1 November 2019

GI News - November 2019

GI News

GI News is published online every month by the University of Sydney, School of Life and Environmental Sciences and the Charles Perkins Centre, and delivered to the mailboxes of our 97,000 subscribers. Our goal is to help people choose the high-quality carbs that are digested at a rate that our bodies can comfortably accommodate and to share the latest scientific findings on food and diet with a particular focus on carbohydrates, dietary fibres, blood glucose and the glycemic index.

Professor Jennie Brand-Miller, AM, PhD, FAIFST, FNSA
Editor: Philippa Sandall
Scientific Editor/Managing Editor: Alan Barclay, PhD, APD, AN
Contact GI News: glycemic.index@gmail.com

Sydney University Glycemic Index Research Service
Manager: Fiona Atkinson, PhD, APD, AN
Contact: sugirs.manager@sydney.edu.au

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“Seeing pink elephants” is an expression describing drunken hallucinations, and a pink elephant is the name of a cocktail containing vodka, cranberry juice, raspberry liqueur and limoncello (lemon liqueur). The expression “the elephant in the room” describes a huge and obvious issue not being addressed. As we head into the festive season, let’s talk about alcohol – the large pink elephant in the room.

pink elephant
There’s a lot of talk among diet tribes about all carbs (starches and sugars) being fattening and in particular, about sugar being poison, however when it comes to the “diet wars” we don’t hear much about alcohol. Unlike sugars, alcohol is a poison, albeit government revenue-generating poison. Considering Australian adults consume 4.8% of their daily kilojoules (calories) from alcoholic beverages, you have to wonder why alcohol has escaped being hit by the blame train.

  • Is it the power and influence of the alcohol industry? 
  • Is it because alcohol is fun and we’re in denial? 
  • Is it because we’re clueless about the adverse health effects and high kilojoule/calorie content? 
To focus on the third question, perhaps we are naive about the fattening nature of alcohol because we’re clueless about how many kilojoules/calories we’re consuming in our favourite tipple. While packaged food must carry nutrition labelling including energy content, alcoholic drinks do not. While at least one large Australian company now includes nutrition information on its beers, they stand out in an industry dead against placing this very sobering information on their products.

Let’s be clear: alcohol is high in kilojoules (calories). While carbohydrate provides 16kJ (4 calories) per gram and protein provides 17kJ (4.2 calories) per gram, alcohol provides 29kJ (7 calories) per gram. And being tipsy tends to make us more uninhibited with what we eat – alcohol is a well-known appetite stimulant.

While the sugar-quitting folk warn about the sugar content of drinks, and low-carb beer has a sizeable market following among the “health conscious”, the numbers tell a different story. Most of the kilojoules in alcoholic drinks come from alcohol, not sugars. Low-alcohol beer beats low-carb beer when it comes to being health and weight-friendly, and for staying in better control of how much and what kinds of food you eat with it.

5 POPULAR DRINKS Let’s look at where the kilojoules (calories) come from in 5 popular drinks. Sugars or alcohol? Note that the percentages don’t add up to 100, because there are also starches and proteins present that contribute total energy. We have rounded the figures.

popular drinks
Table reproduced and adapted with permission from The Ultimate Guide to Sugars and Sweeteners (The Experiment Publishing, New York).

And did you know excess alcohol consumption is a key risk factor for breast cancer? Breastcancer.org reports women who have three alcoholic drinks per week have a 15% higher risk of breast cancer than women who don’t drink any alcohol.

I won’t go into the cultural problem we have with consuming way too much alcohol here, or the health and social costs, except to say they are MAMMOTH. It costs us as a society a lot to drink so much. I love a nice glass of wine or beer, but it would be good to be part of a culture in which getting drunk is not considered normal.

Fighting excessive alcohol consumption is a fight worth having, with no nutritional downsides. Let’s quit the one-nutrient-at-a-time skirmishing and take on a real enemy. Let’s do battle and fight to have the calories/kilojoules clearly printed in at least 10-point type on the label of all alcoholic drinks.

Read More:


Reducing the intake of sugary drinks is presently quite important to many public health advocates. Taxes on sweet drinks are one effective way to do this. And advocates are convinced that the result will be better health – less obesity and less diabetes. But it’s worth asking: what will take the place of those sugary drinks? New data from Australia suggests that alcohol might be part of the answer. ConscienHealth’s Ted Kyle reports.

See saw
OBSERVATIONS OF ALCOHOL AND SUGARY DRINKS Tommy Wong and colleagues looked at self-reported alcohol and sugar sweetened beverage (SSB) consumption. They also analyzed waist circumference measures. Data came from the 2012 Australian Health Survey. Overall, about a third of adults drank no SSBs. But it turns out that those adults made up for the calories from sugar with calories from alcohol. A substitution model found no difference in waist circumference when trading SSBs for alcohol. In other words, they found no evidence here that people who swapped alcohol for sugar did better on this indicator for obesity.

HUMANS PUSH BACK Humans are tricky creatures. Push them to do something you want and they find ways to push back. History is littered with strong responses to constraints on beverage choices. The Tea Party and the Whisky Rebellion are just two examples that come to mind.

Rebellion isn’t the only response. People adapt in unpredictable ways. For example, seltzer is an increasingly trendy alternative to sugary sodas. Smart people don’t drink soda, right? But hey, we need a dash of pleasure with our seltzer. So, voilĂ . We have a trend in hard (alcoholic) seltzers in the US. White Claw is a brand that embodies this trend and it’s become so popular that there’s a nationwide shortage. Tax policy plays a role, too, because taxes are lighter on these seltzers than on distilled spirits. Unintended consequences everywhere you look.

PITFALLS OF A NARROW FOCUS The systems that drive obesity are complex and adaptive. Push on one thing and the systems push back somewhere else. Simply taxing sweet beverages sounds like a good idea. But it’s worth watching to see how all these human systems adapt.

And we might do well to think more broadly, as one of the co-authors of the Wong paper, Prof Jennie Brand-Miller, told us recently: “Humans have always liked to drink calories, starting with day one. I think the harms of excessive soft drink consumption pale in comparison to alcohol. And Australia’s experience tells us that we shouldn’t expect declining consumption of soft drinks to make any difference to obesity trends. If we focus more on calories from alcohol, we might get somewhere.”

Indeed. A serving of breast milk – nature’s perfect food – has 17 grams of sugars. Will we wean humans from sweet and pleasurable beverages? Maybe not. So perhaps a more nuanced and thoughtful approach to promoting healthful behaviors would be wise.

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Drinking lubricates most social functions. It’s one of life’s pleasures. Plain water is unquestionably the best option, but it’s rarely the first choice when drinking socially with family, friends and colleagues. Mineral water (still or sparkling) with ice and a slice of lemon is socially more acceptable and contains relatively small amounts of sodium, potassium, magnesium and calcium. However, there’s an increasingly large variety of beverages out there for the designated driver and for those who don’t drink alcohol for health or religious/cultural reasons. Here we take a look at some of the more popular soft options.

Ingredients: Oranges.
On average, 1 cup (250ml) of freshly squeezed orange juice has 375kJ (90 calories); 19g carbohydrate (sugars), a low GI (50) and medium glycemic load (10). It’s a good source of vitamin C. Tip: Add mineral water and ice cubes and make it a long drink to sip.

Ingredients: Carbonated Water, Sugar, Colour (150d), Food Acid (338), Flavour, Caffeine.

  • 1 cup (250ml) has 450kJ (108 calories); 27g carbohydrate (sugars), a medium GI (63) and medium glycemic load (17). 
  • A 375ml can has 670kJ (160 calories); 40g carbohydrate (sugars), and bumps the glycemic load up to high (25). 
 If you like to drink regular Coke or other sugar sweetened colas and soft drinks, pour into a tall glass with lots of ice. Coca-Cola Zero Sugar and Diet Coke are sugar free.

Ingredients: Carbonated Water, Colour (Caramel e150d), Sweeteners (Aspartame, Acesulfame K), Acids (Phosphoric Acid, Citric Acid), Flavourings (including Caffeine), Preservative (Potassium Sorbate). Contains a source of Phenylalanine.
  • 1 cup (250ml) has 4kJ (1 calorie); 0.2g carbohydrate. 
  • A 375ml can has 6kJ (1.5 calories); 0.2g carbohydrate. 
Like other low joule/calorie or “diet” soft drinks and colas, this is a good alternative to alcohol. It has no effect on blood glucose levels and there’s evidence that substituting regular soft drinks with diet varieties helps people lose weight.

Ginger Lemon Ingredients: Certified organic raw kombucha, (pure water, wild kombucha culture, organic black tea, organic green tea), organic ginger, naturally fermented organic glucose (erythritol), organic lemon, organic stevia (steviol glycosides).
  • 1 cup (250ml) has 75kJ (17 calories); 4g carbohydrate. 
  • A 330ml bottle has 99kJ (23 calories); 5g carbohydrate. 
While you can buy commercial brands, many people make their own. We turned to Taste.com for a recipe, but we reduced their serving size down to 1 cup (250ml). Ingredients: 1.25 litres lemonade (chilled), ½ cup lime juice cordial, 1 teaspoon Angostura bitters, 1 cup small ice cubes, Angostura bitters to serve, lemon slices to serve
  • 1 cup (250ml) has 509kJ (121 calories); 29g carbohydrate. 
Read more:


People have been drinking alcoholic beverages for thousands of years – partly due to their intoxicating effects and partly due to the fact that they once provided a safer means of hydration when clean water was scarce.

For many people around the world today, an alcoholic drink is a regular and enjoyable part of meals and many other social occasions like weddings, parties, etc. There is some evidence that people who drink small quantities of alcohol on a regular basis may have better health outcomes than those who do not drink at all, but these findings have been recently challenged. Heavy drinking has no health benefits and studies consistently report that abstainers have better health outcomes than heavy drinkers.

In terms of nutrition, alcohol is the only substance that is both a food providing energy and a drug affecting brain and nervous system function.

ALCOHOL IS A CONCENTRATED FORM OF ENERGY Pure alcohol provides 29 kilojoules (7 calories) of energy for every gram consumed – second only to fats (37kJ/9 calories per gram) in energy density. Moderate drinkers (1 to 2 standard drinks per day, or 10 to 20 grams of pure alcohol per day) usually consume alcoholic beverages as added energy – on top of their normal food intake. Alcoholic beverages may also stimulate appetite, further increasing energy intakes. For these reasons, some moderate drinkers may inadvertently develop a “beer belly”. Heavy drinkers, on the other hand, usually consume alcoholic beverages instead of food, and consequently are often underweight and malnourished.

ABSORPTION AND METABOLISM When consumed, alcohol is very rapidly absorbed into the blood stream from the stomach and small intestine, as it does not require any digestion, and can consequently bring on the familiar feelings of euphoria within minutes if it is consumed on an empty stomach. Around 2 to 10 percent of the alcohol we drink is lost through urine, sweat, or the breath (this is the basis for the breath test for drunkenness), whereas the other 90 to 98 percent is metabolized in the stomach and liver.

Alcohol metabolism begins in the stomach with an enzyme called alcohol dehydrogenase which converts it to acetaldehyde which in turn is converted to acetate and then acetyl CoA a key energy molecule for most of our body’s cells:

Alcohol metabolism
Women produce less alcohol dehydrogenase than men, which is one of the reasons why they are more affected by alcohol than men of the same body size. Acetaldehyde is a highly reactive and toxic compound that is responsible for many of the damaging effects of excessive alcohol consumption. Excess NADH produced in the first two steps of the metabolism of alcohol inhibits the production of glucose in the liver (via gluconeogenesis) and also inhibits the burning of fatty acids. This is one reason why too much alcohol can cause people with diabetes who take insulin or certain blood glucose lowering drugs to have a hypo.

Most alcohol is metabolised in the liver, and there is a limit to how much it can handle – about 15 grams (or 1½ standard drinks) an hour – so excess amounts can build up in the blood rapidly if you drink more than 1 or 2 Standard drinks (a Standard drink contains 10g of pure alcohol) an hour.

IMMEDIATE EFFECTS Of course, the most immediate affect we associate with drinking alcohol is its effect on the brain and nervous system. Most people think that alcohol is a stimulant because it seems to relieve inhibitions. It is in fact a nervous system depressant. Inhibitions decrease first because inhibitory nerves are more easily sedated than excitatory nerves. Judgement and reasoning are affected first as the alcohol sedates our brain’s frontal lobes first. Next, speech and vision centres are affected – speech becomes slurred and vision becomes blurry. Coordination is affected next, walking becomes staggered. Finally, the conscious brain is subdued, and you pass out, preventing the consumption of more alcohol.

It’s well known that alcohol increases the frequency of urination – indeed, it is the origin of the euphemism for excessive drinking – “getting pissed”. Alcohol depresses the release of anti-diuretic hormone from the pituitary gland. This hormone makes the kidneys re-absorb water, so by reducing its production, more is released into the bladder and thirst increases. Drinking more alcoholic beverages to quench the thirst will of course only make the situation worse. This is why it is important to have a non-alcoholic drink as a spacer between alcoholic drinks – it will help reduce dehydration, one of the more unpleasant symptoms of a hangover.

LONGER-TERM EFFECTS The liver prefers to use fatty acids for fuel, but when alcohol is around, it is forced to use it (alcohol) as a fuel, which can lead to a build-up of fatty acids in the liver and an increase in triglycerides in the blood when consumed in excessive amounts. Frequent excessive drinking may therefore lead to what is known as fatty liver disease (excessive fat accumulation in the liver), which in turn may lead to fibrosis and then cirrhosis if heavy drinking and poor nutrition continue for extended periods of time.

Nutrient deficiencies are virtually inevitable in heavy drinkers, because alcoholic beverages may displace food and alcohol interferes with the body’s use of certain nutrients, making some ineffective even if they are present. For example, small intestinal cells may not be able to absorb certain B group vitamins like thiamin, folate and B12 effectively, liver cells lose their ability to activate vitamin D efficiently, and retinal cells in the eye are not able to utilise vitamin A efficiently. The latter being one of the origins of the old saying for those who are completely inebriated: “blind drunk”.

There may be some social benefits to moderate alcohol consumption but none for heavy drinking: Alcohol is a good servant but a cruel master.

Read more:

Dr Alan Barclay
Alan Barclay, PhD is a consultant dietitian and chef (Cert III). He worked for Diabetes Australia (NSW) from 1998–2014 . He is author/co-author of more than 30 scientific publications, and author/co-author of  The good Carbs Cookbook (Murdoch Books), Reversing Diabetes (Murdoch Books), The Low GI Diet: Managing Type 2 Diabetes (Hachette Australia) and The Ultimate Guide to Sugars and Sweeteners (The Experiment, New York).

Contact: You can follow him on Twitter or check out his website.


Wine is generally destiny for grapes. It seems that was why we first began cultivating them and (mostly) why we still do. Some 76,000 square kilometres (about 47,225 square miles) of Earth’s surface is dedicated to grape growing and over 70% of the harvest is for wine-making. In the kitchen, grapes are typically more garnish than main event, but you can make delicious jams, and jellies, cakes and tarts with them. Most of us however are happy to pick them from the bunch, serve them with cheese or add them to salads and fruit salads. To expand the culinary repertoire, we have included two recipes by Kate McGhie in the Good Carbs Kitchen to try: Pork Meatballs with Fresh Grapes and Wild Rice with Fresh Grapes, Walnuts and Feta.

New season’s grapes start arriving in the produce aisles in summer. Taste one to check for sweetness as they don’t continue to ripen once they have been picked. Look for bunches as inviting as those in a still-life painting: plump fruit attached to moist flexible stems. The powdery bloom, more visible on dark-coloured grapes than on pale ones, is an important sign of freshness; it fades with time and handling. Avoid any sticky, split or wrinkled grapes on withered or limp stems. It’s also worth smelling them to make sure they aren’t starting to ferment. Store unwashed grapes in a plastic bag in the refrigerator and rinse just before using or eating. They should keep for about a week. It’s fun to freeze little bunches to make “grape blocks” for children to snack on.

AusFoods, 2019 and The Good Carbs Cookbook (Murdoch Books)


0:25 Prep • 0:25 Cook • 6 Servings • Family friendly • Main meal

600g (1lb 5oz) minced (ground) pork
2 shallots, finely chopped
2 garlic cloves, crushed
3 tablespoons chopped hazelnuts
Sea salt flakes and freshly ground pepper
Plain (all purpose) flour, for coating
100g (3½oz) sultanas
150ml (5fl oz) hot black tea
2 tablespoons olive oil
3 teaspoons butter
1 onion, finely chopped
1½ cups seedless black grapes
200ml (7fl oz) chicken stock
2 tablespoons finely chopped flat-leaf parsley

Put the pork, half of the shallot, garlic, and hazelnuts in a bowl, and season to taste with salt and pepper. Wet your hands and clump the mixture together. Form the mixture into tiny balls about the size of a golf ball, then toss in flour to coat.

Put the sultanas in a small bowl and pour over the hot tea. Leave for 10 minutes to plump.

Heat the oil and butter in a sturdy pan, over medium heat, and fry the meatballs, in batches if necessary, moving them around the pan to colour evenly, for about 10 minutes or until cooked. Add the remaining shallot, cover the pan, reduce the heat to low, and cook gently until softened. Add the plumped sultanas with the tea, grapes and stock. Simmer gently for 10 minutes with the lid off, or until the sauce reduces and thickens slightly. Sprinkle with parsley just before serving.

Black grapes are particularly delicious in this recipe however for a striking effect you may like to use a mixture of coloured grapes. Other herbs to consider include sage, thyme, marjoram or tarragon.

Per serve 1605kJ/ 385 calories; 22g protein; 21g fat (includes 6g saturated fat; saturated : unsaturated fat ratio 0.4); 26g available carbs (includes 21.5g sugars and 4.5g starches); 3g fibre; 200mg sodium; 635mg potassium; sodium : potassium ratio 0.3.

Kate McGhie, The Good Carbs Cookbook, Murdoch Books.
The Good Carbs Cookbook

0:25 Prep • 0:45 Cook • 6 Servings • Gluten free • Vegetarian • Side dish or light meal

1 cup wild rice
2 cups vegetable stock
Sea salt flakes and freshly ground pepper
1 large orange
⅓ cup extra virgin olive oil
¼ cup fresh orange juice
1 tablespoon red wine vinegar
2 cups seedless grapes, halved if preferred
2 spring onions (scallions) trimmed and sliced
½ cup diced celery
⅔ cup walnut pieces
⅓ cup crumbled feta
3 tablespoons roughly chopped curly-leaf parsley
3 tablespoons chopped mint leaves

Rinse the wild rice under cold running water, drain and put into a pot with the stock over medium heat. Bring to the boil and then reduce the heat to low and simmer uncovered for 45 minutes or until the rice is al dente – it should have a nutty bite to it when cooked. Drain off the excess liquid from the pot, cover and allow the rice stand for 10 –15 minutes.

Cut the peel and white pith from the orange and cut the flesh in to thin segments over a bowl to catch the juice. Whisk the juice together with the oil and vinegar and add salt and pepper to taste.

Tip the rice into a large bowl and add the orange segments, grapes, spring onions, celery and walnuts. Pour over the dressing and toss. Sprinkle with feta, parsley and mint before serving.

TIP Try a mix of coloured grapes and for a stunning garnish, sprinkle over pomegranate seeds before serving.

Per serve 1380kJ/ 330 calories; 10g protein; 26g fat (includes 4g saturated fat; saturated : unsaturated fat ratio 0.2); 14g available carbs (includes 13.5g sugars and 0.5g starches); 5g fibre; 350mg sodium; 445mg potassium; sodium : potassium ratio 0.8.

Kate McGhie, The Good Carbs Cookbook, Murdoch Books.
The Good Carbs Cookbook


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