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1 March 2018
GI News - March 2018
FOOD FOR THOUGHT
ANYTHING TO DECLARE?
Conflict of interest is about much more than money says Dr Arya Sharma. In a blog post in Obesity Notes
(a shortened version reprinted here with permission) he highlights the
conflicts and potential biases nutrition researchers should not hesitate
to acknowledge and disclose that John Ionnadis and John Trepanowski
raise in JAMA.
First, the authors focus on nutrition
research for good reasons. They say: “The totality of an individual’s
diet has important effects on health, [while] most nutrients and foods
individually have ambiguously tiny (or nonexistent) effects. Substantial
reliance on observational data for which causal inference is
notoriously difficult also limits the clarifying ability of nutrition
science. When the data are not clear, opinions and conflicts of interest
both financial and nonfinancial may influence research articles,
editorials, guidelines, and laws. Therefore, disclosure policies are an
important safeguard to help identify potential bias.”
While
the potential for financial conflict in relationship to the food
industry is well recognised and there are now well-established
disclosure norms, other conflicts, of which there are many, are not
routinely acknowledged, let alone, disclosed. For one, there are
significant financial conflicts that have nothing to do with taking
money from industry. For example: “Many nutrition scientists and experts
write books about their opinions and diet preferences. Given the
interest of the public in this topic, books about nutrition, diets, and
weight loss often appear on best-selling lists, even though most offer
little to no evidence to support their frequently bold claims.”
Furthermore: “Financial conflicts of interest can also
appear in unexpected places. For example, many not-for-profit nutrition
initiatives require considerable donor money to stay solvent. Public
visibility through the scientific literature and its reverberation
through press releases, other media coverage, and social media
magnification can be critical in this regard.”
But
conflicts can get even more complicated when they start reflecting
researchers’ own personal views and biases: “Allegiance bias and
preference for favorite theories are prevalent across science and can
affect any field of study. It is almost unavoidable that a scientist
eventually will form some opinion that goes beyond the data, and they
should. Scientists are likely to defend their work, their own
discoveries, and the theories that they proposed or espoused.” While
that is certainly true for any area of research, nutrition scientists
face an additional challenge.
“Every day they must make
numerous choices about what to eat while not allowing those choices to
affect their research. Most of them also have been exposed to various
dietary norms from their family, culture, or religion. These norms can
sometimes be intertwined with core values, absolutist metaphysical
beliefs, or both. For instance, could an author who is strongly adherent
to some religion conclude that a diet-related prescription of his or
her religion is so unhealthy as not to be worthwhile?”
The
authors propose that nutrition researchers: “disclose their advocacy or
activist work as well as their dietary preferences if any are relevant
to what is presented and discussed in their articles. This is even more
important for dietary preferences that are specific, circumscribed, and
adhered to strongly. For example, readers should know if an author is
strongly adherent to a vegan diet, the Atkins diet, a gluten-free diet, a
high animal protein diet, specific brands of supplements, and so forth
if these dietary choices are discussed in an article. The types of
articles in which relevant disclosure should be expected include
original research, reviews, and opinion pieces (such as editorials).”
Although the article focuses on nutrition research, the authors
acknowledge that similar biases may exist in other areas of research.
In
my own experience, ideological biases (although well-intended) are
pervasive through much of the research and publications on topics
ranging from physical activity to public health, where I often see
strong recommendations made based on evidence that is not even remotely
as robust or rigorous as the evidence that comes from, say a large
randomised clinical trials of a new prescription drug.
I
certainly agree with the authors’ recommendation that: “As a general
rule, if an author’s living example could be reasonably expected to
influence how some readers perceive an article, disclosure should be
encouraged. Authors who have strong beliefs and make highly committed
choices for diet or other behaviors should not hesitate to disclose
them. Doing so may help everyone understand who is promoting what and
why.”
Dr Arya M. Sharma, MD/PhD, FRCPC is Professor of Medicine & 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.
Read more:
• John Ionnadis and John Trepanowski: Disclosures in Nutrition Research: Why It Is Different.
• Dr Arya Sharma: Conflict Disclosures in Nutrition Research
WHAT’S NEW?
MEDITERRANEAN DIET AND DEPRESSION
A
new trial from Deakin University shows improving diet quality helps
treat major depression. “We’ve known for some time that there is a clear
association between the quality of people’s diets and their risk for
depression,” says Professor Felice Jacka, president of the International
Society for Nutritional Psychiatry Research. “This is the case across
countries, cultures and age groups, with healthy diets associated with
reduced risk, and unhealthy diets associated with increased risk for
depression. However, this is the first randomised controlled trial to
directly test whether improving diet quality can actually treat clinical
depression.”
The researchers recruited adults with a
major depressive disorder and randomly assigned them to receive over a
three-month period either social support (helpful for people with
depression), or support from a clinical dietitian. The dietary group
were given information and help to improve their diet especially on
increasing vegetables, fruits, wholegrains, legumes, fish, lean red
meats, olive oil and nuts, and reducing sweets, refined cereals, fried
food, fast-food, processed meats and sugary drinks.
Participants
in the dietary intervention group had a much greater reduction in their
depressive symptoms over the three-month period, compared to those in
the social support group. At the end of the trial, a third of those in
the dietary support group met criteria for remission of major
depression, compared to 8 percent of those in the social support group.
“These results were not explained by changes in physical activity or
body weight, but were closely related to the extent of dietary change,”
says Jacka. “Those who adhered more closely to the dietary program
experienced the greatest benefit to their depression symptoms.
Importantly, depression also increases the risk of and, in turn, is also
increased by common physical illnesses such as obesity, type 2 diabetes
and heart disease. Successfully improving the quality of patients’
diets would also benefit these illnesses.”
Read more:
Pregnant women tend to be overwhelmed with unsolicited advice on a whole range of topics including “eat this, don’t eat that” dietary advice. Recently, a slew of fad diet books promoting low carb diets has cranked up the confusion about what to eat when you are expecting several notches by suggesting that by “reducing the intake of carbohydrates, [people] could significantly improve their health and well-being”. To set the record straight, a pregnant woman absolutely needs nutrient-rich sources of carbohydrate (what we call “good carbs”) in the right amounts to ensure she is meeting her own nutritional needs as well as her baby’s.
Prof Clare Collins and University of Newcastle researchers tackled six questions they are endlessly asked about eating carbs during pregnancy in a recent piece in The Conversation. They are now recruiting pregnant women in Australia (12–22 weeks gestation) to take part in an online survey to learn more about their nutrition knowledge and eating habits. The survey takes about 20–25 minutes and participants go into the draw to win one of four $100 gift cards. You can find out more about the survey and sign up to take part HERE.
Read more:
Six common questions about eating carbs during pregnancy answered
CHOOSING THE RIGHT DRINKS
Diabetes is a disease that develops when the body either stops producing the hormone insulin (type 1) or when the insulin it produces is not working properly (type 2). Insulin sensitivity describes how sensitive the body is to the effects of insulin, which is why it’s a key risk marker for diabetes. Someone who is insulin sensitive will require smaller amounts of insulin to lower blood glucose levels than someone who has low sensitivity to insulin.
A recent randomized controlled trial compared three everyday beverage choices on insulin sensitivity: semi-skimmed milk (recommended in dietary guidelines) with sugar-sweetened and “artificially” (intensely) sweetened soft drinks. Water was the non-calorie control. While the researchers hypothesized that drinking milk would improve insulin sensitivity and risk markers of cardiovascular disease in people who were overweight and obese, that’s not what they found. After 6 months’ intake of milk, or sugar-sweetened or intensely sweetened soft drinks, or water, there was no difference in risk markers for type 2 diabetes in the participants who remained weight stable throughout, suggesting the results were also independent of body weight.
Read more:
FEED THE BIRDS
In February, we wrote about how a dog can prompt you to be more active, help calm jagged nerves, and reduce feelings of isolation and loneliness. Interacting with birds is also good for us, mentally and physically, and people like to do this is by feeding the birds in their garden, “a habit that’s natural and extremely popular around the world,” says Prof Daryl Jones.
[Bird feeding] is a really important topic, says Jones, “because of the potential impact we’re having. We’re genuinely changing the shape of the wildlife community that lives in the city with us. These things we must not shy away from – if you are hosting people coming to your place to feed, you don’t allow them to go away sick. You are really, really, careful about how nutrient wise the food is and how clean the plate is. The same goes for birds.
As for a diet of bread and sugar or honey, traditional lorikeet fare in Australia, “that’s not a good idea at all,” says Jones, “as it can become very easily tainted with bacteria and fungi and make the birds ill. Probably the most important suggestion for bird feeders is to avoid mince and bread altogether; the mince is sticky, fatty and has too little calcium; far better is dry or tinned pet food. And bread is terrible for any animal apart from humans.”
Commenting on backyard bird feeding, Grainne Cleary, a researcher at Deakin University who led the Australian bird feeding and watering study, says “we need to understand its effect and provide guidelines to those who regularly feed birds in their backyards or urban settings.” She adds that making healthy food for birds more available on supermarket shelves, rather than just an ordinary cockatiel mix, will drastically improve bird health.
Darryl’s golden rules:
Cleanliness. Sweep up any left overs and spray feeder dish with a mix of water and vinegar. Dry and then add new feed. Daily.
Provide a snack. Not a meal. A little bit of healthy, appropriate food goes a long, long, way.
Never feed birds away from your home. Feeding bread to the ducks and swans at the park is a definite no-no.
Enjoy – because really, you're feeding the birds for yourself, not for their benefit.
Read more:
• Australian Bird Feeding and Watering Study
• Urban Bird Feeding: Connecting People with Nature
• To feed or not to feed
• Bird Feeding Takes Wing in U.S., With Summer Meals, Designer Seed
• Darryl Jones: The Birds at My Table. Why We Feed Wild Birds and Why It Matters (publishing March 2018)
PERSPECTIVES WITH DR ALAN BARCLAY
SOCIAL DRINKING
Many factors influence what,
when, and how much we drink, including taste, cultural background,
religious beliefs, budget, health, and social occasion ... Drinking
lubricates most social functions. It’s one of life’s pleasures. So,
let’s look at some of the more popular options.
Water Plain water is the best drink to quench
your thirst: it is the most refreshing, provides zero kilojoules, plus a
few minerals. However, it doesn’t seem to work so well socially – few
people pop down to the pub for a couple of rounds of water.
Mineral
water (with ice and a slice of lemon) is socially more acceptable.
Plain mineral water (still or sparkling) contains relatively small
amounts of sodium, potassium, magnesium and calcium. Fruit flavoured
varieties are increasingly popular and available in sugar sweetened or
intensely sweetened (“diet”) varieties. Sugar sweetened versions provide
around 400kJ (100 calories) and 24g of carbohydrate (sugars) per cup
(250ml); intensely sweetened varieties provide some 12kJ (3 calories)
and 0.5g of carbohydrate (sugars) per cup. If you are watching your
weight or blood glucose levels, plain or intensely sweetened options are
your best options.
Tea/coffee A cuppa with
family or friends is a popular social activity in most parts of the
world. Black tea or coffee provides very little energy (around 13kJ or 3
calories) or carbohydrate (less than 1g) per cup. Adding milk or sugar
increases both of course, with a cup of unsweetened white tea or coffee
providing about 75kJ (18 calories) and around 2g of carbohydrate; and a
cup of sweetened (2 level teaspoons of sugar) white tea or coffee about
235kJ (55 calories) and around 10g of carbohydrate – enough to raise
blood glucose levels in most people with diabetes if the sugar is
sucrose (GI=65).
However, if you sweeten your tea or
coffee with an intense sweetener like aspartame, saccharin, sucralose or
stevia, you don’t appreciably increase its energy or carbohydrate
content, and so it won’t adversely affect blood glucose levels or body
weight.
Low joule/calorie or “diet” soft drinks
Unlike water, tea or coffee, these soft drinks probably shouldn’t be
consumed daily, but they are still good choices when socialising as an
alternative to alcohol. Carbonated beverages have a low pH (they are
acidic), and in theory, frequent consumption may increase the risk of
developing tooth decay which is a serious health issue for many people.
However, they have no effect on blood glucose levels and provide very
few kilojoules (around 5kJ or 1 calorie per cup). There is good evidence
that substituting regular soft drinks with diet varieties will help
people to lose weight.
Fruit juices and fruit drinks
People enjoy these soft options at social gatherings. They are a source
of calories, vitamin C, dietary fibre and carbohydrate. On average,
they provide approximately 400kJ (95 calories) per cup, and are an
important source of vitamin C providing on average 113mg per cup, which
is more than twice the RDI (45mg per day). Most fruit juice contains a
small amount of dietary fibre, but higher fibre varieties are becoming
increasingly common.
Fruit juices and drinks have a low
pH and are a source of fermentable carbohydrate for cariogenic
bacteria. Frequent consumption may therefore increase the risk of
developing tooth decay. On average, fruit juices and drinks provide 22g
of carbohydrate per cup. All fruit juices made from low GI fruit and
most fruit drinks have a low GI, however a 250ml serve of most varieties
has a medium glycemic load.
Sugar sweetened soft drinks
Save these for special occasions. Like fruit juices and drinks, they
have a low pH and are a source of fermentable carbohydrate for
cariogenic bacteria, and consumption is associated with increased risk
of tooth decay. On average, a small glass (250ml) of sugar sweetened
soft drink provides around 440kJ, 27g of carbohydrate (around 2
exchanges), and most varieties have a medium glycemic index, and a
medium–high glycemic load, and consequently they will raise blood
glucose levels in people with diabetes.
Hard drinks
For many people, social occasions include the enjoyment of alcoholic
beverages in moderation. We have discussed them in detail in previous
issues of GI News (See “Cheers” in Read More).
The bottom line
Plain water is unquestionably the best option for quenching thirst, but
it’s rarely the first choice when drinking socially with family,
friends and colleagues. There’s an increasingly large variety of
beverages out there so choose wisely for your health and enjoyment.
Read more:
- Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including meta-analyses, of the evidence from human and animal studies.
- Cheers
- 1 Australian measuring cup = 250mL
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).
Contact: You can follow him on Twitter.
KEEPING IT GREEN – EATING FOR BODY AND PLANET
MEAT-LESS
Meat-less movement
‘Meatless
Monday’ is not new. It was started by the US government during World
War 1 to reduce consumption of key foods to win the war (interestingly
they also had ‘wheatless Wednesday’). It was revived as a health
awareness campaign in 2003 to address excessive meat intake in the USA.
Since then it has gone from strength to strength. People are seeing the
environmental benefits of eating meat-free (or less meat) and not just
on Mondays. Eating less meat is a growing global movement. According to Google Trends,
interest in ‘vegetarian recipes’ has more than doubled over the past 5
years worldwide. And for those not quite ready to quit meat completely
there is now a new category of eaters called ‘flexitarians’ who eat
mostly vegetarian foods but have the occasional meaty meal.
The true cost of meat
There are some costs that are not included in the ticket price of food – the costs to the environment. According to the IPCC,
not only are more resources required to produce livestock compared to
plant foods, but their manure produces greenhouse gases too - an
environmental double whammy. In countries where there are more cattle
and sheep, these animals were the greatest agricultural contributor of greenhouse gases.
What can we do?
There
is no doubt meat is nutritious, including red meat. Red meat is a great
source of protein, iron and vitamin B12. However, some of us eat more
than we need. To minimise your environmental impact, you need to eat
‘just enough’ meat to meet (pardon the pun) your nutritional
requirements. For example, the Australian Dietary Guidelines
recommended up to 455g cooked lean red meat per week. Ordering a 500g
steak at a restaurant is a week’s worth of red meat on its own. Cooking
500g of raw red meat at a meal is enough for a family of 4. If this
doesn’t seem enough, add some plant protein like legumes and plenty of
vegetables and some wholegrains to fill the plate.
Enjoy variety
Meat
is part of the ‘meat and alternatives’ food group that includes red
meat, white meat, fish, eggs and plant-based alternatives like pulses,
legumes, nuts and seeds. Aim for 2-3 ‘serves’ of a variety of options
from this group per day, where one serve is: 65g of cooked red meat
(100g raw); 80g cooked poultry (100g raw); 100g cooked fish (115g raw); 2
eggs; 1 cup (150g) cooked legumes (lentils, chickpeas, black beans);
170g tofu; or 30g of nuts or seeds.
Eating just enough meat, in a nutshell
- Make meat a side player rather than the main event – aim for ¼ of the plate as meat, half the plate as vegetables, and a quarter as grains (or starchy vegetable).
- Vary your meat choices - smaller animals such as poultry and (sustainable) fish have a smaller footprint. And don’t forget eggs – they offer perfect protein at a smaller environmental cost.
- Replace some of your meat with plant proteins: try adding lentils to your spaghetti Bolognese, burgers, meatloaf or casseroles; or chickpeas or tofu and nuts to curries, soups and salads.
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.
GOOD CARBS FOOD FACTS A TO Z
BEANS
Beans
are packed with good things for good health including slow-digesting
carbs, fibre (including the sticky ones that lower cholesterol),
vitamins and minerals. But what makes them really stand out from the
plant food crowd is their protein – typically 7–10 grams per half cup
cooked dried beans.
Picture: Roasted Beetroot and White Bean Salad from The Low GI Vegetarian Cookbook (Hachette Australia)
Renowned
for farts and jokes, the main culprits in beans are the large
indigestible sugars (raffinose, stachyose and verbascose) which zip
through the digestive system and arrive in the large bowel intact where
the resident healthy bacteria enthusiastically ferment them and feast.
That embarrassing gas is a natural outcome. Eating small amounts
regularly helps your body acclimatize. And rinsing beans several times
before soaking and cooking helps wash them away (the indigestible sugars
are water soluble).
Our word is “bean” and the Roman’s was “faba” – but they actually have a
common ancestor, the Indo-European bhabh or bhabha which means
“swollen” or “swelling”. Whoever had naming rights was spot on – beans
are generous providers, swelling up in the cooking pot so that one cup
of dried beans gives us two or three cups to serve. It’s no wonder they
have made themselves at home in kitchens around the world in classic
dishes, family favourites and vegetarian fare. Not only do they bulk
things out, they thicken, add texture and colour, absorb flavours, make
great partners, and are nourishing, frugal extenders making a little go a
very long way.
Source: The Good Carbs Cookbook
IN THE GI NEWS KITCHEN
STICKS, SEEDS, PODS AND LEAVES
Kate 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 in her cooking, but you can substitute with what you have on hand in your pantry.
BLACK LIME and BEAN SALAD
This
quick salad is wonderfully enhanced by the zing of black lime powder.
It makes a perfect packed lunch that will keep you going all afternoon.
Prep: 5 mins Cook time: 5 mins Serves: 4
2 x 400g (14oz) cans of 3-bean mix, drained
1 x 400g (14oz) can of unsweetened corn kernels, drained
15 green beans, trimmed and cut into 3cm/1½in pieces (or 1 cup defrosted frozen green beans)
1 avocado, cut into 2cm/¾in cubes
2 tbsp olive oil
1 tbsp lime juice
3 tsp Herbie's Spices
Black Lime Powder
½ cup coriander leaves, roughly chopped
If
using fresh beans, blanch for 2 minutes in boiling water, then drain
and add to the serving bowl with 3-bean mix and corn kernels. • Whisk
together olive oil, lime juice and black lime powder. • Stir dressing
through salad with avocado and coriander and serve.
Per serve
2000kJ/480
calories; 17g protein; 20g fat (includes 3.5g saturated fat; saturated :
unsaturated fat ratio 0.21); 47g available carbs (includes 9g sugars
and 38g starches); 17g fibre; 815mg sodium; 840mg potassium; sodium :
potassium ratio 0.97
CHRISSY FREER’S FOOD WITH ADDED LIFE
As
a qualified nutritionist, Chrissy’s philosophy is simple: limit the
amount of processed food in your diet and focus on whole foods. “By
returning to eating whole foods, that is foods in their most natural
state, we allow our bodies to benefit from all the available nutrients
that food can provide.” Steer clear of food fads and miracle cures, if
it sounds too good to be true then it probably is!
SALMON WITH WHITE BEAN MASH
This
delicious meal will be on the table in 25 minutes. It’s rich in the
good omega-3 fats and cholesterol-fighting legumes. Recipe and photo
(Steve Brown) courtesy www.taste.com.au. Serves 4.
1 tbsp olive oil
2 garlic cloves, crushed
1 tsp ground cumin
1 tsp finely grated lemon rind
2 x 400g (14oz) cans cannellini beans, rinsed, drained
1 tbsp fresh lemon juice
1 cup fresh continental parsley leaves
1 small red onion, halved, thinly sliced
1 tbsp baby capers, rinsed, drained
olive oil spray
4
(about 125g/4oz each) skinless salmon fillets
steamed green round beans, to serve
Heat
the oil in a medium saucepan over medium heat. Add the garlic, cumin
and lemon rind and cook, stirring, for 30 seconds or until aromatic. Add
the cannellini beans and lemon juice, and cook for 2 minutes. Use a
fork to coarsely crush. Set aside and cover to keep warm. • Combine the
parsley, onion and capers in a small bowl. • Heat a large non-stick
frying pan over medium-high heat. Spray with oil. Cook the salmon for
3-4 minutes each side for medium or until cooked to your liking. •
Divide the bean mixture among serving plates. Top with the salmon and
the parsley mixture. Serve with green beans.
Per serve
2250kJ/
540 calories; 41g protein; 25g fat (includes 5g saturated fat;
saturated : unsaturated fat ratio 0.25); 27g available carbs (includes
6g sugars and 21g starches); 16g fibre; 690mg sodium; 1300mg potassium;
sodium : potassium ratio 0.53
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