1 February 2020

GI News - February 2020

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.

Publisher:
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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FOOD FOR THOUGHT

SEAFOOD: GET HOOKED SUSTAINABLY 
Dietitian Nicole Senior reports. 
If any food could be considered a super food, it’s seafood (fish and shellfish). High in protein, and low in saturated fat, it’s a major source of healthy long-chain omega-3 fats and rich in nutrients such as iron, zinc, selenium, iodine, and vitamin D. And there is strong evidence eating it is good for the heart. Quality observational studies have shown approximately one to two 100-gram (3½-ounce) servings of fatty fish a week – salmon, herring, mackerel, anchovies, or sardines – reduce the risk of heart disease.

Fresh fish
There is also consistent evidence that consuming fish two to three times a week along with leafy greens and other fruit and vegetables daily and low GI carbohydrates can reduce your risk of developing macular degeneration, or help to slow its progression if it has already become established.

HOW MUCH SEAFOOD? Nutrition guidelines around the world suggest adults eat two serves of seafood a week. A serving is 100g (3½oz) of cooked (or 115g/4oz raw), which is around the size of your hand, or the amount in a small can. While battered and deep‐fried fish ’n’ chips are delicious, steamed, broiled/grilled, baked or pan‐fried fish are better options. Boost the health benefits and serve with plenty of vegetables or salad.

WHICH FISH? There is a huge variety of seafood to choose from but we creatures of habit tend to stick to a limited range of our favourites that are quick and easy to prepare and available all year round. However, globally, overfishing is a big problem. Taking pressure off fish stocks means we need to branch out and try different types of seafood. An added bonus is the less popular species tend to be cheaper.

If you want to expand your options, ask the fishmonger about what’s local and abundant or check out the “nose to tail” movement that promotes using all of the animal or in this case, fish. We as citizen-eaters can help by eating “fin to fin” (i.e. the whole fish and not just our favourite boneless, fillets) and not wasting any because throwing seafood in the bin stinks to high heaven and just adds insult to injury (it wastes the already significant environmental costs in producing it). If you have the space, you can bury your seafood scraps in the yard or garden to enrich the soil.

Look online, and you’ll find there are a number of people and organisations already promoting lesser-known fish with tips on how to choose and recipes to get great results. If you want to be adventurous in the kitchen, a good place to start would be Josh Niland’s The Whole Fish Cookbook (Hardie Grant), which is packed with ideas for cooking undervalued and less celebrated fish, and yes, the whole fish.

WHICH FISH IF YOU ARE PREGNANT? Now is the time to be selective. Avoid raw fish (e.g. sashimi, sushi), pre‐cooked prawns and smoked salmon due to the risk of listeria (a bacteria that can cause problems for the unborn child if the mother becomes infected). Fish and seafood are nutritionally important foods during pregnancy but some species contain high levels of mercury and some caution is required. Check your local health authority for which species to limit or avoid, but keep in mind most are OK and seafood provides essential nutrients during pregnancy. In general, predator fish species at the top of the food chain accumulate higher levels of mercury – smaller fish species are lower in mercury. Canned fish products are not high in mercury.

WHAT ABOUT SUSTAINABILITY? 
Many people are concerned about seafood sustainability, but the twice a week recommendation for health (around 200g total) is about the amount of fish the EAT-Lancet Planetary Health Diet recommends (28g/day or 196g/week) to eat sustainably within natural limits. In reality most people eat less than this now, so sustainability concerns need not stop you from the twice a week target, provided you choose wisely.

Josh Niland sees sustainability as a three-pronged approach. “First, you have to be aware of the stock status of the species, Second, you have to be aware of the practices of the fishermen who caught your fish. Was it trawled in large nets or individually line caught? Finally, waste minimisation.” He believes we need to give far more consideration to the elements that traditionally would be considered as waste. Many of the world’s most highly desired and loved dishes have been born from the utilisation of waste. Why should fish be different?

Choosing sustainable seafood is important to ensure an ongoing supply for future generations. How? Look for sustainability logos when shopping for packaged seafood, such as the MSC (Marine Stewardship Council) logo. Check out the sustainability status of fresh fish and seafood in your country via websites or apps, such as the SAFS (Status of Australian Fish Stocks).

Read more:

Nicole Senior   
Nicole Senior is an Accredited Nutritionist, author, consultant, cook, food enthusiast and mother who strives to make sense of nutrition science and delights in making healthy food delicious.   Contact: You can follow her on Twitter, Facebook, Pinterest, Instagram or check out her website.

WHAT’S NEW?

GO LOW GI – THE DIABETES BENEFITS KEEP STACKING UP 
Almost 40 years ago, David Jenkins and colleagues published the first paper to propose that the glycemic index of foods might be an important measure of nutrition quality. “It was introduced back in 1981 to rate the glycemic character of the carbohydrate in individual foods like bread, breakfast cereal, rice, pasta, apples etc,” says Prof Jennie Brand-Miller. “The purpose was to swap one carbohydrate source with another for snacks and in your meals (e.g. replacing a high GI breakfast cereal like corn flakes with a low one like natural muesli).”

High carbohydrate foods
Choosing good carbs that are low or lower GI for your meals or snacks is now a key dietary choice if you have diabetes. Evidence based recommendations about diet and nutrition from the world’s major diabetes organisations advise people with diabetes to use the GI or GL to help them manage blood glucose levels and reduce their risk of complications including diabetic retinopathy and kidney disease.

Check out the latest findings from two important systematic literature reviews and meta-analyses of randomised controlled trials – considered to be the highest level of evidence.

  • For controlling HbA1c and fasting blood glucose: A systematic review and meta-analysis published in Nutrients in 2018 shows low-GI diets are more effective in controlling HbA1c and fasting blood glucose than higher GI diets and the range of other diets that are typically recommended for people with diabetes including conventional carbohydrate exchange, high fibre and standard diabetic diets. 
  • For reducing risk of type 2 diabetes: A systematic review and meta-analysis published in Nutrients in 2019 shows glycemic index and glycemic load are important markers of food quality and do an excellent job of predicting type 2 diabetes risk for the population as a whole. 
International Federation of Gynecology and Obstetrics also recommend a focus on lower GI foods. “Low GI diets are associated with less frequent insulin use and lower birth weight than in control diets, suggesting that it is the most appropriate dietary intervention to be prescribed to patients with GDM,” they say.

THE GOOD CARBS? These whole foods include milk and yoghurt; fruits and berries; starchy vegetables (potatoes, sweet potatoes, sweet corn); legumes (beans, peas, lentils); nuts and seeds; and grains (oats, rice, buckwheat, quinoa etc) and the traditional staple foods we make from them including noodles, pasta and sourdough and grainy breads.

GOING LOW GI Think of it as adding a filter to your regular healthy eating pattern. First, it only applies to the carb-rich fruits, starchy vegetables, legumes and grains you like to eat. Second, it’s flexible and can be tailored to suit a range of dietary patterns from high carb to low; Mediterranean to Asian; paleo to vegetarian/vegan; gluten-free or low FODMAP. Here’s our 2-step approach to going low GI. 
  • Step 1: Swap it: Replace the high GI foods in your diet with low GI ones. You can find out more about how to do this HERE
  • Step 2: Don’t overload on carbs: Choosing low GI is not a free pass to pile your plate. Keep carb-rich portions moderate so the glycemic load is moderate too. What’s moderate? It’s about a quarter of your dinner plate (inner rim) or 2–3 small lower GI potatoes such as Carisma, GiLicious, Nadine or Nicola, ½ cup diced orange-fleshed sweet potato or corn kernels or baked beans and ⅓ cup cooked basmati or other lower GI rice or al dente pasta. 
Note: The GI does not apply to foods that contain very little carbohydrate like green vegetables, or to protein- and fat-rich foods like meat, fish, chicken, eggs, or cheese that contain no carbohydrate.

FIND THE GI OF YOUR FAVOURITE FOODS 
Check out the Good Carbs Food Facts story in each issue. We create a complete nutrition information panel for these whole foods and traditional staples made from them along with their GI value and the GL of a typical serving. Use the search box at the top right-hand column of GI News to search for your favourite foods.

Search the International GI Database on the official website for the glycemic index based in the Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders and Charles Perkins Centre at the University of Sydney: glycemicindex.com.

Read more:

PERSPECTIVES WITH DR ALAN BARCLAY

EATING FOR HEALTHY EYES 
The risk of developing eye disease increases as we age, potentially undermining our quality of life. The most common eye diseases associated with ageing are: 

  • Age-related cataracts, a clouding of the normally clear lens of the eye, are a leading cause of vision impairment and blindness. 
  • Diabetic retinopathy is associated with diabetes and is a major cause of visual impairment and blindness. It develops when persistently high blood glucose levels damage the small blood vessels in the retina. 
  • Dry eye disease/syndrome occurs when the eyes don’t make enough tears to stay lubricated. This can make the eyes feel irritated, and in some cases, can also cause vision problems. 
  • Glaucoma, which may cause poor eyesight and can lead to blindness, occurs when the eye’s optic nerve is damaged due to increased pressure in the eye. 
  • Macular degeneration (also known as age-related macular degeneration or AMD) is a leading cause of blindness and severe vision loss. It refers to a group of degenerative diseases of the retina – in particular the macula, which is responsible for central and fine-detail vision. 
Eye health goes hand-in-hand with general health. But because of the eye’s constant exposure to light and its high rate of metabolism, some nutrients are especially important.

Blue eyes
The eye is particularly susceptible to oxidative damage, and oxidation and inflammation are implicated in the development of all of the common eye diseases associated with ageing. There is some evidence that dietary antioxidants and anti-inflammatories may help decrease the risk of age-related eye disease. This includes vitamin A, beta-carotene, lutein and zeaxanthin, and vitamins C and E; selenium and zinc; omega-3 fatty acids, eicosapentaenoic acid and docosahexaenoic acid; and omega-6 fatty acid, gamma-linolenic acid.

VITAMINS
Vitamin A is essential for maintaining your eyes’ light-sensing cells (photoreceptors). Insufficient vitamin A may lead to night blindness, dry eyes or blindness, depending on the severity of the deficiency. Liver, egg yolks, and full-cream dairy products are all good sources.

Beta-carotene, a red-orange pigment, can be converted into vitamin A in the small intestine. It’s found in relatively large amounts in fruits and vegetables like cantaloupe/rockmelon, apricots (fresh or dried), orange-fleshed sweet potatoes, kale, spinach, and carrots.

Lutein and zeaxanthin are yellow carotenoid antioxidants known as macular pigments that function as a natural sunscreen. They are concentrated in the macula, the central part of the retina, which is a layer of light-sensitive cells on the back wall of the eye. Consuming foods rich in lutein and zeaxanthin can reduce the risk of chronic eye diseases including age-related macular degeneration and cataracts. Kale, spinach, parsley, green peas, lettuce, squash, Brussels sprouts and pistachios are among the best sources. Egg yolks, broccoli, pumpkin, asparagus and sweet corn are also good sources. Carotenoids are better absorbed when eaten with fats or oils, so dress your vegetables and salads.

Vitamin C (ascorbic acid) is an antioxidant found in fruits and vegetables. There is some evidence it lowers the risk of developing cataracts. When taken in combination with other essential nutrients, it can slow the progression of age-related macular degeneration and visual acuity loss. Many fruits and vegetables are rich in vitamin C including berries, broccoli, Brussels sprouts, cabbage, cantaloupe/rockmelon, cauliflower, capsicum/bell peppers, citrus fruits, guavas and tomatoes.

Vitamin E is a group of fat-soluble antioxidants that protect fatty acids from harmful oxidation and thus protect cells in the eyes from unstable molecules called free radicals, which break down healthy tissue. Almonds, peanuts, sunflower seeds, and vegetable oils like safflower oil and wheat-germ oil are some of the best dietary sources of vitamin E.

MINERALS 
Selenium is a powerful antioxidant. When combined with carotenoids and vitamins C and E, it can help reduce the risk of advanced age-related macular degeneration. Foods rich in selenium include seafood (shrimps/prawns, crab, salmon, halibut), poultry and eggs, Brazil nuts, enriched noodles, and brown rice (depending where it is grown). Zinc is a part of many essential enzymes. It plays a vital role in bringing vitamin A from the liver to the retina to produce melanin, a protective pigment in the eyes.

Zinc is highly concentrated in the eye, mostly in the retina and choroid, the vascular tissue layer lying under the retina. It also appears to be involved in the formation of visual pigments in the retina. For this reason, zinc deficiency may lead to night blindness. Good sources include meat, seafood (fish and shellfish), poultry, dairy milk and yoghurt and peanuts.

FATS 
Omega-3 fatty acids (eicosapentaenoic acid or EPA and docosahexaenoic acid or DHA) are important for eye health. DHA is found in high amounts in the retina, where it may help maintain eye function, and help decrease oxidative stress and inflammation. It’s also important for brain and eye development during infancy. DHA deficiency may impair vision, especially in children. The best dietary sources are oily seafood like salmon, trout, herring, sardines, crab and shrimps/prawns.

Gamma-linolenic acid (GLA) is an omega-6 fatty acid that appears to have anti-inflammatory properties. Sources include evening primrose oil and hemp seed oil.

CARBOHYDRATES
Carbohydrates (sugars and starches) have the greatest impact on our blood glucose levels. Consuming too much carbohydrate overall or too many high GI carbohydrates can lead to persistently high blood glucose levels and increase your risk of developing diabetic retinopathy, macular oedema, cataracts and glaucoma.

Talk to an Accredited/Registered dietitian to find out how much carbohydrate is right for you, and enjoy the low or lower GI varieties including quality wholegrains (e.g., grainy bread, al dente wholewheat pasta), legumes (beans, lentils and chickpeas), fruit and veggies (apples, pears, corn, peas, sweet potato, butternut pumpkin), dairy milk and yoghurt.

PUTTING IT ALL ON YOUR PLATE:
To help maintain optimal eye health, eat more fruits and vegetables, enjoy moderate amounts of quality meat, seafood and/or poultry and make most of low or lower GI carbohydrates.

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.

DIABETES CARE

DIABETIC EYE DISEASES
Ophthalmologist Dr Shanel Sharma explains why it’s vital to be vigilant if you have diabetes and why the eye is vulnerable to damage from the complications of diabetes.

Diabetes is the most common cause of blindness for people between 20 and 65 and diabetic eye diseases can affect anyone with diabetes whether type 1 or type 2. Chronically high blood glucose levels over time damage blood vessels throughout the body. Our small blood vessels are the most vulnerable and are affected first. These include the small blood vessels supplying our eyes, kidneys and our peripheral limbs (toes). People with chronically elevated blood glucose levels have substantially more, and more severe, retinopathy than those with lower blood glucose levels.

What happens in the eye is that the blood vessels become damaged and develop micro-aneurysms, start to bleed causing haemorrhages and stop carrying blood, resulting in retinal ischaemia. Ischaemic retina causes the release of a protein (VEGF – vascular endothelial growth factor), resulting in the development of sick and abnormal blood vessels, which can bleed or cause tractional retinal detachment and loss of vision. The other major way people lose sight is from diabetic macular oedema, from leaking of blood product into the macular. The macular is the part of the eye that allows one to read, look at people’s faces, or do any fine detailed work.

The eye
As there is usually a 10–15-year delay in chronically high BGLs and appearance of diabetic eye diseases, it is important to control BGLs well from the start. Although the damage to the eye is irreversible, early detection and treatment can reduce the risk of blindness by up to approximately 95%.

If you are diagnosed with diabetic retinopathy, don’t despair. Good blood glucose control can reduce its progression. People with diabetes who follow healthy eating principles can reduce their HbA1c levels by 1 to 2 percentage points. On a low GI diet, they can reduce can HbA1c levels by another 0.5 percentage points. While this may not sound significant, a decrease of just 1 percentage point in HbA1c levels will decrease the common complications of diabetes by 19% to 43%. Talk to your doctor or diabetes educator.

Reducing blood pressure helps too. The UK Prospective Diabetes Study showed a reduction of 10mmHg systolic and 5mmHg diastolic reduces the rate of retinopathy by 30%.

As diabetic eye diseases most commonly have no symptoms, it is essential to ensure that you are being screened regularly by your GP, optometrist or your ophthalmologist. Symptoms that are associated with diabetic eye diseases can include intermittent blurred vision, difficulty with focusing, loss of contrast, double vision or distortion to your vision. Additionally, diabetes is an independent risk factor for developing other eye diseases such as cataracts and glaucoma.

Protecting your eyesight is one of the most important things you can do to ensure quality and enjoyment of life.

Read more:

YOUR GI SHOPPING GUIDE

MILK 
We aren’t buying into the milk/fake milk debate. We know people have a whole range of reasons (health, cultural, religious, environmental, ethical) for choosing plant milks rather than dairy. We do recommend you check the ingredient list for plant milks and choose one with added calcium and B12.

Milk
For people with diabetes – Many people count grams of carbohydrate or use 15g Carbohydrate Exchange or 10g Portions to help match their insulin or blood glucose lowering medication to their requirements. We have included both. A 15g Exchange includes food with 12–18g carbohydrate and a 10g Portion 7.6–12.5g of carbohydrate.

Dairy 
Cow’s milk, full fat (4%) 
GI 30 (27–34)
Serving: 1 cup (250ml/9 fl oz)

Table 1

Cow’s milk, reduced fat (1–2%)
GI 29 (20–30)
Serving: 1 cup (250ml/9 fl oz) 

Table 2
Cow’s milk, low/no fat, skim (less than 1%) 
GI 29 (20–30)
Serving: 1 cup (250ml/9 fl oz)

Table 3
Plant milks 
Almond milk, unsweetened 
GI 25
Serving: 1 cup (250ml/9 fl oz)

Table 4
Oat milk 
GI 69
Serving: 1 cup (250ml/9 fl oz)

Table 5
Rice milk, regular 
GI 79
Serving: 1 cup (250ml/9 fl oz)

Table 6
Rice milk, low fat 
GI 92
Serving: 1 cup (250ml/9 fl oz)

Table 7
Soy milk, regular, added calcium,
GI 30 (24–37)
Serving: 1 cup (250ml/9 fl oz)

Table 8
Soy milk, reduced/low fat, added calcium,
GI 36 (34–38)
Serving: 1 cup (250ml/9 fl oz)

Table 9

Read more:

GOOD CARBS FOOD FACTS

BROCCOLI
Broccoli is part of the brassica family of vegetables (also known as cruciferous vegetables) that includes cabbage and Brussels sprouts. It has been around since Roman times and still popular in Italy; the name comes from the Italian word broccoli meaning the flowering crest of a cabbage. We eat the large flowering head of the plant. Broccolini is a newer incarnation with long slender stems and smaller heads, and also known as sprouting broccoli – they are nutritionally the same. They all contain cancer-fighting phytochemicals including sulforaphane. Broccoli is also a good source of the B vitamin folate for a healthy heart, vitamin C for immunity and fibre for digestive health.

BROCCOLI
To retain its nutritional goodness and “fight-o-chemical” power, cook broccoli as lightly as possible – do not boil. As with all vegetables, broccoli can be lightly steamed or microwaved and dressed with a little extra virgin olive oil and perhaps lemon juice, pepper, chilli, or herbs of your choice. For an Asian direction, try soy, honey and sesame seeds. Take care not to overcook and leave some crispness and the rich green colour. To ensure the stems cook through before the florets go mushy, cut a cross into the base of the stem with a small sharp knife to quicken cooking. For added delight, sprinkle over slivered almonds (or any nut really) that have been gently toasted.

BROCCOLI Table
Source: AusFoods, 2019

THE GOOD CARBS KITCHEN

BAKED WHOLE SNAPPER WITH MOROCCAN SPICE PASTE 
0:15 Prep (+ 30 marinating) • 0:25 Cook • 4 Servings • Main Meal • Easy Entertaining

BAKED WHOLE SNAPPER WITH MOROCCAN SPICE PASTE
INGREDIENTS 
½ cup firmly packed coriander (cilantro) leaves + extra to garnish
½ cup firmly packed mint leaves + extra to garnish
1 long red chilli seeded and finely chopped
1 garlic clove crushed
1 teaspoon finely grated ginger
1 teaspoon ground cumin
1 tablespoon lemon juice
2 teaspoons olive oil
1 whole snapper (1kg/2lb 4oz), scaled and gutted
1 lemon thinly sliced

METHOD 
Finely chop the herbs, chilli, garlic, ginger and cumin in a food processor. Add the lemon juice, olive oil and 1–2 tablespoons of water or enough to make a smooth paste. Process until smooth.

Cut three deep diagonal slashes through the skin and down to the bone on each side of the snapper. Place in a large non-metallic dish and fill the cavity with the lemon slices. Spread the spice paste over the fish and turn to coat well. Cover and refrigerate for 30 minutes.

Preheat the oven to 220°C (425°F).

Place the fish on a large paper-lined baked tray and bake for 20–25 minutes until the thickest part flakes easily with a fork. Serve garnished with extra coriander and mint leaves.

Tip: You can replace the snapper with 2 x 500g baby snappers. The cooking time will decrease to 15-20 minutes.

NUTRITION 
Per serve 1185 kJ/285 calories; 52g protein; 7g fat (includes 1.5g saturated fat; saturated : unsaturated fat ratio 0.3); 2g available carbs (includes 1g sugars and 1g starch); 2.2g fibre; 219mg sodium; 1258mg potassium; sodium : potassium ratio 0.2

RECIPE 
Chrissy Freer, Book (The Anti-inflammatory Cookbook, Murdoch Books)

The Anti-inflammatory Cookbook

SALT-BAKED SNAPPER
0:20 Prep • 0:40 Cook • 4 Servings • Entertaining

INGREDIENTS 
2 whole snapper, about 350g (12oz) each
1 lemon, sliced
1 bunch fresh coriander (cilantro), roots, stems and leaves, roughly chopped
1.5kg coarse sea salt
2 egg whites, beaten
2 stalks lemongrass, roughly chopped

METHOD 
Preheat oven to 200°C (400°F).

Clean the snapper and put lemon slices and 1 tablespoon of the chopped coriander in the cavity and season.

Combine the salt, egg whites, lemongrass and remaining chopped coriander in a large bowl.

Spread a layer of the salt mixture in a baking dish and top with snapper. Then completely cover fish with remaining salt mixture. You don’t want to be able to see any fish at all.

Bake in hot oven for 40 minutes. The salt mixture will turn to a hard crust that you can crack with the back of a knife – this is fun to do at the table for guests. Then take out the steaming whole fish, brushing off any excess salt.

NUTRITION
Per serve 785kJ/190 calories; 38g protein; 3g fat (includes 1g saturated fat; saturated : unsaturated fat ratio 0.5); 1g available carbs (includes 0.8g sugars and 0.2g starch); 1g fibre; 3027mg sodium; 887mg potassium; sodium : potassium ratio 3.4

RECIPE 
Ian Hemphill with recipes by Kate Hemphill, Spice Notes and Recipes.

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Nutritional analysis To analyse Australian foods, beverages, processed products and recipes, we use FoodWorks which contains the AusNut and Nuttab databases. If necessary, this is supplemented with data from www.calorieking.com.au or http://ndb.nal.usda.gov/ndb/search.

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