GI News—March 2006

In This Issue:

• Food for Thought
  —Johanna Burani article
  
• GI News Briefs
  —Making the Switch, Making a Difference
  —Risk Assessment
  —Sense and Sensitivity
  
• GI Values Updates
  —White Bread Matters
  —Sweet Cactus Farms Premium Agave Nectar
  
• Low GI Food of the Month
  —Soy Milk: A Great Way to Include Soy Protein in Your Diet
  
• Low GI Recipe of the Month
  —Sourdough French Toast with Peaches
  
• Success Stories
  —Sanna’s Story: Giving Your Body the Fuel It Is Actually Meant to Run On
  —John’s Story: Managing Diabetes with GI
  
• GI Profile
  —Prof. Jennie Brand-Miller
  
• Books, DVDs, Websites: What’s New?
  —The 10-day GI Diet
  —The Low GI Guide to Your Heart and the Metabolic Syndrome
  
• Feedback—Your FAQs Answered
  —What effect good or bad, can a GI diet have on prostate cancer patients undergoing hormone treatment to limit testosterone?
  —I enjoy brown rice and always assumed it had a lower GI than any kind of white rice, but I see that Basmati’s is lower. Why’s that?
  —Does it matter if you eat carbs after 5pm? Will this affect your fat metabolism?
  —Dispelling Some Myths About Hypoglycemia
  
  

If you have posted a question in our newsletter, be assured that the GI Group will answer this as soon as possible. We welcome your views about our articles and other reader’s suggestions. Please POST your comments on the site.

We receive a great deal of feedback from readers and visitors to our website about how a low GI diet has made a real difference to their lives along with some inspiring weight loss and blood glucose control stories. Please share your success. Your experiences really can motivate others. If you feel you have a story that will inspire or help others and you are prepared to give permission for it to be published in GI News, please click HERE to send us your story.

If you want to print a copy of just one article (ie. the recipe from the newsletter), simply click on the recipe or article name in the right-hand column under PREVIOUS POSTS. You will arrive at the page you have chosen. Select PRINT and you will find that you can print just the information you want.

To receive our FREE e-newsletter each month, click the SUBSCRIBE link in the right-hand column. Your email address will be kept strictly confidential and you can unsubscribe at any time.

Want to search the GI News Archive for a particular topic, food or recipe? Make the most of our search feature with Google. Simply enter the term in the space provided and press SEARCH.

GI News Editor: Philippa Sandall
Web Design and Management: Scott Dickinson

Food for Thought

People Power for People with Diabetes
In February GI News, Atarah Grysman made the point that: ‘Many people today are ready and willing to be active participants in their own health care. They want to learn more about their conditions and how to manage them, even if this entails more than a few simple rules, and requires a deeper understanding of how their body works.’

The findings of a study by Johanna Burani of Nutrition Works in New Jersey and Dr Palma Longo of the University of Massachusetts in The Diabetes Educator (Volume 32, Number 1, January/February 2006 ) confirm this point. In a small retrospective study to evaluate the incorporation of low-GI carbohydrates into daily meal planning as an effective behavioural lifestyle change for people with type 1 and type 2 diabetes, the authors found that in most cases, patients were keen to succeed in their diabetes self-management care. And they were successful too. The participants in the study reduced HbA1c by an average of 19% and BMI by 8% simply by lowering the GI of their meals by 25% (15 points) over the period of the survey (3 to 36 months). Once presented with basic information about incorporating low-GI carbohydrates in meal planning, they made their own decisions and over time converted this dietary change into a way of life to improve their overall glycemia and preserve quality of life say the authors. They report that ‘learning to incorporate low-GI carbohydrates affords patients a practical skill that is within their grasp. It empowers them to “own” their diabetes and actively contribute to their control over it … The documented responses to the subjects’ conceptual and practical knowledge of the GI confirm their acceptance of this approach as a permanent behavioral lifestyle change and not a diet.’


Johanna Burani

GI News Briefs

Making the Switch, Making a Difference
Studies are showing that metabolic syndrome or insulin resistance syndrome is widespread among adults in developed nations, with estimates in Australia alone for example of one in two adults over 25 years having at least two features of what is seen to be a silent disease. People with metabolic syndrome are three times as likely to have a heart attack or stroke compared with people without the syndrome and they have a five-fold greater risk of developing type 2 diabetes (if it’s not already present). David E Laaksonen and his team from Finland report in the American Journal of Clinical Nutrition that a simple dietary modification may lower the risk of developing type 2 diabetes in people with metabolic syndrome by enhancing early insulin secretion. They assigned 72 overweight or obese men and women with the metabolic syndrome to a 12-week diet in which either rye bread and pasta or oat and wheat bread and potato were the main carbohydrate sources (34% and 37% of energy intake, respectively). Body weight did not significantly change in either group during the trial. However, only the pasta-based carbohydrate modification enhanced early insulin secretion (by 33%) and was associated with improved glucose tolerance reducing the risk for the development of type 2 diabetes.
—American Journal of Clinical Nutrition. 82(6):1218-278, 2005 Dec



Risk Assessment
Reduce blood glucose (sugar) levels and you’ll reduce the risk of coronary heart disease reported Elizabeth Selvin and her colleagues in Archives of Internal Medicine (September 2005; 165, pp1910-1916). ‘For non-diabetics, lifestyle modifications, such as increased physical activity, weight loss and eating a healthful, low-glycemic, index diet rich in fibre, fruit and vegetables, may not only help prevent diabetes, but also reduce the risk of heart disease.’ This study was based on what’s called the Atherosclerosis Risk in Communities Study (ARIC). Analysing the data from this long-term program has helped to give us a clearer understanding of heart disease risks. Set up in 1987 to measure the associations of established and suspected CHD risk factors in men and women, it tracked almost 16,000 people from North Carolina, Mississippi, Maryland and Minnesota. Participants had four medical examinations (1987-90, and 1990-93, 1993-96, and 1996-99), and were contacted every year to update their medical histories.

In Selvin’s study reported in December 2005 Diabetes Care, her team looked at the ARIC data for 2,060 people with diagnosed and undiagnosed diabetes. The researchers identify several associations between HbA1c (a measure of long-term blood glucose) and known CVD risk factors and suggest that HbA1c is independently related to thickening of the carotid artery walls (a sign of heart and blood vessel disease). They conclude that: ‘chronically high blood glucose levels may contribute to the development of atherosclerosis in people with diabetes independent of other risk factors.’


photo: scott dickinson

Sense and Sensitivity
Writing in December 2005 Diabetes Care Liese et al report on the association of digestible carbohydrates, fibre intake, glycemic index and glycemic load with a number of factors including insulin sensitivity in 979 adults from the Insulin Resistance Atherosclerosis Study. The researchers analysed data from the study and estimated nutrient intake using a food frequency questionnaire and concluded that: ‘Carbohydrates as reflected in glycemic index and glycemic load may not be related to measures of insulin sensitivity, insulin secretion, and adiposity. Fibre intake may not only have beneficial effects on insulin sensitivity and adiposity but also on pancreatic function.’
—Diabetes Care 28:2832-2838, 2005

GI Group: The food frequency questionnaire used in the study does not assess an individual’s carbohydrate intake very well. Comparison with another method of assessing an individual’s carbohydrate shows that the food frequency questionnaire has a very poor correlation ( just 0.37) for carbohydrates and thus it would be judicious to question the study’s conclusions.

Assessing a person’s food intake accurately is challenging. People tend to under-report some foods and overestimate others. There isn’t a perfect method. Food records, dietary recalls and list-type methods such as food frequency questionnaires are all subject to some error and bias. That’s why it’s important to assess the relative validity of estimates of nutrient intake statistically by comparison with independent methods to see how well they compare. The GI Group requires a correlation >0.5 for carbohydrate for these types of studies to be accepted and a recent paper published by the Harvard Group (Park et al. JAMA. 2005; 294:2849-57) corroborates this decision.

The average GI for the older Americans in the Liese et al study was 58, with a relatively small variation (standard deviation of 4). The relatively small variation would have meant it would be very difficult to find statistical differences between the groups with high and low insulin sensitivity, insulin secretion and adiposity. This may be because the food frequency questionnaire used does not measure carbohydrates well, or that their study population has a very similar diet from a GI perspective.

Interestingly, research in Australia shows a similar average GI for the older Australian population of around 56, and this appears to be pretty typical for those developed nations that have been studied. Although more research is needed, it appears that the average GI associated with the least risk of developing chronic lifestyle diseases like type 2 diabetes, heart disease and some cancers, is around the low to mid-40s as stated in the Liese et al study . The GI Group has previously suggested that individuals need to decrease the average GI of their diet by around 15 units and this is consistent with Liese et al.

GI Values Update

White Bread Matters
While many parents would prefer their children to eat high fibre, wholegrain bread they know their kids, particularly once they are at school, will be wanting sandwiches made with white bread like everyone else. Even with the best of intentions, parents generally find it’s hard to get the grainy or soy and linseed breads into children. Don’t give up trying. And don’t despair. There are now two low GI white breads (with published GI values) on Australian supermarket shelves and one in the UK. They are ideal to set children up with a sustaining breakfast and fill those lunch boxes with healthy sandwiches: George Weston Foods Tip Top UP EnerGI (GI 54), Goodman Fielder’s Wonder White Low GI (GI 54) and Warburtons All in One loaf (GI 49). They were specially formulated by the manufacturers in response to the growing recognition of the benefits of eating low GI foods in treating childhood obesity and preventing type 2 diabetes later in life. There are other benefits too. ‘Studies have shown that low glycemic index foods are an important part of a healthy diet for children as they supply them with sustained energy levels during the day, which helps maintain physical and mental concentration,’ says Prof. Jennie Brand-Miller from the University of Sydney’s Human Nutrition Unit.



Both the Australian breads carry the GI Symbol meaning they have had their GI tested using the accredited methodology and meet the strict nutritional criteria set out in the public health program run by the University of Sydney, Diabetes Australia and the Juvenile Diabetes Research Foundation. For more information visit: www.gisymbol.com



Sweet Beginnings—Agave Nectar Is the First US Product to Carry GI Symbol
Sweet Cactus Farms Premium Agave Nectar: (GI 19) is extracted from the pineapple-shaped core of the Blue Weber agave (Agave tequilana), a succulent plant (not a cactus) native to Mexico. It’s been cultivated for hundreds of years giving the world aguamiel, pulque, and tequila as well as agave nectar, a liquid sweetener. Premium Agave Nectar is around 90 percent fructose (which accounts for its low GI), and about 25 per cent sweeter than sugar so you don’t need to use as much. You can use it to sweeten food or drinks including tea and coffee. Sweet Cactus Farms says that if you are using it in your baking instead of sugar:

• Replace 1 cup sugar with ¾ cup of Agave Nectar
• Reduce recipe liquids by one-third
• Reduce the oven temperature by 25°F (approx. 4°C)

It is suitable for kosher, parve (pareve) and vegan diets.

For more information check out www.sweetcactusfarms.com

Low GI Food of the Month

Soy Milk—a Great Way to Include Soy Protein in Your Diet
Once enjoyed mainly by vegetarians, soy milk is the completely dairy- and lactose-free beverage that has become increasingly popular, because it tastes good and is rich in phytoestrogens. Soy milk is usually made by mixing soybeans – which are usually GM/GE free (check the label) – with filtered water and flavourings to produce a milk-like product.

You can buy reduced fat, calcium fortified soy milk GI 36–44 fresh from the chilled dairy cabinet, in long life packs and in powdered forms. You can also buy flavoured products. To ensure it is a suitable alternative to regular dairy milk, soy milk is often enriched with a range of vitamins and minerals including calcium and riboflavin (vitamin B12). Choose a low fat calcium-enriched milk and use it exactly as you would regular milk – on your breakfast cereal, with hot or cold drinks or in your cooking when making desserts and sauces. If you haven’t tried calcium-enriched low fat soy milk before, here are some easy ways to get started.

• Mix it in with mashed sweet potato, pumpkin or potato; or in a combination of all three vegetables.
• Try a soy latte or soy banana smoothie or use in other flavoured milk drinks.
• Use it to make white sauce for lasagne or moussaka.
• Make dairy desserts with soy milk.
  

—From Low GI Eating Made Easy (available in Australia, New Zealand, the UK and the US)

Low GI Recipe of the Month

Sourdough French Toast with Peaches
Simply halve the quantities to make for two people. For just one serving you’ll only need 1 peach and 1 slice of bread, but you’ll still have to use 1 egg, 125 ml milk and 2 teaspoons of maple syrup and you’ll have a little mixture left over.

Serves 4
Preparation time: 10 minutes
Cooking time: 8 minutes

2 eggs
250 ml (10 fl oz) low fat milk
1 tablespoon pure 100% maple syrup
pinch nutmeg
olive oil spray
4 slices of wholemeal sourdough, each about 2 cm (3/4 in)
thick
4 fresh peaches, sliced

1. Whisk the eggs, milk, maple syrup and nutmeg together in a shallow bowl. Lightly spray a non-stick frypan and heat over a medium heat.
2. Dip the bread in the egg mixture and turn to coat completely. Place the bread in the heated pan and cook for 2–3 minutes on each side until golden brown. Set aside and keep warm.
3. Spray the pan lightly again, and cook the peach slices for 1–2 minutes on each side, until just softened. Serve the French toast topped with the peaches.

Per serving:
960 kJ/226 Cal; Protein 12 g; Fat 5.5 g (Saturated fat 1.5 g); Carbohydrate 31 g
—From The Low GI Guide to Managing PCOS available in the US, Australia and New Zealand as The New Glucose Revolution Guide to Managing PCOS

Your Success Stories

Sanna’s Story: Giving Your Body the Fuel It Is Actually Meant to Run On
‘I found out about GI in a food magazine in Sweden last year. I had never been on a diet, and cannot count calories if my life depended on it! But as I read in this magazine about the principles of eating with low GI, I thought, hey, I want to try! So I systematically exchanged my white flour, sugar, and potatoes to lentils, beans, veggies and dark whole grain bread. The results were immediate. Since my second daughter was only three months old when I entered my GI adventure, people were quite upset with me that I would “diet” when I was still breast feeding. But what I was doing was not dieting at all! I simply began eating more healthy, and my overweight just melted away. In three months I went from 72 kg to 64 (I am 166 cm), and I felt great! I happily continued to nurse my daughter until she turned one, and then I lost another 3 kg.

I feel energised, slim, healthy and HAPPY! Thank you for spreading the word about GI! It is not hard at all! I never go hungry, and I don't skip meals to try to force myself to lose weight (that most often leads to later binging anyway). In the beginning it was quite a challenge to overcome the sugar pull, because that stuff is as addictive as anything! But now I don't even crave it anymore! I am free!

Try it out you too! Find a friend, and walk the GI road together. It is great to have someone to encourage you, and with whom you can exchange new exciting GI recipes. You will not want to go back once you have experienced the enerGi boost of giving your body the fuel it is actually meant to run on!’


Sanna

John’s Story: Managing Diabetes with GI
‘Having just finished reading The New Glucose Revolution I would like to share with you my success in managing diabetes with a GI diet. I am 64 and was diagnosed diabetic at the end of May 2005. I was admitted to hospital very ill – blood pressure 256/149; HBA1C 13.2; blood glucose 11.4; cholesterol 7.2; weight 113 kg.

For several months I had been ill and showed all of the typical symptoms of diabetes – weight loss, craving for sweets, continual need to urinate etc. But being a typical male I refused to seek treatment until my condition was chronic. After five days in ICU and three in a recovery ward I was discharged with my blood glucose at 8.2 mM, blood pressure controlled by medication and using Lantus 24 ml daily. Other medication was Tritace 10 mg, Lipitor 20 mg and Ecotrin 81 mg (which I had been taking for 15 years) daily and Glucophage 500 mg bd. Fortunately, scans and tests revealed no abnormality to heart, lungs, liver and kidneys. Eyesight had deteriorated but has since restored itself and all pulses and nerves to extremities were normal. Eyesight has since restored itself and I use the same reading glasses I used before diagnosis.

After having visited one of the South African diabetic associations, which was a disaster, I found out about the glycemic index and started the diet. Having now read several of your publications and visited many websites I have adopted this as a lifestyle and have adhered to it for 6 months and intend to do so for the rest of my life. I have found the experience stimulating and fulfilling and limitations on dietary requirements minimal. In addition I have a regimented regular exercise program of a minimum of 30 minutes, 5 days a week on a treadmill at 6 km per hour. Over the past 6 months I have reduced my insulin requirements and for4 weeks now have stoped all insulin injections. Random blood glucose readings vary between 4.5 and 6.4 mM and this week I underwent my biannual medical the results of which are as follows. Blood pressure 126/74, HBA1c (glycated) 5.5, cholesterol 3.27, LDL 1.24, HDL 1.57. All liver, kidney and urine tests normal. ECG normal. Weight 100 kg. I believe this is testament to the success in low GI foods in the control of type 2 diabetes. Thanks for all your research and long may it continue.’

GI Profile

Prof Jennie Brand-Miller
In this occasional series, we ask some of the world’s leading GI researchers to tell their story. This month we look at the University of Sydney’s GI Group leader, Prof. Jennie Brand-Miller’story. What follows is an edited version of her Australia Day 2006 speech. Jennie is acknowledged worldwide for her expertise in the area of carbohydrates and health. Since 1981 she and her team have played a key role in establishing the scientific validity, benefits and practicalities of the glycemic index. Jennie is Professor of Human Nutrition at the University of Sydney. She holds a Personal Chair in the Human Nutrition Unit of the School of Molecular and Microbial Biosciences. Her research interests focus on many areas of nutrition – the glycemic index of foods, diet and diabetes, insulin resistance, lactose intolerance and infant nutrition. But Jennie has another story to tell.


Jennie Brand-Miller

‘Eight years ago I was ready to resign from my job and felt like resigning from life. I had worked hard at school, got a scholarship to the University of New South Wales, did a bachelor’s degree and then a PhD and landed my dream job at the age of 25 – a lectureship at the University of Sydney. But not everything was going my way, there were black clouds on the horizon. Slowly but surely, over the course of 25 years, I lost the hearing in both ears. Today I am profoundly deaf. The decline in hearing was an emotionally painful process. I was excruciatingly embarrassed. I dreaded being considered stupid, especially in a world of intellectuals at the university. I learned to avoid difficult hearing situations. Any gathering of people, any meeting, any noisy environment, was stressful. The telephone became a source of great torment. People's names escaped me and transcribing numbers, addresses and dates became impossible. I gradually lost the ability to enjoy television and movies. Public address announcements were impossible.

But since 1998 my life has done a complete ‘about face’. How come? I was given the gift of hearing – a cochlear implant or bionic ear – something only possible because of the achievements of Professor Graeme Clark. Graeme Clark developed the world first bionic ear from an early prototype to successful commercial venture (go to http://www.cochlear.com/). The cochlear implant was like jump leads to a car with a flat battery. Suddenly I had more confidence, more energy, more self-esteem and I was so proud of the cochlear implant and the fact that it was Australian technology. Instead of being humiliated by my hearing loss, I was suddenly proud of it and I what I could do. I wanted to tell everybody about my bionic ear. And I do.’

Books, DVDs, Websites: What’s New?

The 10-day GI Diet
Azmina Govindji RD and Nina Puddefoot
‘Feed a man fish and he eats for a day. Teach a man to fish and he eats for life.’ This 10-day diet is intended as a ‘kick start to a new healthier you.’ Despite the ‘lose up to an inch’ promise of the sub-title, the authors are well aware that it is just a beginning. Not a miracle. The idea is to get you enthused and then hooked on healthy eating. It’s not GI, it’s GiP, a special system that the authors have devised based on nutritional criteria that encompass a food’s GI, energy density (calories/kilojoules) and portion size – special GiP tables are in the book. So there are numbers or GiPs to keep a count of and add up each day. But, it’s well written and packed with practical tips, menus and some 60 healthy recipes made with low GI ingredients you can get on the table in around 20 minutes.
—Vermilion, £6.99



The Low GI Guide to Your Heart and the Metabolic Syndrome
Prof Jennie Brand-Miller and Kaye Foster-Powell
Scott Dickinson, GI News designer and web manager who is also completing his PhD on glycemic index and cardiovascular disease risk, thinks that this is the best little book on GI out there. ‘Short, succinct and easy to understand’ is how he describes it. It covers the benefits of GI for heart health, includes practical tips to help readers make the switch to low GI eating and sets out the 10 basic steps to a healthy heart diet along with a week of menus to get you started. Recognising that metabolic syndrome is a world-wide problem, this completely revised and updated edition of the pocket guide by the same name includes more than 100 Chinese, SE Asian, Indian, Mediterranean and Middle Eastern meal ideas from dietitians Johanna Burani, Linda Cumines, Effie Houvardis and Sangita Nayak.

Feedback—Your FAQs Answered

What effect good or bad, can a GI diet have on prostate cancer patients undergoing hormone treatment to limit testosterone?
We couldn’t find any published research on the links between the GI of your diet and hormone treatment for prostate cancer patients to limit testosterone. There are however, well established dietary guidelines for men to reduce their risk of prostate cancer by reducing the amount of red meat and high-fat dairy foods they eat and making sure they eat five or more servings of vegetables and fruits each day. Reducing the GI of your diet is now added to the ‘reduce the risk’ list as prostate cancer has been linked to high circulating levels of insulin. A study from Italy and Canada reports a direct relationship between dietary GI and GL and prostate cancer risk – men whose diets were highest in GI and/or GL were more likely to develop prostate cancer even after adjusting for all other factors. The researchers explain that low physical activity levels together with high GI carbohydrate and hence higher blood insulin levels were likely responsible for the increased cancer risk (International Journal of Cancer ( 2004; 112(3):446-50). The strength of this particular study is the large number of participants and controls and the use of a reproducible and validated questionnaire. For additional information, contact Claudio Pelucchi, Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea 62, 20157 Milan, Italy. E-mail: pelucchi@marionegri.it.

I enjoy brown rice and always assumed it had a lower GI than any kind of white rice, but I see that Basmati’s is lower. Why’s that?
The GI group is on the hunt for a brown low GI rice – stay tuned! Rice can have a very high GI value, or a low one, depending on the variety (there are around 2000 varieties worldwide) and its amylose content. Amylose is a kind of starch that resists gelatinisation. Although rice is a wholegrain food, when you cook it, the millions of microscopic cracks in the grains let water penetrate right to the middle of the grain, allowing the starch granules to swell and become fully ‘gelatinised’, thus very easy to digest. So, if you are a big rice eater, opt for the low GI varieties with a higher amylose content such as Basmati. These high-amylose rices that stay firm and separate when cooked combine well with Indian, Thai and Vietnamese cuisines.
Brown rice is an extremely nutritious form of rice and contains several B vitamins, minerals, dietary fibre and protein. Chewier than regular white rice, it tends to take about twice as long to cook. The varieties that have been tested to date have a high GI, so enjoy it occasionally, especially combined with low GI foods such as legumes.



Sushi rice (Koshihikari rice GI 48) is a short-grain rice with a slightly, sticky soft texture when cooked. Wild rice (GI 57) is not actually rice at all, but a type of grass seed.
Arborio rice releases its starch during cooking and has a medium GI.

Does it matter if you eat carbs after 5pm? Will this affect your fat metabolism?
The first point to make is that people with diabetes who are taking insulin or other blood glucose lowering medication should definitely not practice a carb curfew – they could develop a hypo. The second point is that there’s no scientific evidence yet to support the carb curfew theory. It’s certainly not endorsed by health authorities.

‘I think the “carb curfew” myth for weight loss arose from the body builders on one their pre-competition regimes,’ says dietitian Catherine Saxelby (www.foodwatch.com.au). ‘They are heavily into protein and denial and usually follow a semi-fast before a competition to remove surface fat and better define their muscles. Cutting out carbs like potato, pasta or rice with dinner is simply a way of cutting down on kilojoules (calories). That’s all. Here’s what you’ll save:

• Cut out a large baked potato and you reduce your dinner intake by 580 kilojoules.
• Cut out a cup of steamed white rice and you’re down 770.
• Cut out a cup of cooked spaghetti and you’re down 840.

So out of a total dinner intake of say 1200 kJ for grilled steak, potato and a salad, you can knock off over 50% if you say No to the carbs. That’s why you lose weight! But there’s no point in eating an unbalanced meal – it only sets you up to snack the night away because you’re still hungry. A steak or fish fillet with non-starchy vegetables is not a balanced meal. Add a small carb portion and you’ll feel a lot better and you’ll feel satisfied. Just half of cup of rice or pasta or a small potato or even a slice of grainy bread will balance things out nicely.’

Dispelling some myths about … Hypoglycemia

Hypoglycemia is a condition in which the glucose level in the blood falls below normal levels. It derives from the Greek words “hypo” meaning under and “glycemia” meaning blood glucose – hence blood-glucose level below normal. People with diabetes know all about it. If you don’t have diabetes, but you have vague health problems ranging from tiredness to depression and think you may have hypoglycemia or someone tells you that you probably have ‘low blood sugar’, see your doctor and get a proper diagnosis.

• Hypoglycemia is far less common that once was thought in people who do not have diabetes.
• Hypoglycemia due to a serious medical problem is rare.
• The most common form is reactive hypoglycemia, which occurs after eating.

What you need to know about reactive hypoglycemia
What is it?
If you have reactive hypoglycemia, it means that your blood-glucose level rises too quickly after you have eaten causing the release of too much insulin. This then draws too much glucose out of the blood, your blood-glucose levels fall below normal and you suffer a variety of unpleasant symptoms from sweating, tremor, anxiety, palpitations, and weakness to restlessness, irritability, poor concentration, lethargy, and drowsiness.

How is reactive hypoglycemia diagnosed?
Diagnosis is difficult because there are no clear diagnostic criteria. Your doctor may:

• ask you about signs and symptoms
• test your blood glucose while you are having symptoms (The doctor will take a blood sample from your arm and send it to a laboratory for analysis. A personal blood glucose monitor cannot be used to diagnose reactive hypoglycemia.)
• check to see whether your symptoms ease after your blood glucose returns to 70 mg/dl or 3.5 mmol/L or above (after eating or drinking)

If your doctor uses an oral glucose tolerance test (OGTT) to diagnose hypoglycemia you have to continue it for at least 3-4 hours (the normal time is 2 hours). Your insulin levels would be measured at the same time.

How is it treated?
The aim of treating reactive hypoglycemia is to prevent sudden large increases in your blood-glucose levels so you won’t produce excessive, unnecessary amounts of insulin and your blood-glucose levels will not plunge to abnormally low levels.

You can achieve smooth, steady blood-glucose levels by changing from high- to low-GI foods. This is particularly important when eating carbohydrate foods by themselves. Low GI foods like wholegrain bread, low-fat yogurt, and low GI fruits are best for snacks. If you can stop the big swings in blood-glucose levels, then you will not get the symptoms of reactive hypoglycemia and chances are you will feel a lot better.
—Source: The New Glucose Revolution

© ® & ™ The University of Sydney, Australia

GI News—February 2006

In This Issue:

• There May Not Be a Magic Bullet, But We still Have Commonsense
• The Protective Power of Plant Protein
• Did Your Kids Eat Breakfast This Morning?
  
• If You Want to Give Your Kids a Headstart, Give Them Oatmeal for Breakfast
  
  
• Pita Bread: The Perfect Pocket
  
• Pure Maple Syrup: The Real Thing
• Chinese Combination Soup for One
  
  
• Success Stories—One day in the summer of 1998, Leigh Hatcher’s life turned upside down. A simple virus took him into the wilderness of Chronic Fatigue Syndrome for more than two years—until he found low GI …
• The New Glucose Revolution (direct mail edition)
  
  
• I haven't been able to find a reference as to what GI number a person should shoot for when trying to diet. Is there a formula, such as ‘take goal weight, multiply by age, divide by activity level?
• I’m confused. What’s the difference between GI and GL? Should I use GI or GL and does it really matter?
• How do you figure out the GL numbers?
• Does Low Carb automatically mean low GI?
• Does Sugar Cause Diabetes?
• Is sugar the worst thing for people with diabetes?
  

If you have posted a question in our newsletter, be assured that the GI Group will answer this as soon as possible. We welcome your views about our articles and other reader’s suggestions. Please POST your comments on the site.

We receive a great deal of FEEDBACK from readers and visitors to our website about how a low GI diet has made a real difference to their lives along with some inspiring weight loss and blood glucose control stories. Please share your success. Your experiences really can motivate others. If you feel you have a story that will inspire or help others and you are prepared to give permission for it to be published in GI News, please send your story to us HERE.

If you want to print a copy of just one article (ie. the recipe from the newsletter), simply click on the recipe or article name in the right-hand column under PREVIOUS POSTS. You will arrive at the page you have chosen. Select PRINT and you will find that you can print just the information you want.

To receive our FREE e-newsletter each month, click the SUBSCRIBE link in the right-hand column. Your email address will be kept strictly confidential and you can unsubscribe at any time.

‘Carbohydrate is nature’s primary fuel.
The simplest carbohydrate, glucose, is the main source of energy for our muscles, it’s also the essential fuel for our brain, for our red blood cells and for helping a growing foetus become a healthy baby.’

Jennie Brand-Miller

GI News Editor: Philippa Sandall
Web Design and Management: Scott Dickinson

Food for Thought

There May Not Be a Magic Bullet, But We Still Have Commonsense
While numerous studies have consistently shown the glycemic index (GI) to be an effective tool in reducing blood glucose and insulin levels and the risks of certain diseases, it sometimes comes under criticism for not being the ‘magic bullet’ people sometimes expect in weight management.

The glycemic index is a powerful tool when used in the right way—that is, in combination with healthy eating, regular exercise, and medications as needed. The glycemic index is not intended to be used in isolation, with a disregard to commonsense. When used appropriately (ie in the context of a good diet), the GI can benefit overall health, promoting satiety and minimising diabetes risk and complications. The concept of the GI improves outcomes because it involves a more complete understanding of how carbohydrates are digested in the human body, recognising differences between different carbohydrate-containing foods (not just sugars versus starches), and how this will affect our physiological responses after consumption.

This leads to what some view as criticisms of the GI—that there is a such a broad range of GI values for different types of potatoes, for example, or that the GI of bananas will change depending on their stage of ripeness. However, we should not hold the GI to higher standards than we apply to other nutrient factors. We know the carbohydrate and fibre content of a banana will vary with ripeness, or its vitamin C content with storage. We would never expect the fat content of the local supermarket’s sausages to be exactly the same as that listed in the national tables of food composition.

While there are notable variances in GI (eg for different varieties of rice), there is also notable consistency. Apples, oranges, legumes and pastas have GI values in the 40s, white bread in the 70s, cornflakes in the 80s. Moreover, clinical intervention studies suggest that current GI tables are sufficiently accurate to produce differences in average blood glucose values in people with diabetes (Brand-Miller et al, Diabetes Care 2003).

Many people today are ready and willing to be active participants in their own health care, wanting to learn more about their conditions and how to manage them, even if this entails more than a few simple rules, and requires a deeper understanding of how their body works. Those who put the effort into understanding their physical condition and how they can help themselves will surely reap the long-term rewards and health benefits relating to the GI and beyond.

—Atarah Grysman, MSc, Glycemic Index Laboratories, Toronto

GI News Briefs

The Protective Power of Plant Protein

High in fibre and low in fat, it’s long been acknowledged that fruit, vegetables and legumes (pulses) play a central role in a healthy heart diet. In fact, increased consumption of these healthful foods is associated with a lower incidence of cancer, cardiovascular disease and other age-related diseases. Now a four-country study led by Prof Paul Elliott of Imperial College London has found that diets rich in vegetable protein tend to reduce blood pressure. High blood pressure is associated with an increased risk of heart disease and stroke and is the biggest cause of preventable mortality worldwide. During Elliot’s study, 4,680 volunteers aged 40–59 in Japan, China, UK and the US had their blood pressure read eight times and wrote down everything they had consumed in the 24 hours before each of the four checkup sessions over a 6-week period. Writing in the January issue of the Archives of Internal Medicine, the researchers report ‘an inverse relationship between individual’s vegetable protein intake and their blood pressure’—the higher the vegetable protein intake, the lower the blood pressure.
—Archives of Internal Medicine, Vol 166, pp79–86


Photo: Ian Hofstetter, www.ianhofstetter.com.au The Low GI Diet Cookbook

GI Group: You don’t need to eat meat, chicken or fish every day (or at all) to get enough protein. Plant proteins can provide us with all the essential and non-essential amino acids we need so long as we eat a wide variety of foods. These plant proteins include many low GI foods such as legumes (pulses), wholegrains such as barley and traditional oats, foods rich in soy protein like tofu, nuts and seeds, and vegetables. There’s no need to worry about special combinations of plant foods at the same meal, the body keeps a short-term supply of essential amino acids so that ‘protein combining’ can happen over the whole day.

Did Your Kids Eat Breakfast This Morning?
Most of us have been told (countless times) that breakfast is the most important meal of the day. But a lot of us skip breakfast. Not a good example because alarmingly around 40 per cent of kids are breakfast skippers too. Why? Well, the usual suspects. Too tired. Needed more sleep. Rushed. Not hungry. Don’t like breakfast. Dieting.



Writing in the Journal of the American Dietetic Association last year, Dr Ruth Striegel-Moore reported that the older a girl gets, the more likely she is to skip breakfast. They found that 77 per cent of white nine-year-old girls and 57 per cent of the black nine-year-old girls regularly ate breakfast. By age 19 this had plummeted and less than 32 per cent of the white girls and 22 per cent of the black girls in the study were regularly eating breakfast. The researchers analysed dietary information from the nine-year National Heart Lung and Blood Institute Growth and Health Study from 2,379 girls who entered the study at age 9 or 10. They also report that the breakfast eaters’ diets were consistently higher in calcium and fibre than the skippers and that they had a lower BMI.
—Journal of the American Dietetic Association, Volume 105, Issue 6, June 2005, Pages 938–45


If You Want to Give Your Kids a Headstart, Give Them Oatmeal for Breakfast
In recent years, numerous studies have shown that eating breakfast can improve speed in short-term memory tests, alertness (which may help memory and learning), and mood, calmness and reduce feelings of stress. Breakfast also helps school children perform better in creativity tests. Breakfast helps to replenish blood glucose levels, which is important since the brain itself has no reserves of glucose, its main energy source...



Reporting in Physiology & Behavior in 2005, Tufts University psychologists confirmed previous studies that when kids eat breakfast they do better in tests that require processing brainpower for complex visual display (such as puzzles) than when they skip brekkie. Taking it a step further this time, the Tufts team gave the kids different breakfasts on different occasions—oatmeal and milk one day and Cap’n Crunch with milk another and then compared the test results. They found that the 60 elementary school students performed better on a raft of tests after tucking into stick-to-the-ribs oatmeal rather than firing up on Cap’n Crunch. Children aged 9–11 notched up improvements in their spatial memory (things like puzzles, drawing, and geography, as well as some technical skills used in math and science); while the 6–8-year-olds listened better and also scored higher on spatial memory. The researchers believe that their results show that what kids eat for breakfast really matters. They say ‘due to compositional differences in protein and fiber content, glycemic scores, and rate of digestion, oatmeal may provide a slower and more sustained energy source and consequently result in cognitive enhancement compared to low-fibre high glycemic ready-to-eat cereal.’
— Journal of Physiology and Behavior, Volume 85, Issue 5, 2005, Pages 635–45

GI Values Update

Pita Bread: The Perfect Pocket
Top it, stuff it, wrap it, cut it into wedges and dip it, or split it open and bake it to make ‘crisps’—pita is the ultimate meal-in-a-bread to have around for all occasions. The original value for white unleavened pita bread was from Canada (GI 57). New results have been published for pita breads available through Tesco stores in the UK including ‘Mini White Pitta’ (GI 68), Value ‘White Pitta’ (GI 69) and ‘Wholemeal Pitta’ (GI 56). (British Journal of Nutrition (2005, 94).



Try these simple serving suggestions to boost your vegetable and legume intake.

• Wrap up with hommous, shredded lettuce, felafel, tabbouli and a tangy tomato salsa; or avocado, mushrooms, bean salad, shredded lettuce and capsicum strips; or tuna, borlotti beans, onion rings, cucumber, feta and a drizzle of oil and vinegar.
• Use pita bread as an instant pizza base—top with tomato paste, mushrooms, capsicum, finely sliced onion, olives and a sprinkle of Parmesan cheese.
• Serve dips such as hommous and babaghanoush with pita crisps—simply cut the pita bread into triangles, open out the ‘halves’ and spray with a little olive oil, sprinkle over paprika for extra flavour and bake at 180ºC (350ºF) for about 5 minutes, or until crisp.

—From Low GI Eating Made Easy (available in Australia, New Zealand, the UK, the US and Canada)

Low GI Food of the Month

Pure Maple Syrup: The Real Thing
With sugar maple sap about to flow in northern US and Canada, it seems timely to look at this deliciously natural sweetener. The sugars in fruit and honey have provided carbohydrate energy in human diets for millions of years. Sweetness is not a learned taste: everyone could be said to be born with a ‘sweet tooth’. We don’t know why this is so, but it may be related to our brain’s dependence on glucose as its sole source of fuel. What we do know is that our hunter-gatherer ancestors relished honey and other concentrated sources of sugars such as honey ants, dried fruit and maple syrup tapped straight from the tree.



Pure maple syrup (GI 54) was one of the first foods that was glycemic index tested (by Profs David Jenkins and Tom Wolever at the University of Toronto). As demand outstrips supply, it is probably the most expensive sweetener on your supermarket shelf. Made by boiling and concentrating the sap from maple trees, it takes approximately 40 gallons (about 150 litres) of maple sap to make one gallon (about 3½ litres) of pure maple syrup. So beware and be aware and check that label to make sure you are buying ‘Pure Maple Syrup’ as the gap in the market unfortunately is filled by those high GI, corn syrup toppings that have been blended with as little as 3 per cent maple syrup. Not the real thing at all!

Use a little maple syrup instead of sugar or honey in your tea or coffee; to sweeten your porridge oats or low GI breakfast cereal; to drizzle over buckwheat pancakes or a scoop of low-fat vanilla ice-cream. You can also use it to glaze meats such as ham, chicken or pork or vegetables such as sweet potato, yams, parsnips, squash or pumpkin. Or instead of sugar in many recipes from baked beans to rice puddings or muffins. One very simple way is to use maple syrup instead of sugar or honey is in marinades or in dressings.

Balsamic Vinaigrette with Maple Syrup
Try this vinaigrette tossed with a roasted vegetable salad (eggplant/aubergines, zucchini/courgettes, capsicum/peppers, leeks and pumpkin) or add a pasta shapes to make a meal of it. The dressing is also delicious made with a nutty oil such as walnut or macadamia oil. Makes about 1/3 cup (65 ml) dressing, enough for a salad for 4 people.

1 clove garlic, peeled and crushed
2 tablespoons olive oil
2 tablespoons balsamic vinegar
1 teaspoon pure maple syrup (or to taste)
freshly ground black pepper, several twists
a pinch of salt (optional)

Combine all the ingredients in a screwtop jar and shake well.

Per serving (4 teaspoons)
Energy 368 kJ; Fat 9.1g (Saturated 1.3g); Carbohydrate 1.3g; Dietary fibre 0.2g

Low GI Recipe of the Month

Chinese Combination Soup for One
You can buy boiled wontons, lean barbecued pork and Chinese chicken stock in Chinese markets and Asian produce stores. Frozen wontons are also available in larger supermarkets. In this recipe, you can use any other Asian greens or vegetables such as handful of raw bean sprouts, baby corn, champignon mushrooms instead of the choy sum. For a seafood combination soup replace the pork slices with 2 or 3 prawns, 2 or 3 cubes diced white fish and 2 or 3 small pieces of squid or calamari and make it with a seafood stock.
Preparation time: 10 minutes

4 boiled wontons
40 g (small handful) egg noodles, blanched and drained
½ bunch choy sum, washed, leaves separated and blanched
3 slices of lean barbecued pork
2 cups (500 ml) hot Chinese chicken stock (or regular chicken stock)

To serve
1 tablespoon finely chopped shallots (spring onions)
1 tablespoon chopped fresh coriander (cilantro)
½ teaspoon finely chopped red chilli

Place the wontons, egg noodles, choy sum and pork in a single-serve large Chinese bowl. Ladle the hot stock over. Garnish with the shallots, coriander and chilli.

Per serve
KJ/Cal 1860/445; Protein 36 g; Fat 10 g (saturated 4 g); Carbohydrate 50 g; Fibre 4 g; GI Low

To make a traditional Chinese stock
Place 1 chicken, skin removed and cleaned under cold water, 4 large slices of ginger, ½ bunch shallots (spring onions), washed and roughly chopped, 2 cloves of garlic, 1 carrot, roughly chopped (optional), and 2 litres of cold water in a large stock pot. Bring to the boil then reduce the heat to low and simmer for 2 hours. Skim off any residue. Freeze in 500 ml (2-cup) containers and use as required.


Linda Cumines

This recipe is from Linda Cumines who has been in private practice as an Accredited Practising Dietitian for the past 23 years. This has given her an extensive knowledge of how people respond to diet trends. Linda is a fourth generation Australia-born Chinese who finds great satisfaction in helping people to eat well. Linda is committed towards encouraging every one of us to enjoy eating, and eating healthily.

Your Success Stories

Leigh Hatcher has been an Australian TV and radio journalist and newsreader for 32 years. One day in the summer of 1998 his life turned upside down. A simple virus took him into the wilderness of Chronic Fatigue Syndrome for more than two years—until he found low GI. Here he tells his story.
"It began simply and suddenly. I was in the middle of our annual holiday at a great Aussie beach and after a marvellous morning in the surf, I laid down for my daily 10-15 minute ‘power nap’. For once I woke up 2 hours later, feeling as if I’d been run over by a truck.

By the end of that week, still feeling below par, I was sent off for some blood tests which showed I’d contracted a viral hepatitis. I was told to take two weeks off work and I’d be fine.

However, I kept returning to the doctor for weeks – months, struggling to describe a body and brain that were both running on empty. It seemed like something toxic was flowing through my veins. I was overwhelmed by crushing fatigue and weakness.

Within six months, I lost my high profile job as a frontline TV reporter and news reader. After a year of increasingly rarefied tests which came back ‘normal’ – (normal was the last thing I was feeling!) – I was diagnosed as suffering ‘Chronic Fatigue Syndrome’.

I remained in this ‘wilderness’ for another year until a doctor friend discovered some research which said that for a proportion of CFS sufferers, it’s worth looking at their metabolism. I went for a 5 hour glucose tolerance test, where both glucose and insulin were tested and just for once ‘abnormal’ readings came back – in the ‘pre-diabetic’ range.

A dietitian put me on a low GI diet, with graded activity, then graded exercise, with a prediction that I’d notice an improvement in my health in two weeks! A fortnight later I returned to see her and announced – ‘You’ve given me a life again!’

Today, five years later, I’m still on the low GI diet, swimming 5 kilometres a week again and continue to revel in good health. I’m not back to 100% - probably 90-95%.

Low GI is not the ‘key’ for every CFS sufferer, but it has transformed my life and the lives of numbers of sufferers I’ve known. Coupled with exercise and a decent amount of sleep – it’s given me a life again."


Leigh Hatcher

—Leigh Hatcher has written about his journey through the wilderness of Chronic Fatigue Syndrome in I’m Not Crazy, I’m Just A Little Unwell. See his website at www.notcrazy.net

Books, DVDs, Websites: What’s New?

Now Available—The New Glucose Revolution
now available in the US and Canada in a hardcover direct mail edition published by Rodale. This expanded edition includes:

• Scientific evidence to support the health benefits of choosing low-GI foods
• Strategies for making the transition to a low-GI diet
• 50 delicious, easy-to-prepare recipes, all with low to moderate GI ratings
• Glycemic index values for approximately 800 foods
• Targeted guidelines for using the glycemic index to lose weight, protect against diabetes and heart disease, and enhance mental and physical performance
• Answers to the most common questions about the glycemic index

For more information visit www.rodalestore.com



The Low GI Diet Cookbook is now available in the UK at all good book stores or online at Amazon..



Low GI Eating Made Easy is now available in the US at all good book stores or online at Amazon.

Feedback—Your FAQs Answered

My husband and I are following the 12-week Action Plan in The Low GI Diet. However, I am currently breastfeeding and I wonder whether you need to eat a little more than usual to allow for lactation or pregnancy?
Increased energy intake is recommended during pregnancy and lactation. The greatest requirement is for lactation—add 2000 kJ (500kcal) to daily requirements. In early pregnancy there is no greater need but by the 3rd trimester an extra 2000 kJ (500kcal) are recommended daily. This is based on a normal/healthy pre-existing body weight. If you are already overweight then you wouldn't need to increase by so much.
Estimations of energy requirement should always be taken as a guide only. Differences between people can be enormous. Often it is more realistic to use appetite as a guide to whether you are eating enough.



The increased calories can come from any source (carbohydrate, protein or fat) but it is safest to increase calories from carbohydrate or protein if you are unsure about amounts, because these nutrients have the greatest effect on satiety.

I haven't been able to find a reference as to what GI number a person should shoot for when trying to diet. Is there a formula, such as "take goal weight, multiply by age, divide by activity level?
The simple answer is no, there’s no formula. You don’t need to add up the GI each day. In fact there’s no counting at all as there is with calories/kilojoules. The basic technique for eating the low GI way is simply ‘This For That’: swapping the high GI carbs in your diet with low GI foods. This could mean eating muesli at breakfast instead of wheat flakes, low GI bread instead of normal white or wholemeal bread, or a sparkling apple juice in place of a soft drink. So, what you need ‘to shoot for’ is identifying the high GI carbs in your current diet and swapping them for some quality low GI carbs. Dietitian Kaye Foster-Powell says in Low GI Eating Made Easy: ‘We have found that many people who substitute low for high GI foods in their everyday meals and snacks reduce the overall GI of their diet, gain better blood glucose control and lose weight.


Kaye Foster-Powell

If you are looking for some guidelines, here’s how she answers the ‘what do I eat’ question. Every day you need to:

• Eat at least three meals—don’t skip meals. Eat snacks too if you are hungry.
• Eat fruit at least twice—fresh, cooked, dried, juices.
• Eat vegetables at least twice—cooked, raw, salads, soups, juices and snacks.
• Eat a cereal at least once—such as bread, breakfast cereal, pasta, noodles, rice and other grains in a wholegrain or low GI form
• Accumulate 60 minutes of physical activity (including incidental activity and planned exercise).
• Every week you need to:
• Eat beans, peas and/or lentils—at least twice. This includes baked beans, chickpeas, red kidney beans, butter beans, split peas and foods made from them such as hommous and dhal.
• Eat fish and seafood at least once, preferably twice, each week—fresh, smoked, frozen or canned.
• Eat nuts regularly—just a tiny handful.

I’m confused. What’s the difference between GI and GL? Should I use GI or GL and does it really matter?
Your blood glucose rises and falls when you eat a food or meal containing carbohydrate. How high it rises and how long it remains high depends on the quality of the carbohydrate (its glycemic index value or GI) as well as the quantity of carbohydrate in your meal. Researchers at Harvard University came up with a term that combines these two factors—glycemic load (GL). Some people think that GL should be used instead of GI when comparing foods because it reflects the glycemic impact of both the quantity and quality of carbohydrate in a food. But more often than not, it’s low GI not low GL that predicts good health outcomes. So which one should you use?

We are often asked this question. Our advice is to stick with the GI rather than GL—the reason being that following the low glycemic load (GL) route can lead you straight to a low carb diet: ie fatty meats and butter, for example have a low GL. .
But if you eat plenty of low GI foods, you’ll find that you are automatically reducing the GL of your diet and at the same time you’ll feel fuller for longer with these satisfying carbohydrate-containing foods, as well as improve many health parameters.

We also emphasise that there’s no need to get overly technical about this. Think of the GI as a tool allowing you to choose one food over another in the same food group—the best bread to choose, the best cereal to choose etc.—and don’t get bogged down with figures. A low GI diet is about eating a wide variety of healthy foods that fuel our bodies best—on the whole these are the less processed and wholesome foods that will provide carbs in a slow release form.
The take-home message:

• Slow carbs, not low carbs
• Use GI to identify the best carbohydrate choices.
• Take care with portion size with carb-rich foods to limit the overall GL of your diet.

How do you figure out the GL numbers?
Glycemic load is calculated simply by multiplying the GI of a food by the amount of carbohydrate in the portion (in grams) you are eating and dividing by 100. Here’s how
Glycemic load = (GI x carbohydrate per serving) ÷ 100
Let’s say you wanted to have an apple for a snack. Apples have a GI of 40 and 1 medium apple contains 15 grams of carbohydrate.
So, the glycemic load of your apple snack is (40 x 15) ÷ 100 = 6.
If you were very hungry and tucked into 2 apples you be eating 30 grams of carbs and the GL of your snack would be 12. The GI doesn’t change, but you are eating more carbs because you are eating 2 apples.



Does Low Carb automatically mean low GI?
Not at all. Here’s why. Low carb is just about quantity; it simply means that a food or meal does not contain much carbohydrate at all. It says nothing about the quality of the carbs in the food or meal on your plate. You could be eating a low carb meal but the carbs have a medium or high GI. Low GI on the other hand is all about quality.


Photo: Ian Hofstetter, www.ianhofstetter.com.au The Low GI Diet Cookbook

Whether you are a moderate or high carb eater, low GI carbs (wholegrain breads, legumes /pulses, many fruits and vegetables) will have significant health benefits—promoting weight control, reducing your blood and insulin levels throughout the day, and increasing your sense of feeling full and satisfied after eating. We suggest that you make the most of quality carbs and reap the add-on health benefits such as:

• Vitamin E from wholegrain cereals
• Vitamin C, beta-carotene and potassium from fruits and vegetables
• Vitamin B6 from bananas and wholegrain cereals
• Pantothenic acid, zinc, iron and magnesium from wholegrains and legumes
• Anti-oxidants and phytochemicals from all plant foods
• And fibre which comes from all of the above and doesn’t come from any animal food

Dispelling Some Myths About … Diabetes

Myth: Sugar causes diabetes.
Fact: There is an absolute consensus that sugar in food does not cause diabetes. Type 1 diabetes (insulin-dependent diabetes) is an auto-immune condition triggered by unknown environmental factors such as viruses. Type 2 diabetes (non-insulin dependent diabetes) is strongly inherited, but lifestyle factors such as a lack of exercise or being overweight increase the risk of developing it. Because diabetes treatment in the past involved strict avoidance of sugar, many people, wrongly, believed that sugar was in some way implicated in the cause of the disease. But while sugar is off the hook, high GI foods are not. Studies at Harvard University indicate that high GI diets that produce high blood glucose levels increase the risk of developing both diabetes and heart disease.

Myth: Sugar is the worst thing for people with diabetes.
Fact: For a long time strict avoidance of sugar was the mainstay of diabetes diets. Health-care professionals were taught that simple sugars were solely responsible for high blood glucose levels. But research shows that moderate consumption of refined sugar (around 40 grams/1½ oz or 2–3 tablespoons) a day doesn’t compromise blood glucose control. This means people with diabetes can choose foods that contain refined sugar or even use small amounts of table sugar.

What should you do? Try to spread your sugar budget over a variety of nutrient-rich foods that sugar makes more palatable. Remember, sugar is concealed in many foods—a can of soft drink contains about 40 grams of sugar—your entire daily allowance! Most foods containing sugar do not raise blood glucose levels any more than most starchy foods. Kelloggs Cocopops™ (GI of 77) contains 39 per cent sugar while Rice Bubbles™ (GI of 87) contains very little sugar. Many foods with large amounts of sugar have GI values close to 60—lower than white bread. Sugar can be a source of enjoyment and help you limit your intake of high fat foods, but the blood glucose response to a food is hard to predict. Use GI tables and your own blood glucose monitoring as a guide.
—Source: The New Glucose Revolution

© ® & ™ The University of Sydney, Australia

GI News—January 2006

In This Issue:

• Why Nutrition Changes
• Tesco Tests
• Getting Satisfaction
  
• What Kids Want
  
  
• What’s Cooking? And How?
  
• Pulses (Legumes) Help Fight Diabetes
• Fresh Plum and Ricotta Strudel
  
  
• Success Stories—Sarah and Felix
• Nutrition for Life
• I have recently been diagnosed with type 2 diabetes. I am trying to eat a healthy low GI diet, but find it hard to say no to occasional treat foods like potato chips (crisps) and chocolate. Which is better for my blood glucose?
• I am about to introduce my baby to solids and have been advised to start with rice cereal. What is the current guidance on GI for babies and young children?
• Is there a GI Plan for nursing mothers?
  

If you have posted a question in our newsletter, be assured that the GI Group will answer this as soon as possible. We welcome your views about our articles and other reader’s suggestions. Please POST your comments on the site.

We receive a great deal of FEEDBACK from readers and visitors to our website about how a low GI diet has made a real difference to their lives along with some inspiring weight loss and blood glucose control stories. If you feel you have a SUCCESS STORY that will inspire or help others and you are prepared to give permission for it to be published in GI News, please send it to us HERE.

Want to search the GI News Archive for a particular topic, food or recipe? Make the most of our search feature with Google. Simply enter the term in the space provided and press SEARCH.

To receive our FREE newsletter each month, click the SUBSCRIBE link in the right-hand column and send us an email. Your email address will be kept strictly confidential and you can unsubscribe at any time.

We would like to wish all our readers a happy and HEALTHFUL NEW YEAR.

‘A side salad tossed with a vinaigrette dressing with your meal,
especially a high GI meal,
will help you keep your blood glucose levels under control.’

Jennie Brand-Miller

GI News Editor: Philippa Sandall
GI News Graphics & Web Design: Scott Dickinson

Food for Thought

Why Nutrition Changes
By Catherine Saxelby

People often ask me why we nutritionists keep changing our minds! One year, carbohydrate is wonderful, the next year it’s not. One year, fat is a no-no, the next year, it’s only saturated fat the we should worry about, the other fats are ‘good’ fats that are OK to eat and enjoy. Protein was ‘forgotten’ for some years, now it’s back and considered important for satiety and weight loss. And the same happens with foods. Eggs make a good example. They were off the acceptable list for many years due to their high cholesterol. Anyone with a high cholesterol was advised to limit them to only 2 a week. Now it’s OK to eat an egg a day if you wish. As long as you don’t drown it in butter or cream! The body regulates the cholesterol it makes in response to what you eat. But it can’t cope with the saturated fat that’s already a big problem in our daily diets.

However I rationalise and justify these paradigm shifts, there’s no doubt that nutrition changes. It evolves, it twists and turns, it often swings back to an earlier position. This is confusing for consumers but hardly surprising for a new science that is blended from biochemistry, physiology, medicine, food science and the culinary arts. As new terms and new discoveries keep popping up, there are shifts in thinking on many issues.

Just 5 years ago, we dietitians were still talking ‘simple’ and ‘complex’ carbohydrates. How naive was that thinking?! Thanks to the GI research, we now have a better understanding of what happens to foods like bread, potato, rice and pasta once we’ve ingested them. Some are fast, some are slow. It’s got nothing to do with simple or complex – it’s much more complex than that.

So should you NOT take on board the latest advice? Even though nutrition changes at the edges, the basics remain similar and I often remind people of those ‘golden rules’ or ’10 commandments’ as I like to call them. For a healthy diet:

• Aim to eat plenty of vegetables and fruit (note the order)
• Cut back on sugar
• Cut back on salt
• Choose whole grains
• Go easy on fat
• Steer clear of overly-processed and refined foods
• Aim for more fresh and home-prepared meals
• Be moderate with alcohol
• Eat a little of what you like, and (last but not least)
• Moderation in most things

Sound familiar? It’s probably your Grandma would have told you.
—Catherine Saxelby is a dietitian and author of Nutrition for Life (Hardie Grant $29.95). For regular updates on nutrition as it happens, you can join her popular Foodwatch Club at www.foodwatch.com.au


Catherine Saxelby

GI News Briefs

Tesco Tests


The results of GI testing of 140 foods commercially available in the UK for the supermarket giant Tesco are published for the first time in the British Journal of Nutrition. The testing, conducted by the Oxford Brookes team led by Prof. Jeya K. Henry, found that the majority of GI values of UK foods compared well with published values of foods in the International Table of Glycemic Index and Glycemic Load Values (2002). However, there were a few exceptions such as fruit loaf (higher) and bran flakes (lower), highlighting the importance of testing foods in their country of consumption wherever possible. The number of ready-to-eat meals (24) in the list make this report a welcome addition to the GI database. Most of the mixed meals had a low GI. Cottage pie, shepherds pie and sausage and mash which all include plenty of mashed potato had medium GI values. In his conclusion Henry emphasises that ‘it is important to test the GI of composite meals, instead of trying to calculate the GI from GI tables.’
—British Journal of Nutrition (2005), 94, 922–930

Comment from Professor Jennie Brand-Miller: The decision making behind the common cut-offs for high and low GI (70 or higher, 55 or lower) was based on the scatter of GI values among single foods. These cut-offs are probably not appropriate for mixed meals. If the future holds more testing of composite meals, then the cut-offs need to be redefined, specifically for mixed meals, taking into account the observed range. It’s important to remember that the GI was introduced to rank the glycemic nature of the carbohydrate in individual foods. The purpose was to exchange one carbohydrate source with another in a mixed meal situation. That application remains valid and shifts the focus away from lowering glycemia at all costs (not a good idea), towards overall nutritionally balanced meals.

Getting Satisfaction
Feeling satisfied isn’t what you normally expect on a diet. Hunger is a pretty big challenge—which is why overly restrictive diets are so hard to stick to. Few of us have the long-term grit to ignore that gnawing feeling in the gut. However, more than 25 studies around the world have already confirmed that low GI foods are more filling, delay hunger pangs for longer, and/or reduce energy intake for the remainder of the day compared with their high GI counterparts.



Now a new Weight Watchers International Germany study in a real life setting led by F. Bellisle of Nutrition, Hotel-Dieu Paris adds weight to the evidence. Sixty-five women were recruited as they started the Weight Watchers points program. One group of 30 followed the regular program for 12 weeks. The other group of 35 followed a modified program, with special emphasis on low GI foods. Over the 12 weeks the researchers asked the women to rate hunger and desire to eat (they used visual analogue scales on one day per week, several times a day: before and after each meal or snack, and in between). The women in the low GI group consistently revealed a lower intensity of hunger and desire to eat, especially during the afternoon! The researchers conclude that: ‘The subjective benefits of the low glycemic index diet may be a worthwhile contribution to the motivation of dieters, even though they did not predict improvement in objective outcome measures.’
—Obesity Reviews 2005; 6 (Suppl 1)



In a more academic setting, CSIRO diet gurus Manny Noakes and Peter Clifton with J Bowen also report that the GI affects acute satiety in a small cross over study with 19 obese men. The men were given four liquid ‘breakfast’ preloads (80% energy from whey, calcium, lactose or glucose). For the next three hours subjective appetite ratings and plasma glucose, insulin, amino acids, cholecystokinin (CCK), ghrelin and gastric emptying were measured. At a buffet lunch that followed the researchers then assessed how much the men ate. They found that energy intake, appetite ratings and ghrelin were greater three hours after the high GI ‘preload’ compared with the low GI and protein preloads.
—CSIRO Health Sciences and Nutrition.

What Kids Want
Thanks to vigorous low fat campaigns, many kids have been consuming more carbs and less fat in recent years. But the result hasn’t quite been what the health professionals expected. The highly processed high GI convenience foods and soft drinks has increased the glycemic load in children’s diet and can be linked to the increase in child obesity and risk of metabolic syndrome. Anette E Buyken and her colleagues at the Research Institute of Child Nutrition in Dortmund looked at the diets of healthy German school children aged 7–8 to see how much the GI and GL of diets in 2002 had changed from 1990 and 1996. They also looked at the kinds of carbs the kids were eating to see how much (if at all) they had changed.



They found that compared with 1990, the 2002 children’s diet was slightly higher in GI (56.5 vs 55.1) and GL (17.5 vs 16.7). According to Buyken ‘the most important finding is that the ‘tolerated food groups’ comprising sweets, sweetened soft drinks, cakes and cookies, and salty snacks had the largest impact on the overall dietary GL, even exceeding the impact of bread and rolls. We had expected bread and rolls, the most important carbohydrate source in Germany, to contribute the most to the dietary GL. Another interesting finding is the small impact of potatoes on the overall dietary GL in all three time periods.’ They also found that generally speaking the children in the lowest GI tertile, but not those in the lowest GL tertile, had a better dietary nutrient profile and made more favourable food choices.

She concludes that: ‘partial replacement of high-GI ‘tolerated food groups’ for foods with a low dietary GI, especially fruits and vegetables, may help to reverse the observed slight increases in the GI and GL since 1990, and to enhance the overall dietary quality in children.’
—British Journal of Nutrition (2005), 796–803

GI Values Update

What’s Cooking? And How?
Critics like to complain about the fact that the GI of a food can change with the way you cook it or prepare the food and the overall GI of a meal can vary depending on what you serve. But if they gave this a bit of thought, they would see that this is a plus (in more ways than one) and not a minus. It actually increases the number of foods we can eat and recipes we can enjoy that will keep our blood and insulin levels on an even keel. Not only that, food is more nutritious and delicious cooked and prepared the ‘low GI’ way (you haven’t boiled away all the goodness) or served with healthful ingredients that will help lower the overall GI of a meal (a jacket potato topped with baked beans, corn or chickpeas).

Let’s start with the ever-popular potato. As we said in last month’s GI News, boiled, mashed, steamed or fried, just about everybody loves potatoes. Unfortunately, a low GI variety of potato is hard to come by and it’s going to take a while for every variety of potato to be tested! The good news for potato lovers is that a potato salad made the day before, tossed with a vinaigrette dressing and kept in the fridge will have a much lower GI than potatoes served steaming hot from the pot. There are a couple of simple reasons for this. The cold storage increases the potatoes’ resistant starch content by more than a third and the acid in the vinaigrette whether you make it with lemon juice, lime juice or vinegar will slow stomach emptying. ‘That's good news about eating acidic potato salad for us genetic potato lovers (i.e., Germans),’ said one of our regular readers. ‘One of our national dishes is (what is called in English) German Potato Salad. It's made ahead of time with vinegar, carrots, garlic and bacon bits, and is available in many standard U.S. supermarkets.’ Another great ingredient to toss into a potato salad are crispy green beans just cooked al dente. But don’t go overboard, keep the portion size moderate!


photo: Scott Dickinson

What about pasta? Pasta in any shape or form has a relative low GI (30 to 60) but it needs to be cooked al dente (‘firm to the bite’). And this is the best way to eat pasta—it’s not meant to be soft. It should be slightly firm and offer some resistance when you are chewing it. Overcooking boosts the GI. Although most manufacturers specify a cooking time on the packet, don’t take their word for it. Start testing about 2–3 minutes before the indicated cooking time is up. But watch that glucose load. While al dente pasta is a low GI choice, eating too much will have a marked effect on your blood glucose. But a cup of al dente pasta combined with plenty of mixed vegetables and herbs can turn into three cups of a pasta-based meal and fits easily into any adult’s daily diet.



To lower the GI of a meal or recipe, simply add vinegar or lemon or lime juice to dressings, marinades or sauces. The effect appears to be related to the acidity, because other organic acids (such as lactic acid and propionic acid) also have a blood-glucose-lowering effect, but the degree of reduction varies with the type of acid. Essentially, the acidity in food puts the brake on stomach emptying, slowing the delivery of food to the small intestine. Digestion of the carbohydrate in the food is therefore slowed and the final result is that blood-glucose levels are significantly lower. And as we reported last month, Swedish researchers have found that vinegar may also help dieters eat less and reduce cravings brought on by sugar spikes after meals. The more vinegar consumed (up to 2–3 tablespoons before a meal), the more satisfied people felt.

Low GI Food of the Month

Pulses (Legumes) Help Fight Diabetes
By Rosie Schwartz
Using your bean is definitely one of the smartest nutritional moves you can make. In the battle against diabetes, pulses (beans, chickpeas and lentils) appear to offer a wide range of weapons. Firstly, because of their effects on weight control, they provide a front line defence. Achieving and maintaining a healthy weight is one of the major strategies in halting the epidemic of diabetes. Increasing body weights and sedentary living are partnering to drive up the odds of developing diabetes in all age groups.


Rosie Schwartz

Adding pulses to the menu may not only reduce the risk of diabetes due to their effects on girth control, but they also work against the disease in other ways. The type of fibre as well as the starch they contain leads to a slow rate of digestion and therefore more gradual rises in blood sugar and insulin readings, making them a boon for both diabetes prevention and blood sugar control in those who have the disease. While eating bean quotas may help those with type 2 diabetes control their blood sugar readings without taking medication, research shows that for those with type 1 or insulin-dependent diabetes, consuming pulses may lessen the amount of insulin required to control blood sugar levels. This slow rise in blood sugar gives pulses the distinction of being a low GI food.

Yet even though many people are aware of the health perks of consuming pulses, they're not what you would call a regular visitor at the dinner table in most homes. Here are some tips for palate-pleasing pulses, keeping in mind that they partner wonderfully with seasonings from every cuisine and can be part of any course of any meal.

• Pureed pulses, seasoned with a variety of herbs and spices, make for wonderful dips and spreads. Keep cans of chickpeas or beans on hand for a snack in a flash. Rinse and drain them and give them a whirl in the food processor with cumin, garlic, tahina (sesame seed paste) or olive oil and lemon juice for a speedy hummus or bean dip for vegetables.
• Add pulses to pasta sauces for a change of pace. And for youngsters, or even adults who aren't yet fans of beans or lentils, puree a small amount with some of the sauce and then add the mixture back into the entire sauce. Over time, as tastes adjust, puree smaller quantities of the pulses, keeping them intact.
• Add pulses to homemade or prepared vegetable soups before serving. Simmer for at least a few minutes.
• Add white or red kidney beans or chickpeas to a mixed salad or toss with tuna, sliced red onion and tomatoes and an olive oil and vinegar dressing for a taste of the Mediterranean.

—Source: National Post (www.nationalpost.com). Reproduced with permission of the author and the National Post.



Rosie Schwartz is a Toronto-based consulting dietitian in private practice and is author of The Enlightened Eater's Whole Foods Guide: Harvest the Power of Phyto Foods (Viking Canada).

Low GI Recipe of the Month

Fresh Plum and Ricotta Strudel
Plums and other blue-red fruit such as cherries, blueberries and cranberries, are rich in a particular type of antioxidants known as anthocyanins. Here’s a low-fat version of the strudel Catherine Saxelby makes using plums instead of apples. From Eating for the Healthy Heart and also reproduced in The Low GI Diet Cookbook.


Photo: Ian Hofstetter, The Low GI Diet Cookbook

Serves 6
Preparation time: 20 minutes
Cooking time: 45 minutes

30 g (1 oz) monounsaturated or polyunsaturated margarine
½ cup (40 g) fresh wholemeal breadcrumbs (about 3 slices)
1/3 cup (80 g) brown sugar
½ teaspoon cinnamon
425 g (15 oz) can plums, drained well (or 6 fresh plums about 250 g/9 0z)
6 sheets filo pastry
olive oil spray
125 g (4½ oz) reduced fat ricotta cheese

1. Melt the margarine in saucepan over medium heat. Add the breadcrumbs and sugar (reserving 2 teaspoons of sugar) and cook for 15 minutes stirring well to break up any lumps. Remove from heat. Stir in the cinnamon. Allow to cool.
2. Halve the plums, removing stones and slice the flesh thinly.
3. Preheat the oven to 190°C (375°F). Lightly grease a baking tray. Lay two sheets of filo pastry on top of one another spraying the upper most sheet with oil. Sprinkle with one-third of the crumb mixture and top with two more sheets. Spray top layer with oil and add another one-third of the crumb mixture. Top with the remaining two sheets and sprinkle with final third of the crumbs.
4. Spread ricotta along edge of pastry. Arrange plums on top of ricotta. Sprinkle with reserved 2 teaspoons of sugar. Roll up pastry as for a Swiss roll, tucking in the edges. Transfer to a lightly oiled baking tray. Bake for 10 minutes. Reduce heat to moderate (180°C/350°F) and bake a further 20 minutes until crisp and brown. Serve warm with low-fat vanilla ice cream

Per serving
Low GI, kilojoules 865/calories 205, fat 6 g (saturated 2 g), protein 5 g, carbohydrate 30 g, fibre 3 g, sodium 260 mg

Your Success Stories

Sarah
‘I want to share with you about how applying the “GI factor” to what I eat has changed my life! I was always slim until I reached about 15, then over a period of three years I put on more and more weight. I do not really know why this was, maybe pressure from school, personal problems. When I started university, I became conscious of my weight and attempted to lose weight through various means and methods for about 5 years. Sometimes, it was a planned diet such as the ‘Greenlane’ eating plan, but more often than not it was trying to control or lessen the amount of kilojoules (calories) I was taking in and increasing my exercise. Seems, sensible, but in hindsight I can see that following the traditional ‘food pyramid’ I was eating a lot of low calorie but high GI products. For example, I would have one salad sandwich or bread roll for lunch and then a muffin for afternoon tea, toasted bread for breakfast etc. Sometimes, I did manage to lose quite a bit of weight but then I would ALWAYS yoyo back up to my original weight or more. Everyday, I battled with the scales and it almost became and obsession, I could not figure out where I was going wrong. Also—I was always hungry! I associated diets with being hungry.'

'Anyway, after doing Atkins (successfully losing weight but then putting it back on) a friend recommended the GI book. I read it and started applying the principles (e.g. I ate Bran cereal instead of white bread in the morning, pasta instead of a sandwich, fruit for a snack instead of a muffin). Slowly, but surely (and with a bit of exercise) the weight fell off to the point where I lost more than 10 kg—and got down to about 52 kg (I am short). Even better, I was not suffering from the same energy drain, constant hunger etc. Now, sometimes I eat—just because it is dinnertime—but not because I am hungry! My self esteem has picked up as a result etc. too. I bought a GI cookbook and have tried out a few recipes. The best thing is, this is not a fad but a way of eating that I will always stick too.’

Felix
‘Well, my story goes a bit like this. Back in late 2003, at age 41, although my general health appeared OK, I began to notice that my weight was inexplicably starting to drop, and I was starting to drink a lot of water and felt the need to urinate quite a lot. By early 2004 things had worsened considerably. Basically I began to feel very unwell. Dizzy, extreme lethargy, blurry vision and the weight loss continued. Although I realised that something was clearly wrong with my health and yes I was worried, I was extremely reluctant to visit my GP! In the end, urged by family, I did and the blood tests that followed showed a very high blood sugar level of 23. Yes I was diabetic Type 2.’

‘It was all rather a shock, and I was immediately placed on the usual diabetic medication, and I began to learn all about type 2 diabetes in the hope of managing my condition. Not long after, a Ham Radio friend, (thank you Ron), told me about the ‘GI’. I had vaguely heard of the term, but knew nothing really about it. Searching around on the net I found this excellent web site and my knowledge of the GI began to grow. I went out and bought some of the books and began eating in accordance with low GI principles. It has been a most interesting road of discovery ever since. During my growing up years, my mother, although well intentioned, had been feeding us some of the worst possible foods in terms of high GI, things like plenty of white bread, white rice potatoes and these were essentially the staples of our diet. And yes at first sight, they are nutritious foods.’

‘In retrospect, it is now obvious to me that I was borderline diabetic for some years prior to being officially diagnosed. Looking back now I realise I had all the symptoms. Back to early 2004, my initial success with low GI eating was quite spectacular. My blood sugar levels were rapidly brought back until control, to the point where I was able to give the medication away completely by mid 2004. I preached the low GI message wherever I went. I even did a well received radio studio interview on ABC radio in Townsville preaching the virtues of low GI eating only a month or so after commencing to eat the ‘low GI’ way. The best thing was that I had never felt better.’

‘Perhaps the one thing that clearly shows the value of low GI eating, is the fact that prior to official diagnosis of type 2 diabetes, I had already begun a regular exercise program, mainly walking, in the hope of improving my general fitness. However that didn't prevent the appearance of type 2 diabetes with all the worst symptoms! I still do the same kind of regular exercise, the only thing different now is strict adherence to low GI eating! Need I say more? My mother is a convert to GI eating and likewise, she has seen clear health benefits. My father, well, he still likes his refined white bread, but he mostly eats the ‘right stuff’ in terms of low GI.’

‘For me anyway, the road to good diabetes control and good health has been quite an adventure, and admittedly there have been some low points where I've done the wrong thing and paid the price, but as long as I do the ‘right thing’, all is fine. In all honesty, it isn't that hard to stick to the ‘straight and narrow’. Temptation is always there. But all I have to do, is remember what happens when I do the ‘wrong thing’ (extreme dizziness, confusion, hallucinations and being basically feeling very ill), and the temptation simply disappears, and they are just the short term effects of a very rapid blood sugar rise! My only regret to all this is the fact that I didn't know about the GI twenty years ago! Still, I can say that despite the effects of time, I can say without any doubt at all, that my general health now is better than it's ever been, thanks to low GI eating. Long may it continue.’