1 July 2020

GI News - July 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.

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

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

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A new study finds that machine learning can predict differences between people in how they respond to meals If you are managing to stay lean in today’s obesogenic environment (lucky you!), you might suspect that it’s your good genes and/or disciplined adherence to a healthy diet and lifestyle. On the other hand, if you’ve struggled with body fat and dieting for most of your life, you live in hope there’s a specific type of diet (or perhaps better still, a drug) that’s perfect for you… if only you could identify which one. Enter Personalised Nutrition.

Healthy range of foods

In the June issue of the prestigious journal Nature Medicine, Sarah Berry and her colleagues took a major step in that direction. They presented the findings of PREDICT (1), a large-scale study involving ~1000 people, including twins and other adults from the US and UK. Using machine learning, the goal was to use the data to derive ‘algorithms’ (mathematical formulas) that predict a person’s postprandial (after-meal) responses, that is, the rise in glucose, insulin and triglycerides (fats) in the blood after meals of varying composition.

The end-game of this kind of research is the ability to give scientifically valid ‘personalised’ dietary advice based on factors such as age, body mass index (BMI), specific genes, large bowel microbial flora (the “micobiome”) and postprandial responses.

But the findings were not what they expected. They found much more person-to-person variation than was expected, but differences in genes, the gut microbiome and insulin levels explained only a minor proportion of the differences.

By contrast, they were surprised to find a person’s response to the same foods was fairly predictable and reproducible. Food composition and macronutrient (carbohydrate, fat and protein) distribution explained some of the variation in post-meal blood glucose levels, but not in triglyceride levels. And interestingly, blood glucose responses did not predict triglyceride levels; indeed, they warned that advice based just on glucose responses (such as flash glucose monitoring) alone would be misleading.

From our point of view, the associations between the carbohydrate content of meals, post-meal blood glucose levels and other factors were among the most interesting findings. High blood glucose levels after meals are a well-established predictor of type 2 diabetes, the metabolic syndrome, fatty liver, and cardiovascular disease (2).

We have known for a long time that people vary widely in their ‘glucose tolerance’, i.e. the absolute blood glucose response to a carbohydrate challenge. In a lean, active person, the area under the curve (AUC) after a 50 g glucose challenge can be as low as 50 units, but in a sedentary person with a family history of type 2 diabetes, it can be 400 units, an 8-fold difference. Higher AUC means the beta-cells (insulin producing) in the pancreas are working hard. If you have a family history, your pancreas may not have what it takes to do this without becoming dysfunctional over time.

We know that glucose tolerance worsens (measured as higher AUC) with age, increased body weight and sedentary lifestyle. We also know that the background diet is important – low carbohydrate consumption is associated with a higher glycemic response to a glucose challenge. However, it’s reversible - just a day or so of higher carbohydrate intake will improve glucose tolerance.

Is there an optimal diet composition for your body? Is one diet better than another for you but not me? Does human evolution play a role here? Yes! Many different diets can reduce blood glucose responses on a day-to-day basis. Indeed, we have argued that this is one of key mechanisms behind the success of the Mediterranean diet, low GI diets, vegetarian diets based on legumes and lower carbohydrate diets.

Logically, reductions in blood glucose can also be achieved with carefully planned, very-low-carbohydrate diets (50-100 g/day), with parallel improvements in body weight and HbA1c (glycated haemoglobin) in people with type 2 diabetes (3). However, it would be very easy to choose a poor quality very-low-carbohydrate diet and it may be hard to sustain in the longer-term. It may not be as effective (or as easy) as changing the kind (quality) of carbohydrate.

For a given amount of carbohydrate, the glycemic index of a food predicts the degree of glycaemia relative to a standard reference food. Choosing a diet based on low GI foods such as pasta, legumes, most fruit, milk, yogurt and specific types of rice and bread can halve the AUC and reduce HbA1c in individuals with diabetes. Furthermore, meta-analyses of observational studies confirm that diets based on low GI food choices are associated with reduced risk of type 2 diabetes (4) and cardiovascular disease (5). The relative risk reduction is biologically significant, similar to increasing the amount of exercise or dietary fibre.

In our view, the potential of personalised nutritional guidance versus standard advice (national dietary guidelines) to improve weight control is far from proven. In many ways, the findings of PREDICT are important because they challenge so much of the prevailing hype.


  1. Berry S, and colleagues. Decoding human postprandial responses to food and their potential for precision nutrition: the PREDICT 1 study
  2. The DECODE group. European Diabetes Epidemiology Group. Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria
  3. Wycherley TP, and colleagues. Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials
  4. Livesey G, and colleagues. Dietary Glycemic Index and Load and the Risk of Type 2 Diabetes: A Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies
  5. Livesey G, and colleagues. Coronary Heart Disease and Dietary Carbohydrate, Glycemic Index, and Glycemic Load: Dose-Response Meta-analyses of Prospective Cohort Studies

Professor Jennie Brand-Miller       
Professor Jennie Brand-Miller holds a Personal Chair in Human Nutrition in the Charles Perkins Centre and the School of Life and Environmental Sciences, at the University of Sydney. She is recognised around the world for her work on carbohydrates and the glycemic index (or GI) of foods, with over 300 scientific publications. Her books about the glycemic index have been bestsellers and made the GI a household word.   



If you’re trying to lose weight, there’s no shortage of ‘diets’ and weight loss programs promising impressive results. But is there really one type of diet that is more effective than others?

Person on scales

A new study published in the April edition of the British Medical Journal (BMJ) set out to answer this question. The researchers conducted a systematic review and meta-analysis looking at the effect of different dietary macronutrient patterns and popular diet programs on weight loss and improvement of cardiovascular risk factors in overweight adults. They included 121 randomised controlled trials involving almost 22 000 subjects. The diets included low fat, low carbohydrate and popular named diets such as Atkins, Zone, DASH (Dietary Approaches for Stopping Hypertension) and Ornish.

When they compared these diets to usual or control diets, low fat (such as Ornish), low carbohydrate (such as Atkins and Zone) and moderate macronutrient diets (such as DASH and Mediterranean) all resulted in moderate weight loss at 6 months but not 12 months. The average weight loss at 12 months was 2kgs and any differences between the diets are described as being trivial to small.

At six months, each of these diets also reduced blood pressure and the low fat and moderate macronutrient diets reduced levels of ‘bad’ LDL cholesterol. However, these improvements almost disappeared by 12 months.

The authors conclude that people wanting to make dietary changes to lose weight should choose the diet they prefer. This is an important point. For example, an older study comparing four different diets with different macronutrient ratios (Atkins, Ornish, Zone and Weight Watchers) found that weight loss was similar on all four diets and what predicted success was cutting kilojoules and being able to stick to the diet.

This new study, and previous research comparing different diets for weight loss, show us that there are different ways to achieve the same result – it’s not one size fits all. The key is to find an eating plan you can adopt for the long-term as this is the only way to lose weight and keep it off.

Read more:

Kate Marsh     
Kate Marsh is an is an Advanced Accredited Practising Dietitian, Credentialled Diabetes Educator and health and medical writer with a particular interest in plant-based eating and the dietary management of diabetes and polycystic ovary syndrome (PCOS).    
Contact: Via her website www.drkatemarsh.com.au.



Diet-related health conditions like obesity, type 2 diabetes, heart disease and certain cancers (e.g., bowel) are increasing all around the globe and governments are struggling to cope with their economic costs as are individuals with their social, psychological and financial costs.

Strategies for reducing their burden range from public health nutrition at one end of the intervention spectrum, using a systems approach to sustainably re-shape the food and nutrition supply, and at the other, there is personalized dietary advice ideally provided by suitably qualified health professionals like dietitians and nutritionists. While the two are not mutually exclusive, they often do play complimentary roles.

Public Health Nutrition 

The epitome of public health nutrition is the federal government’s Dietary Guidelines that provide advisory statements for the general population (i.e., healthy children, adolescents and adults). They are very similar around the globe. Australia’s most recent version published in 2013 advises people to:

  1. Be physically active and choose amounts of nutritious food and drinks to meet energy needs. 
  2. Drink plenty of water and enjoy a wide variety of nutritious foods from the five food groups every day:
    - plenty of vegetables, including different types and colours, and legumes/beans
    - fruit
    - grain (cereal) foods, mostly wholegrain and/or high fibre varieties, such as breads, cereals, rice, pasta, noodles, polenta, couscous, oats, quinoa and barley
    - lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans
    - milk, yoghurt, cheese and/or their alternatives, mostly reduced fat (reduced fat milks are not suitable for children under the age of 2 years). 
  3. Limit intake of foods containing saturated fat, added salt, added sugars and alcohol. 
  4. Encourage, support and promote breastfeeding. 
  5. Care for your food; prepare and store it safely. 

The Guidelines stated aims are to:
  • promote health and wellbeing; 
  • reduce the risk of diet-related conditions, such as high cholesterol, high blood pressure and obesity; and 
  • reduce the risk of chronic diseases such as type 2 diabetes, cardiovascular disease and some types of cancers. 
They are primarily used by health professionals, policy makers, educators, food manufacturers, food retailers and researchers, so they can find ways to help people eat healthy diets.

In theory, Dietary Guidelines apply to all healthy people, as well as those with common health conditions such as being overweight. However, they do not apply to people who need special dietary advice for a medical condition like diabetes or heart disease, or to the frail elderly.

In some countries like the USA, they are updated every 5 years and as such they are based on the most recent and best available scientific evidence. Unfortunately, in others, like Australia, they are not updated on a regular basis and may be scientifically outdated.
A healthy diet
Personalised dietary advice 

Ideally, people with specific diet-related health conditions like obesity, type 2 diabetes, heart disease, cancer, etc… will see a registered/accredited dietitian or nutritionist for personalised dietary advice.

A dietitian/nutritionist assesses your:
  • vital statistics (height, weight, waist circumference, etc…), 
  • biochemistry (blood glucose, insulin, blood proteins, iron status, etc..) and 
  • eating and drinking habits (diet recall, food frequency, etc…), 
to form an overall picture of your nutritional status.

Based on this, they will then work out what area of your diet needs improvement, if any, and what changes can be made based on your own:
  • personal goals (weight loss, weight gain, blood glucose, pressure, cholesterol, etc…), 
  • food preferences, 
  • family situation, 
  • cultural background, and 
  • finances. 
Depending on your needs, a structured menu plan may be provided, tailor-made to your own unique requirements.

Shopping lists, information sheets and other written materials (e.g., booklets) may also be provided, depending on your own personal needs.

Follow-up appointments cover how well you are feeling and how you are managing with your dietary changes, assessment of your vital statistics and biochemistry, and general progress towards your goals, trouble‑shooting and further refinement of your personalised eating plan.

It is easy to see that public health nutrition epitomised by Dietary Guidelines is by necessity very different from personalised nutrition advise provided by a qualified health professional. Unfortunately, sometimes debates about what constitutes a healthy diet get heated and the two are conflated, with some fad diet advocates erroneously believing that dietitians/nutritionists simply advise everyone regardless of their personal circumstances to follow the latest version of the Dietary Guidelines. The reality is that both public health nutrition and personalised dietary advice can help people purchase healthy, affordable foods to ensure they enjoy a sustainable diet that will help them achieve optimal health, whatever their circumstances.

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, LinkedIn or check out his website.



Efforts to identify a single optimal diet for the treatment of overweight and obesity have so far failed.


Overall, the body of scientific evidence from randomised controlled trials (RCTs) indicate that in order to lose weight, individuals need to consume less energy (kilojoules/calories) than they are expending through their physical activities and basal metabolic rate. Dietary energy can come from a range of different diets with varying macronutrient contents. The macronutrients are carbohydrate, fat, protein and arguably alcohol (although not officially a macronutrient, for some people it is a significant source of energy). One size does not fit all, and the best diet for most people is the one that they can stick to (the one that suits their cultural, religious, familial and personal food preferences, and budget) in the long run.

Due to the high cost of conducting RCTs, most are short-term (conducted over a period of 3-6 months) and few are long-term studies (at least 2 years). Short-term studies often do suggest that one dietary pattern is superior to another, but these results rarely hold true after 12 months in the rare instances that they last that long, and differences usually completely disappear by 2 years as people develop diet fatigue and are no longer able to maintain the disruptions to their family, religious and social lives.

Because they are rare, when a well-designed long-term RCT is conducted, we should pay attention to the results. Back in 2010, a group of American scientists randomised around 300 people to one of two diets and followed them up for 2 years: 

  • One of the diets was low-carbohydrate, which consisted of limited carbohydrate intake (20 g per day for 3 months) in the form of low–glycemic index vegetables with unrestricted consumption of fat and protein. After 3 months, people in the low-carbohydrate diet group increased their carbohydrate intake (5 g per day per week) until a stable and desired weight was achieved. 
  • The other was a reduced energy (1200 to 1800 calories (5000 to 7500 kJ) per day) low-fat diet that provided no more than 30% of calories from fat. 
Weight loss was significant at 1 year (a decrease of approximately 11 kg) and 2 years (7 kg), however, there were no differences in weight, body composition, or bone mineral density between the two different diet groups at any time point.

However, a group of Danish scientists worked with the original American scientists last year, re-analysing the study data according to whether the people in the study had prediabetes (blood glucose between 5.6-6.9 mmol/L) or high fasting blood insulin. After 2 years, participants with prediabetes and high fasting insulin lost 7.2 kg more with the low-fat compared to the low-carbohydrate diet, whereas those with prediabetes and low fasting insulin tended to lose 6.2 kg more on the low-carbohydrate diet than low-fat diet.

This new analysis of a well-designed long-term randomised controlled trial helps explain why there is not one single optimal diet for the treatment of overweight and obesity. Tailor-making dietary advice to suit the specific needs of individuals is the direction we need to be heading in.

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, LinkedIn or check out his website.



Spending more time at home means easier access to food, especially unplanned extras, like snacks. Ideally snacks are chosen from core foods - things like a piece of fruit, a handful of nuts, a hard-boiled egg or a slice of wholegrain bread - and make a valuable nutrient contribution to our diet. More popular options like crispy, crunchy crisps and cookies don’t give us much except starchy carbohydrate that add to the glycemic load of the diet. Here we’ve taken a look at how the GI and GL of starchy snack foods compares.

Starchy snack


Popcorn (commercial microwave popcorn) 
GI 51-67
Serving: 1 small bag (25g/1oz)
Starchy snack

Potato chips/crisps 
GI 51-60
Serving: 1 single serve bag (50g/1 ¾oz)
Starchy snack

Flavoured extruded crispy packaged snack 
GI 74-90
Serving: 1 single serve bag (50g/1 ¾oz)
Starchy snack

Wholegrain rye crackers 
GI 59-74
Serving: 2 large crackers (20g/ ¾oz)
Starchy snack

Plain crackers - white flour based, e.g., Soda cracker or Sao
GI 63-78
Serving: 3 large, or 6 small crackers (20g/ ¾oz)
Starchy snack

Puffed Rice cake 
GI 82-91
Serving: 3 thick or 5 thin rice cakes (30g/1oz)
Starchy snack

Oatmeal biscuit or cookie 
GI 45-55
Serving: 2 cookies (20g/3/4 oz)
Starchy snack

Read more:

 Kaye Foster-Powell     
Kaye Foster-Powell is an Accredited Practising Dietitian who has worked with people with diabetes for 30 years. She was co-author of the original series of international, best-selling books on the glycemic index. She conducts a specialized private practice for people with diabetes in the Blue Mountains, west of Sydney, Australia.    
Contact: Via her website.


I know its winter because the citrus trees in my neighbourhood are laden with fruit. The citrus fruit family has something for everyone, whether it be the sweet and juicy orange, the cute and easy to peel mandarin, the gorgeously fragrant lime, the cook’s favourite lemon or bittersweet grapefruit. Then there are the more exotic citrus fruits such as the gigantic pomello (aptly named citrus maxima), the oh-so-hip Japanese yuzu or the gorgeous pot plant and preserve favourite, cumquat. There really is a citrus fruit for everybody but the whole citrus family shares the qualities of intensely exhilarating refreshment and beautifully bright colours.
Citrus is famous for its fresh zing, both in your mouth and in the air around you when you peel them. For cooks, their sour astringency makes them ideal to partner with creamy or fatty foods as they ‘slice through’ the richness for an altogether more satisfying taste sensation. This is used to great effect in Asian savoury dishes, in the famous French dish duck a l’orange and my grandma’s specialty lemon butter (or lemon curd). Citrus zest packs amazing flavour. Use a microplane or zester and add zest to baking, sauces and anything with a citrus ingredient to turn up the citrus flavour volume to the max. The sourer the citrus, the better they balance with sweetness, so lemon and lime cakes taste divine and lemon curd is sunshine and happiness on a spoon.

Citrus are also perfect for juicing but limit to small amounts and eat mostly whole fruit to preserve all their nutritional goodness and fibre. If you only drink citrus you juice yourself this puts a natural brake on your intake. And once you’ve experienced the joy of freshly squeezed, it’s hard to go back.

Citrus fruits are a powerhouse of nutrition. They are perhaps best known for their vitamin C content, however this is only part of their good news story. They are packed with natural phytochemicals with a laundry list of health benefits including antioxidant, anti-inflammatory and anti-cancer properties. All this and they are also low GI.

Source: AusFoods, 2019

Nicole Senior     
Nicole Senior is an Accredited Practising Dietitian, author, consultant, cook and food enthusiast 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.


0:20 Prep • 4 Serves • Main • Every day


1 tablespoon olive oil
1 leek, chopped
2 x 400g packets fresh pre-chopped soup vegetables
5 cups reduced-salt chicken stock
2 cups shredded or chopped BBQ chicken
4 small slices rye bread, toasted, to serve

¼ cup chopped flat-leaf parsley
2 tablespoons lemon thyme leaves
1 garlic clove, crushed
3 tablespoons fresh grated Parmesan

Place the olive oil in a large, heavy-based pan on medium-high heat. Add the chopped leek; sauté for 2–3 minutes, or until just softening. Add vegetables; cook, stirring for 1–2 minutes.

Add stock to pan and bring the mixture to the boil. Cover, reduce the heat and simmer for10 minutes. Add chicken, stir to heat through. Add an additional ½–1 cup of water, if the soup needs more liquid. Season with cracked black pepper.

Meanwhile, make gremolata: Combine all the ingredients in a small bowl. Season and mix well.

Divide soup between serving bowls. Top with gremolata and serve with rye toast.

Per serve 1691kJ/405 calories; 34g protein; 14.6g fat (includes 4.8g saturated fat; saturated : unsaturated fat ratio 0.5); 28g available carbs (includes 9g sugars and 19g starch); 11.5g fibre; 414mg sodium

Courtesy of Australian Healthy Food Guide magazine.

Australian Healthy Food Guide

For more healthy recipe inspiration and expert advice, visit healthyfoodguide.com.au

0:15 Prep • 0:08 Cook • 4 Servings • Entrée • Vegetarian


½ cup dried wood ear mushrooms
1 cup celery
1 cup enoki mushroom
4 cups water
1 tablespoon soy sauce (salt-reduced or dark soy sauce is preferred)
2 tablespoons Chinese black vinegar
1 teaspoon sesame oil
1 teaspoon ginger
2 teaspoons white sesame seeds (optional)
Oil for cooking (2-3 tablespoons)

Gently rinse the wood ear mushrooms with tap water. Soak with 2 cups of warm water in a big bowl. Rehydrate for 30 minutes or until tender. Prepare the celery by chopping it into small pieces. Remove tough ends of wood ear mushrooms, then chop into bite-sized pieces. Grate the ginger.

Add the water to a pot, and then add the wood ear mushrooms and enoki mushrooms to it. Brining the water to a simmer. Transfer the mushrooms to the dish, and combine with the celery, soy sauce, Chinese black vinegar, ginger, and sesame oil.

Top with white sesame seeds (optional) and serve.

TIPS • For a nut-free and gluten-free dish, use gluten-free soy sauce.

DO YOU KNOW? Dark soy sauce is less salty than the regular soy sauce. Dark soy sauce is darker, thicker and sweeter due to added molasses. It is often used for seasoning and dipping. You can use dark soy sauce to replace regular soy sauce in stir-fries, stews and casseroles.

Per serve Energy: 152kJ/36 Calories; 1.8g protein; 2.1g fat (includes 0.3g saturated fat; saturated : unsaturated fat ratio 0.2); 1g available carbs (includes 0.5g sugars and 0.5g starches); 1.2g fibre; 227mg sodium; 252mg potassium; sodium : potassium ratio 0.9.


Shannon Shanshan Lin
Shannon Shanshan Lin is an is an Accredited Practising Dietitian and Credentialled Diabetes Educator with a particular research interest in culturally and linguistically and indigenous populations. She has been actively involved in the various committees both national and internationally, including the Australian Diabetes Educators Association, Global Chinese Diabetes Association and Beijing Key Laboratory of Nutrition Intervention for Chronic Disease. Contact: You can follow her on.


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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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