GI Values Update

The latest GI values

Kellogg’s Sustain
‘Breakfast is a great opportunity to go for low GI Gold by selecting a low GI breakfast cereal,’ says Prof Jennie Brand-Miller. As there aren’t many low GI packaged breakfast cereals on the supermarket shelves here in Australia, it’s good to see another join the ranks: Kellogg’s Sustain - with a GI of 55 (and that’s on its own, without any milk). Add the milk and fruit and you’ll be well on the way to going for Gold and achieving a lower GI breakfast that Jennie advocates. For more nutrition information check out the Kellogg website: www.kellogg.com.au



My Dutch website gives beer a GI of 110. You say it doesn’t have one. Can you explain the discrepancy?
What you need to know is that a glass of beer has so little carbohydrate that it's difficult to test its GI. That's why we listed its GI and GL as 0 in earlier editions of the New Glucose Revolution series books. But eventually we decided that the valid way to test beer (because we are always being asked by beer drinkers) would be by comparing responses to a 10 g carbohydrate portion of beer (about 300 ml or a bit over a cup) with a 10 g carbohydrate portion of glucose (in standard GI testing a 50 g carbohydrate portion is normally used). In this test the GI came out as 66. The GL will be therefore be 66 x 10/100 = 6.6 (round up to 7).



It appears that your Dutch website is quoting a figure from the Montignac database which says maltose beer has a GI of 110. We asked the Montignac people recently (you can contact them through their website) how they determined the GI of foods in their tables. Here’s what they said:
‘We use official published tables when we think they are reliable and make our own calculation with the in vitro method when needed.’

This is clearly of great concern because access to accurate information about GI values is vital for consumers, health professionals and people with diabetes so they can make informed food or beverage choices. The key point is that the GI of a food must be tested physiologically – that is in people not test tubes. There’s a standardised international method of what’s called in vivo (in people) testing adopted by leading labs around the world and Australia has the world’s first published GI Testing Standard (GI News February 2007) which is currently being reviewed by the International Standards Organisation for possible adoption by other member countries. In vitro testing (ie in a test tube) is a handy shortcut method manufacturers sometimes use in developing foods because it’s much, much cheaper to do, but it is also unreliable: it may or may not reflect the true GI of a food. See the discussion about the two different methods in the European Journal of Clinical Nutrition ‘Testing the glycaemic index of foods: in vivo not in vitro’, EJCN (2004) 58, 700–701. Doi:10.1038/sj.ejcn.1601856.

Here’s how the GI is measured in vivo:
To determine a food's GI rating, measured portions of the food containing 10–50 grams of carbohydrate are fed to 10 healthy people after an overnight fast. Finger-prick blood samples are taken at 15–30 minute intervals over the next two hours. These blood samples are used to construct a blood sugar response curve for the two hour period. The area under the curve (AUC) is calculated to reflect the total rise in blood glucose levels after eating the test food. The GI rating (%) is calculated by dividing the AUC for the test food by the AUC for the reference food (same amount of glucose) and multiplying by 100 (see Figure 1). The use of a standard food is essential for reducing the confounding influence of differences in the physical characteristics of the subjects. The average of the GI ratings from all ten subjects is published as the GI of that food.



If you are unsure about how to use the GI database, just scroll down to the bottom of GI News and see the step-by-step guide.

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

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

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A Step-by-Step Guide to the GI Database on www.glycemicindex.com
Use the database to find the GI value of your favourite carbohydrate foods that have been tested over the past 25 years from all around the world. You can also check the glycemic load (GL) and grams of carbohydrate per serve. If you want to dig a little deeper, you can see where and when the food was tested and whether the test subjects were healthy or had diabetes. Although our database is the most comprehensive GI database resource on the web, we don’t have the GI values of every carbohydrate food tested. Sometimes food companies prefer not to publish the GI of their products, and sometimes they don’t want their foods tested at all.

Step 1
Go to www.glycemicindex.com and click on the GI Database link in the left-hand menu.



Step 2
To search for ‘beans’ for example, insert ‘beans’ in the ‘Name of the Food’ box and click search.



Step 3
To refine your search, use the less than (<) and greater than (>) symbols, to tell the database to show you only foods containing beans with a GI less than 55 and a GL greater than 20. Use the drop-down menu on the far right, to tell the database to sort the results by the GI and in ascending order.





Step 4
Now click on the actual food name (the text will change colour) and the following page appears.



The GI of the kidney beans was calculated using glucose as the standard. The serve (in grams) refers to the nominal serving size. This value is then used to calculate the GL value for each product. For example:

Red Kidney Beans
Serve (g): 150 g
CHO/serve (g): 60.3
GI: 51
GL = 31

In this case the test period was the standard 2 hours where a total of 9 finger-prick blood samples were taken in 10 subjects over that period (this includes 3 fasting samples). The subjects were ‘normal’ which means they were healthy volunteers. In some tests, ‘Type 2’ refers to testing in people with type 2 diabetes. Finally, the reference shows where the food was tested and in which journal the results were published if applicable.

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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—June 2007

‘Chestnuts roasting on an open fire ...’ Did you know that they were part of the staple diet of Southern Europe, Turkey and Asia for centuries. In fact until potatoes arrived on the scene, they were a major source of carbohydrate. And now we know that they are low GI. Check out Food of the Month and GI Values Update. This issue we also look at how low a GI diet should go, whether you’ll burn up more fat if you exercise before breakfast and how a low GI diet benefits your genes. There's more on low carb-high protein diets, too - what’s the long-term risk to your health? The jury may still be out, but Prof. Walter, Willett from Harvard reminds us that it’s the type of carbohydrate and the type of fat rather than the relative amounts that make a difference. Enjoy June GI News and don’t forget to try our real food recipes this month: Chilli Chestnut Fettuccine, Chicken and Sweet Corn Soup and Instant Berry Fool.



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

Food for Thought

How low should a low GI diet go?
Prof Jennie Brand-Miller and Diabetes Australia's Alan Barclay believe there's a real need to define the numerical difference between a low GI diet and a low GI food. Because a low GI food is defined as 55 or less, people have made the reasonable assumption that a whole diet that averages less than 55 is 'low enough'. In fact the AVERAGE Australian and American diet already has a GI of 56 to 58 because we all eat low GI fruits and dairy products and of course sugar (GI 60). So to reduce the risk of chronic disease, a low GI eating pattern/diet must have much lower number.

What we now know from observational/cohort studies is that the GI of the diet of the people in the lowest quintile (20% of the population) is about 40–45. Since this reduces the risk of chronic diseases like diabetes and heart disease and people can achieve it in real life, we think it's a reasonable definition of a low GI diet (i.e. less than 45). How do you achieve this? Substitute low for high GI foods in your everyday meals and snacks, especially in the breads you choose. Breakfast in particular is your opportunity to go for gold by selecting a low GI breakfast cereal. Don't assume that adding milk to crispy flakes makes it a low GI meal. If you don’t eat breakfast cereal, make sure you choose a low GI bread for your toast, and of course low GI breads are a must for those sandwiches at lunch.’



Seven secrets to making healthier eating a habit
Now that a large US study published in the April edition of American Psychologist has come to the obvious conclusion that (fad) diets don’t work, GI News asked Nutrition for Life author Catherine Saxelby what sort of eating plan helps people lose that excess and keep it off.

‘Well, the best way of eating if you are overweight, is a diet you enjoy and can stick to for more than a week. It has to be sustainable – it’s not about dropping a dress size, it’s about healthy eating for life! Cut down the fat, especially saturated fat. Eat protein at each meal for satiety. Choose high fibre or low GI carbohydrates to slow digestion and absorption. Cut down, but don’t cut out! Eat a large salad a day. It fills you up for few kilojoules. Don’t skip meals, especially breakfast. But food aside, you need to adopt some healthier eating habits. Remember, although motivation may get you started, it’s habit that keeps you going and keeps the kilos off.’


Catherine Saxelby

1. Listen to your stomach. Your stomach is only the size of your fist clenched. Imagine this and you’ll soon realise that it doesn’t take a lot of food to fill that volume. Aim to eat only when you’re hungry. Stop when you’re comfortably full – not stuffed. I believe this notion is so important, I created a ‘Hunger-Fullness Log’ where you can plot your hunger rating over the day (peckish, hungry, ravenous, running on empty, starving or too weak to chew). You can download it at www.foodwatch.com.au/foodwatching.
2. Think long term. Think weeks or months, not one week. Your excess weight crept on gradually and that’s the best way for it to come off – slow and gradual. That way, you won’t trigger your body’s ‘fast and famine’ mode.
   
3. Eat small. It’s now clear that the bigger the portion in front of you, the more you’ll end up consuming, as Prof. Brian Wansink has amply demonstrated in his new book Mindless Eating. Watch your portions. You can still enjoy a treat as long as it’s small. Don’t let waiters and fast food chains upsize your portions for very little more money. It’s a trap – if it’s not waste on your plate, it will end up around your waist!
   
4. Practise mindful eating. Eat slowly, savouring each mouthful and enjoying the different flavours and aromas. Focus on the food in front of you. Put your fork and knife down between bites. Sit down to eat, even if it’s only for a snack. Turn the TV off and don’t read. Check in with your stomach every so often – it takes the stomach 20 minutes to signal the brain that it’s FULL! Before you start to eat, take a long breath in and out to trigger the start of your mindful eating.
   
5. Plan meals ahead.
   Have something in the fridge or freezer that you can defrost and cook when you come home tired. If you’re going out, take a salad box or sandwich with you so you don’t have to buy fast food.
   
6. Use the 90/10 rule. If 90% of your intake is healthy, then the remaining 10 per cent of an occasional treat won’t derail your efforts. And the odd treat will stop you feeling deprived and less likely to pig out and binge. One chocolate won’t spoil a healthy diet – but the whole box will!
   
7. Think positive. Don’t dwell on what you CAN’T eat! Think of the good things you CAN enjoy from a bowl of hearty chicken and vegetable soup to good Greek yoghurt.

And finally, be active – just walking more helps! ANY exercise is better than none!



Catherine Saxelby’s most recent book, Zest, The Nutrition for Life Cookbook, includes 120 ‘real food’ recipes for vitality and good health that will help you achieve and maintain a weight that’s right for you. For more information about Zest, check out Catherine’s website: www.foodwatch.com.au

GI News Podcast

GI News Podcast: Strategies for Cooking and Eating Low GI Foods
In the fourth of the New Glucose Revolution podcasts, Prof. Jennie Brand-Miller talks about strategies for cooking and eating with the glycemic index. Where do you begin? How to get your engine revving at breakfast time.




Play the Podcast above or download here

GI News Briefs

Putting your genes on a diet
It’s a commonplace to say you are what you eat, but Petteri Kallio and colleagues writing in the American Journal of Clinical Nutrition in May suggest that’s pretty much what’s happening at a molecular level in a study that highlights changes in gene expression in people consuming diets with different effects on post-meal insulin concentrations. The researchers from the University of Kuopio in Finland randomly assigned 47 men and women with metabolic syndrome either to a rye-pasta diet producing a low insulin response or an oat-wheat-potato diet producing a high insulin response for 12 weeks and assessed the effect by looking at the effect on subcutaneous fat (that's the fat under the skin). They found the genes regulating insulin signalling were down-regulated on the rye-pasta diet, and genes related mainly to stress were up-regulated on the oat-wheat-potato diet.

In an accompanying editorial entitled ‘Putting your genes on a diet’, Dr Sandra Salsberg and Dr David Ludwig say: ‘The present study has direct implications concerning our understanding of the dietary glycemic index (GI). High-GI meals produce greater postprandial insulin concentrations and C-peptide excretion than do nutrient-controlled low-GI meals. Observational and interventional studies have linked GI to the risk of obesity, diabetes, heart disease, and cancer, although the topic remains much debated …. The results of the present study emphasize the age-old wisdom to “use food as medicine” – in this case, for the targeted prevention and treatment of obesity, diabetes, and heart disease.’
- American Journal of Clinical Nutrition 2007;85:1417–27
– http://www.ajcn.org for the accompanying editorial


Dr David Ludwig

GI Group: Gene expression is the process by which a gene’s DNA sequence is converted into the functional proteins of the cell. For more detail check out Wikipedia.

Is the jury in or out on the long-term effects of low carb-high protein diets?
In the past 20 or so years, people struggling to get rid of extra pounds frequently opted for a high protein-low carb diet on the basis of promises that these diets led to faster weight loss and better weight control. Recent evidence has in fact suggested that these diets do deliver faster weight loss. But, a more serious question is whether sticking to these diets long term is compatible with long-term health? Fans of these diets gave a collective sigh of relief last year when a US observational cohort study based on the Nurses Health Study revealed no link between a low carb diet and mortality, particularly from heart disease. Two new studies from Sweden (Dr Lagiou’s) and from Greece (Prof Trichopoulou’s) appear to flatly contradict this, both concluding on the basis of similar long-term studies with large numbers of women that prolonged consumption of a diet that’s low in carbohydrate and high in protein was associated with increased total and particularly cardiovascular mortality among women. So where does that leave us? Harvard’s Prof Walter Willett to the rescue. In an editorial comment in the Journal of Internal Medicine, he makes the point that the complexities of human diets make comparisons of patterns between one population and another difficult, suggesting that the most likely interpretation of the inconsistency between the US and Swedish studies is that both are correct in the context of their respective populations and diets. He says:
‘Within the relatively lean and younger Swedish women, replacement of largely whole grains with the protein packages consumed in that population probably have an adverse effect on cardiovascular disease. In contrast, within a heavier and older population of US women, replacement of mainly refined starch and sugar with almost any source of calories is not likely to increase the risk of cardiovascular disease. This conclusion emphasizes the most fundamental conclusion of research into diet and cancer during the last decade: it is the type of fat and type of carbohydrate rather than the total amounts of either that influence risk of cardiovascular disease. Thus, in the Nurses’ Health Study, a low-carbohydrate pattern that emphasized vegetable sources of protein and fat was associated with a significantly lower risk of coronary heart disease … There is every reason to believe that a moderately low carbohydrate intake (approximately 30–40% of energy) can result in low risk of cardiovascular disease if the proteins and fats are mainly from plant sources (but do not include hydrogenated oils) and the remaining carbohydrates are from whole grains, fruit and vegetables.’
– Journal of Internal Medicine 261; 366–374 (Swedish study) and 363–365 (Walter Willett)
– European Journal of Clinical Nutrition (2007) 61, 575–581 (Greek study)



Exercise benefits women with PCOS
A structured exercise training program is a simple way to help reduce cardiovascular risk in women with PCOS say researchers from the University of Naples writing in The Journal of Clinical Endocrinology & Metabolism. There are other benefits as well as this small study shows. Ninety overweight young women with PCOS but otherwise healthy took part in the randomised trial. Half undertook a supervised and structured exercise program that included aerobic activity 3 times a week with 30 minutes on a bicycle. The other half did no structured exercise. Both groups were encouraged to follow a healthy balanced meal plan with 50% of calories from carbohydrates, 25% from protein and 25% from fat. All the women completed the trial. After 3 months (84 days to be precise), the exercisers had achieved a significant reduction in BMI, waist circumference, hip to waist ratio and insulin resistance. Sixty per cent also had normal menstrual cycles. No changes were observed in the non-exercisers.
– JCEM Vol. 92, No. 4 1379–1384
– http://www.medscape.com (login required)

Want to take part in a PCOS diet study?
The University of Sydney is conducting a dietary study for women with PCOS. If you have PCOS, live in Sydney (Australia), are aged 18-40, and are not taking the pill or trying to get pregnant, contact pcosdietstudy@nnd.com.au for more information.



Australians get help in managing type 2 diabetes
Medicare rebates are now payable for group services provided by eligible diabetes educators, exercise physiologists and dietitians for people with type 2 diabetes, on referral from a GP. The new rebates are in addition to the current Medicare items for individual services provided by health professionals. For more information and a referral ask your doctor.

Low GI Food of the Month

Chestnuts
Chestnuts are something of an anomaly in the nut family – they are very low in fat and are a great source of smart carbs (GI 54 for crushed uncooked chestnut kernels). They are also high in dietary fibre and rich in minerals like potassium and calcium and in B group vitamins. What else? Well, they are versatile – just roast them in ‘that open fire’ and enjoy hot, or add them to soups, stir fries, stuffings, casseroles, vegetable dishes, pasta, risotto and desserts. You’ll find fresh chestnuts in your supermarket or produce store from Fall through to early winter. Look for even-sized nuts which feel heavy for their size, with undamaged, firm shells. One kilogram of chestnuts yields approximately 700 grams (1 lb 10 oz) of shelled chestnuts. Because they are about 50% water, store them in the crisper drawer of the refrigerator to stop them from drying out. You can also buy them year round frozen, canned, vacuumed packed, pureed and dried.



How to prepare chestnuts
Chestnuts have two skins. One is the hard outer shiny brown shell and the other is the inner thin skin known as the pellicle. Chestnuts Australia shared their prep tips with us.

Cut
Lie chestnut on its flat side and cut or score halfway around the nut piercing both the outer
shell and inner skin.

Cook
Microwave: place layer of cut chestnuts in a covered container on high/100% for 2-3 minutes until shell opens and flesh is soft.
Roast/bake/grill: place cut chestnuts on oven tray and cook at 200C (400F) or under a moderate grill for 15 minutes until shells open.
Boil/steam: place cut chestnuts in a pan of cold water or steamer, cover, bring to boil and simmer for 15-20 minutes until shell opens and flesh is soft.

Peel
Immediately wrap hot cooked chestnuts in a tea towel for a few minutes, and whilst still
hot, peel off outer shell and inner brown skin.

Chilli chestnut fettuccine
Here’s a great way to use leftover pasta. This spicy, nutty blend delivers a tasty meal in double-quick time. Even if you have to start from scratch and cook the pasta, it’s a speedy meal.
Serves 4; Preparation time 5 minutes; Cooking time 10 minutes



3 tablespoons (60 ml) extra virgin olive oil
1 teaspoon crushed garlic
2 long red chillies, deseeded and finely sliced
1/3 cup flat-leaf parsley leaves, chopped
2 cups chestnuts, finely chopped
freshly ground black pepper
300 g cooked fettuccine (or your favourite pasta shapes)
shaved parmesan, to taste

1. Heat oil in a large non-stick frying pan and add garlic, chilli, chestnuts and parsley until golden and fragrant.
2. Add cooked, drained fettuccine and toss to coat in chestnut mixture and heat through. Serve topped with parmesan cheese and extra chestnuts, if desired.

Nutrition analysis per serve
1562 kJ/372 cal; 14 g fat (includes 2.5 g saturated fat); 12 g fibre; 7 g protein; 49 g carbohydrate

For more information on chestnuts visit www.chestnutsaustralia.com.au

Low GI Recipes of the Month

The low GI recipes this month are from Zest, Catherine Saxelby’s new cookbook written with Woman’s Day Food Director, Jennene Plummer and published by Hardie Grant. Each recipe has been analysed for calories/kilojoules, fat, fibre and sodium. Low GI recipes are highlighted.

Instant berry fool
Instead of berries you can use chopped mangoes, papaya, bananas or passionfruit says Jennene. And if you are wondering what to do with those leftover yolks, use them to bind patties or meat balls or to enrich sauces. They can also be frozen for up to a month.
Serves 4; Preparation time; 5 minutes



3 egg whites
¼ cup (55 g/2 oz)caster sugar
2 cups (500 ml) low fat pouring custard
2 cups (300 g/10 1/2 oz) mixed berries of choice
1 tablespoon chopped toasted almonds

1. In a clean, dry bowl, beat the egg whites with an electric beater until soft peaks form. Take care not to over-beat them, though, or they will collapse and cannot be used.
2. Gradually add then sugar, beating until it is thick and glossy.
3. Gently fold in the custard and berries and spoon into serving glasses. Chill until required. Serve topped with almonds.

Nutrition analysis per serve
810 kJ/193 Cal; 3 g fat (includes saturated fat 1 g); 2 g fibre; 9 g protein; 33 g carbohydrate; 100 mg sodium

Chicken and sweetcorn soup
To serve, whisk an egg and stir through soup just before serving to make ‘egg flowers’ – shreds of cooked egg through the soup, says Jennene. For a change, add 120 g (4 oz) of thinly sliced button mushrooms and some sliced chilli.
Serves 4; Preparation time 10 minutes; Cooking time 10 minutes



2 cups (500 ml) chicken stock
2 cups (500 ml) water
¼ cup (60 ml) sherry
1 tablespoon grated ginger
3 garlic cloves, crushed
1 skinless chicken breast fillet, thinly sliced
400 g (14 oz) creamed corn
50 g (1½ oz) baby corn, halved lengthwise
½ bunch choy sum, sliced
6 green onions (spring onions/shallots), sliced

To serve
soy sauce
grainy bread or bread rolls

1. In a large saucepan combine the stock, water, sherry, ginger and garlic. Bring to the boil then reduce the heat and simmer for 3 minutes.
2. Stir in the thin chicken slices and corn and simmer for 5 minutes. Add the choy sum and green onions and simmer for another minute.
3. Ladle the soup into bowls and serve immediately with a drizzle of soy sauce if desired. Accompany with grainy bread.

Nutrition analysis per serve (includes 1 slice of sourdough or grainy bread)
1215 kJ/289 Cal; 6 g fat (includes saturated fat 1 g); 6 g fibre; 21 g protein; 32 g carbohydrate; 815 mg sodium

Your Success Stories

‘The low GI lifestyle works. My weight dropped 35 kilos over 18 months.’ – Lisa
‘I turned 42 last week and have been living with diabetes since my first pregnancy when I was 23. I was also diagnosed with gestational diabetes at the onset of my second pregnancy 7 months later (yes I know, nice and close). I largely ignored all the advice from the health sector for the first 7 years after diagnosis, swallowing the prescribed pills and conducting blood testing when I remembered. I made the odd trip to the specialist who was always at pains to tell me how non-compliant I was along with all the dire warnings about heart disease, blindness, amputation etc. By the time I was 30, I was extremely overweight with out of control BGLs and generally disgusted with myself. Around this time I discovered a new GP who really put himself out to try to get me on the straight and narrow. He gave me a copy of The New Glucose Revolution and I have been religiously following the concept ever since. My weight dropped 35 kg over 18 months and has stayed off to this day, my BGLs average around 5 mmol and I still have my eyes, feet and very luckily for me, no obvious complications from my years of self neglect. The low GI lifestyle works and it was so easy to make the changes to my every day foods with such amazing results.’



‘We are finding more energy to do more activities as a family. I believe this is due to a conscious decision to eat better carbohydrates with a lower GI.’ – Michael
‘In the 1990s I was extremely fit, competing in triathlons of all distances including Ironman. However, since 2000, a back injury and work commitments led to a fairly sedentary lifestyle where I put on 15 kg. The back would not heal and finally a chiro advised me to start back exercising. By exercising at least once daily I was able to cure my back injury by strengthening my abdominals. Recently I discovered low GI foods and their assistance with weight loss and in sustaining energy allowing longer sessions without flat – last weekend I completed a 3-hour run without any after effects, my longest run in 7 years.

I used to eat only white bread and jasmine rice etc. I have now changed to wholegrain bread, Doongara and basmati rice. I am now learning that these foods actually taste better when creatively used. Some of the recipes found on http://ginews.blogspot.com have really helped bring back the flavour to foods and also assist with a steady flow of energy rather than the quick hit and drop off of the type of carbohydrates I was used to consuming.

My whole family is benefiting from this. We all eat the same meals and no one complains about my cooking or my wife’s. My wife who has always been fairly sedentary is now running and doing triathlons as are 2 of my daughters, aged 7 and 11 (at 20 months the youngest is still a bit young). My wife has also lost approx 8 kg and working towards her pre-children weight. We are finding more energy to do more activities as a family. I believe this is due to a conscious decision to eat better carbohydrates with a lower GI. I still am amazed about the differences in GI content in not only the individual raw ingredients but also amongst different brands etc.

Recently I completed a 25 km 2 day hike with my 2 daughters (7 and 11 years old). Without the use of low GI foods I don’t believe it would have been as easy. We are finding every week that we are benefiting from making a conscious choice of low GI foods.

Websites such as www.glycemicindex.com have proved invaluable as a resource to assist us in our quest for a better form of carbohydrate as we know that they are not the evil foods portrayed in the late 90\'s but rather an essential part of an active lifestyle.’

‘I lost 10 pounds within 3 months and feel great!’ – Jamie
‘At the age of 31 I had my first child. After a 3 month maternity leave I returned to work thinner than before pregnancy. My weight gain began after I weened my daughter 6 months later. I was used to eating more food. When my daughter turned one, I knew I needed to make some changes. I weighed 17 pounds more than before pregnancy! I learned of the Glycemic Index eating plan. Our family now consumes very little processed carbohydrate. I lost 10 pounds within 3 months and feel great! Now I plan to add in more exercise and lose those last 7 pounds.’

Inspire others. Share your GI story.


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

Move it and Lose it!

Glenn answers those FAQs about exercise
When should I exercise? I have read that you will burn more fat if you exercise before breakfast.
The biggest factor for burning body fat is whether you do the activity in the first place. It may be interesting to speculate whether you burn more fat in certain circumstances, but the best I can give you is a general guide.


Glen Cardwell

1. To burn fat you have to be active in the first place.
2. The fitter you are the better your body is at burning fat. To get to a reasonable level of fitness, you need to move your body 3–5 times a week.
3. It doesn’t matter if you walk or jog. You will burn more fat jogging for 30 minutes than walking for 30 minutes. On the other hand, you will burn more fat by walking for 60 minutes than jogging for 30 minutes.
4. The amount of incidental activity during the day will potentially burn more fat than a jog. Getting up from your chair, having a stretch, taking a quick walk around the office, using the stairs etc will probably burn more body fat during the day. So don’t do 30 minutes of exercise then tick the exercise box and plonk your bum on a chair for the rest of the day.
5. Weight bearing exercise like walking, aerobics and jogging are better at burning up fat stores than weight supported exercise like swimming or cycling. However it’s better to do something you enjoy than analyse its fat burning potential. Refer back to point 1.
   

For more information see Gold Medal Nutrition.

Exercise goals for June
Fitness expert Dr Joanna McMillan Price says aim to walk at a steady comfortable pace for 20 minutes on four days. Plus complete three resistance exercises – squats (see April GI News); single leg extensions (see May) and assisted push-ups on three days.


Joanna McMillan-Price

Assisted push-ups strengthen and tone chest, shoulders and arms
The push-up is undeniably one of the best upper body exercises you can do. The push-up involves the muscles of the chest, shoulders and arms and is therefore an efficient means of toning the upper body all at once. Why do most people hate push-ups? The answer is easy—because they are hard! In fact, they are even harder if you are carrying too much body weight since you are effectively lifting your own body weight against gravity. Here is a modified version of the traditional push-up, which enables you to gain the benefits of the exercise but makes it easier for you to perform it correctly. You will need a low coffee table – alternatively, use the second or third bottom step of your stairs.

How to do it:

1. Start in a kneeling position with your hands wider than your shoulders on the edge of the table or stair. Move your knees back until your body is a straight diagonal line from head to knee.
2. Slowly lower your chest towards the edge of the table/stair while keeping your back flat and without letting your bottom stick up.
3. At the bottom of the move, your elbows should be directly above your hands – adjust your hand position as appropriate before returning slowly to the starting position.

How many: 2 sets of 10 repetitions with a short rest in between

– Source: The Low GI Diet and The Low GI Diet Revolution.

Feedback—Your FAQs Answered

My 10-year-old daughter has recently been diagnosed with insulin resistance. We are already eating a low GI diet but I need some help with portion sizing and interesting meals that are kid-friendly. I am having great difficulty finding this information – can you give me some advice?
‘That’s a tough one,’ says dietitian Kaye Foster-Powell who helped us answer this. ‘Insulin resistance at age 10. It may be a good idea to consult a registered dietitian with special expertise in children’s needs as well as an understanding of the GI, in the meantime, here are some ideas.’

A typical day

• Breakfast: ½ cup of cooked porridge made from traditional oats (not instant) with a teaspoon of sugar or honey served with ½ cup low fat milk
• Lunch: Low GI bread sandwich including 2 slices of bread, 2 teaspoons of canola margarine, 60 g (2 oz) of chicken, lean roast beef or pork, egg or canned fish with a couple of vegetable serves either as salad on the sandwich or served separately as carrot, celery, red capsicum, cucumber bits, grape tomatoes, baby beets, etc.
• Dinner: Around 80–100 g (2½–3 ½ oz) lean meat or chicken or 150 g (5½ oz) fish + 2 starchy serves and plenty of veggies.

Plus the following incorporated as part of these meals or as snacks:

• 1 cup of low fat fruit yoghurt
• An apple
• 2 mandarins
• A cup of low fat milk

Some typical main meals

• 1 cup of pasta with 1 cup of vegetable-rich bolognaise sauce
• 1 cup of cooked rice with about ½ cup of stir-fried meat strips and at least 1½ cups of vegetables
• 1 cup of noodles, 1 or 2 eggs and a combination of Asian stir-fried vegetables
• 1 roast chicken drumstick without skin served with 1 medium baked potato or similar sized sweet potato chunk plus at least 1 cup of other vegetables such as roast pumpkin, peas, beans, broccoli, and cauliflower
• A bowl of home-made vegetable soup followed by ½ cup of baked beans, an egg plus 2 slices of toast
• 4 regular sized taco shells filled with chilli beans, lettuce, tomato slices, grated reduced fat cheese and about ¼ avocado

Kaye Foster-Powell

Why aren’t the GI values of all those vegetables we are urged to eat 5 serves a day of on the GI database?
The GI is a measure of carbohydrate quality and only applies to carb-rich foods. Most vegetables from artichokes to zucchini along with all your favourite greens and salad veggies contain so little carbohydrate they won’t have much effect on blood glucose levels at all, and their GI can’t be measured following the international standardised procedure. Root vegetables such as carrots and parsnips and squash such as butternut pumpkin/winter squash contain a little carbohydrate and have low GI values, so pop them on the plate when serving dinner.

What we say is, brighten your plate (at least half of it) with a variety of colourful vegetables. They are full of fibre and essential nutrients that fill you up without adding extra kilojoules/calories. Try leafy green and salad vegetables; green peas and beans; broccoli, cabbage and cauliflower; zucchini and baby squash; onions and leeks; fennel and asparagus; carrots, parsnips and pumpkin; and don’t forget mushrooms (yes we know that they are really fungi). Opt for flavour and enjoy vegetables fresh in season or frozen year round. If choosing canned convenience, make sure you buy brands with no added salt.


Photo: Ian Hofstetter, from Zest by Catherine Saxelby and Jennene Plummer

Starchy vegetables such as potatoes, sweet potato, sweet corn, yams, taro and legumes, belong in the carb-rich foods (not the vegetables) part of the plate. You need to keep portions moderate (a quarter of the plate as the diagram shows) and choose the low GI types. These carb-rich foods are all in the GI database and listed in The New Glucose Revolution Shopper’s Guide to GI Values.

If you are unsure about how to use the GI database, just scroll down to the bottom of GI News and see the step-by-step guide.

GI Values Update

The latest GI values

Chestnuts
Crushed uncooked chestnut kernels: GI 54, tested by the International Diabetes Institute, Melbourne Australia.

Beech-Nut Good Morning Products
As we get lots of questions about healthy foods for kids, we were interested when a press release arrived on our desk (well computer screen) from Beech-Nut Nutrition Corporation. This company develops baby foods that are free of preservatives, artificial colours and flavours, trans fats, soy and added refined sugar. Their Good Morning products based around oats have a low GI says the press release. We followed up to see where the products were tested and what the GI actually was so we could share this with GI News readers.



In fact the Good Morning range hasn't been clinically tested. It was ‘calculated from GI values of its ingredients by the method of Wolever and Jenkins [AJCN 43:197-172, 1986], using total carbohydrate and total fibre data from the USDA Nutrient Database and the clinically measured GI of each ingredient (Foster-Powell et al., Univ. Sydney)’ Beech-Nut told GI News.

We agree with Beech-Nut's nutritional scientists that the products couldn’t possibly be tested in babies! But we feel that it would be great if they followed up all the good work invested so far in developing these healthy products for babies and toddlers with some clinical testing in adults – just to make sure that the GI really is low. If it is, they really have come up with a first. Testing is important to reliably know the GI value, because in addition to ingredients, other factors such as food processing techniques can have a significant impact on the GI. Milling, cooking, baking, extrusion, granularity – these can all have an effect. For more information: www.beechnut.com

GI Symbol News
The Organic Beverage Company (TOBC) Syzmo™ has joined the GI Symbol Program. Syzmo™ organic energy drink (GI 30) meets the GI Symbol Program’s nutritional criteria for carbonated beverages – it’s a reduced kilojoule/calorie beverage with 24 grams of carbohydrate per 1 cup (240 ml) serving (be aware that the 12 fl oz can you buy contains 1½ cups, so you may like to share it with a friend). The sweetness is from blue agave – no high fructose corn syrup here! The energy-enhancing ingredients include guarana, yerba mate extract and caffeine. It also contains a host of added vitamins and minerals including B12. It’s certified organic by USDA. And it’s not recommended for children, pregnant women, or people sensitive to caffeine. You may or may not be in favour of energy drinks (or any carbonated drinks for that matter), but they are a fact of life, and if people are going to drink and enjoy them (in moderation we hope), then opting for the healthier product is a very smart decision. For more information, check out: www.syzmo.com



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

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

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A Step-by-Step Guide to the GI Database on www.glycemicindex.com
Use the database to find the GI value of your favourite carbohydrate foods that have been tested over the past 25 years from all around the world. You can also check the glycemic load (GL) and grams of carbohydrate per serve. If you want to dig a little deeper, you can see where and when the food was tested and whether the test subjects were healthy or had diabetes. Although our database is the most comprehensive GI database resource on the web, we don’t have the GI values of every carbohydrate food tested. Sometimes food companies prefer not to publish the GI of their products, and sometimes they don’t want their foods tested at all.

Step 1
Go to www.glycemicindex.com and click on the GI Database link in the left-hand menu.



Step 2
To search for ‘beans’ for example, insert ‘beans’ in the ‘Name of the Food’ box and click search.



Step 3
To refine your search, use the less than (<) and greater than (>) symbols, to tell the database to show you only foods containing beans with a GI less than 55 and a GL greater than 20. Use the drop-down menu on the far right, to tell the database to sort the results by the GI and in ascending order.





Step 4
Now click on the actual food name (the text will change colour) and the following page appears.



The GI of the kidney beans was calculated using glucose as the standard. The serve (in grams) refers to the nominal serving size. This value is then used to calculate the GL value for each product. For example:

Red Kidney Beans
Serve (g): 150 g
CHO/serve (g): 60.3
GI: 51
GL = 31

In this case the test period was the standard 2 hours where a total of 9 finger-prick blood samples were taken in 10 subjects over that period (this includes 3 fasting samples). The subjects were ‘normal’ which means they were healthy volunteers. In some tests, ‘Type 2’ refers to testing in people with type 2 diabetes. Finally, the reference shows where the food was tested and in which journal the results were published if applicable.

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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—May 2007

Real food is our focus for May starting off with Michael Pollan’s 9 rule-of-thumb principles of healthy eating, followed by David Ludwig’s recipe for the whole family to make a ‘Clean Sweep’. We know Clean Sweeps aren’t that easy (or that inexpensive), but David makes it seem very achievable, so give it a try. Take it a step at a time and like the rest of us you’ll get there. After this, we tempt your tastebuds with some real food recipes including Tangy Roasted Beet and Walnut Salad, Creamy Fish Pie, and Turkey and Bean Chili with Avocado Salsa. Something for everyone we hope. We don’t have a big budget, so we really are very grateful to the people and organisations who share their healthy recipes with us along with delicious food photography that makes you want to cook it right now.

Eat well and enjoy the taste of a wide variety of real food.



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

Food for Thought

Michael Pollan’s rule-of-thumb principles of healthy eating.


Michael Pollan

1. Eat Food. Though in our current state of confusion, this is much easier said than done. So try this: Don’t eat anything your great-great-grandmother wouldn’t recognize as food. (Sorry, but at this point Moms are as confused as the rest of us, which is why we have to go back a couple of generations, to a time before the advent of modern food products.) There are a great many foodlike items in the supermarket your ancestors wouldn’t recognize as food (Go-Gurt? Breakfast-cereal bars? Nondairy creamer?); stay away from these.
2. Avoid even those food products that come bearing health claims. They’re apt to be heavily processed, and the claims are often dubious at best. Don’t forget that margarine, one of the first industrial foods to claim that it was more healthful than the traditional food it replaced, turned out to give people heart attacks. When Kellogg’s can boast about its Healthy Heart Strawberry Vanilla cereal bars, health claims have become hopelessly compromised. (The American Heart Association charges food makers for their endorsement.) Don’t take the silence of the yams as a sign that they have nothing valuable to say about health.
3. Especially avoid food products containing ingredients that are (a) unfamiliar, (b) unpronounceable (c) more than five in number – or that contain high-fructose corn syrup. None of these characteristics are necessarily harmful in and of themselves, but all of them are reliable markers for foods that have been highly processed.
4. Get out of the supermarket whenever possible. You won’t find any high-fructose corn syrup at the farmer’s market; you also won’t find food harvested long ago and far away. What you will find are fresh whole foods picked at the peak of nutritional quality. Precisely the kind of food your great-greatgrandmother would have recognized as food.
5. Pay more, eat less. The American food system has for a century devoted its energies and policies to increasing quantity and reducing price, not to improving quality. There’s no escaping the fact that better food – measured by taste or nutritional quality (which often correspond) – costs more, because it has been grown or raised less intensively and with more care. Not everyone can afford to eat well in America, which is shameful, but most of us can: Americans spend, on average, less than 10 percent of their income on food, down from 24 percent in 1947, and less than the citizens of any other nation. And those of us who can afford to eat well should. Paying more for food well grown in good soils – whether certified organic or not – will contribute not only to your health (by reducing exposure to pesticides) but also to the health of others who might not themselves be able to afford that sort of food: the people who grow it and the people who live downstream, and downwind, of the farms where it is grown.
   ‘Eat less’ is the most unwelcome advice of all, but in fact the scientific case for eating a lot less than we currently do is compelling. ‘Calorie restriction’ has repeatedly been shown to slow aging in animals, and many researchers (including Walter Willett, the Harvard epidemiologist) believe it offers the single strongest link between diet and cancer prevention. Food abundance is a problem, but culture has helped here, too, by promoting the idea of moderation. Once one of the longest-lived people on earth, the Okinawans practiced a principle they called ‘Hara Hachi Bu’: eat until you are 80 percent full. To make the ‘eat less’ message a bit more palatable, consider that quality may have a bearing on quantity: I don’t know about you, but the better the quality of the food I eat, the less of it I need to feel satisfied. All tomatoes are not created equal.
6. Eat mostly plants, especially leaves. Scientists may disagree on what’s so good about plants – the antioxidants? Fiber? Omega-3s? – but they do agree that they’re probably really good for you and certainly can’t hurt. Also, by eating a plant-based diet, you’ll be consuming far fewer calories, since plant foods (except seeds) are typically less ‘energy dense’ than the other things you might eat. Vegetarians are healthier than carnivores, but near vegetarians (‘flexitarians’) are as healthy as vegetarians. Thomas Jefferson was on to something when he advised treating meat more as a flavouring than a food.
7. Eat more like the French. Or the Japanese. Or the Italians. Or the Greeks. Confounding factors aside, people who eat according to the rules of a traditional food culture are generally healthier than we are. Any traditional diet will do: if it weren’t a healthy diet, the people who follow it wouldn’t still be around. True, food cultures are embedded in societies and economies and ecologies, and some of them travel better than others: Inuit not so well as Italian. In borrowing from a food culture, pay attention to how a culture eats, as well as to what it eats. In the case of the French paradox, it may not be the dietary nutrients that keep the French healthy (lots of saturated fat and alcohol?!) so much as the dietary habits: small portions, no seconds or snacking, communal meals – and the serious pleasure taken in eating. (Worrying about diet can’t possibly be good for you.) Let culture be your guide, not science.
8. Cook. And if you can, plant a garden. To take part in the intricate and endlessly interesting processes of providing for our sustenance is the surest way to escape the culture of fast food and the values implicit in it: that food should be cheap and easy; that food is fuel and not communion. The culture of the kitchen, as embodied in those enduring traditions we call cuisines, contains more wisdom about diet and health than you are apt to find in any nutrition journal or journalism. Plus, the food you grow yourself contributes to your health long before you sit down to eat it. So you might want to think about putting down this article now and picking up a spatula or hoe.
9. Eat like an omnivore. Try to add new species, not just new foods, to your diet. The greater the diversity of species you eat, the more likely you are to cover all your nutritional bases. That of course is an argument from nutritionism, but there is a better one, one that takes a broader view of ‘health.’ Biodiversity in the diet means less monoculture in the fields. What does that have to do with your health? Everything. The vast monocultures that now feed us require tremendous amounts of chemical fertilizers and pesticides to keep from collapsing. Diversifying those fields will mean fewer chemicals, healthier soils, healthier plants and animals and, in turn, healthier people. It’s all connected, which is another way of saying that your health isn’t bordered by your body and that what’s good for the soil is probably good for you, too.
   – Copyright Michael Pollan and reproduced with permission.
   

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Michael Pollan is the best-selling author of Second Nature. His most recent book, The Omnivore’s Dilemma was chosen by the editors of ‘The New York Times Book Review’ as one of the 10 best books of 2006.

GI News Podcast

GI News Podcast: Understanding GI Food values
In the third of the New Glucose Revolution podcasts, Prof Jennie Brand-Miller explains why the GI value of foods matters for everybody - not just people with diabetes - and where choosing smart carbs that reduce the peaks and troughs of your blood glucose levels fits, in the context of a healthy diet that's low in saturated fat and has plenty of fruits and vegetables.




Play the Podcast above or download here

GI News Briefs

The calcium factor
A recent study in March Diabetes Care reports that over a 6-month period, a diet rich in low-fat dairy calcium boosted weight loss in overweight people with type 2 diabetes - particularly in females. Those with the highest intake of dairy calcium were 2.4 times more likely to see a weight loss of greater than 8% versus those with the lowest intake of dairy calcium, despite consuming more kilojoules (calories). Such a diet may be helpful for people with diabetes who find it hard to stick to other weight loss regimes suggest the authors Dr Danit R. Shahar from Ben Gurion University and colleagues.
Diabetes Care 2007;30:485–489



Does the diabetes clock start ticking earlier for women?
The diabetes clock may start ticking in women long before it’s possible to diagnose it by rising blood glucose levels according to new research published in February Diabetes Care. Epidemiologists at the University at Buffalo report that risk factors for diabetes found in the blood, such as markers of endothelial dysfunction, chronic sub-acute inflammation and blood clotting factors, are present early on in women who eventually progress from normal glucose status to prediabetes. The study involved 1,455 healthy men and women from the Western New York Health Study who were given a physical examination when they entered the study and for the follow-up. Results showed that 52 women and 39 men had progressed from normal blood glucose levels to prediabetes over the previous six years. Whether this relates to the higher risk of heart disease among women with diabetes needs more study. Meantime, lead author Richard Donahue, PhD, professor of social and preventive medicine and Associate Dean for research in UB's School of Public Health and Health Professions suggests that women whose blood glucose increases over time, even if it doesn't reach diabetic levels, should be screened more intensively for cardiovascular disease.
Diabetes Care 2007;30:354–359



What does endothelial dysfunction mean?
GI Group: The endothelium are the cells that line the inner surface of all our blood vessels including arteries and veins. Endothelial dysfunction is a physiological dysfunction of their normal biochemical processes and is thought to be a key event in developing atherosclerosis and significant in predicting stroke and heart attacks.


Cross-section of the vascular endothelium

Does the low GI diet have enduring merit?
‘A low-GI diet [is] a prudent approach to the prevention and treatment of diabetes, heart disease and obesity’ concludes Dr David Ludwig from the Department of Medicine, Children’s Hospital Boston in The Lancet. In reviewing the evidence for the benefits of low GI eating he says: ‘The low-GI diet, with its focus on carbohydrate quality rather than quantity, aims to address an underlying physiological cause of diseases arising from excessive swings in postprandial glycemia. Because the diet does not restrict either fat or carbohydrate, it may be more behaviourally sustainable. Although the data are variable, most published studies report beneficial effects of lowering the GI and virtually no study suggests potential for harm (by contrast with low-fat and very-low-carbohydrate diets that can adversely affect some risk factors for cardiovascular disease).
The Lancet Vol 369 March 17, 2007


Dr David Ludwig

Nuts over nuts
A review by Australian nutrition experts in Current Opinion in Lipidology provides further support for the heart-health benefits derived from regularly eating nuts. In their conclusions, researchers Dr Alison Coates and Professor Peter Howe describe nuts as ‘ready-to-eat snack foods that are satisfying, have healthy lipid profiles, and are excellent sources of protein … There’s an extensive body of literature describing the beneficial effects of regular consumption of nuts on blood lipid profiles, and there are also different ways that bioactive nutrients in nuts can act – possibly synergistically – to improve blood circulation by enhancing the ability of blood vessels to dilate,’ said Professor Howe. Beyond the direct heart health benefits, nuts can offer a wider array of benefits, including:

• weight loss in an energy restricted diet
• satiating effect to balance appetite and energy through high fibre, protein and energy content, and
• improved insulin sensitivity, with a positive impact on type 2 diabetes risk.

‘Many would-be nut eaters are concerned that the high fat content of nuts will contribute to weight gain,’ said Dr Coates, although evidence suggests this is not the case.
Current Opinion in Lipidology 2007 Feb;18(1):25–30.



Hyperglycemia and cancer risk
Swedish researchers report a statistically significant association between cancer and hyperglycemia in Diabetes Care and write that: ‘A lifestyle that decreases blood glucose levels may reduce overall cancer risk not only among overweight or obese subjects but most likely also among subjects with normal body weight. At the same time, current evidence suggests that such a strategy also would contribute to the prevention of diabetes and cardiovascular disease.’ In their prospective cohort study, Dr Par Stattin of Umea University Medical Center and colleagues examined data from 31,304 men and 33,293 women who had participated in a larger study and identified a total of 2478 cases of cancer. They found that abnormal glucose metabolism was associated with an increased risk of cancer overall in women but not in men. However, for both men and women, high fasting blood glucose was significantly associated with an increased risk of cancer of the pancreas, endometrium, urinary tract and malignant melanoma.
Diabetes Care 2007;30:561-567.