1 July 2006

GI News—July 2006

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In This First Anniversary Issue:

  • Food for Thought
    —Slow Carb Not Low Carb
  • GI News Briefs
    —Unite for Diabetes
    —The Rice Factor
    —Foretelling Early Insulin Resistance
    —GI: The Real Meal Deal
  • GI Values Updates
    —Breakfast Cereals and Beverages
  • Low GI Food of the Month
    —Do You Have the GI for Fresh Rhubarb Stalks?
  • Low GI Recipe of the Month
    —Diane Temple’s Sweet Potato and Lentil Bake
  • Success Stories
    —‘A Low GI Diet – Best Thing I've Done in a Long Time’ Says Lorraine
    —Jaws Drop at the Gym When Margaret Walks In
  • What's New?
    Weight Loss for Food Lovers
  • Feedback—Your FAQs Answered
    1. What’s the GI of meat, chicken, fish, eggs and cheese? I can’t find these foods in the GI database.
    2. I have heard that pasta made of strong wheat flour (such as durum) has a lower GI than pasta made of softer wheat flour. Is this true?
    3. I've been following The Low GI Diet and have noticed some recipes include the use of filo pastry. Does filo pastry have a low GI? I love spinach pastries and even vegetable pies, but I am wondering if pastries have a high GI value?
    4. I have read in some GI lists that fresh coconut is low GI, is this true? Coconut does not seem to be on your list!
    5. Look it up in our A–Z: The GI Glossary continued
  • Events
    —Carbohydrates, Glycemic Index and Health: The State of the Art
    —Dietary Study for Women with PCOS

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Welcome to our first anniversary issue. We would like to thank the thousands of subscribers and visitors who have made the newsletter such a success and whose comments and questions have played a key role in shaping the newsletter over the first twelve months.

The GI Group launched GI News a year ago to make available to a broader audience the latest scientific research covering carbohydrates and health (including both positive and negative GI research results), diet and weight loss; diabetes; heart disease; and PCOS along with the latest published GI values. To help people incorporate more of the right carbs into their own diet and lifestyle, we also included information on low GI foods and a recipe or two. And to inspire and motivate we added blood glucose control ‘success stories’. We wanted to hear what our visitors had to say, too. That’s why we set GI News up as a blogspot to allow people to post their own comments or send questions to the GI Group for more detailed answers.

Since posting our first issue on 11 July 2005, we have clocked up around 250,000 visitors and have more than 16,000 subscribers from right around the world. We are pretty proud of this result as we don’t have any sponsorship or advertising dollars to spend on promotion. To receive our free e-newsletter each month, all you have to do is click the SUBSCRIBE link in the right-hand column. Your email address will be kept strictly confidential and you can unsubscribe at any time. We hope you enjoy our first anniversary issue and please pass the link on to friends and colleagues you feel will find the site useful.

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

Food for Thought

Slow Carb Not Low Carb
In May, ‘News Brief’ reported on a woman who was hospitalised for life-threatening ketoacidosis after following the Atkins diet. We then listed the reasons why we advocated a low GI diet rather than a low carbohydrate diet. Some of our readers admonished us for our stance. Here are their comments and our responses.

  1. Opposers of low carb regimes tend to stick to criticism that are really directed to the so called ‘induction phase’ which lasts only two weeks. After that, dieters on Atkins can and should consume a great variety of green, leafy nutritious vegetables, among many others, like mushrooms, eggplant, peppers, broccoli, cauliflower etc. Atkins never encourages you to eat zero carbs. 20 grams for the first 2 weeks, and you raise those levels after that.
    Yes, that’s true, criticism is often aimed at the induction phase but it’s also true that the second phase is restricted in carbohydrates (around 50 grams a day) too, and adherents are encouraged to return to the induction phase (20 grams a day) if weight loss slows. Furthermore, because Atkins recognised that the diet was not nutritionally balanced, a vitamin and mineral supplement program is compulsory.

    The study by Yancy et al (Annals of Internal Medicine 2004: 140; 769) compared an Atkins diet with a prudent (low fat but high GI) diet in 120 overweight volunteers. Those following the Atkins diet lost twice as much weight in 24 weeks but read the small print. Specifically, adverse effects occurred more frequently in the low-carbohydrate diet group than in the low-fat diet group, including constipation (68% vs. 35%; P < p =" 0.03)," p =" 0.02)," p =" 0.01)," p =" 0.006)." style="font-style: italic;">Annals of Internal Medicine 2004; 140: 778), two persons on the low carbohydrate diet died, and a third was hospitalised. No such adverse events were recorded in those following the high carbohydrate diet.

  2. There might have been some underlying health reasons for the ketoacidosis you mention.
    The case of a woman who was hospitalised for life-threatening ketoacidosis was written up in The Lancet (Chen TY, Smith W, Rosenstock JL, Lessnau KD The Lancet – Vol. 367, Issue 9514, 18 March 2006, Page 958). The precipitating factor, whatever her individual vulnerability, was strict adherence to a low carbohydrate diet. Fortunately, most people don’t or can’t adhere strictly to the Atkins diet.

  3. No diet is really recommended for ill or pregnant people.
    Pregnant women have to eat and the diet they eat affects their baby’s development. We use the word ‘diet’ in the sense of ‘eating plan’ (as defined by most dictionaries), not restricted energy intake. We agree that it’s not a good idea to restrict energy intake during pregnancy (one reason being the adverse effect of ketones on fetal development). But it’s vitally important that women eat a healthy diet throughout their pregnancy and throughout their reproductive years – because not every pregnancy is planned. A low GI diet fits the bill perfectly, a low carbohydrate diet doesn’t (and you appear to agree). If a diet’s not good for a developing fetus, why would it be good for anyone else?

  4. It is not true that consuming bad fats is unavoidable. You can and should avoid them and stay within Atkins.
    If carbohydrates occupy only 10% of your energy intake (i.e. you eat about 50 grams of carbohydrates per day), then the other 90% of energy must come from a mix of protein and fat. The upper limit on protein intake by humans is around 40% of their calories (kilojoules) because of limits on the liver’s capacity to produce urea. By a process of deduction, that means more than 50% (and more often 60%) of energy comes from fat. Even if you ate a perfectly healthy balanced diet with a P:M:S: ratio of 1:1:1 (polyunsaturated, monounsaturated, saturated fat), you’d be consuming about 20% of your calories as saturated fat. The recommendation is less than 10%.

  5. I love carbs, I could be happy with a GI diet, and I will resort to it as soon as I reach my goal weight, but losing weight with GI diets is complicated because as soon as you surpass the level of carbs you can consume, you stop losing weight and start gaining.
    That was the claim Atkins made but he had no scientific evidence to back that. To our knowledge, there’s still no evidence. Indeed, recent studies suggest that people find it very hard to stick to a diet with so little carbohydrate (too much discipline is needed) and eventually re-gain the weight they lost. Is there any point in losing weight and then re-gaining it? Wouldn’t it be better to align food habits with something that’s not only healthy, helps you lose weight and keep it off for good?

  6. As soon as I can start incorporating more carbs into my diet, they will be of the low glycemic load kind.
    That’s good. Why not cut to the chase early?

  7. There should really be no quarrel between low glycemic and Atkins because they are fundamentally the same. The diets you should be strongly opposing are the low caloric and the low fat diets.
    No, that’s incorrect. Atkins wants to ditch carbs. Low GI diets can be moderately or even very high in carbs, but of the low GI kind. If Atkins had known what we know now, he would have seen ways to lower insulin levels without cutting the carbs. He recognised that high insulin levels interfered with weight control, but he did not have sufficient knowledge to work out the best way to lower insulin. Remember he had no training in nutrition.

  8. The truth is that Atkins works. Once you get to your equilibrium level, then you can do low GL and stay in a narrow weight band.
    Yes, we agree that Atkins works in the short term. But not the long term. So what’s the point in following such a diet?
James Krieger, M.S., M.S. 20/20 Lifestyles Research Associate, PRO Club (http://www.proclub.com) and Editor, Journal of Pure Power (http://www.jopp.us) makes the point that: ‘You lose fat, water, and muscle’ is true of ANY diet. My recent meta-regression, published in the February 2006 issue of AJCN, shows quite clearly that fat loss is significantly higher on ketogenic diets, even after control for energy intake. Fat-free mass loss was also greater, but not by a large amount.

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James Krieger

‘There is no apparent metabolic advantage associated with ketosis during dieting’ report researchers from the Department of Nutrition, Arizona State University, Inflammation Research Foundation, Marblehead and Conscious Cuisine, Scottsdale in the May issue of the American Journal of Clinical Nutrition. In summarising their findings, Prof. Carol Johnson says: ‘In the current study, the ketogenic low-carb diet did not offer any significant metabolic advantage over the nonketogenic low-carb diet. Both diets were effective at reducing total body mass and insulin resistance, but, because blood ketones were directly related to LDL-cholesterol concentrations and because inflammatory risk was elevated with adherence to the ketogenic diet, severe restrictions in dietary carbohydrate are not warranted. Furthermore, the nonketogenic low-carb diet was associated with feelings of high energy and a more favorable mood profile than was the ketogenic low-carb diet.’ They recommend anyone wanting to follow a low-carb diet to choose low-fat meats and dairy products, and eat 8–9 servings of fruit and vegetables and 100–125 grams of carbohydrate a day.

GI News Briefs

Unite for Diabetes
During the last 20 years, the total number of people worldwide with diabetes has risen from 30 million to 230 million according to the International Diabetes Federation. The number is expected to reach 350 million by 2025. The top five countries with the most diabetes sufferers in 2003 were India 35.5 million, China 23.8 million, USA 16 million, Russia 9.7 million and Japan 6.7 million.

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Facing the facts:

  • There are 6 million new diabetes sufferers in the world each year.
  • Half of all diabetes sufferers around the globe do not know they have it. In some parts of the world 80% of sufferers don't know.
  • Diabetes raises the sufferer's risk of developing a cardiovascular disease by two to four times. Cardiovascular disease, the number one cause of death in the industrial world, will soon be the number one cause of death globally.
  • Diabetes is now the fourth biggest cause of death worldwide.
  • Every ten seconds someone in the world dies as a result of having diabetes – 3 million deaths a year.
  • Good control of blood glucose levels significantly reduces the diabetes patients’ risk of developing complications. Managing hypertension and raised blood lipids is also crucial.
Diabetes is threatening to overwhelm future medical services if left unchecked. The International Diabetes Federation (IDF) is leading a worldwide ‘Unite for Diabetes’ campaign to have the United Nations recognise the global burden of diabetes. Why a UN resolution? If governments begin now by promoting low-cost strategies to alter diet, increase physical activity and modify lifestyles, the advance can be reversed. The proposed resolution would recognise the need for prevention and acknowledge the special needs of children and adolescents, the elderly, pregnant women, migrant populations and indigenous peoples. The aim is for the UN Resolution to be declared on World Diabetes Day 2007 (November 14). For more information about the campaign, visit www.unitefordiabetes.org.
– International Diabetes Federation Press Release from the American Diabetes Association’s 66th Scientific Sessions

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The Rice Factor
Heart disease and diabetes are serious health problems in Japan just as they are in many other parts of the world. In fact, heart disease is the second leading cause of all deaths and more than 6.7 million people in Japan have diabetes. Will adopting a low GI or low GL diet reduce the risk? So far, most studies showing the beneficial effects of low GI and GL diets have been carried out in the US, Europe and Australia with people who eat western diets. What happens in Asia where rice is the staple? In Japan, for example, rice contributes 43% to total carb intake and 29% to energy intake (calories).

Japanese researchers have found positive correlations between dietary GI and body mass index, serum triglyceride levels, fasting plasma glucose and HbA1c; and between GL and serum triglyceride levels, fasting plasma glucose and decreased levels of high-density lipoprotein (HDL), or good, cholesterol. They published the results of their cross-sectional study of 1354 healthy Japanese women eating a traditional diet based on a self-administered diet-history questionnaire in AJCN (May 2006). The main contributor to the GI and GL of the women’s diet was white rice (59%) followed by confectionary (11%), fruit (7%), sugars (6%), bread (4%), noodles (3%), other rice (3%), and potatoes (3%). The authors make the point that although the results may not be extrapolated into the general Japanese population (the subjects were selected Japanese female farmers), they should ‘provide valuable insight from a prevention perspective.’
Am J Clin Nutr 2006;83: 11161–9

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Fortelling Early Insulin Resistance
‘Insulin resistance not only predisposes individuals to type 2 diabetes, it is also a major risk factor for cardiovascular disease,’ says Timothy Graham, MD, a researcher at Beth Israel Deaconess Medical Center (BIDMC). ‘In the clinical setting however, it is often difficult to distinguish individuals with and without insulin resistance.’ Insulin resistance develops when the body's muscles, fat and liver cells lose the ability to respond to the hormone insulin.

Elevated levels of a molecule called retinol-binding-protein-4 (RBP4) can foretell early stages of insulin resistance, a major cause of type 2 diabetes as well as heart disease, reveal BIDMC researchers writing in The New England Journal of Medicine.

The researchers were looking to see whether levels of RBP4 correlated with the presence or absence of insulin resistance in three groups and they repeated the measurements after exercise training for one group. They found that RBP4 levels were higher in all cases in which insulin resistance was high. Elevated RBP4 was also closely associated with increased BMI, waist-to-hip ratio, serum triglyceride levels, and systolic blood pressure, as well as decreased levels of high-density lipoprotein (HDL), or good, cholesterol. All the people who improved their insulin sensitivity with exercise also lowered their serum RBP4 levels. Among the third who did not improve their insulin sensitivity, neither did their RBP4 levels go down.


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Dr Barbara Kahn

Barbara Kahn, MD, Chief of the Division of Diabetes, Endocrinology and Metabolism at BIDMC and Professor of Medicine at Harvard Medical School says: ‘Collectively, these findings tell us that RBP4 is a useful marker for therapeutic improvement and that this protein could play a causal role in insulin resistance in humans. Because RBP4 levels consistently corresponded with insulin resistance – even among lean subjects whose genetic risk for the development of diabetes might otherwise be overlooked – this protein could be an important marker for type 2 diabetes among the general population. Being able to determine diabetes risk well before the onset of symptoms could provide an important opportunity for patients to take preventive measures,’ she adds. ‘For those who are overweight or sedentary, this could mean making changes to their diet and fitness routines. For those who are lean and fit, but have a family history of type 2 diabetes, this could mean taking antidiabetic medication. Either way, these findings could help clinicians to better manage this growing epidemic.’
NEJM 354:2552–2563; BIDMC Press Release

GI: The Real Meal Deal
Recent criticism of the GI has focused on unpredictable outcomes of blood glucose values in meals because of variations in fat, protein and fibre levels.

Researchers in the University of Toronto's Department of Nutritional Sciences and the University of Sydney’s Human Nutrition Unit have some reassurance for people with diabetes and carb-counters. The glycemic index (GI), the table that lists the quality of carbohydrates in more than 750 common foods, works just as predictably whether subjects consume a single portion of one item, or a normal meal. ‘The good news it that the GI index works’ says Prof. Tom Wolever. ‘For sensible people it makes a lot of sense. It's simple proportional measure – like mixing paint.’

Concerned about the methodology of recent studies done elsewhere showing unpredictable responses, Wolver and his associate, Prof. Jennie Brand-Miller of the University of Sydney, each conducted studies on two groups of healthy subjects. Fourteen different test meals were used in Sydney and Toronto, and the food combinations reflected typical breakfast choices such as juice, bagels and cream cheese, etc. Despite the variations in food, blood glucose responses remained consistent with GI measures.

‘We had previously done much smaller studies. We revisited the question, using more meals and variety in two different centres with judiciously selected foods. I was startled by the degree of predictability,’ says Wolever. ‘The carbohydrate, fat and protein composition of the meals varied over a wide spectrum. The glucose responses varied over a five-fold range range, and 90 per cent of the variation was explained by the amount of carbohydrate in the meal and the GI values of the foods as given in published GI tables. The concept works.’ The results are published in the June issue of the American Journal of Clinical Nutrition.
Am J Clin Nutr 2006;83:1306–12; University of Toronto press release

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GI Values Update

Breakfast Cereals and Beverages
The latest GI values from SUGiRS.

Breakfast cereal
Morning Sun Muesli GI 49

Beverages
Ribena blackcurrant fruit syrup (prepared with water according to the instructions) GI 52
Schweppes lemonade GI 54

lemonade

In publishing the GI values of two sweetened drinks, Kaye Foster-Powell reminds parents that they are definitely not an everyday beverage. Here’s why.

‘Liquid calories are a little stealthier than most, in that they tend to sneak past the satiety centre in our brain, which would normally help to stop us from overeating,’ she says. ‘This isn’t to say that we should all avoid full-strength soft drinks, but to keep on the healthy diet food-frequency scale, consumption ought to rank as “occasional”(or even “keep for a treat” if you’re trying to lose weight) and definitely not be everyday. If consumption figures are any indication, an increase in sugar-sweetened soft drinks and cordials is contributing to our child obesity problem. Not only have fatter children been found to have higher consumption, but overall, our children are drinking more of these sweetened drinks than we ever did when we were kids. And of course the increase in serving size from the old fashioned 8 oz (240 ml) to the current 600 ml ‘buddy’ doesn't help. It isn't only soft drinks and cordials that are the problem either. Too much fruit juice, sweetened or unsweetened, is an easy way for us to gulp down extra calories.’

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

Low GI Food of the Month

Do You Have the GI for Fresh Rhubarb Stalks?
No. Despite being popularised by celeb chefs as a great low GI food in their TV shows and books, fresh rhubarb contains so little carbohydrate (less than 2 grams per 100 grams), that it is actually not possible to measure its GI. But if you like to crunch raw rhubarb, pile your plate high and enjoy a veggie that’s a great source of vitamin C and potassium and a good source of fibre with virtually no calories and certainly no fat. However, most of us find eating rhubarb this way a little hard to take: unbearably tart and way too crunchy. And so we cook it and sweeten it. And that’s where the carbs come in along with the calories (kilojoules) – and the GI. Sugar is probably the favourite sweetener (brown sugar is hard to beat) and many recipes recommend around 120 g/4 oz sugar (or even more – they call it ‘to taste’) to 450 g/1 lb chopped rhubarb stems. However, you can sweeten rhubarb in other lower GI ways: try combining it fifty/fifty with chopped (low GI) apple, a little grated ginger root, the juice of 1 orange and about 3 tablespoons of pure floral honey … or leave out the ginger and orange and bake it with a couple of split vanilla beans. The options are endless as you’ll find if you check out the ‘Rhubarb Recipe Collection’ on www.rhubarbinfo.com/recipe-index.html

rhubarb

Rhubarb is a leafy vegetable from the buckwheat family (it’s a cousin of sorrel) but in 1947 the US Customs Court in Buffalo New York classified it as a fruit because that’s mostly how we eat it. The red stems are the edible bit; the leaves are toxic. When shopping, choose bunches with slender, younger stems that are dark pink to red. The thicker the stalk the stringier it gets. It is a very versatile veg (fruit). Just trim the ends, remove the leaves and cut the stems into 2.5 cm (1 inch) chunks. It cooks down to a syrupy liquid in minutes so don’t add too much water and watch the pot. You can also cook it in the microwave or bake it in the oven.

Low GI Recipe of the Month

Diane Temple’s Sweet Potato and Lentil Bake

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Diane Temple

Freelance home economist and former dietitian Diane Temple created this colourful dish especially for GI News. It is quick to prepare, full of flavour, and an easy way to get some of the five serves of vegetables you need every day. Serve with a mixed lettuce salad dressed with olive oil and lemon juice. It’s all you’ll need. If you use fresh capsicum (pepper), add it to the pan with the onion and garlic. For professional recipe development or testing you can contact Diane on tel 612 9958 3165; email: diane.temple@bigpond.com

Preparation time: 20 minutes
Cooking time: 45 minutes
Serves: 4

450 g (1 lb) sweet potato, peeled, halved lengthwise and sliced thinly
2 teaspoons olive oil
1 medium onion, chopped
3 cloves garlic, crushed
1 teaspoon chopped fresh rosemary
400 g (14 oz) can diced tomatoes
400 g (14 oz) can brown lentils, drained
¼ cup drained and chopped fire roasted marinated red pepper (capsicum) strips or ¼ fresh red capsicum (pepper) diced
2 tablespoons chopped fresh parsley
1/3 cup frozen peas
freshly ground black pepper
1 cup grated, reduced-fat pizza cheese

  • Preheat oven to 180ºC (350ºF). Steam or microwave sweet potato until cooked. Set aside to cool.
  • Meanwhile, in a large non-stick frying pan, heat the oil and cook onion, garlic and rosemary until soft, about 3–4 minutes. Add the tomatoes, bring to the boil and then reduce the heat and simmer for 5 minutes. Stir through the lentils, red peppers, parsley and peas. Season to taste with freshly ground black pepper and cook for 2 minutes or until the mixture is just heated through.
  • In a 1½ litre (6-cup) baking dish, spoon in half the lentil sauce, then layer with half the sweet potato and half the cheese. Add remaining lentil sauce, then the sweet potato. Sprinkle the remaining cheese over the top. Bake in the oven for 30–35 minutes or until cheese has melted and top is lightly golden.
Nutritional analysis per serving
We have included a nutritional analysis using standard pizza cheese and reduced fat pizza cheese. As you can see, there’s not a great deal of difference nutritionally in this recipe. So, if reduced fat pizza cheese is not on the supermarket shelf, use pizza cheese and you'll still be enjoying a reasonably low fat meal with lots of delicious veggies.

Standard pizza cheese
Kj: 1110
Calories: 265
Fat: 10 g (sat fat 4.5 g)
Protein: 17 g
Fibre: 7 g

Reduced fat pizza cheese
Kj: 1053
Calories: 251
Fat: 8 g (sat fat 3 g)
Protein: 18 g
Fibre: 7 g

Your Success Stories

‘A low GI diet – best thing I've done in a long time’ says Lorraine
‘I started hearing about low GI diets back in 2004 but only looked into them properly in early 2005. At the time I weighed 90 kg which was at least 20 kg over a healthy weight. Ironically, I work in the fresh produce industry, I had a good working knowledge of nutrition and healthy eating guidelines plus I have quite good cooking skills. Previous attempts at calorie-controlled diets failed because the hunger pangs would win out in the end. And a few months going low carb in search of a quick fix left me heavier than ever.

After reading up on GI principles and seeing that this clearly wasn’t another complicated fad diet I opted to join an excellent online site offering a personalised GI diet plan. Pretty quickly I could see that I hadn't been eating regularly enough, my food choices hadn’t been ideal, there hadn’t been enough variety in my diet and that my portion control had been non-existent.

Today I am 21 kg lighter and have a healthy BMI (body mass index). I maintain my weight by a combination of sensible portion control and food selection. Fruit, vegetables, salads and pulses are now the major part of my diet. Pasta/rice/bread and potatoes are limited to much smaller portions and are always the wholegrain version. I limit meat to two or three small portions per week (red meat just once a week) and I try to include a low-fat dairy item every day. I've found that the GI principles are flexible enough to be applied to eating out, holidays, special occasions and so forth. It’s a rare event when I'm faced with a choice where nothing is suitable. Not everything I eat is low GI by any means, but certainly the majority.

Medically speaking I feel much fitter. An asthmatic condition has all but disappeared and I am confident that I have halted what would have been an inevitable slide into diabetes, heart disease and a host of other more minor complaints.’

Jaws dropped at the gym when Margaret walked in
‘I was 60 years old last July. When I saw the photos of me at my surprise birthday party I was depressed at the amount of fat that had accumulated around my midriff! I weighed 80 kg and should have weighed 65 kg. I set out to put this right by eating ‘diet’ and ‘low fat’ foods along with my regular gym sessions and lots of walking. I was attending my local gym on average five times weekly for aquarobics and Pilates. Nothing was working. Very frustrating and even more depressing! I attended a session at the local RSL Club at which Dr Sandra Cabot was speaking about the effects of high GI carbs and sugar in foods and their impact on the syndrome X condition. It just clicked with me that I was going down the wrong path to achieve weight loss. I weighed 82.7 kg that day.

By 24 January 2006, I weighed 76 kg and my doctor was impressed! My subsequent blood glucose, cholesterol tests were all in normal range. They were all raised to upper levels of normal range in the previous year. Exactly one year on from my 60th birthday I am 72 kg and my BMI = 26.4, a bit too high still. Waist is 84 cm and hip 111 cm. I am wearing size 14 much better than the 16–18s of last year! I feel great but know that a few less kilos would be preferable. My goal is 68 kg. However, I have so much more energy for all the activities of daily life including an upcoming trip to China, Northern Thailand and Nepal assured in the knowledge that I will have the energy to enjoy fully all that these countries have to offer. All the people who attend my gym classes have remarked on how great I look and want to know what the ‘secret’ is!’

Send Us Your Success Story!
success story

Books, DVDs, Websites: What’s New?

Weight Loss for Food Lovers by Dr George Blair-West

Question: Why is it that over 80% of people who lose weight eventually regain what they lose and often more?
Answer: Because dieting is not about what we eat, it is about why we eat. Diets typically fail to recognise that food is the world’s most addictive substance. Craving food is much more widespread than craving nicotine, alcohol and other substances.

book

‘It’s not what in your mouth, it’s what’s in your mind’ says George Blair-West. As Director of Psychophysiology at the Obesity Rehabilitation Unit at River City Private Hospital in Brisbane and a weight-loss group psychotherapist, his particular area of interest is helping people maintain long term weight loss. This isn’t another diet book. There’s not a food menu or recipe in sight. Weight Loss for Food Lovers talks about motivation and sabotage, and provides practical strategies to help people maximise their chances of success whatever diet they embark on. When talking about carbs, Blair-West opts for the glycemic load (GL) approach and includes a GL table of foods derived from The New Glucose Revolution (Brand-Miller, Foster-Powell and Colagiuri). But you need the serving size to put the good doctor’s advice into practice. Go to The New Glucose Revolution Shopper’s Guide 2006 or www.glycemicindex.com for GI, GL, carbs per serving and the serving size.

For more information: www.weightlossforfoodlovers.com

Feedback—Your FAQs Answered

What’s the GI of meat, chicken, fish, eggs and cheese? I can’t find these foods in the GI database.
The GI is a measure of carbohydrate quality. Meat, eggs, fish and cheese are protein foods so they don’t have a GI because they have either no carbs, or so little the GI can’t be measured.

eggs

Eaten alone protein foods like these have very little effect on your blood glucose levels. It’s carbohydrates that are mainly responsible for the rise and fall in blood glucose after meals. Foods that are high in carbs include:

  • Cereal grains (rice, wheat, oats, barley and rye and anything made from them like bread, breakfast cereals, pasta and noodles)
  • Starchy vegetables like potatoes, taro, yams, sweet corn and sweet potatoes. Most green or salad vegetables have so little carbohydrate we can’t measure the GI
  • Legumes (pulses) including beans, chickpeas, lentils and split peas
  • Fruit such as apples, pears, peaches, oranges, strawberries, mangoes, bananas and melons
  • Dairy foods like milk, ice cream and yoghurt (but not cheese which is a protein food, or butter or cream which are mostly fat)
I have heard that pasta made of strong wheat flour (such as durum) has a lower GI than pasta made of softer wheat flour. Is this true?
We asked Prof. Jennie Brand-Miller to answer this. She says: ‘My understanding is that durum wheat is a very hard wheat and that makes it ideal for pasta manufacture. It gives the pasta its lovely golden colour because the aleurone layer is included with the endosperm fraction. Hardness and strength are two different things. Hardness refers to how the grain cracks up in the milling process, while strength refers to its protein content. Many Australian wheats, for example, are both hard and strong at the same time, making them highly desirable for many applications, especially bread making.’

pasta

She goes on to say, ‘I have seen data showing that pasta made from any old wheat has a relatively low GI. It's the low degree of gelatinisation (low moisture dough) that makes it low GI. The high protein content might help a little but it’s not the major factor. If you make bread from durum wheat, it will have a high GI because bread making allows for full gelatinisation. If you overcook pasta (perhaps canning too), then it will become more highly gelatinised and that will increase its GI. For the most part, properly cooked pasta (al dente) has a GI of 40–50.’

I've been following The Low GI Diet and have noticed some recipes include the use of filo pastry. Does filo pastry have a low GI? I love spinach pastries and even vegetable pies, but I am wondering if pastries have a high GI value?
Pastry by itself hasn’t been GI tested. It’s not something you normally eat as a meal. But the real problem with most shortcrust and flaky pastry products is that they tend to be very high in fat, particularly saturated fat (remember the ingredients for making pastry are essentially flour and butter with a little water plus sugar for a sweet pastry). The reason we include occasional recipes with filo pastry is that you can get that lovely crisp in the mouth pastry feel with a lot less fatty pastry. Just 2 or 3 sheets of filo lightly sprayed with olive oil (not melted butter) will do the job. So a spinach triangle or a vegetable pie made with filo can provide a nourishing and tasty meal and help you achieve those five serves of veggies a day – providing you make sure it’s got lots of veggie filling and just a little filo pastry! Catherine Saxelby’s Fresh Plum and Ricotta Strudel made with a few sheets of filo shows you how you can up your fruit intake with a delicious low fat, low GI dessert. You’ll find the recipe in our January 2006 GI Newsletter.

pastry
Photo: Ian Hofstetter, The Low GI Diet Cookbook

I have read in some GI lists that fresh coconut is low GI, is this true? Coconut does not seem to be on your list!
Coconut is a nut (not a fruit) and it has not been GI tested. It contains very little carbohydrate per serving (just 1 g in a 15 g portion) and it is virtually impossible to GI test. But it is high in fat (5 g in a 15 g portion) and the fat it contains is nearly 90 per cent saturated. So use very small amounts of coconut products such as coconut milk or desiccated coconut in your cooking.

coconut

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

Atherosclerosis or hardening of the arteries is a slow progressive disease and can go virtually unnoticed until it produces problems such as angina or a heart attack. Most heart disease, whatever form it takes, is caused by atherosclerosis—clogging on the inside wall of the arteries through the slow build up of fatty deposits (called plaques) which narrows the arteries and reduces the blood flow. This is not just a ‘plumbing’ problem, but one in which inflammation plays a key role. Atherosclerosis can affect the arteries elsewhere in the body including the brain, kidneys, and the arms and legs. When the arteries to the heart are affected and blood flow is reduced, the heart muscle doesn’t get enough oxygen for pumping blood, and eventually this causes central chest pain (angina pectoris). Elsewhere in the body when blood flow is restricted by atherosclerosis there’s a similar effect: in the legs, it can cause muscle pains on exertion; in the brain, it can lead to a variety of problems from ‘funny turns’ to strokes. An even more serious consequence of is when a thrombosis (blood clot) forms over a patch of atherosclerosis on an artery. This process can occur anywhere in the arterial system and lead to a complete blockage of the artery. The consequences can range from a small heart attack to sudden death.

Beta cells The cells in the pancreas that produce insulin. They are found grouped together in the Islets of Langerhans.

Blood pressure The pressure of the blood on the walls of the blood vessels caused by the beating of the heart. Every body has blood pressure, although not everyone’s blood pressure is high. Hypertension is defined as having blood pressure above 140/90 mm HG. An abnormal blood pressure is considered to be 120/80.

Carbohydrate, a vital source of energy found in all plants, is the starchy part of foods like rice, bread, legumes, potatoes, and pasta and the sugars in foods like fruit, milk and honey. Cheap, plentiful and sustainable, it is the most widely consumed substance in the world after water and the basis for a healthy diet. Some foods contain a large amount of carbohydrate (such as cereals, potatoes, and legumes) while other foods such as carrots, broccoli and salad vegetables are very dilute sources. The simplest form of carbohydrate is glucose, which is a universal fuel for our body cells, the only fuel source for our brain, red blood cells and a growing foetus, and the main source of energy for our muscles during strenuous exercise.

Cholesterol is a soft, waxy substance found in the blood and in all the body's cells. It's an important part of a healthy body because it is part of the walls around all of our cells, and is a major component of many of the hormones our body’s produce. Most of the cholesterol in our body does not come from the foods we eat, but is in fact manufactured by the liver. High levels of cholesterol in the blood may lead to blocked arteries, heart attack and stroke. Cholesterol and other fats can't dissolve in the blood. They have to be transported to and from the cells by special carriers called lipoproteins. There are several kinds, but the most common ones are low-density lipoprotein (LDL) and high-density lipoprotein (HDL).

Coeliac disease is a condition where the lining of the small intestine is damaged due to an immune reaction from your own body to a small protein known as gluten. Gluten is found in certain grain foods like wheat, rye, triticale and barley, and in much smaller amounts in oats (as a contaminant). The only treatment for coeliac disease at present is a gluten-free diet.

Diabetes
Type 1 diabetes is characterised by high blood glucose levels due to the body’s complete inability to produce insulin. It occurs when the body’s immune system attacks the insulin-producing Beta cells in the pancreas and destroys them. The pancreas then produces very little or no insulin. Type 1 diabetes occurs most often in young people but can develop in adults.

Type 2 diabetes is characterised by high blood glucose levels caused by an insufficiency of insulin and the body’s inability to use insulin efficiently. It is thought to occur when the body becomes resistant to insulin. The pancreas compensates initially by producing more insulin, then eventually becomes exhausted and produces insufficient insulin. Type 2 diabetes occurs most often in middle-aged and older people but is being seen increasingly in younger adults and teenagers.

Gestational diabetes can occur during pregnancy, but usually goes away after the baby is born. Hormones released by the placenta during pregnancy reduce the effectiveness of the mother’s insulin. It is usually managed successfully with healthy eating and regular physical activity, but in some cases extra insulin is needed.

Dyslipidaemia abnormal levels or composition of the blood fats known as cholesterol and triglycerides.

Fat provides lots of kilojoules/calories – more than protein or carbs per gram – so you only need a small amount each day. The message today is know your fats. Focus on the good ones (mono- and poly-unsaturated fats) and give the bad fats (trans fats and saturated fats) the flick.
Saturated fats are solid at room temperature. These are the fats on meat or chicken skin, and in butter, cheese, palm oil and coconut oil. We don’t actually need to eat any saturated fat, since the body can make all it requires, but it is fairly difficult not to eat some, since all fats are actually mixtures of saturated and unsaturated fats.
Unsaturated fat is liquid at room temperature. These good mono- and polyunsaturated fats provide you with essential fatty acids that form your cell membranes; help you absorb the fat-soluble vitamins A, D, E and K; form part of your body’s hormones; provide insulation; and help you absorb some anti-oxidants from fruit and vegetables.
Trans-fats are produced during manufacture and behave like saturated fat in a product (increasing its firmness), as well as in our bodies (increasing the risk of heart attack). Foods high in trans fats include fried fast foods, some margarines, crackers, cookies and snack – so read the label before you buy these foods.

Fatty liver is the build up of excessive amounts of triglycerides and other fats inside liver cells; also known as steatohepatitis or NASH (Non-Alcoholic Steato-Hepatitis).

Fibre Dietary fibre only comes from plant foods – the outer bran layers of grains (corn, oats, wheat and rice and in foods containing these grains), fruit and vegetables and nuts and legumes (dried beans, peas and lentils). We need about 30 grams of fibre a day for bowel health and to keep regular. There are two types of fibre—soluble and insoluble—and there is a difference.
Soluble fibres are the gel, gum and often jelly-like components of apples, oats and legumes. By slowing down the time it takes for food to pass through the stomach and small intestine, soluble fibre can lower the glycemic response to a food. Good sources include: oatmeal, oat bran, nuts and seeds, legumes (beans, peas and lentils), apples, pears, strawberries and blueberries.
Insoluble fibres are dry and bran-like and commonly called roughage. All cereal grains and products that retain the outer coat of the grain they are made from are sources of insoluble fibre, eg wholemeal bread and All-Bran®, but not all foods containing insoluble fibre are low GI. Insoluble fibres will only lower the GI of a food when they exist in their original, intact form, for example in whole grains of wheat. Here they act as a physical barrier, delaying access of digestive enzymes and water to the starch within the cereal grain. Good sources include: wholegrains, wholewheat breads, barley, couscous, brown rice, bulghur, wheat bran, seeds, and most vegetables.

Fructose or fruit sugar is an alternative sweetener that is nearly twice as sweet as table sugar but provides the same amount of kilojoules. As the name suggests, it is found naturally in most fruits.

To be continued next month.

Events

Carbohydrates, Glycemic Index and Health: The State of the Art
Millions of people around the world are following carbohydrate-modified diets for weight loss as well as general health, judging from the sales figures for popular diet books including, Atkins’ New Diet Revolution, The Zone, The South Beach Diet, The Glucose Revolution, and at least two dozen other titles. With regard to low glycemic index diets, major studies have been published in JAMA, The Lancet, AJCN, American Journal of Epidemiology and International Journal of Obesity in the last three years suggesting beneficial effects on appetite, energy metabolism or body weight. Other recent studies have been inconsistent. How do we distinguish between the good and poor research in this field? What is the difference between low glycemic load and low glycemic index? How do approaches that aim to reduce carbohydrate amount compare with those that focus on carbohydrate quality, specifically GI? Are some individuals more likely to see benefits of low GI diets than others? Are these diets safe over the long term? This ‘state of the art’ one-day symposium in Sydney, Australia on 2 September 2006 will provide a forum for the vigorous exploration of these questions.

conventions

The sponsor: The University of Sydney Nutrition Research Foundation
The convenors: Prof Jennie Brand-Miller, Human Nutrition, The University of Sydney, Australia and Prof David Ludwig, Boston Children’s Hospital, USA
For more information
Ms Elisabeth Eaton
GI Symposium Secretariat, PO Box 949, Kent Town SA 5071, Australia
phone +618 8363 1307; Fax +618 8363 1604
email FI2006@fcconventions.com.au

Dietary Study for Women with PCOS
The University of Sydney is conducting a dietary study for women with PCOS. If you live in Sydney, Australia, are aged 18–40 with PCOS and are not taking the pill or trying to conceive, contact pcosdietstudy@nnd.com.au for more details.

Making the Most of GI News

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© ® & ™ The University of Sydney, Australia

1 June 2006

GI News—June 2006

collage

In This Issue:

  • Food for Thought
    —Let's Do Lunch
  • GI News Briefs
    —Test Is Best
    —A Public Health Time Bomb
    —Teenagers Make Healthy Changes Given the Chance
  • GI Values Updates
    —No Time to Cook? Nestle LEAN Cuisine; Sanitarium Lunch Today
    —What’s the GI of …? A Step-by-Step Guide to the GI Database on www.glycemicindex.com
  • Low GI Food of the Month
    —The Antioxidant-rich Orange
  • Low GI Recipe of the Month
    —Citrus Salad with White Wine and Thyme Syrup
  • Success Stories
    —Sue Drops a Dress Size
  • What's New?
    —Peter Howard’s Delicious Living
    —Revised US edition of What Makes My Blood Glucose Go Up and Down?
  • Feedback—Your FAQs Answered
    1. I've read that while fats slow down the body's response to high GI foods, the body still sees the same level of glucose response from the food, just over a considerably longer period of time (which is perhaps not accounted for when doing GI testing). Is this true?
    2. What about a glossary? I'm familiar with glycemic index, glycemic load, and a few other ‘normal’ GI terms, but when I start reading terms like ‘glycemic response’ or ‘glycemic impact’ I begin to wonder whether I know anything at all.
    3. Are NutraSweet or Splenda considered as being low GI?
    4. Why is there no information about stevia?
    5. I read that people just trying to lose weight or eat more healthily should use GL, but people with insulin resistance (like me) should use GI. Is this true?

june quote

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

Food for Thought

Let's Do Lunch
While most people agree that eating a healthy lunch is important, one in three skip it at least once a week, and one in 10 rarely or never have it according to a recent ACNeilsen Omnibus poll of 1,400 Australians. ‘Too busy’ is the main catch-cry of lunch-skippers. ‘We don’t have time to go out or make something to eat’ said 43% of the skippers; while another one in ten said they had too many personal chores to do to fit food into their break. A further 20% of respondents simply said that they weren’t hungry at lunchtime. Dietitian Cathy McDonald of the Sanitarium Health Food Company who commissioned the poll said the research shows that many people are clearly not making lunch – and their health – a priority. ‘Eating lunch assists in ensuring you get all the vitamins, minerals and other nutrients you need each day. Taking time out can also help improve concentration levels, give you time for building relationships and even increasing fitness levels if you do some exercise during your break.’

She said that the poll also confirms that many people grab a bite to eat rather than ‘doing’ lunch. One in three people have a 20–30 minute lunch break; a further one in five take less than 20 minutes; 5% don’t stop for lunch at all; and one in five eat at their desk or on the run. ‘This might seem great for productivity, but a rushed lunch-time means you are missing out on important health benefits both from a nutritional, stress management and a relaxation perspective,’ she said. ‘Taking time to eat lunch is critical to maintaining health, controlling weight, boosting energy and concentration levels and simply feeling better overall.’ The team at GI News wholeheartedly agrees! In fact it can be more productive to take a break from office stresses, to ‘do lunch’ with friends/co-workers and get back to your desk with a fresh perspective on the job in hand.

cathy
Cathy McDonald

Check Out the GI Group’s ‘Let’s Do Lunch’ Basics
Lunch doesn’t need to be a big meal. But you need to choose a food from each group – carbs, protein and fruit and vegetables. Here’s how:
Start with a low GI carb such as wholegrain or sourdough bread, pasta, noodles, sweet corn, legumes (pulses).
Add some protein like fresh or canned salmon or tuna, lean meat, sliced chicken or turkey, reduced fat cheese or an egg. Legumes (pulses) also can count as protein.
Plus vegetables or salad to help fill you up. A large salad made with a variety of vegetables would be ideal.
Round off with fruit. If you opt for juice, remember, about ¾ cup (200 ml) is one serving. So if you are thirsty, make it a spritzer and top it up with sparkling mineral water.

Try these simple suggestions for a cup of soup, a sandwich or filled roll or a salad bowl you can make yourself or pick up from the local deli.

  • Minestrone soup made with plenty of beans and vegetables and served with a little grated parmesan and a grainy roll.
  • Salad sandwich made with mixed grain, soy and linseed or sourdough bread (or a roll) and filled with lean turkey slices, tomato, sprouts, grated carrot, finely sliced onion rings and mixed salad greens. Try a smear of avocado on the bread instead of margarine and add a dollop of cranberry jelly.
  • Chilli salmon salad: In a bowl, combine 1 small can red salmon (drained and flaked) with ½ punnet cherry tomatoes, slices of red onion, red and yellow capsicum strips and mixed salad and baby spinach leaves. Toss in a chilli dressing made from olive oil, lemon juice and minced chilli and serve with a grainy or sourdough bread roll.
– Source: Low GI Eating Made Easy

minestrone
Photo: Ian Hofstetter, The Low GI Diet Cookbook

GI News Briefs

Test is Best
The GI was introduced to rank the glycemic nature of the carbohydrate in individual foods. The purpose was to exchange one carbohydrate source with another in mixed meals or snacks. People often ask about the effect of extra protein and fat in the food on GI and blood glucose response. Eaten alone, protein and fat have little effect on blood glucose levels, but that’s not to say they won’t affect your blood glucose response when combined with a carb-rich food. This is because protein and fat both tend to delay stomach emptying, thereby slowing the rate at which carbohydrate can be digested and absorbed. So a high fat meal will have a lower glycemic effect than a low fat meal even if they both contain the same amount and type of carbohydrate. As most GI testing to date has been with carb-rich single foods, there’s been some uncertainty and controversy about the best way to apply it to mixed meals and whether it can be predicted using GI tables.

Prof Jeya Henry and colleagues from Oxford Brookes University set out to investigate the impact of protein and fat toppings on the glycemic response to three popular carb foods (potato, pasta and white toast). Writing in the European Journal of Clinical Nutrition the researchers report that toppings of cheddar cheese, chilli con carne, baked beans or tuna on baked potato, pasta and toast had a consistent lowering effect on the GI. The high fat cheese topping (42 g fat, most of it saturated) produced the greatest reduction in the glycemic response, especially when combined with the potato which, when eaten alone, had the highest GI value of the three staples (from GI 93 down to GI 39). In concluding the authors say that the ‘findings highlight the importance of investigating the GI of composite meals’. (The study was sponsored by the British Potato Council.)
European Journal of Clinical Nutrition 2006 Jan 25

GI Group: As we said in January GI News, the common cut-offs for high (GI 70) and low GI (55 or lower) were based on the scatter of GI values among single foods. If the future holds more testing of the glycemic impact of mixed meals, then the cut-offs may need to be redefined, taking into account the observed range. More importantly, a meal’s GI value doesn’t make it good or bad for you. You need to base your food choices on the overall nutritional content along with the amount of saturated fat, salt, fibre and of course, GI value. We have found that people who simply substitute a low GI food for a high one in their everyday meals and snacks (especially with their choice of breads, breakfast cereals, starchy vegetables) reduce the overall GI of their diet, gain better blood glucose control and lose weight.

See ‘Feedback’ for more on fats, spikes and glycemic response.

A Public Health Time Bomb
‘The obstacles are enormous in contemporary society where daily physical activity opportunities are limited for some youngsters, entertainment is sedentary, and high-fat, high-energy foods are cheap, ubiquitous, convenient and heavily promoted’ writes Dr Arlan L. Rosenbloom in the May issue of Archives of Pediatrics and Adolescent Medicine. He was responding to Glen Duncan’s data published in the same issue suggesting that the US faces a public health time bomb – around 39,000 teenagers aged between 12 and 19 may have type 2 diabetes and 2.8 million impaired fasting glucose levels. Duncan put some realistic figures on the potential size of the problem in the US using data from the National Health and Nutrition Examination Survey (1999–2002).

The estimates have important implications for public health because of the high rate of conversion from impaired glucose fasting level to type 2 diabetes in adults and the increased risk of cardiovascular disease in individuals with type 2 diabetes. It’s unknown, says Rosenbloom ‘whether weight loss will prevent or slow the progression to diabetes in this age group.’
Archives of Pediatrics and Adolescent Medicine Vol 160 May 2006

Teenagers Make Healthy Changes Given the Chance
Simply replacing sugar-sweetened beverages with non-caloric drinks in the home (where young people get most of their food and beverages) helped a group of teens cut consumption of high calorie drinks by more than 80%. They also shed pounds according to a randomised pilot study reported in the March issue of Pediatrics.

Consumption of sugar-sweetened drinks – sodas, sports drinks, juice drinks, iced teas, lemonades and punches – has surged in recent decades, in step with the surge in childhood obesity. So is there a connection? Researchers from Children's Hospital Boston carried out a controlled trial led by Cara Ebbeling, PhD, and David Ludwig, MD, PhD, to test the effect of decreasing sugar-sweetened beverages on body weight. ‘We opted to study one simple, potentially high-impact behaviour, and made it easy for adolescents to replace sugary drinks with non-caloric beverages in the home’ says Ebbeling.

teenagers

They enrolled 103 children aged 13 to 18 through a Boston area high school. The teens were offered a $100 mall gift certificate if they stuck with the six-month study, and they all did. Half the group, received weekly deliveries of non-caloric beverages of their own choosing – bottled waters and artificially sweetened drinks. They were instructed on how to avoid sugar-sweetened beverages and given tips on choosing non-caloric drinks outside the home. Prompts included monthly phone calls and refrigerator magnets (‘Think Before You Drink’). The rest of the teens, serving as a control group, continued with their usual eating and drinking patterns. At the end of six months, the beverage delivery group had an 82% reduction in consumption of sugary drinks, while sugary drink intake in the control group remained unchanged.

The heavier the teen was initially, the stronger the effect on body weight. Among the heaviest one-third of teens, there was a marked decrease in body mass index (BMI) in the beverage-delivery group, and a slight increase in the control group – a group-to-group difference of almost 1 pound per month. Other factors affecting obesity – physical activity levels and television viewing – did not change in either group.
Pediatrics, March 2006

Corollary: Stopping School Soda Sales – Taking a Step in the Right Direction
Cadbury Schweppes PLC, Coca-Cola Co. and PepsiCo Inc have agreed to halt nearly all sales of sodas to US public schools (vending machines and cafeterias) agreeing to sell only water, unsweetened juice and low-fat milks to elementary and middle schools. Diet sodas would be sold only to high schools. The agreement should cover around 87% of the public and private school drink market. The Alliance for a Healthier Generation, a collaboration between the William Clinton Foundation and the American Heart Association, helped broker the deal.

soda

Sugary soft drinks will also be banned from school canteens and vending machines in Australia from 2007. Ian Caterson, the Boden Professor of Nutrition at Sydney University said banning the soft drinks would help get the message across to parents that they were bad for children.

GI Symposium
Carbohydrates, Glycemic Index and Health: The State of the Art
When: 2 September 2006
Where: Powerhouse Museum, Ultimo, Sydney, Australia
Convenor Professor Jennie Brand-Miller, University of Sydney
Sponsor The University of Sydney Nutrition Research Foundation

For more information or to register, contact:
Elisabeth Eaton
GI Symposium Secretariat
PO Box 949, Kent Town SA 5071, Australia
Phone +618 8363 1307
Fax +618 8363 1604
Email FI2006@fcconventions.com.au

Presenters

  • Professor Jennie Brand-Miller, University of Sydney, Australia
    ‘Overview of carbohydrates, GI and health, strengths and weaknesses of the GI concept’
  • Associate Professor Frank Hu, Harvard University, USA
    ‘Saturated fat or refined carbohydrates: which is the worse villain for heart disease?’
  • Dr Anette Buyken, Forschungsinstitut für Kinderernährung, Germany
    ‘The European experience of using GI – potential pitfalls’
  • Dr Emma Stevenson (or Clyde Williams), Nottingham University, UK
    ‘GI, exercise and fuel partitioning’
  • Ian Barclay, NSW, Australia
    Title to be confirmed
  • Kate Marsh, NSW, Australia
    ‘Putting the GI into good practice’
Dietary Study for Women with PCOS
The University of Sydney is conducting a dietary study for women with PCOS. If you live in Sydney, Australia, are aged 18–40 with PCOS and are not taking the pill or trying to conceive, contact pcosdietstudy@nnd.com.au for more details.

GI Values Update

No Time to Cook?
The home meal replacement market is here to stay. It’s a trend, not a fad – and it can provide a healthier option than a takeaway meal for time-pressed and kitchen-shy consumers who want to be able to open the fridge (or freezer) door, take their pick, heat and eat. There’s no question it’s handy. But with a worldwide obesity boom, how healthy is it? Here are six GI tested, single serving mixed meals available in Australian supermarkets. They were formulated by the manufacturers to be nutritionally balanced. The LEAN Cuisine meals also meet the GI Symbol program’s strict nutritional criteria regarding fat, saturated fat and sodium. Pre-portioned meals like these can help you avoid over-eating (if you stop at one). Just remember to sit down at the table while you eat and eat slowly – it takes 20 minutes before your stomach tells your brain that you're full. Toss a simple salad together for starters and finish with a piece of fruit to help you get your seven servings of fruit and veggies a day.

lean cuisine

LEAN Cuisine Wholegrain Goodness range (Nestlé)
‘These low GI meals were specifically developed by Nestlé to meet consumer requests for healthy, sustaining heat-and-eat meals that would reduce their afternoon snacking and night-time cravings,’ says Penny Small, Manager Corporate Nutrition, Nestlé Australia Limited. ‘Initial sales have exceeded expectations,’ she says ‘which all goes to show that given a real choice, time-poor consumers will take the healthy option when it’s offered.’

GI symbol
International GI symbol

GI tested at Sydney University’s Glycemic Index Research Service (www.glycemicindex.com), the LEAN Cuisine meals carry the international GI symbol, which gives consumers a credible, independent signpost to healthier food choices. For more information on the Glycemic Index Symbol Program’s nutritional requirements, go to www.gisymbol.com and select ‘industry information’ from the menu then ‘program eligibility’ and finally ‘nutrient requirements’.

Burmese Vegetable Curry & Rice GI 50
Chicken Pomodoro GI 47
Honey Soy Beef GI 53

honey soy

Sanitarium Lunch Today
These lunches/light meals were developed by Sanitarium to be 98% fat free and to include as many whole foods as possible. The Sweet Vegetable Risotto for example is 63% veggies and the Fajita 55% veggies plus 9% legumes. They were GI tested at Sanitarium Development and Innovation. (GI Group note: for the purposes of GI testing, the use of small glucometers is not ideal, as demonstrated by Valangi et al 2005).

Mediterranean Pasta GI 49
Sweet Vegetable Risotto GI 59
Mexican Fajita GI 52

fajita

What’s the GI of …? 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.

link

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

fields

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.

beans

beans2

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

results

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.

Low GI Food of the Month

The Antioxidant-rich Orange
One orange (GI 42) provides you with your whole day’s vitamin C requirement. But that’s not all. This fruit is also rich in anti-oxidants and a good source of folate and potassium. Much of the sugar in an orange is sucrose, a ‘double’ sugar made up of glucose and fructose. When digested, only the glucose molecules have an impact on your blood glucose levels. This and the high acid content account for the low GI. There are many varieties available these days to help you enjoy eating a juicy orange year round. The main ones are jaffa (generally available year round), navel (autumn/fall, winter and spring) and valencia (spring and summer). But try something different. There are many other varieties worth keeping an eye out for. Blood oranges (winter through to early spring) for example are popular in Europe, particularly Mediterranean areas such as Spain and southern Italy where they grow prolifically. This variety, unusually for citrus fruit, contains anthocyanin, the blue/red pigment found in berries, red capsicum (pepper) and eggplant. Anthocyanin functions as an anti-oxidant, minimising the damage to cell membranes that occurs with aging.

oranges
Food: Lynne Mullins; Photo: Jennifer Soo

Here are some ideas for upping your orange intake:

  • Peel and enjoy the juicy segments with breakfast cereal, as a snack, or as an after-dinner palate cleanser.
  • Chop segments into fruit salads, toss into salads, add to soups or casseroles or to couscous; slice oranges and add to fruit punch.
  • Carrot and orange make a great couple—enjoy them together in a soup or salad.
– Reprinted courtesy Low GI Eating Made Easy (published by Hodder in Australia and NZ, Hodder Mobius in the UK and Marlowe & Company in the US)

Low GI Recipe of the Month

This fruity finish comes from Australian food writer Lynne Mullins who regularly contributes to Good Living and Sunday Life, reviews for the SMH Good Food Guide has published two books: Noodles to Pasta and Relish and currently presents fresh produce segments on radio 2UE and Channel Nine’s ‘Mornings with Kerri-Anne’.

lynne
Lynne Mullins

Citrus Salad with White Wine and Thyme Syrup
Ring the changes with the seasons with this dish. If navel oranges are all that’s available, it’s still delicious. The recipe is sweetened with pure floral honey (yellow box). If you prefer, sweeten to taste with an alternative sweetener that’s suitable for cooking.

Serves 4

1 blood orange
1 ruby orange
1 navel orange
2 black or green figs, halved
low fat yoghurt, to serve

White wine and thyme syrup
1/2 cup (125 ml/4 fl oz) fruity white wine, such as riesling
3 tablespoons pure floral honey (or to taste)
thinly peeled piece of lemon rind
1/2 cup (125 ml/4 fl oz) water
2 teaspoons fresh thyme leaves

To make the wine and thyme syrup, place wine, honey, lemon rind and water in a saucepan and stir over low heat until honey has dissolved into the mixture, then bring just to the boil, reduce heat and simmer over medium heat for 8–10 minutes or until syrupy. Discard rind, stir in thyme and cool.

Using a small knife, cut rind and pith from the oranges, then cut fruit into wedges and place in a large bowl with fig halves. Pour wine syrup over and toss gently to combine. Divide salad among bowls and serve immediately topped with yoghurt.

Per serving (with 1 tablespoon of low fat yoghurt)
Energy: 637 kilojoules/152 calories, protein: 2.8 g, fat: 0.2 g, carbohydrate 29.5 g, fibre 2.7 g

dessert
Food: Lynne Mullins; Photo: Jennifer Soo

Your Success Stories

Sue Drops a Dress Size
‘Having tried countless diets over the years to lose excess weight, I embarked on a low GI diet after Christmas 2005. Always a ‘foodie’, I not only enjoy nice food but I love to cook. My problem was portion control and my sweet tooth. I decided that low GI seemed a sensible route to continue to enjoy good food, but some re-education was necessary. I desperately wanted to drop several dress sizes and my determination was strong. That’s why I decided against the traditional slimming club (many of which I had tried in the past which only served to make me food obsessed).

I invested in several low GI cookbooks instead to ring the changes and to avoid meal-time boredom setting in, and I enrolled at my local gym. Meal times were interesting and plentiful and I honestly never felt hungry. The first couple of weeks I missed puddings and chocolate but soon kicked the sugar cravings – I now reward myself with an occasional square of dark chocolate and savour and enjoy it. I increased my activity levels steadily. I take a brisk daily walk for 20 minutes or so and I tried various gym classes until I found two which I love and look forward to immensely. No obsessive calorie counting has meant this new regime is not a ‘slimming diet’ but has become my new way of life, my family and I are all much healthier for it. I have lost 1 stone 10 lbs (24 pounds/11 kg) in 4 months with real ease and I am so much happier and more confident. Learning about low GI has changed my life!’

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Books, DVDs, Websites: What’s New?

Delicious Living
By Peter Howard, New Holland Publishers AUD$19.95

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Peter Howard

Peter Howard is a well-known food and wine commentator. For many years his national television segments, regular radio interviews and articles in magazines and newspapers have kept Australian audiences informed of the latest trends. Two years ago, he was diagnosed with diabetes. ‘I know, like so many folk now, that we have a disease that will not go away, but can be controlled by diet, exercise and restraint or discipline’ he says in the introduction to this book. ‘I know many diabetics before me have faced and won this same dilemma. It is a difficult, private battle. We have to forgive ourselves for arriving at this stage and just get on with life … and our newfound lifestyle.’ Here’s a taste of the recipes he lives by … 99 per cent of the time. The book is endorsed by Diabetes Australia.

Spiced Yoghurt Pork Fillet and Pan-fried Pears
Preparation time 30 minutes
Cooking time 20 minutes
Serves 4

600 g (1 lb 5 oz) pork fillet cut into (4–5 cm/1¾–2 inches thick), all fat removed
150 ml (5 fl oz) no fat natural yoghurt
1 teaspoon smoked paprika
1 teaspoon fennel seeds, roughly crushed
1 teaspoon coriander powder
1/4 medium onion, finely chopped
1 tablespoon minced fresh oregano
2 teaspoon mustard seed oil
lemon flavoured cracked peppercorns
8 canned pear halves, well drained
120 g (4 oz) cooked silverbeet or spinach leaves

Preheat the oven to 180ºC (350ºF). In a small bowl, combine the yoghurt, paprika, fennel, coriander, onion and oregano and mix well.

Gently flatten the pork medallions by pounding them with the heel of your hand. Smear each piece of pork with the yoghurt mixture and leave to sit for 15–30 minutes, or longer if you have the time. Place the pork medallions on a baking tray and cook in the oven for 15 minutes or until firm. It is OK to leave your pork fillet pink. Heat the oil in a non-stick pan, sprinkle the pear halves with cracked pepper and pan fry to golden brown.

Pile equal amounts of cooked silverbeet on each plate, top with equal quantities of pork and 2 pear halves each.

pork

Per serving:
1200 kJ/280 calories, 36 g protein, 6 g fat (1.6 g sat fat), 19 g carbohydrate,
low GI

What Makes My Blood Glucose Go Up and Down? revised edition published by Marlowe & Company is now available. We reviewed this in October 2005 GI News. Check the ‘Archive’ or use the Google Search facility to read the review.

book

Feedback—Your FAQs Answered

I've read that while fats slow down the body's response to high GI foods, the body still sees the same level of glucose response from the food, just over a considerably longer period of time (which is perhaps not accounted for when doing GI testing). Is this true?
No, this isn’t true. Fats do slow down digestion and reduce overall blood glucose levels, even if we continued testing beyond 2 hours. But you need the same amount of insulin, possibly more because excess fat intake makes you insulin resistant. The bottom line: choose a diet of 25–35% energy from fats. Good fats of course. We published a paper in 2004 on it in the American Society for Nutritional Sciences entitled: ‘The degree of fat saturation does not alter glycemic, insulinsemic or satiety responses to a starchy staple in healthy men’.

What about a glossary? I'm familiar with glycemic index, glycemic load, and a few other ‘normal’ GI terms, but when I start reading terms like ‘glycemic response’ or ‘glycemic impact’ I begin to wonder whether I know anything at all.
We try where possible to turn the science into everyday language, but sometimes terms are quite specific so a glossary is a great idea. We’ll start with the ‘GI terms’ you raise and keep building the glossary over the next few issues. When it’s completed, we’ll post it on the website as a ready reference.

Glucose When you eat carbohydrate foods such as bread, cereals and fruit, your body converts them to glucose (a monosaccharide sugar that’s present in most animal and plant tissues) during digestion. It is this glucose that is absorbed from the intestine and becomes the fuel that circulates in the bloodstream. As the level of blood glucose rises after you have eaten a meal, your pancreas gets the message to release insulin which then drives the glucose out of the blood and into the cells. Once inside the cells it is channelled into several pathways simultaneously – to be used as an immediate source of energy, converted into glycogen (a storage form of glucose) or into fat.

Blood glucose (blood sugar) is the amount of glucose in the blood stream. If you haven’t eaten in the past few hours (and you don’t have diabetes), your blood glucose level normally falls within the range of 3.5–6 mmol/L. If you eat, this will rise, but rarely above 10 mmol/L. The extent of the rise will vary depending on your glucose tolerance (your own physiological response) and the type of food you have just eaten. Although blood glucose levels will fluctuate over the course of the day, they will normally remain with this fairly narrow range. Keeping levels within the normal range is important for your health whether you have diabetes or not.

The test that measures your average blood glucose level over the past 2–3 months has a variety of names. It’s mostly described as HbA1c (hemoglobin A1c or glycated hemoglobin). It indicates the percentage of hemoglobin (the part of the red blood cell that carries oxygen to the cells and sometimes joins with glucose in the bloodstream) that is ‘glycated’. Glycated means has a glucose molecule riding on its back. This is proportional to the amount of glucose in the blood. The higher the level of HbA1c, the greater the risk of developing diabetic complications. People with diabetes should aim to keep their HbA1c at or less than 7%.

Glucagon Between meals your blood glucose levels will start to fall. As this happens, the pancreas releases the hormone glucagon into the blood. This hormone promotes the conversion of glycogen stored in the liver and muscles to glucose and raises your blood glucose level to keep it within the normal range.

Glycemia is the concentration of glucose in the blood. Hence the adjective, glycemic.

Glycemic Index (GI) Different carbohydrate foods can behave quite differently in your body. Some break down quickly during digestion and release glucose rapidly into the bloodstream; others break down gradually as you digest them and slowly trickle glucose into the blood stream. The glycemic index or GI, a relative ranking on a scale of 0 to 100, is how we describe this difference. After testing hundreds of carbohydrate foods around the world, scientists have found that foods with a low GI will have less effect on your blood glucose than foods with a high GI. High GI foods tend to cause spikes in your glucose levels whereas low GI foods tend to cause gentle rises. To make a fair comparison, all foods are compared with a reference food and tested following an internationally standardised method.

Glycemic Load (GL) How high your blood glucose actually rises and how long it remains high when you eat a meal containing carbohydrate depends on both the quality of the carbohydrate (its GI) and the quantity of carbohydrate in the meal. Researchers at Harvard University came up with a term to describe this: glycemic load. It is calculated by multiplying the GI of a food by the available carbohydrate content (carbohydrate minus fibre) in the serving (expressed in grams), divided by 100.
GL = GI/100 x available carbs per serving.

Glycemic potential A food or meal’s predicted blood glucose raising effect.

Glycemic response or glycemic impact describes the change or pattern of change in blood glucose after consuming a food or meal. Glucose responses can be fast or slow, short or prolonged. It is primarily determined by the food’s carbohydrate content. Other factors include how much food you eat, how much the food is processed and even how the food is prepared (for example, pasta that is cooked al dente has a slower glycemic response than pasta that is overcooked).

Glycogen is the name given to the glucose stores in the body. It can be readily broken down into glucose to maintain a normal blood glucose concentration. In an adult male, approximately two-thirds of the body’s glycogen is found in the muscles and one-third in the liver. The total stores of glycogen in the body are relatively small however, and will be exhausted in about 24 hours during fasting or starvation.

Hypoglycemia (also called an insulin reaction) occurs when a person’s blood glucose falls below normal levels – usually less than 4 mmol/L. People with diabetes know all about it. Hypoglycaemia is treated by consuming a carb-rich food such as a glucose tablet. It may also be treated with an injection of glucagon if the person is unconscious or unable to swallow. If you don’t have diabetes, but you have vague health problems ranging from tiredness to depression and think you may have hypoglycemia or someone tells you that you probably have ‘low blood sugar’, see your doctor and get a proper diagnosis. Hypoglycemia is far less common that once was thought in people who do not have diabetes.

Impaired glucose tolerance is sometimes called pre-diabetes or impaired fasting glucose. It is a condition in which blood glucose levels are higher than normal, but are not high enough for a diagnosis of diabetes. People with impaired glucose tolerance are at increased risk of developing diabetes, heart disease and stroke.

Insulin is a hormone produced by the pancreas that helps the body use glucose for energy. Although the body needs glucose, it doesn’t want it all in one hit, so it pumps out insulin to drive the glucose out of the blood and into the tissues. The pancreas should automatically produce the right amount of insulin to move glucose into the cells. People with type 2 diabetes do not always produce enough insulin. People with type 1 diabetes produce no insulin at all. When the body cannot make enough insulin, it has to be taken by injection or through use of an insulin pump. It can’t be taken by mouth because it will be broken down by the body’s digestive juices.

Insulin is not only involved in regulating blood glucose levels, it also plays a key part in determining whether we burn fat or carbohydrate to meet our energy needs – it switches muscle cells from fat burning to carb burning. For this reason lowering insulin levels is one of the secrets to life-long health.

Insulinemia simply means the presence of insulin in the blood; hyperinsulinemia is excessive amounts of insulin in the blood.

Insulin resistance When insulin levels are chronically raised, the cells that usually respond to insulin become resistant to its signals. The body then responds by secreting more and more insulin, a neverending vicious cycle that spells trouble on many fronts. Insulin resistance is at the root of diabetes, many forms of heart disease, and polycystic ovarian syndrome (PCOS).

Insulin sensitivity If you are insulin sensitive, your muscle and liver cells take up glucose rapidly without the need for a lot of insulin. Exercise keeps you insulin sensitive: so does a moderately high carbohydrate intake.

I have heard that the GI of sugar is 67 – is this true? Are NutraSweet or Splenda considered as being low GI?
In our online database, regular table sugar is listed under the scientific name ‘sucrose’, not as ‘sugar’. But point taken and we’ll see what we can do to get it cross referenced to make it easier to use the database. Sucrose has been tested on a number of occasions and has an average GI of 68. You can add a teaspoon of sugar to your tea or coffee without upsetting your blood glucose levels. For lower GI sweeteners, try a pure floral honey, 100% pure maple syrup, apple juice, grape nectar, or Sweet Cactus Farms agave nectar, or fructose sweeteners such as such as Sweetaddin® or Fruisana®.

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Alan Barclay

Dietitian Alan Barclay of the GI Group says: ‘If you are trying to lose weight or reduce your insulin or oral hypoglycemic medications, alternative sweeteners can be handy. There are numerous brands, but essentially just two main types:

  • nutritive sweeteners
  • non-nutritive sweeteners
Nutritive sweeteners including sugars, sugar-alcohols, and oligosaccharides (medium-sized chains of glucose) are simply different types of carbohydrate with varying levels of sweetness. The sugar alcohols like sorbitol, mannitol and maltitol are generally not as sweet as table sugar, provide fewer kilojoules and have less of an impact on blood glucose levels. To overcome their lack of sweetness, food manufacturers usually combine them with non-nutritive sweeteners to help keep the kilojoule-count down and minimise the effect on blood glucose levels so check the ingredient listing on the food label.

Non-nutritive sweeteners (such as Equal®, Splenda®, NutraSweet® or saccharin) are all much sweeter than table sugar and have essentially no effect on your blood glucose levels because most are used in such small quantities and are either not absorbed into or metabolised by the body. Because they are only used in minute amounts, the number of kilojoules they provide is insignificant. The best non-nutritive sweeteners to cook with are Splenda®, saccharin and Neotame®, and to a lesser extent Equal Spoonful®. This is because the non-nutritive sweeteners made of protein molecules often break down when heated for long periods and lose their sweetness.’

Why is there no information about stevia?
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, they 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. You can buy the herb, stevia leaf powder, online from specialty spice merchants such as Herbies Spices (www.herbies.com.au). Herbie (Ian Hemphill) has a couple of hints for using stevia. He says: ‘use sparingly as there is a bitter aftertaste if too much is added to food. Because stevia does not have the same properties of sugar, it is not suitable as a sugar substitute when baking.’

stevia
Stevia plant

I read that people just trying to lose weight or eat more healthily should use GL, but people with insulin resistance (like me) should use GI. Is this true?
Our advice is to stick with the GI in all but a few instances. When you choose low GI carbs you’re invariably getting a healthy diet with an appropriate quantity and quality of carbohydrate. Portion size still counts, though. And this is where low GI foods are star performers – the foods with the lowest GI values also have the best fill-up factor. If you listen to your true appetite, you are far less likely to overeat when you are choosing low GI foods.

GL doesn’t distinguish between foods that are low carb or slow carb. Going with GL could mean you’re eating an unhealthy diet, low in carbs and full of the wrong sorts of foods. So the take home message is to use GI to identify the best carbohydrate choices and take care with portion size to limit the overall GL of your diet.