Feedback—Your FAQs Answered

Is there any way I can change a bad carb like potatoes into a good carb? Or mellow a bad carb’s effects?
We tend not to talk good carbs bad carbs. We think it is more a question of balance. While you’ll benefit from eating healthy low GI carbs at each meal or for snacks, this doesn’t have to be at the exclusion of all others. High GI, carb-rich foods such as potatoes, wholemeal bread and brown rice make a valuable nutritional contribution to your diet. And when you combine them in a meal with low GI carbs such as lentils or beans or protein foods such as a piece of steak or fillet of fish, the overall GI value of the meal will probably be medium. See our tips for reducing the GI of your diet in Food for Thought this month. And if you love potatoes as so many people do, start by cutting back on the quantity. Either have one or two tiny chat potatoes with a small cob of corn, or make a cannellini bean and potato mash replacing half the potato with cannellini beans, or enjoy a small portion of potato salad with a vinaigrette dressing.



Should I use the GI or GL when planning meals?
We are often asked this. We recommend you use the GI, rather than GL, to identify your best carbohydrate choices. Emphasis on GL (ie GI x the amount of carbohydrate in the food) could easily lead to an unhealthy diet based on too few carbs. Some health professionals have unwittingly recommended the use of GL in place of GI on the basis that GL gives the best impression of a food’s overall effect on blood glucose levels. A few foods, for example, have a high GI but a normal serving of the food has a low GL (eg watermelon). That might well be true but it’s not a good reason to concentrate exclusively on the GL. Here’s why.

Carbohydrates with a low GI have a lot more going for them than simply keeping blood glucose levels on an even keel. Slow carbs, as we call them, are digested and absorbed slowly throughout the length of the small intestine. This makes them more likely to be filling and to stimulate the brain-gut peptides that spell ‘satiety’. Low GI carbs are also far more likely to be healthy foods such as legumes, fruits and dairy products that make a positive contribution to health in many ways (not just lowering blood glucose levels).



If you concentrate on foods/meals with a low GL, you could well end up eating a diet that is too low in carbs and too high in saturated fat. Fatty meats like salami and bacon and cheese after all have a low GL. Although the GL concept is useful in scientific research, it’s the GI that’s proven to be most helpful to people day-to-day, say our dietitians. If you choose healthy low GI foods – at least one at each meal – chances are you’re eating a diet that not only keeps blood glucose within the healthy range, but contains balanced amounts of carbohydrates, fats and proteins.

I recently became a diabetic and was given a very brief course in nutrition to help me manage my glucose levels – without much success. Which of your books would help me?
Many people with diabetes struggle to keep their blood glucose on an even keel and lose weight – and not just when they are first diagnosed. It’s ongoing. That’s why it’s really important to see a registered dietitian who specialises in helping people with diabetes. It can really make a real difference long term. Your family doctor should be able to recommend one. As for books, we usually suggest Low GI Eating Made Easy for starters. It’s very practical and an easy read. It covers making the change to low GI eating in easy steps and lists the top 100 low GI foods and ways to include them in your diet. There’s also a week of low GI eating – breakfast, lunch, dinner and dessert ideas and the GI tables. If you want a bit more of the science behind the GI, check out The New Glucose Revolution Low GI Guide to Diabetes. You can get these books from Amazon and major booksellers.

Can I estimate a food’s GI by looking at the ingredient listing or nutrition label?
We are often asked this question. And the simple answer is that you can’t ‘work it out’. A packaged food’s Nutrition Facts panel will tell you the carbohydrate content, but it won’t indicate the GI of that food. If it contains at least 10 grams of carbohydrates per serving, you can be sure it will have at least some effect on your blood glucose concentration – but there’s no way of telling whether it will be a little or a lot. Similarly, you can’t estimate the GI of a food by looking at its ingredient list, because it won’t tell you the final state of the starches in the food – which ultimately determine GI value.




However, you can make some generalisations about the GI of different foods that you can keep in mind when shopping. Legumes, for example, have some of the lowest GI values whether you buy them dried or canned, it doesn’t matter about the brand. Most pasta and noodle products tend to be low GI foods too as are most fresh fruits and dairy foods like milk, yogurt, ice cream, and custards. In contrast, most bread, bakery products, rice and breakfast cereals are high GI, although those that are less processed may be lower GI. Protein-rich foods—cheese, meat, eggs, and poultry – don’t have measurable GI values, because they contain little if any carbohydrates. The same is true for salad vegetables. Check out the database at www.glycemicindex.com for the most comprehensive list of GI values available. If you want something portable, you might like to pick up The New Glucose Revolution Shopper’s Guide to GI Values. It is updated each year, so look for the 2007 edition which should be published around November/December. And hound the manufacturers of your favourite foods to have them glycemic index tested ‘in vivo’ (that means what happens in real people not in a glass test tube) following the standard international procedure.

Have you done a GI study on winter squashes (pumpkins) such as hubbard, acorn, butternut etc?
There’s only been one published result for winter squash (it is listed as pumpkin) and it had a high GI (75). The actual variety tested isn’t given. But a typical serving of say 80 grams cooked winter squash is only going to have around 5–6 grams of carbohydrate, so the glycemic load will be quite low. That’s why we classify these healthy vegetables like winter squash and swedes etc. as ‘everyday caution with portion foods’ as we want people to eat plenty of vegetables (at least five servings a day) on a low GI diet. It’s only the starchy, carb-rich potato with a high GI that we suggest people cut back on.

GI Values Update

Many of the products in GI Values Update are not available in the USA. Why’s that?
The answer is pretty simple. Very few US companies are GI testing their products, and those that are don’t always release the results for publication. Where do the values we publish in GI News come from? We publish the GI values of foods that have been tested by a lab that provides a legitimate GI testing service following the standardised in vivo procedure – and currently there are only a few centres around the world that do this. We also need the manufacturer to give us permission to publish the results. And they don’t always do this. We really do understand how frustrating it is not to be able to find the GI of your favourite foods. We always urge people to hound manufacturers to get their foods GI tested. But we also know that’s much easier said than done, especially when you use the ‘HOW TO CONTACT US’ page on that corporate website. Following a recent press release that was published internationally, we asked Kraft in the US for a few more details about a new ‘healthy’ range of snacks and cereals that they are promoting. We filled in all the ‘compulsory (asterisked) fields, so they probably now know more about us than we do about their products.



GI Group: ‘Have you glycemic index tested your ‘Back to Nature’ granolas, cereals, cookies and crackers? Are any low GI? Are any gluten free? If not do you plan to GI test these products in future?’

Kraft: ‘Thank you for visiting www.kraft.com/responsibility. Unfortunately, we don't have that information available at this time. If you haven't done so already, please add our site to your favorites and visit us again soon!’

Don’t despair. Keep hounding and together we will make a difference. It just may take a bit of time. And please tell us about products you know have been GI tested by an accredited laboratory. The takehome message: Enjoy plenty of the foods that are naturally low GI (legumes/pulses, fruit and vegetables, pasta and noodles, reduced fat dairy foods). To find out more about them, you might like to check out a copy of Low GI Eating Made Easy which has a whole section on the top 100 low GI foods you can tuck into without worrying about brands.

The latest GI values from SUGiRS


Fiona Atkinson

These super tasty breakfast cereals now on the shelves in Australian supermarkets had to be kept under lock and key during GI testing reports Fiona Atkinson from the SUGiRS team.

Vogel's Café Style Fibre-Rich Muesli GI 48
Vogel's Cluster Crunch Classic GI 50
Vogel's Cluster Crunch Honey Hazelnut GI 43
Wild Oats Cluster Crunch Hazelnut Chocolate GI 43

• For nutrition and product information from the manufacturer, check out www.vogels.com.au for the Vogels products and www.specialtycereals.com.au for the Wild Oats product.
  
  
• For information on nominal serve sizes, available carbohydrate and glycemic load, check out the GI database at www.glycemicindex.com

GI Symbol Program News
Australian health bread specialist, Country Life Bakery has created a low GI gluten-free loaf. This ground-breaking product will be welcomed by all those in Australia who need to eat a gluten-free diet and keep their blood glucose on an even keel.



Country Life Low GI Gluten-free Bread GI 40

• For nutrition and product information, check out www.countrylife.com.au

And four more delicious breads from Goodman Fielder carry the GI symbol
Vogel’s Rye with Sunflower GI 47
Vogel’s Soy + Linseed with Oats GI 49
Vogel’s Seven Seed GI 50
Vogel’s Original Mixed Grain GI 54

What does the GI symbol mean?
The GI symbol on a food is a guarantee that the stated GI value is reliable and that the food is a healthy choice in its food group. To earn certification, foods that carry the symbol must be a good source of carbohydrate and meet a host of other nutrient criteria including kilojoules (calories), total and saturated fat, sodium (salt), and where appropriate, dietary fibre and calcium. The GI Symbol Program is a public health initiative run by Glycemic Index Limited, a non-profit company whose members are the University of Sydney, Diabetes Australia and the Juvenile Diabetes Research Foundation.

Where can I get more information on the GI symbol program?



Alan Barclay
Acting CEO, Glycemic Index Ltd
Phone: +61 2 9785 1037
Fax: +61 2 9785 1037
Email: awbarclay@optusnet.com.au
Web www.gisymbol.com.au

Where can I get more information on GI testing?

North America
Dr Alexandra Jenkins
Glycemic Index Laboratories
36 Lombard Street, Suite 100
Toronto, Ontario M5C 2X3 Canada
Phone +1 416 861 0506
Email info@gilabs.com
Web www.gilabs.com

Australia
Fiona Atkinson
Research Manager, Sydney University Glycemic Index Research Service (SUGiRS)
Human Nutrition Unit, School of Molecular and Microbial Biosciences
Sydney University
NSW 2006 Australia
Phone + 61 2 9351 6018
Fax: + 61 2 9351 6022
Email sugirs@mmb.usyd.edu.au
Web www.glycemicindex.com

New Zealand
Dr Tracy Perry
The Glycemic Research Group, Dept of Human Nutrition
University of Otago
PO Box 56 Dunedin New Zealand
Phone +64 3 479 7508
Email tracy.perry@stonebow.otago.ac.nz
Web glycemicindex.otago.ac.nz

Making the Most of GI News

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GI News endeavours to check the veracity of news stories cited in this free e-newsletter by referring to the primary source, but cannot be held responsible for inaccuracies in the articles so published. GI News provides links to other World Wide Web sites as a convenience to users, but cannot be held responsible for the content or availability of these sites. This document may be copied and distributed provided the source is cited as GI News and the information so distributed is not used for profit.

© ® & ™ The University of Sydney, Australia

GI News—October 2006

In This Issue:

• Food for Thought
  —Something to chew on
  
• GI News Briefs
  —What women athletes need
  —More low fat dairy food, less type 2 diabetes
  —High blood glucose increases coronary artery disease risk
  —Giving children a healthy life
  —Why a low GI diet can help women with PCOS
  
• Low GI Food of the Month
  —Green peas
  
• Low GI Recipe of the Month
  —Gluten-free Apricot Nut Slice
  
• Success Stories
  —‘It is nothing short of a miracle’ – Rose
  
• What's New?
  —Healthy Parent, Healthy Child
  
• Feedback—Your FAQs Answered
  
  1. I have gestational diabetes. What should I choose from the menu at my local Asian restaurant to stick to my daily food guide for carb serves?
     
  2. I love to bake, but want to reduce the GI of the products? Can you answer some questions about this?
     
  3. I have recently been diagnosed with irritable bowel disease and am interested to know if following a low GI diet would be recommended to help control my symptoms.
  4. Look it up in our A–Z: The GI Glossary completed
     

The publishers of the New Glucose Revolution series, Hachette Livre Australia, Hodder Mobius UK and Marlowe & Company New York, have agreed to give away a copy of The Low GI Diet Cookbook to every 1000th subscriber from now on. To subscribe, just click on 'SUBSCRIBE' at the top of the right-hand column.



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

Food for Thought

Something to chew on
Periodontitis is a leading cause of tooth loss in adults – around 30% have it. It’s a serious infection that destroys the soft bone and tissue that support your teeth but it is both treatable and preventable. It’s long been known that daily brushing and flossing and regular professional cleaning can greatly reduce chances of developing gum disease. Findings from the first study to look at wholegrain intake in conjunction with periodontitis risk (American Journal of Clinical Nutrition 2006;83:1395-400) suggest that eating at least 4 servings of wholegrains a day may reduce the likelihood of periodontitis in healthy people possibly by improving their insulin sensitivity suggest the authors. And although it’s still early days, the news is encouraging.

In a prospective study, researchers from McMaster University in Canada tracked more than 34,000 healthy men (those with diabetes, heart disease or a history of stroke were excluded) aged 40–75 years at the start of the study over 14 years. The men eating the most wholegrain foods (around 3 or more servings a day) including brown rice, dark breads, oats, whole grain breakfast cereals, popcorn, wheatgerm, bran and other grains were 23 per cent less likely to develop periodontitis than those who ate less than one serving a day. Although they also found that the men who ate the most cereal fibre were less likely to develop gum disease, they found no link between total dietary fibre and periodontitis risk.

As we have said before, there are countless reasons to include more whole cereal grains in your diet, but it’s hard to go past the fact that you are getting all the benefits of their vitamins, minerals, protein, dietary fibre and protective anti-oxidants. Many wholegrain foods (but not all) also have a low or moderate GI slowing the digestion and absorption of carbohydrates from the gut, keeping blood glucose levels on an even keel. There are a number of studies that show that managing blood glucose levels reduces the risk of periodontitis in people with diabetes, so it may well be that lower blood glucose levels will reduce the risk of periodontitis in non-diabetics.

Take steps to prevent gum disease

• Brush your teeth twice a day and floss once a day.
• Visit your dentist every six months for a check up and clean to remove the build-up of tartar from areas your brush can’t reach.
• Eat a healthy diet including plenty of low GI wholegrains – at least 4 servings a day.
• If you have diabetes, manage your blood glucose levels.
• Do not smoke – people who smoke are four times more likely to develop gum disease than people who don’t.
  

GI News Briefs

What women athletes need
Whether you are a serious endurance athlete or exercising seriously to lose body fat, the results of a study from researchers at Nottingham and Loughborough Universities show that being choosy about your carbs before training or events can help maximise fat oxidation (burning). In a study involving 8 healthy, active, young women Dr Emma Stevenson reports that ‘altering the GI of a mixed meal eaten 3 hours before exercising significantly changed the post prandial hyperglycemic and hyperinsulinemic (see below) responses in the women’. In 2 separate trials the women were given a high GI breakfast (GI 78) or a low GI breakfast (GI 44) 3 hours before a 60-minute run at 65% VO2max on a motorised treadmill. Both breakfasts provided 2 grams of carbohydrate per kilogram of body weight.

The women had a higher rate of fat oxidation during exercise after the low GI breakfast than after the high GI one reports Stevenson. This is because large glycemic and insulinemic responses to a high GI meal lead to increased carbohydrate oxidation and a reduction in the mobilisation and oxidation of free fatty acids. Increasing fat oxidation during exercise is what you need to do to lose body fat. Stevenson and her co-authors make the point that further research needs to look at exercise at different intensities and of shorter duration and also in older women and oral contraceptive users.
– American Journal of Clinical Nutrition 2006;84:354–60



More low fat dairy food, less type 2 diabetes
Older women who eat plenty of low fat dairy foods could reduce their risk of type 2 diabetes reports a new study from Harvard in July Diabetes Care. The researchers looked at the associations between dairy food and calcium intake and incidence of type 2 diabetes in 37,183 women without a history of diabetes, cardiovascular disease or cancer at the start of the study. ‘Each serving-per-day increase in dairy intake was associated with a 4% lower risk of type 2 diabetes, says Liu. While acknowledging that dairy food’s lower GI may contribute to the reduced risk, the researchers conclude: ‘our results show independent associations after adjusting for glycemic load. These data are consistent with the possibility that milk seems to influence glucose tolerance more through its insulinotropic effect (stimulating the release of insulin) than its relatively lower glycemic load.’
– Diabetes Care, 29(7), July 2006



High blood glucose increases coronary artery disease risk
Diabetes is well recognised as a major risk factor for heart disease. Impaired fasting glucose is increasingly common (affecting some 35 million Americans), so the next big question is at what point does elevated blood glucose (often associated with impaired glucose tolerance) in the absence of diabetes become a risk factor? In a retrospective study published in Diabetes Care using the records of 24,160 non-diabetic patients (mostly men) from US Veterans Affairs medical centers, Dr Christopher Nielson and his co-researchers looked for associations between morning glucose and subsequent incidents of heart attack and angina etc. They found that elevated fasting glucose greater than 100 mg/dl (5.5 mmol/L) was associated with a greater incidence of coronary artery disease (CAD) independent of typical risk factors such as age, weight, blood pressure etc. This retrospective study both extends the previous descriptions of the association between glucose and CAD and suggests that the commonly used morning glucose test can provide a useful indication of CAD risk.
– Diabetes Care, 29(5), May 2006



Giving children a healthy life
‘Best estimates are that a white child born in the United States in the year 2000 has a 1 in 3 chance of developing diabetes in his/her lifetime, and a 1 in 2 chance if he she is black or Hispanic’ writes Dr Patrick Hughes and co-authors in the Wisconsin Medical Journal in the introduction to their Wasau SCHOOL Project study. Designed to measure the prevalence and magnitude of known risk factors for heart disease and diabetes in school-age children in Wausau, Wisconsin, the SCHOOL Project was small cross-sectional study of a representative sample of students in grades 2, 5, 8 and 11. Here’s what they found: ‘Of the children studied, 39% had at least 1 lipid (blood cholesterol) abnormality and 22% had 2 or more. Abnormal blood pressure, overweight and cigarette smoking were present in 29%, 16% and 11% respectively. While elevated fasting glucose levels were uncommon, insulin resistance was noted in 25% of the sampled population and nearly 50% of sampled children with a BMI greater than the 85th percentile in the survey … Multiple risk factors rose dramatically with age. By 11th grade, 38% of those surveyed had 2 or more risk factors and 23% had 3 or more.



The authors conclude: ‘Primary prevention of atherosclerotic cardiovascular disease must begin in childhood. At an early age, children will find it easier to learn and adopt healthier lifestyles if the encouragement they receive from parents, teachers and society is reinforced by example and actions.’ Here are some of the healthier lifestyle changes that they suggest. ‘Daily physical education classes at all grade levels, an emphasis on life sports, promotion of nutritious foods in schools and restaurants, freedom from environmental tobacco exposure in public places throughout the community, and widespread, actively promoted, year-round opportunities for physical activity regardless of socioeconomic status.’
– Wisconsin Medical Journal 2006, 105(3)

Why a low GI diet can help women with PCOS
In September, accredited practising dietitian and diabetes educator Kate Marsh addressed the annual polycystic ovarian syndrome conference in Sydney on how diet can help women manage the symptoms of PCOS. The conference was organised by the Polycystic Ovarian Syndrome Association of Australia Inc – www.posaa.asn.au


Kate Marsh

Polycystic Ovary Syndrome (PCOS) is a hormonal (endocrine) disorder that affects 5–10% of women. Symptoms include irregular or absent periods, infertility or reduced fertility, hirsutism (excess hair growth on the face, chest and abdomen), alopecia (scalp hair loss), acne, obesity and difficulty losing weight and increased risk of miscarriage. Many women also complain of excessive tiredness and fatigue, hypoglycaemia (low blood sugar), and poor memory and concentration. We don’t know why PCOS develops, but we do know that there are a number of different causes and that for many women it’s high levels of insulin in the blood resulting from insulin resistance. Having insulin resistance means the body is insensitive to insulin and because the insulin isn’t working effectively, the pancreas pumps out more and more to keep blood glucose levels under control. It’s these high levels of insulin circulating in the bloodstream that cause many health problems including PCOS.

Here’s why. High levels of insulin act on the ovaries to cause increased production of male hormones, which disrupt the normal ovulation cycle and cause many of the symptoms of PCOS. The link between these two conditions also means that women with PCOS are at an increased risk of developing health problems including impaired glucose tolerance (the stage before diabetes), gestational diabetes (diabetes during pregnancy), type 2 diabetes and cardiovascular disease. The good news is that treating insulin resistance significantly improves all or most of the symptoms because it reduces androgen (male hormone) levels and restores ovulation.

Here’s how. You can improve insulin resistance with lifestyle changes such as a healthy eating plan, exercise and weight loss. You may also need medication, but is only effective if used in combination with lifestyle changes. Making these lifestyle changes has restored ovulation in women with PCOS, even with weight losses of as little as 5% of body weight. There are other benefits too. Eating well helps regulate your blood glucose levels, improve your energy levels and reduce your risk of type 2 diabetes and heart disease.

The best type of healthy eating plan is low in saturated fat and high in fibre and includes low GI carbs. Low GI foods are more filling and satisfying, which helps to control hunger and assists with weight loss. They result in lower levels of insulin circulating in the bloodstream, which means fat is less easily stored by the body and is more easily burnt. Lower insulin levels also mean that less male hormones are produced, which can improve many of the symptoms of PCOS, help to reduce the risk of diabetes and heart disease and improve blood fat levels. Spreading your food intake evenly across the day is important too, as this helps prevent spikes in your blood glucose and insulin levels.

But, the most important thing with any eating plan you choose, is that you can actually stick to it long term – short term quick fix weight-loss diets are doomed for failure. If you have PCOS and need help with your diet, make an appointment to see an accredited practising (registered) dietitian who specialises in this area to develop an eating plan to suit your needs.

Diet alone is not enough. You need to combine your healthy eating plan with some regular exercise – at least 30 minutes of activity on most days. It is best to include a combination of both aerobic exercise (walking, running, dancing) and resistance training (weights) – a number of studies have now shown the benefits of lifting weights for improving blood glucose and insulin levels.

– Kate Marsh BSc, M Nutrition Dietetics, Graduate Certificate in Diabetes Eduction & Management

GI Group: To find out more about the PCOS and low GI diets, check out The Low GI Guide to Managing PCOS by Prof. Nadir Farid, Prof. Jennie Brand-Miller and Kate Marsh. This should be available in all good bookshops in Australia, NZ, the US and the UK or from Amazon.

Low GI Food of the Month

Green Peas

I eat my peas with honey
I’ve done it all my life’
It makes the peas taste funny
But it keeps ’em on the knife.
– Anon

There’s nothing like the aroma of shelling and eating fresh, green peas (GI 48) straight from the pod. Today, most of us buy them in frozen packs – the manufacturer has done the hard work. They are rich in fibre and vitamin C and higher in protein than most vegetables.



Although a good source of thiamin, niacin, phosphorus and iron when fresh, cooking will reduce the nutrient levels. If you do buy peas in the pod, you’ll need about 350 grams (12 oz) of pods to fill a cup with shelled peas. And tempting as it is to pick up a pack of ‘freshly’ shelled peas from your greengrocer or supermarket, only do so if you know they really have been freshly shelled and you plan to use them immediately. Boil, steam or microwave peas for about 4–5 minutes (remember, cooking destroys the nutrients) or add to rice dishes such as risottos, pilafs, pasta dishes, frittatas, soups and stews (at the last minute), or combine with a little mashed potato, sweet potato or yams. Peas with edible pods such as snowpeas and sugar snaps (immature pods) only need the minimum of cooking time, too, and are delicious in stir-fries, or steamed or cooked in the microwave for a side dish. Here are some serving suggestions:

• Whip up an omelette with onion, a little lean ham or bacon if you wish, plus corn kernels and fresh or frozen green peas.
  
• For comfort food, purée or mash cooked peas with chicken stock and a little light margarine.
  
• Add blanched snowpeas or sugar snaps to salads or serve with vegetable platters and dips.

– Low GI Eating Made Easy (Hachette Livre Australia, Hodder UK, Marlowe & Company USA)

Individual Frittatas with Capsicum, Sweet Potato, Baby Peas And Feta
Serves 6
Preparation time 15 minutes; Cooking time 30–35 minutes; Cooling time 10 minutes


Photo: Ian Hofstetter

1 tablespoon extra virgin olive oil
1 red (Spanish) onion, halved, thinly sliced
1 red capsicum (pepper), cut into short thin strips
300 g (10½ oz) orange sweet potato, cut into 1 cm pieces
1 garlic clove, crushed
150 g (5½ oz) frozen baby green peas
70 g (2½ oz/1/3 cup) semi-dried tomatoes, finely chopped
100 g (3½ oz) low fat fetta, crumbled
olive oil spray
7 eggs
125 ml (4 fl oz/½ cup) low fat milk or soy milk
freshly ground black pepper
Dressed salad leaves, to serve

1. Preheat the oven to 190ºC (375ºF/Gas 5). Spray a large 6-hole muffin pan with oil.
2. Heat the oil in a large non-stick frying pan over medium-high heat. Add the onion, capsicum, sweet potato and garlic. Cook, stirring often, for 5 minutes. Add the peas and cook for 3 minutes. Remove from heat and set aside to cool a little. Stir in the semi-dried tomatoes and fetta.
3. Whisk the eggs and milk together. Season with pepper. Divide the vegetables among the muffin pan holes. Pour the egg mixture evenly over the vegetables. Bake for 20–5 minutes or until the frittatas are set and lightly golden. Set aside in the pan for 10 minutes before turning out. Serve warm with dressed salad leaves.

Nutritional analysis per individual frittata
Energy 1052 kJ/251 cal, protein 17 g, fat 12 g (sat fat 4 g), fibre 5 g, carbohydrate 16 g

–The Low GI Vegetarian Cookbook (Hachette Livre Australia, Hodder UK, Marlowe & Company USA)

Low GI Recipe of the Month

Gluten-free Apricot Nut Slice
‘Gluten-free recipes I can do. Recipes for people with diabetes I can do,’ said dietitian/home economist Diane Temple, ‘but together it’s a pretty tough challenge.’ And after lots of testing, here’s Diane’s delicious gluten-free slice that’s ideal for school lunch boxes. It is easy and quick to make, contains good fats and is rich in fibre. From our calculations, the GI is likely to be moderate. This is because the GI of the gluten-free biscuits you use and the rice flour will probably be high, but the dried fruits are low. Here’s a tip before you whip up a batch: when baking slices, check the actual base measurement of the pan, you’ll find it may be different from the labelled size – usually a little smaller.



Makes 12 pieces ▪ Preparation time 10 minutes ▪ Cooking time 25 minutes

Base
120 g (4 oz) plain, sweet gluten free biscuits
1/3 cup (60 g/2 oz) brown rice flour
1/3 cup (35 g/1¼ oz) hazelnut meal
40 g (1½ oz) polyunsaturated or monounsaturated margarine, melted
1 egg white

Filling
200 g (7 oz) dried apricots
60 g (2 oz) dried cherries
1 cup (250 ml) water
2 teaspoons caster sugar
30 g (1 oz) flaked almonds

1. Pre-heat the oven to 180ºC (350ºF). Grease 26 x 16 cm/10½ in x 6½ (base measurement) slice pan.* Line the base and the 2 long sides with baking paper and extend the paper a few centimetres above the edge of the pan to help with removing the slice when it is cooked and cooled.
2. To make the base: combine the biscuit crumbs, flour and hazelnut meal in a medium bowl. Whisk the egg white until slightly foamy. Add the margarine and egg white to the crumbs and mix together using your hands to combine. Press the mixture into the base of the prepared pan. Bake for 10 minutes or until base is lightly browned.
3. For the topping: place the apricots, cherries and water in a small saucepan and bring to the boil. Simmer for 10 minutes until the fruit is soft, stirring occasionally to break up the fruit. Mix through the sugar. Spread the filling evenly over the cooked base. Sprinkle the flaked almonds over the top.
4. Bake the slice for 15 minutes or until the almonds are lightly toasted. Leave in the pan to cool. Slice when cold and store in an airtight container.

*Slice pan labelled size is 19 x 29 cm (11½ x 7½ in)

Nutritional analysis per piece
Energy 720 kJ/170 cal, protein 3 g, fat 9 g (sat fat 2 g), fibre 3 g, carbohydrate 21 g

For professional recipe development or testing contact Diane Temple on:
tel 612 9958 3165 ▪ email diane.temple@bigpond.com

Your Success Stories

‘It is nothing short of a miracle’– Rose
My husband had a major stroke in 2004, and was diagnosed with type 2 diabetes, as well. His blood sugar has been like a roller coaster no matter how carefully I monitored his diet, until we accidentally happened upon The Low GI Diet Guide to Diabetes at our local book store. For the past 3 weeks we have followed your 7-days of menus religiously and my husband’s blood sugar has been holding so well it is unbelievable. The calorie and carb levels of your menu plans appear to be absolutely perfectly calibrated as he cannot exercise because he is paralysed.

It is nothing short of a miracle. In just 3 short weeks there's been a remarkable turnaround in his blood sugar and in the way he feels. His blood sugar has been right on target every day and he has lost 6 pounds! It's wonderful to see him feeling so well. Now he has asked if I could come up with 7 more days of menus so that he doesn’t eat the same thing every week!



Send Us Your Success Story!


We'll send you a free copy of The Low GI Diet Cookbook if your story is published.

Books, DVDs, Websites: What’s New?

Weight Watchers Healthy Parent Healthy Child: simple rules for a healthy-weight home
By Karen Miller-Kovach



The sub title says it all. Using insights gained from an ongoing family pilot program being conducted by WeightWatchers in the US, this book gives parents some practical tips to help them navigate today’s fast food, time poor culture and create a healthy-weight home. It’s based on five basic rules and the five special roles that parents need to play to help give their kids a healthy lifestyle. It’s not about nutrition and there are only a few recipes. It’s really about behaviour (eating and activity) and how you can make some little changes about the house that can make a big difference. There are lots of personal stories from the actual families and Weight Watcher ‘coaches’ who participated in the pilot program making it more than just theory. No single book is going to solve the obesity crisis, but you may find this one may a handy guide if you are looking for practical pointers to help you make some changes to your family’s diet and lifestyle. So what are the five simple rules?

1. Focus on wholesome nutritious foods
2. Include treats
3. Aim to keep homework computer or television time at two hours (or less) a day
4. Try and be active an hour a day or more
5. The Rules apply to everyone in the home.

And the five roles that parents play:
Role model ▪ Provider ▪ Enforcer ▪ Protector ▪ Advocate

Australia: Allen & Unwin RRP $29.95

Feedback—Your FAQs Answered

I have gestational diabetes. What should I choose from the menu at my local Asian restaurant to stick to my daily food guide for carb serves – a noodle soup with rice noodles; a dish with rice noodles (thick or thin); a dish with Hokkien (egg) noodles; or a dish with boiled rice?
The noodle soup is probably best as the noodles are low GI and the amount in a soup should fit into your recommended carb serves per meal. The other noodle dishes are also low GI, but will probably have a larger quantity of noodles, so you would need to limit the amount of these you eat and combine them with some vegetables. Or you could ask the restaurant proprietor to make you a noodle dish with half the amount of noodles as usual and to fill the rest of the plate with vegetables. In an Asian restaurant, the rice is likely to be Jasmine, long grain or calrose – all of which are high GI, so it is best to limit this. If you were choosing rice, keep the portion small, and again fill your plate with lots of vegetables.



I love to bake, but want to reduce the GI of the products? Here are my questions – all seven of them!

1. Can I estimate the GI/GL for baked goods?
   Estimating the GI of baked goods is not an accurate science by any means. There are too many variables that can affect the resultant GI and GL. It is always best to test baked goods. However we can make general assumptions – such as replacing flour with lower GI ingredients such as oats, dried fruit, oat bran and so on. Estimating a final GI would only ever be a rough estimate however.
   
   
2. Since spelt flour hasn’t been GI tested, can I estimate its GI value?
   No we can’t estimate it and given the reported health properties of this grain (it is a variety of wheat) it would be nice to have it tested. It does have a higher protein content than plain or all-purpose wheat flour and this may make a difference, although not necessarily. With the present information we could only play conservatively and give it the same GI as plain or all-purpose wheat flour – but emphasise the other nutritional qualities of spelt.
   
   
3. Flax seed and oat bran are said to lower GI, what proportion is necessary to get a lowering effect?
   To get a GI lowering effect the flaxseed or oat bran would need to replace some of the flour – the extra soluble fibre is what really has an effect on the GI. It’s difficult to put an absolute value on how much but we would estimate as least 10% in order to have a realistic effect on the GI. You need to weigh up how much can be added without negatively affecting the taste of the end product.
   
   
4. Ingredients like almonds, sunflower seeds, soy protein, eggs, butter – are they just ‘bulk’ that will ‘dilute’ the GI/GL per gram of finished product? Or will they have actual effect on GI?
   None of these ingredients contain an appreciable amount of carbohydrate and so do not have a GI themselves and neither will they affect the GI of the end product. They will however affect the GL since they alter the gram weight of the finished cookie…in other words more fat and protein will reduce the amount of carbohydrate per gram of cookie.
   
   
5. Is brown sugar the same as regular sucrose?
   Yes – although marginally less carbohydrate per 100 grams than white sugar any effect on GL will be minimal. Brown sugar is just sucrose with some of the molasses still present.
   
   
6. Is there a GI value for molasses?
   No – but it is unlikely to be very different from sucrose since it is predominantly sucrose, with some fructose and glucose also present. It does however contain less carbohydrate per 100g than brown or white sugar and so the contribution to the overall GI and GL of the product will be affected if molasses replaces some of the sugar in the original recipe. There are of course a few extra minerals found in molasses too.
   
   
7. I use fructose in my baking when it’s doable, but right now there is a lot of debate about fructose and it’s being described as the really bad guy.
   Fructose is a refined carbohydrate, and as such we recommend using it in moderation – 1–2 teaspoons in a cup of tea or coffee, and up to about a ½ cup as a sweetening substitute for sugar in recipes. After this we would start recommending you opt for a non-nutritive sweetener, especially if you had diabetes.

I have recently been diagnosed with irritable bowel disease and am interested to know if following a low GI diet would be recommended to help control my symptoms. I am also trying to lose weight.
A low GI diet could certainly help you with weight loss, but IBS is very individualised when it comes to diet. It would be best to see an Accredited Practising or Registered Dietitian who could help to design an eating plan to help with both your IBS symptoms and with losing weight.


Look it up in our A–Z: The GI Glossary (continued)



Starches are long chains of sugar molecules. They are called polysaccharides (poly meaning many). They are not sweet-tasting. There are two sorts – amylose and amylopectin.

Amylose is a straight-chain molecule, like a string of beads. These tend to line up in rows and form tight compact clumps that are harder to gelatinise and therefore digest.

Amylopectin is a string of glucose molecules with lots of branching points, such as you see in some types of seaweed. Amylopectin molecules are larger and more open and the starch is easier to gelatinise and digest.

Starch gelatinisation is what happens when starch granules have swollen and burst during cooking – the starch is said to be fully gelatinised. The starch in raw food is stored in hard, compact granules that make it difficult to digest. Most starchy foods need to be cooked for this reason. During cooking, water and heat expand the starch granules to different degrees; some granules actually burst and free the individual starch molecules. The swollen granules and free starch molecules are very easy to digest because the starch-digesting enzymes in the small intestine have a greater surface area to attack. A food containing starch that is fully gelatinised will therefore have a very high GI value.

Stevia (Stevia rebaudiana), native to South America, first came to the attention of the Western world in the 1800s, but remained relatively obscure until it was used as an alternative sweetener in the UK during the Second World War. It’s not widely available. The leaves of this semi-tropical herb of the aster family are around 30 times sweeter than cane sugar but with no kilojoules (calories). As a herb, the leaves can be used fresh or dried. In the dried form less than 2 tablespoons of crushed leaves can replace a cup of sugar, although it's hard to be specific as actual sweetness can vary. Stevioside, its extract, is 250–300 times sweeter than sucrose and is not approved for use as a food in Australia but is listed as a ‘therapeutic good’ with the Therapeutic Goods Administration.

Sugars are a type of carbohydrate. The simplest is a single-sugar molecule called a monosaccharide (mono meaning one, saccharide meaning sweet). Glucose is a monosaccharide that occurs in food (as glucose itself and as the building block of starch). If two monosaccharides are joined together, the result is a disaccharide (di meaning two). Sucrose, or common table sugar, is a disaccharide, as is lactose, the sugar in milk. As the number of monosaccharides in the chain increases, the carbohydrate becomes less sweet. Maltodextrins are oligosaccharides (oligo meaning a few) that are 5 or 6 glucose residues long and commonly used as a food ingredient. They taste only faintly sweet. Sugars found in food:

Monosaccharides (single-sugar molecules)
glucose
fructose
galactose

Disaccharides (two single-sugar molecules)
maltose = glucose + glucose
sucrose = glucose + fructose
lactose = glucose + galactose

Triglycerides also known as triacylglycerols or blood fats are another type of fat linked with increased risk of heart disease. Having too much triglyceride often goes hand in hand with having too little HDL cholesterol. Having high levels of triglycerides can be inherited, but it’s most often associated with being overweight or obese. Normal ranges for triglycerides are 1.0–2.3 mmol/L, people with diabetes should aim to keep their triglyceride levels under 2.0 mmol/L as they are at greater risk of cardiovascular disease.

Making the Most of GI News

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If you would prefer to read GI News or a page from glycemicindex in a language other than English, there is a very easy way to translate them (or any site for that matter), using a service provided by Altavista called ‘Babel Fish’. Simply head over to babelfish.altavista.com and copy and paste a block of text into the first window (up to 150 words), or enter the website address to translate an entire page into the ‘Translate a Web Page’ box. Next, select which language you would like the English text translated to from the drop-down menu. Click the Translate button and Babel Fish will do all the work for you in just a few seconds.


Babelfish homepage

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GI News endeavours to check the veracity of news stories cited in this free e-newsletter by referring to the primary source, but cannot be held responsible for inaccuracies in the articles so published. GI News provides links to other World Wide Web sites as a convenience to users, but cannot be held responsible for the content or availability of these sites. This document may be copied and distributed provided the source is cited as GI News and the information so distributed is not used for profit.

© ® & ™ The University of Sydney, Australia

GI News—September 2006

In This Issue:

• Food for Thought
  —Burning up
  
• GI News Briefs
  —The vegan advantage
  —High blood glucose linked to dementia
  —Not chubby by choice
  —The chromium question
  
• GI Values Updates
  —The latest GI values from SUGiRS: Ginger
  —The mystery of BR16
  
• Low GI Food of the Month
  —Low GI and gluten free
  
• Low GI Recipe of the Month
  —Thai-style pear and chicken salad
  
• Success Stories
  —Amy kills two birds with one stone
  
• What's New?
  —The Low GI Vegetarian Cookbook
  
• Feedback—Your FAQs Answered
  Joanna McMillan-Price and Alan Barclay answer this month’s FAQs
  
  1. I am 53 and not overweight, but I constantly feel tired and run down. And my mood can get low at times. Would low GI eating be of benefit to me?
     
  2. Does it matter if you eat less protein than is recommended in the 12-week action plan on The Low GI Diet?
     
  3. I heard people with diabetes should eat between meal snacks and supper before going to bed – is that true?
  4. Look it up in our A–Z: The GI Glossary continued
     

In late August we welcomed aboard the 20,000th subscriber to GI News. As a thank you, we have a special gift – a copy of The Low GI Diet Cookbook. At the same time we would like to thank all our subscribers who have helped to make the Newsletter a great success and whose comments and questions play a key role in shaping each issue.

The publishers of the New Glucose Revolution series, Hachette Livre Australia, Hodder Mobius UK and Marlowe & Company New York, have also agreed to give away a copy of The Low GI Diet Cookbook to every 1000th subscriber from now on. To subscribe, just click on 'SUBSCRIBE' at the top of the right-hand column.



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

Food for Thought

Burning up
As you break out in a sweat over a bowl of chilli, think of the benefits. Not just reducing insulin demand as we reported in GI News in August, but helping you burn calories while you eat. Researchers from Maastricht University, Wageningen Centre of Food Science in Holland, and Laval University in Quebec have reviewed the evidence for capsaicin, black pepper, ginger and mixed spices with respect to energy balance and heat generation (thermogenesis). Reporting in a recent issue of Physiology & Behavior they conclude: ‘Consumption of spiced foods or herbal drinks often leads to greater thermogenesis … Therefore, it is suggested that these ingredients can realistically be considered as functional agents that could help in preventing a positive energy balance and obesity.’ For example:

• Capsaicin, the compound gives red chilli pepper its heat, has been reported by several studies to boost heat generation by the body, which means you burn more energy.
• This means that people who drank tomato juice with a little bit of red pepper added effectively consumed 10% less energy.
• Black pepper is also reported to stimulate metabolism.

– Physiology and Behavior, 30 Aug 2006, 89(1): 85-91


Dried Chilli

If you like it hot, try this recipe from Herbies Spices ‘Seriously Chilli Spice Kit’. For a vegetarian version, drop the bacon and add another 1/2 cup of mushrooms.

Mexican chilli soup
Serves 4

2 Ancho chillies
3 large tomatoes, thickly sliced
1 small onion, thickly sliced
1 clove garlic, chopped
4 cups (1 litre) chicken stock (home-made, or low-salt if purchased)
1 cup finely chopped mushrooms
½ cup chopped lean bacon (all fat removed)
1 tablespoon olive oil
1 tablespoon ricotta
fresh coriander (cilantro), to serve

1. Preheat the grill or barbeque griddle plate till very hot. Toast the whole chillies, turning often to avoid burning (blackening). Remove the chilli seeds and stems (veins) reserving them in case you want to increase the heat of the soup later. Soak the chillies in 1 cup of the stock for 10 minutes then blend the chilli and stock mixture until smooth in a food processor or blender.
2. Char the onion slices and whole garlic clove all over. Peel the garlic clove after cooling a few minutes. Char the tomato slices then chop roughly.
3. Blend the onion, tomato and peeled garlic clove with 2 cups of the stock until smooth and add to the chilli mixture.
4. Heat the tablespoon of olive oil in a pan then fry the chopped bacon. After a minute or two, add the mushrooms and cook for about 5 minutes. Blend (or pulse if you like a more textured soup) the bacon and mushroom mixture with the ricotta in the remaining cup of stock. Combine with the rest of the soup in a large pan and reheat for about 5 minutes. Serve garnished with the fresh coriander.

If you want to increase the heat of the soup, puree some of the chilli seeds and veins with the bacon and mushroom mixture. For more spicy ideas go to: www.herbies.com.au

Energy: 653 kJ/155 cals; Protein: 10.2 g; Total fat 9.8 g (saturated fat: 2.8 g); Carbohydrate: 5.6 g; Fibre: 2.7 g

GI News Briefs

The vegan advantage
For over a hundred years, people with diabetes have been given advice on what to eat. It was not until the 1970s that carbohydrate was considered to be a valuable part of the diabetic diet. Researchers found that not only did the nutritional status of patients improve with a higher carbohydrate intake, but their insulin sensitivity improved as well. Now a US and Canadian research team led by Dr Neal Barnard suggests that a high carbohydrate (favouring low GI carbs), low fat vegan diet treats type 2 diabetes more effectively than a diet based on American Diabetes Association (ADA) guidelines – especially in reducing the need for diabetes medications.


Neal D Barnard, MD

In the randomised, controlled pilot trial, 49 people with type 2 diabetes followed a low-fat vegan diet consisting of about 10% of daily calories from fat, 15% from protein, and 75% from carbohydrates. They avoided animal products and added fats and favoured low GI foods like beans and green vegetables. Portion sizes and total daily calories or food intake were unrestricted and they took a B12 supplement because people on a vegan diet are at risk for vitamin B12 deficiency.

The other 50 participants followed a low-fat diet based on ADA guidelines – 15%–20% protein, 60%–70% carbohydrates and monounsaturated fats (such as olive oil), and less than 7% saturated fats (such as animal fats and butter). Total cholesterol was also limited to 200 milligrams or less per day. Overweight participants in this group were also advised to reduce daily calorie intake by 500–1,000 calories per day.

Participants on both diets significantly improved their glycemic control and reduced unhealthy cholesterol levels; but the changes were even greater in the vegan group.

• 43% of those on the vegan diet reduced their need to take drugs to manage their diabetes compared with 26% of the ADA group.
• Weight loss averaged more than 14 pounds in the vegan group; it was less than 7 pounds in the ADA group.
• LDL ‘bad’ cholesterol dropped by an average of 21% in the vegan group compared with 11% of those in the ADA group who did not change their cholesterol drug use.

It’s early days, as the research team acknowledges concluding that ‘further research is necessary to establish longer term diet effect and sustainability.’ However, in a news release, Dr Barnard makes the point that: ‘The diet appears remarkably effective, and all the side effects are good ones – especially weight loss and lower cholesterol. I hope this study will rekindle interest in using diet changes first, rather than prescription drugs.’
– Diabetes Care 29:1777-1783, 2006


Photo: Ian Hofstetter

Want to try some delicious veg-based recipes? Check out The Low GI Vegetarian Cookbook reviewed in this issue – it features 80 vegetarian and vegan recipes along with 7-day menu plans for vegetarian and vegan adults, teenagers and children.

High blood glucose linked to dementia
A four-year study of post-menopausal women has found that chronically elevated blood glucose (glycated hemoglobin or HbA1c levels of 7% or higher) is linked with an increased risk of developing mild cognitive impairment or dementia. ‘We already know there’s a connection between diabetes and cognitive problems,’ says the study’s lead author Dr Kristine Yaffe of the University of California, San Francisco. ‘We were interested in what this measurement would tell us about a group of women with and without diabetes who were followed for four years. Nobody has really looked at that before.’

The four-year prospective study looked at 1,983 women whose HbA1c levels were tested at the beginning of the study. Over the course of the study, 86 women developed mild cognitive impairment or dementia – for every 1% increase in HbA1c, the women had a greater age-adjusted likelihood of developing mild cognitive impairment or dementia. Women with a HbA1c of 7% or higher at baseline were four times more likely to develop mild cognitive impairment or dementia than women who tested at less than 7%. Even when the researchers excluded the 53 women known at the outset to have diabetes, there was still a statistically significant association between elevated HbA1c and cognitive risk.

‘Type 2 diabetes is a very common and growing problem,’ says Yaffe. ‘The point is that now you can identify people who are at risk for mild cognitive impairment or dementia and monitor them closely ... I think we need to take these people who are at risk and see whether we can target them for trials or interventions for better blood glucose control.’
– Journal of Nutrition, Health, and Aging (10) 4.

What’s glycated hemoglobin?
Glycated hemoglobin, also known as HbA1c or simply A1c, measures the percentage of hemoglobin – the oxygen-bearing protein in red blood cells – that is bound to glucose. A result of 4 to 6% is normal. In people with diabetes, 7% or less indicates good long-term blood glucose control. Unlike a standard blood glucose test that measures your blood glucose at the moment of testing, HbA1c gives an indication of your blood glucose levels over the 2–4 months preceding the test.


Red Blood Cells

Not chubby by choice
The energy equation says energy intake and energy expenditure need to be in balance if you are to maintain a healthy weight. Simple isn’t it. So if you are overweight or obese you eat too much or exercise too little. And it is your fault. No, says Dr Robert Lustwig, professor of clinical pediatrics at UCSF Children’s Hospital. It’s not like that. Certainly not when it comes to children. They should not be blamed or expected to take personal responsibility for their diets when they are offered foods full of sugar and devoid of fibre. ‘The concept of personal responsibility is not tenable in children. No child chooses to be obese,’ he says.



In a comprehensive (and passionate) review of obesity research published in the August edition of Nature Clinical Practice Endocrinology & Metabolism, he concludes that changes in manufacturing processes over the past 30 years have made food ‘toxic’ and ‘addictive’, leading to obesity. ‘Our current Western food environment has become highly insulinogenic (elevates insulin levels),’ says Dr Robert Lustig, ‘as demonstrated by its increased energy density, high-fat content, high glycemic index, increased fructose composition, decreased fibre, and decreased dairy content.’ This upsets the balance of two hormones, which regulate how much we eat – leptin and insulin.

Here’s how it works. Insulin encourages eating in two ways. It blocks the signals that travel from the body’s fat stores to the brain by suppressing the effectiveness of leptin – and this leads to increased eating and decreased activity. It also promotes the signal carried by the chemical dopamine that seeks the reward of eating. So we want to eat for that pleasurable dopamine ‘rush’ – and this is the addictive bit.

Calorie/kilojoule intake and expenditure are normally regulated by leptin. When leptin is doing its job it ‘increases physical activity, decreases appetite, and increases feelings of well-being.’ When it is not, activity levels decrease, appetite increases and you get ‘leptin resistance’. Prof Lustig suggests that two factors which are promoting insulin production and making foods addictive are adding sugar to foods that never used to have it, and removing fibre in the processing.
– Nature Clinical Practice Endocrinology & Metabolism (2006) 2: 447–458


Robert H Lustig, MD

The chromium question
Chromium is an essential mineral that plays an important role in how our bodies metabolise carbohydrate, fat and protein. Current research suggests that it helps insulin work more effectively in the cells of the body, which in turn will help the body manage blood glucose levels better. So, if you have type 2 diabetes, will taking extra chromium as a supplement improve your blood glucose levels. To date studies have yielded conflicting results. A new, small double blind study by Julie Martin from the University of Vermont published in Diabetes Care in August found that ‘chromium picolinate supplementation in subjects with type 2 diabetes who are taking sulfonylurea agents significantly improves insulin sensitivity and glucose control’. The researchers tested whether chromium supplements were useful in combination with a sulfonylurea medication – an older class of diabetes drugs that often spur weight gain. They randomly assigned 29 diabetic adults to take either the medication plus 1,000 micrograms of chromium picolinate per day or the drug plus a placebo (sugar pill) for 6 months. In the end, study participants who took the supplement showed greater improvements in insulin sensitivity and blood glucose control. They also gained less weight and body fat than those on the medication alone.
– Diabetes Care 29: 1826-1832, 2006

GI Group: A word of caution about this interesting result – the researchers did not monitor the participants’ food or physical activity before or during the study. So it is not possible to say conclusively that the improvements were due to the chromium picolinate alone.

In addition, the body loses many vitamins and minerals (including chromium) in urine, and when urination increases, as it does with poorly managed diabetes, losses can be excessive and lead to a deficiency. Most people with type 2 diabetes can reverse this deficiency within a few months by achieving and maintaining optimal blood glucose levels. During this initial period, it may be useful to take a multivitamin supplement to boost the replenishment process. But once an individual is managing blood glucose levels and eating a healthy diet this should no longer be necessary. As for chromium, the body only needs only a minute amount – around 25 micrograms a day for women and 35 micrograms a day for men. And it is found in many foods. Good sources are bran-based breakfast cereals and wholegrain breads and cereals; brewers yeast; cheese; fruits such as apple, oranges and pineapple; vegetables such as broccoli, mushrooms, potatoes with their skin on, tomatoes; liver; peanuts; and some spices.

GI Values Update

The latest GI values from SUGiRS: Ginger
Valued the world over as a culinary spice, condiment and home remedy with beneficial properties that have long been recognised and recorded, ginger has made its presence felt and entered the language with phrases like ‘ginger up’ and ‘ginger group’. Although grown in Asia and India for hundreds of years, we don’t know exactly where it originally came from. But we do know it’s a great grower when you plant those juicy rhizomes in the right spot. Buderim, about 100 km (60 miles) north of Brisbane (Australia) is one such spot.


Ginger root

Not long before World War 1, some pieces of raw ginger found their way to Buderim where the comparatively high rainfall and humidity provided ideal growing conditions. During World War 2, when the supply from China was non-existent, five local farmers saw an opportunity and formed The Buderim Ginger Grower's Co-operative Association Limited with 25 pounds, two wooden vats and 14 tons of green ginger. Today, Buderim Ginger produces some of the world's finest ginger, and exports to 17 countries around the world (check their website to order online or find your nearest stockist: www.buderimginger.com). It also makes the world first GI-tested ginger products.

Buderim Ginger Divine Date Spread (mix of dates and ginger): GI 29
Buderim Ginger Original Ginger Marmalade: GI 50
Buderim Ginger Ginger Spread (no cane sugar): GI 10
Buderim Ginger Sucrose-free Ginger (looks like candied ginger): GI 10

For nominal serve sizes, available carbohydrate and GL, check out the GI database at www.glycemicindex.com

For more information about GI testing at Sydney University, please contact:
Fiona Atkinson sugirs@mmb.usyd.edu.au
Research Manager, Sydney University Glycemic Index Research Service (SUGiRS).
Human Nutrition Unit, Department of Biochemistry (GO8)
Sydney University, NSW 2006 Australia


Fiona Atkinson

The mystery of BR16
Many readers have asked where they can buy ‘Bangladeshi rice BR16’ a long-grain, white rice with a GI of 39 that’s posted in the GI database. First the bad news. We have checked with numerous international rice suppliers and sadly no one can identify a commercial branded product of this rice you can buy. Now the good news. In the next month or so, we will be publishing the results of a new low GI rice that carries the GI Symbol and will be available in supermarkets in Australia initially and then internationally. So watch this space.

Low GI Recipe of the Month

Thai-style pear and chicken salad
Versatile pears are an excellent source of fibre, and they are rich in vitamin C and potassium. Enjoy this low GI fruit juicy fresh as the perfect portable snack, in a salad or poached in red wine with a touch of cardamom. This tangy Thai-style low GI recipe from Horticulture Australia who have joined the GI Symbol Program makes a delicious starter or a complete light meal on its own.



Serves 1

1 pear, cut into wedges
1 Lebanese cucumber, sliced
100 g (3½ oz) skinless chicken breast, cooked and sliced
1 tablespoon chopped coriander
1 tablespoon chopped mint
Juice from 1 lime
1 teaspoon honey
1/4 teaspoon fish sauce
1 clove garlic (optional)

Combine the pear, cucumber, chicken, mint and coriander.
Mix together the lime juice, honey and fish sauce and garlic.
Pour the dressing over the salad, mix through and serve.

Recipe analysis
Energy: 1400 kJ/330 cals; Protein: 30 g; Total fat 8.5 g (saturated: 2.3 g; Carbohydrate: 31.4 g; Fibre: 6.3 g

Serving suggestions

• Serve in lettuce cups for an instant sang choy bau.
• Fill into softened rice paper for quick and easy rice paper rolls.

Low GI Food of the Month

Low GI and gluten free
Even on a wheat-free or gluten-free diet, you’ll find that there are many low GI foods you can enjoy. There is an ever-growing range of gluten-free products on supermarket shelves, and many foods that naturally have a low GI are also suitable for a gluten-free diet. So with a little extra care, you can still enjoy delicious and nutritious meals as well as keep your blood glucose levels within the optimal range. You’ll find low GI gluten-free foods in four of the five food groups:

• Virtually all fruits and vegetables
• Wholegrains in the bread and cereals group
• Legumes of all types in the meat and alternatives group
• Milk and yoghurt among the dairy foods.

We are currently developing a low GI gluten free fact sheet which we will be posting on our website later this year.



Not many special gluten-free products have been GI tested. It’s important to ask (hound!) the manufacturer of your favourite gluten-free foods to do this with an accredited lab. Hats off to Australian company, Freedom Foods. Many of their gluten-free products have been GI-tested – a great help for people who have both type 1 diabetes and celiac disease who have to eat a wheat free diet and keep their blood glucose on an even keel. Although Freedom Foods porridge oats are manufactured in an oat only environment, it is probably a good idea to trial a small portion first if you have celiac disease to make sure you can tolerate them. Here are the results their GI testing:

Cereals
Quick Oats Porridge GI 50
Mueslis
Gluten Free Wheat Free GI 50
Breakfast bars
Gluten Free Breakfast Bar GI 50, Omega BarGI 21
Slices
Strawberry Slice GI 58
Snacks
Chick Pea Chips GI 44
Fruit strips
Apricot & Apple GI 29; Plum & Apple GI 29; Peach & Pear GI 29
Pastas
Spaghetti GI 51; Rice Pasta GI 51
Flour shakes
Corn Fritter Mix GI 34; Pancake Mix GI 61
Fruit spreads
Apricot Spread GI 43; Strawberry Spread GI 29; Marmalade Spread GI 27; Raspberry Spread GI 26
Fruit and nut bars
Apricot & Almond GI 54; Macadamia & Pineapple GI 56; Yoghurt Coated Almond & Apricot GI 52; Simply Nuts GI 39

• Visit www.freedomfoods.com.au if you want to check out the ingredient list for these.
• For nominal serve sizes, available carbohydrate and GL, check out the GI database at www.glycemicindex.com

Your Success Stories

Amy kills two birds with one stone …
When I consulted dietitian Johanna Burani about my weight and my diabetes, I weighed in at 320 pounds and I am only 5 foot 7 inches (giving me a scary BMI of 50) – yes, I had trouble walking and even getting out of bed! My doctor was not optimistic about what the future held unless things changed as there's diabetes on both sides of the family. I really hoped there'd be a way to control it naturally. I am not a 'pills' person, and was already taking blood pressure medication and was not happy about that at all.



I knew I simply had to straighten out my diet and the big incentive was when my doctor told me I could come off Glucophage if I lost weight and kept it off. So I started walking for 45 minutes in my lunch hour and lost 36 pounds. But I always felt hungry and the temptation to grab a cake or donut or chocolate candies to snack on was constant, and all too often I gave in and raided my boss' candy dish in the afternoons. And all too soon the weight started coming back on.

So I decided to consult a dietitian. When I first saw Johanna, she asked me to construct a 24-hour food and drink diary. It's not as easy as it sounds! I had never really thought about portions. I just ate what I was served – or as much food as I felt like. But I am not a fussy eater at all and I love my fruits and vegetables. What did become clear was that I was eating far too many 'gushers' (high GI foods).

Johanna explained that she could probably 'kill two birds with one stone' – that is she could help me lose weight and control my blood glucose levels naturally! So we put together a game plan that I could stick to. Essentially all I had to do was exchange my quickly digested carbs for more slowly digested ones. This meant I had to decrease the high GI fruits and replace them with trickler fruits; breads had to be whole grain (with lots of grainy bits) and my evening meal would consist of smaller starch and protein portions with half my plate covered in vegetables.

Amazingly Johanna said that this might be all I would have to do (as well as some exercise and drinking lots of water). I have to say I couldn't believe it; but it was virtually all I had to do! I signed up at a women's only gym near where I worked doing both cardiac and resistance training for 45 minutes most lunchtimes and stuck to my low GI ‘trickler’ diet. In a little over a year I lost 118 pounds – and after the first 50 my doctor took me off blood pressure medication! My most recent bloodwork shows a 31 percent jump in my good HDL cholesterol; a 74 percent drop in triglycerides and a 26 per cent drop in mean glucose levels. So I got my wish – no medication and a nice bonus – no joint pain. I also got back my life. I workout six days a week and I really love my spinning classes. In fact I am thinking of becoming a spinning class instructor – part time of course.
– From Good Carbs, Bad Carbs by Johanna Burani, published by Marlowe & Company and reproduced with Amy’s and Johanna’s permission.

Send Us Your Success Story!


We'll send you a free copy of The Low GI Diet Cookbook if your story is published.

Books, DVDs, Websites: What’s New?

The Low GI Vegetarian Cookbook: 80 delicious recipes for vegetarians and vegans
Prof Jennie Brand-Miller, Kaye Foster-Powell and Kate Marsh with Philippa Sandall



Whether you are vegetarian, vegan, or simply want to eat a healthy balanced diet and find new ways to include more fibre-rich wholegrains and legumes in your diet, this book has a place in the kitchen. Illustrated with mouth-watering colour photography by Ian Hofstetter with food styling by Katie Holder, it really does show you how to combine the basics of a healthy vegetarian or vegan diet with the benefits of low GI carbs to successfully make the switch to the low GI way of eating.

Part 1, ‘The Healthy Vegetarian’, explains how vegetarians and vegans can get their diet into tip top shape with all the necessary vitamins and minerals including iron, zinc, calcium and vitamin B12.

• ‘What Should I Eat’ shows you how to build your diet around plant foods to give you all the nutrients you need
  
• ‘Why Choose Low GI Carbs’ –how vegetarians and vegans can choose the right kinds of carbs for their long-term health and wellbeing
• ‘The Healthy Veggie’ – six guidelines to help you make the most of fresh vegetables and fruit, wholegrain breads and cereals with a low GI, a variety of vegetarian sources of protein, plus nuts, seeds and the healthy fats including omega-3.
  
• ‘Six Healthy Veggie Menu Plans’ –seven-day menus for adults, teenagers and children

Part 2 includes 80 recipes for breakfast, lunch, dinner, snacks and desserts, like the ‘Shiitake, ginger and tofu hokkien noodles’ recipe illustrated here, making it deliciously easy to get all the nourishment you need from a healthy vegetarian or vegan diet.

ANZ edition: Hachette Livre Australia; Hachette Livre NZ now available
UK edition: Hodder Mobius to be published December 2006
US edition: Marlowe & Company November 2006

Feedback—Your FAQs Answered

I am 53 and not overweight, but I constantly feel tired and run down. And my mood can get low at times. Would low GI eating be of benefit to me? My doctor says I am healthy, I am just going through menopause. I do weight training and I am trying to walk more. I have a sister who is diabetic with high blood pressure and a sister and brother with high cholesterol. I don’t want to end up with these problems which seem to run in the family. I want to have a healthy middle to older age.
The Low GI Diet co-author, Joanna McMillan-Price says: ‘Yes we do believe a low GI diet would benefit you enormously. Carbohydrate-rich foods have been shown to be important in brain function and in improving mood, while low GI carbohydrates specifically can help you to maintain constant energy levels over the course of the day. They also help keep cholesterol levels down and there is increasing evidence to show they play an important role in preventing diabetes. Since you are also doing a moderate amount of exercise you will find that you need your carbs to keep you going. All up therefore a low GI diet sounds perfect for you. A low GI diet is not just important for those who need to lose weight, but for all of us for good health. The only difference will be in the quantity of food that you eat. Make sure you focus on consuming as many healthy foods as possible and use the GI as a tool to choose the best quality carbohydrates. You can use the database on our website www.glycemicindex.com to search specific foods or look to one of the Glucose Revolution books for more advice on how to put a low GI diet into practice. Since you don’t need to lose weight, perhaps Low GI Eating Made Easy is the one for you. Best of luck!’

Does it matter if you eat less protein than is recommended in the 12-week action plan on The Low GI Diet? A man of my husband's weight is supposed to eat 8 carb, 8 protein and 4 high fat serves. There’s only so much protein you can jam into a roll at lunch time so I’m having trouble fitting enough into the earlier part of his day. Do you have any suggestions on easy to make/handle high protein nibbles he can munch in the afternoon so he won't be tempted to go back to eating hot chips?
Joanna says: ‘Don’t get too caught up on trying to measure exact portions of carbs, protein and fat – it is there as a guide only. We recommend an increase in your protein intake in order to help in eating less overall – this is because protein foods are known to be satiating and keep you full and satisfied for longer. If your husband is not finding he is hungry between meals then his protein intake is absolutely fine. Remember the most essential part of your eating plan is to listen to your body and respond to your appetite cues. So long as he is not eating too much fat or resorting to carb-rich, high GI snacks to fill him up then all is well. If he is hungry between meals then you can try boosting his protein at meals or choose to snack on a low fat flavoured milk or yoghurt, a handful of nuts and dried fruit, carrot sticks with hummous or a low GI snack such as fruit.’


Joanna McMillan-Price

I heard people with diabetes should eat between meal snacks and supper before going to bed – is that true?
Alan Barclay from Diabetes Australia says: ‘Children with type 1 diabetes and people using some of the older types of insulin’s often need to have in between meal snacks and a supper to prevent them from going hypo. People with pre-diabetes or type 2 diabetes probably don’t need to snack. In fact, evidence is mounting that in between meal snacks lead to weight gain, which may in turn make your diabetes worse: aim to have three moderate size meals based around low GI carbohydrates to keep your blood glucose levels stable throughout the day. If you find you are still going low between main meals, ask your diabetes team to review your blood glucose lowering medications.’


Alan Barclay

Look it up in our A–Z: The GI Glossary (continued)



Ketones Our bodies need to maintain a minimum threshold level of glucose in the blood to provide energy for our brain and central nervous system. If for some reason, glucose levels fall below this threshold, (a very rare state called hypoglycemia) the brain will make use of ketones – a by-product of the breakdown of the body’s fat stores. Ketones are strong acids, and when they are produced in large quantities they can upset the body’s delicate acid-base balance. They are normally released into the urine, but if levels are very high or if the person is dehydrated, they may begin to build up in the blood. High blood levels of ketones may cause fruity-smelling breath, loss of appetite, nausea or vomiting, and fast, deep breathing. In severe cases, it may lead to coma and death. In a pregnant woman, even a moderate amount of ketones in the blood may harm the baby and impair brain development. Large amounts of ketones in the urine may signal diabetic ketoacidosis, a dangerous condition that is caused by very high blood glucose levels.

Ketosis is the metabolic state when the body is burning fat for fuel. Normally carbohydrates are the main source of fuel for your brain, heart and many other organs.

Kilojoule or kJ is the metric system for measuring the amount of energy produced when food is completely metabolised in the body. The Calorie is the imperial measure of energy, and can be calculated from the number of kilojoules by dividing by 4.2.

Lipids or fats are found in the blood and the walls of all of the body’s cells. The most common lipids are cholesterol and triglycerides (sometimes called triacylglycerols).

LDL cholesterol see Cholesterol

Millimole (mmole) is a unit for measuring the concentration of glucose, cholesterol, triglycerides and other substances in a certain volume of blood – usually 1 litre (L).
Mono-unsaturated fat is found in large quantities in olive and canola oil, and some nuts and seeds. Like all fats, mono-unsaturated fats are high in kilojoules. Mono-unsaturated help lower LDL cholesterol levels and are thought to help reduce the risk of heart attack and stroke.

Events

PCOS Conference
The Sixth Annual Conference on Polycystic Ovarian Syndrome (PCOS) will be held in Sydney, on Saturday September 30 at the Tattersalls Club in Sydney (181 Elizabeth Street). The conference is organised by the leading advocacy and support group for PCOS women, the Polycystic Ovarian Syndrome Association of Australia Inc (POSAA). While the event is aimed at PCOS patients, POSAA encourages family doctors and all health professionals who treat PCOS patients to attend. Registration costs start from $60 for POSAA members.

Further information about the speakers can be found by downloading a registration form from POSAA’s website.

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