reputation of sugar as the primary culprit behind obesity trends has been growing. U.S. consumption of added sugars and sugar sweetened beverages peaked at the turn of the millennium. But the market for sugar continued to grow in developing markets. That refuge for marketing sugary foods is fading away.



The Rabobank report describes a cycle of consumer preferences. At its heart, this is a story of steadily rising global obesity rates, finger pointing, and the repercussions of consumers cycling through a love/hate relationship with the three macronutrients – carbohydrate, fat, and protein – and, in the process, demonizing certain foods. Currently, protein is on the rise (certainly in North America and Europe), as sugar, sugar-containing products, and other highly refined carbohydrates are increasingly cast as the main villain in the unremitting rise in obesity and metabolic syndrome rates. A “clean label” with a short ingredient list is the imperative that food companies are chasing. Added sugar will drop out. Artificial sweeteners are scary, so they aren’t coming back, either.

Now that global food makers are bowing to the storm of pressure that started with public health advocates, what are those advocates saying? Tom Farley, Philadelphia’s health commissioner, says it will take many years before any of this has an impact on public health. He says: “Sugar is a problem, but sugar is not the only problem.” In responding to doubts about the impact of Mexico’s sugar sweetened beverage tax, Barry Popkin and colleagues recently wrote: “The obesity epidemic will take decades to slow down, stop, and finally reverse itself, but other benefits might be seen sooner.” In other words, don’t hold your breath for health miracles from declining trends in sugar consumption.

To read more 

• Rabobank Report 
• ConscienHealth News 

Ted Kyle is a healthcare professional experienced in collaborating with leading health and obesity experts for sound policy and innovation to address health needs and the obesity epidemic in North America. Through ConscienHealth, he works to advance changes in policy and public opinion that will allow new approaches to be developed and put into use.

NEW GI VALUES 18 EMIRATI FOODS



“I welcome this unique set of data, which provide local populations with a practical and more effective way of controlling their blood glucose levels,” says award-winning Registered Dietitian Azmina Govindji (a media spokesperson for the British Dietetic Association and NHS Choices who was Chief Dietitian to Diabetes UK for 8 years).

“Eating well is about enjoyment, nutritional balance, and also cultural appropriateness. There is a growing incidence of diabetes in UAE and up until now, we’ve only had nutritional and GI information on Western-style foods.

Accurate analysis of the glycaemic impact of locally available produce, as well as dishes cooked using traditional methods, can help people with diabetes make more informed choices about local cuisine. This new research will fill an important gap, enabling healthcare professionals to have a more effective means of providing tailored dietary advice.

The data shows, for example, that foods like khameer bread and beef harees perform well on the GI scale, whereas regag bread and beef thareed are best saved for special occasions.”



Test method: For each test food, at least fifteen healthy participants consumed 25 or 50g available carbohydrate portions of a reference food (glucose), which was tested three times, and a test food after an overnight fast, was tested once, on separate occasions. Capillary blood samples were obtained by finger-prick and blood glucose was measured using clinical chemistry analyser. A fasting blood sample was obtained at baseline and before consumption of test foods. Additional blood samples were obtained at 15, 30, 45, 60, 90 and 120 min after the consumption of each test food. The GI value of each test food was calculated as the percentage of the incremental area under the blood glucose curve (IAUC) for the test food of each participant divided by the average IAUC for the reference food of the same participant.

Study 

• Glycaemic index and glycaemic load values of commonly consumed foods in the United Arab Emirates 
• Azmina Govindji http://on.fb.me/AzNutrition | twitter.com/AzminaNutrition

PERSPECTIVES WITH DR ALAN BARCLAY

PURE BUT NOT SO SIMPLE 
Most nutrition experts have been recommending that we enjoy traditional healthy eating patterns like the Mediterranean and Okinawan diets for many years now, rather than focusing on single nutrients, ingredients or food groups. After all, we eat foods, not nutrients, and the one-nutrient-at-a-time approach is fraught with unintended consequences as nutrition scientists such as Dr David Katz have enumerated very clearly on numerous occasions. However, the old fat versus carbohydrate debate still seems to attract media attention and the recent publication of the results of the PURE (Prospective Urban Rural Epidemiology) study are another example of hype over serious dietary substance.



The PURE study followed over 135,000 people living in 18 countries (three high-income (Canada, Sweden, and United Arab Emirates), 11 middle-income (Argentina, Brazil, Chile, China, Colombia, Iran, Malaysia, occupied Palestinian territory, Poland, South Africa, and Turkey) and four low-income countries (Bangladesh, India, Pakistan, and Zimbabwe) for over 7 years and found that death rates were highest in those who reported having the highest carbohydrate intakes, and conversely were lower in those with higher fat intakes. “Global dietary guidelines should be reconsidered in light of these findings,” they proclaim.

While the PURE study may sound impressive, like all observational studies, it can only show associations (like the Methodist minister and Cuban rum story). It also has a number of significant limitations, including the fact that the associations were only observed in the extreme levels of consumption (43% and 78% of energy from carbohydrates and 11% and 38% of energy from fats), and that diabetes diagnosis was self-reported (so we don’t know how many people really had diabetes). Many people in the low-income countries may have had diabetes but didn’t know it. This would significantly confound the results. However, one of the most significant limitations is how they estimated people’s food and nutrient intakes.

At the very beginning of the study (seven years in the past), a food frequency questionnaire was used to assess people’s food intakes. That was the only time people were asked what they ate. Food frequency questionnaires ask you to recall all the foods and drinks you consumed over the previous 12 months – a difficult task for most of us at the best of times (what did you eat last week?). These questionnaires also have to be carefully designed to reflect the food preferences of the people being studied – it’s not wise to use a questionnaire designed for one country in a different country, as food preferences and the food supply are usually very different. And finally, food frequency questionnaires need to be validated to see how well they measure actual food and nutrient intakes. There are many different ways of doing this. Overall, it’s highly unlikely that the protein, fat and carbohydrate estimates used in the PURE study are very accurate, which of course has profound implications for the results and their interpretation.

Finally, the study looked at the different kinds of fat (saturated, mono and polyunsaturated) but for some reason was not able to look at carbohydrate quality – not even examining the effect of dietary fibre, let alone refined carbohydrates (both starches and sugars), glycemic index or load. Like fats, all carbohydrates are of course not the same, and it is not very useful to lump them all together.

Despite all these significant limitations, and taking the study’s results at face value, we must consider how relevant they are in comparison to what the average person is eating today. In Australia, for example, our most recent national nutrition survey determined that the average adult consumed 43.5% of energy from total carbohydrate and 30.9% from fat. The nutrient reference values that underpin Australia’s dietary guidelines recommend that Australians consume 45-65% of energy from carbohydrates from carbohydrates and 20-35% of energy from fats. These ranges are very similar to what are recommended in the PURE study – our dietary guidelines therefore do not need updating based on this. We are already eating the minimum amount of carbohydrate and close to the upper end of the recommended range for fat. We therefore need to be eating better quality (minimally refined, high fibre, low GI) carbohydrates, not less, and similarly we need to be eating more poly and mono-unsaturated fat, not more saturated fat.

This is all very academic. We eat foods not nutrients. Most people don’t know what percent of energy they get from protein, fat or carbohydrate. Patterns of eating are much more useful, which is what most modern dietary guidelines focus on: recommending that we eat mostly “good carbs” like fruits, vegetables, legumes, wholegrains, milk and yoghurt and save refined carbohydrates like sugar-sweetened beverages, confectionery, savoury starchy snacks (e.g., chips, crisps), etc for special occasions. Keep it relevant. Keep it simple.

Study 

• Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study.

   
Alan Barclay, PhD is a consultant dietitian. He worked for Diabetes Australia (NSW) from 1998–2014 . He is author/co-author of more than 30 scientific publications, and author/co-author of  The good Carbs Cookbook (Murdoch Books), Reversing Diabetes (Murdoch Books), The Low GI Diet: Managing Type 2 Diabetes (Hachette Australia) and The Ultimate Guide to Sugars and Sweeteners (The Experiment, New York).