News Briefs

Healthy curves
Studies are showing that when it comes to blood glucose, it’s the roller-coaster ride (the sharp glucose spike and the degree of blood glucose fluctuation) after eating that’s the problem as it can damage the body, contributing to the development of chronic diseases, particularly atherosclerosis.

The American Diabetes Association still emphasises the amount of carbohydrate to optimise glucose control and slow the development of complications. However, the key finding of this latest study backs up the growing body of evidence suggesting that if a reduction in postprandial glycemia (high glucose after eating) is to be part of the strategy for preventing and managing diabetes and cardiovascular disease, the GI (or carb quality) is just as relevant as carb quantity.


Prof Jennie Brand-Miller

Prof Jennie Brand-Miller’s GI team at Sydney University’s Human Nutrition Unit drew on their database of 1126 foods tested since 1995 to explore the association between a food’s GI and the shape of the curve in healthy young people (average age 24, BMI 22). The study is a first in a couple of ways – to attempt to systematically characterise the relation between a food’s GI and other attributes of post-meal blood glucose and to explore differences in the shape of the curve within and between food categories.

‘From the standpoint of defining what’s “normal” postprandial glycemia, our study is unique,’ says Prof Jennie Brand-Miller. ‘Our results suggest that the “normal” response depends on the choice of carbohydrate food. Our study’s key take-home messages are that:

• The GI reliably predicts the glycemic response, and the overall shape of the post-meal glycemia curve is similar for high, medium and low GI foods. Since they say that a picture is worth 100 words, check out the curves (incremental blood glucose profiles if you want to be technical) for high medium and low GI white breads, breakfast cereals, potatoes and pasta, soft drinks, wholegrain breads, rices, cereal and protein bars, fruit and juice.
• To control high blood glucose after meals, carb quality (or its GI) and carb quantity both count. So the general message is say “less” and say “low GI” with carb-rich foods.
• The simple “eat more wholegrains” health message needs fine tuning. Just telling people to “eat wholegrains” can encourage them to eat carbs with a high GI on par with white bread (GI 70). So it’s not an ideal message for helping people manage blood glucose spikes. It’s the low GI wholegrains with their gentler curves they need.’
  

Click for full-size image

Shedding pounds without pangs
Eating ‘feel full’ foods that satisfy appetite faster and keep you feeling fuller for longer, puts you on the path to shedding pounds effortlessly without pangs. Research shows that when we consume foods (not beverages) that our bodies really notice we are eating, our gut and intestines (see below) send the brain the vital ‘I’m full’ signals. There’s quite a range of ‘feel full’ foods to choose from including:

• Foods that we have to chew a lot like lean meat, pearl barley, muesli, very grainy breads, apples and carrots.
• Protein-rich foods (lean meat, fish, chickpeas, nuts) that encourage our stomach and small intestine to produce hormones that send ‘I’m full’ signals to the brain. There’s added value with these too – they make you hotter after eating, which uses up more energy.
• Slow digesting low GI carbs can also increase the production of some ‘I’m full’ hormones and help keep our blood glucose steady after eating. In a recent study from the University of Sydney’s Human Nutrition Unit in the European Journal of Clinical Nutrition, lead researcher Rebecca Reynolds reports that ‘eating lower GI meals throughout the day produced significantly lower glucose and insulin concentrations along with higher concentrations of the satiety (fullness) hormone, cholecystokinin (CCK), compared with high GI meals’.
• Foods that have lots of fibre and water (high volume foods) deliver the ‘I’m full’ feeling. This is because volume, especially ‘sticky’ volume, like porridge means that food really touches the gut walls and leaves the brain in no doubt that it’s there. They also stick around the gut longer clinging to the walls.
  

So, make the most of ‘feel full’ fruit, vegetables, eggs, lean meat and chicken, fish, muesli/porridge made with traditional chewy (not instant) oats, dense grainy bread (look for the GI Symbol in Australia and NZ), pasta (especially whole wheat or wholemeal), basmati rice and other lower GI rices such as Doongara Clever rice and Moolgiri medium-grain rice, (especially brown basmati, but not quick cooking versions) and low fat dairy foods like milk and yoghurt. What about potatoes? If you are a fan, cut back on quantity and choose smaller tubers of lower GI varieties such as Nicola or Almera – not overcooked, or cooked and cooled e.g. in a potato salad. Or replace them with other feel full starchy foods like pearl barley or bulghur for a change.



Feel full foods are perfect for slim budgets too. You’ll find you can eat better for less when you cut back on modern refined foods. The body just doesn’t seem to pick up so well on the presence of these foods that are high in fat (the least filling macronutrient) and quick digesting carbs, which makes it hard to know when to stop eating. When these processed foods are around en masse encouraging us to eat more at each meal and eat more often, it’s hard for the body to regulate its weight.

GI Group: ‘How we make decisions to start and stop eating is a complex process. Your gut and brain “communicate” to determine when you are full, with your brain sending out the all important Stop Eating signal with the help of information it receives from hormones produced by your gut,’ says researcher Rebecca Reynolds. ‘Appetite is orchestrated by a part of your brain called the hypothalamus. It receives signals from the gut via the blood and spinal cord. Within about 15–30 minutes after you start eating, satiety (fullness) signals are transmitted from your small intestines. These act as a sedative on the gastrointestinal tract, slowing down the passage of food and creating a sense of fullness. However (there’s always one of those), keep in mind that psychological factors such as boredom, unhappiness, temptation etc. also influence your food intake and can overpower signals from the hypothalamus.’

Low GI diets better than high cereal-fibre diets for managing diabetes
A healthy, low GI diet achieved a greater improvement in blood glucose and cholesterol levels than a healthy, high cereal-fibre diet in people with type 2 diabetes report Canadian researchers in the prestigious Journal of the American Medical Association. Simply eating more dietary fibre is not enough to improve diabetes management is one of the study’s key findings.

Two hundred and ten overweight Canadian volunteers with type 2 diabetes (average age 60 years) who were being treated with anti-hyperglycemic medications were randomly allocated to go on to either a low GI diet (average GI 44) or a high cereal-fiber diet (average GI 61) for 6 months. The moderate carbohydrate (200 grams a day), moderate fat (60 grams a day), moderate protein (40 grams a day) diets were matched for kilojoule (calorie) intake and changes in blood glucose and other measures of diabetes management were recorded at regular intervals. (The low GI diet emphasised foods like pumpernickel bread, bulgur-and-flax breakfast cereal, and peas, lentils, and nuts; the high-cereal-fibre diet emphasized whole-grain breads and breakfast cereals, brown rice, and avoidance of starchy foods.)

At the end of the study, those on the low GI diet showed greater improvements in average blood glucose levels and good cholesterol (HDL). Glycated haemoglobin or HbA1c decreased by 0.5% points on the low GI diet compared with only 0.2% points on the high cereal-fibre, higher GI diet. HDL levels rose on the low GI diet but fell on the standard high cereal-fibre diet. ‘Improvements like these in blood glucose control would reduce the risk of common complications of type 2 diabetes like eye and kidney disease by up to 12%, and the risk of heart disease by up to 20%,’ says Dr Alan Barclay, Chief Scientific Officer of the GI Symbol Program.

No need to drop dairy foods
Dairy foods are often among the first to be struck off the shopping list by dieters, especially women. A recent study funded by the National Dairy Council and published in Nutrition and Metabolism didn't find eating the recommended three servings of dairy food a day (1 cup milk or 1 cup yoghurt or a 42 g piece of hard cheese) made any difference when it came to helping people maintain weight loss, but it did show that they were able to consume more calories without gaining weight compared with people who consumed less than one dairy serving a day.



Australian Better Health ‘Measure Up’ initiative
Belly fat has been linked to an increased risk of heart disease and diabetes and now to early death according to a study in the New England Journal of Medicine. Researchers following some 360,000 Europeans in one of the largest and longest health studies in the world found that people with the most belly fat had about double the risk of dying prematurely compared with people with the least belly fat. Death risk increased with waist circumference, whether the participants were overweight or not.

The Australian Government is supplying tape measures as part of its ‘Measure Up’ campaign to drive home to Australians the scary facts about flab. For most Australians a waist measure of more than 94 cm (37.6 in) for men and 80 (32 in) for women means a risk of developing a lifestyle-related chronic disease such as diabetes or cardiovascular problems. The tape moves into the red (yes, they are colour coded) if it goes over 102 cm (40.8 in) for men or 88 cm (35.2 in) for women, indicating increased risk of chronic diseases like type 2 diabetes and heart disease.

Being overweight causes excess fat around your waist to coat your organs. This fat is called visceral or intra-abdominal fat. Subcutaneous fat is the fat right under the skin. Both types play a role in contributing to health problems, however intra-abdominal fat contributes more. It is not yet clear exactly what links intra-abdominal fat with chronic disease, but what is clear is that even a small deposit of this fat increases the risk that you will have serious health problems. So Measure Up, get active, eat better and reduce your risk.



The Flexitarian Diet
Dawn Jackson Blatner, RD, LDN
This is a flexible vegetarian nutrition plan that minimises meat without excluding it. We like it because there are no rules or restrictions. You just eat more plants during your regular meals. There’s a 5-week eating plan with 100 recipes (breakfast, lunch, dinner, snacks and desserts) including plenty of quick and easy ways with beans (canned of course). Love her motto, too: ‘Be good to the body you have and it will be good to you.’ Each recipe makes ONE serving. So if there’s two of you, double the quantities. It’s published by McGraw-Hill and available in bookshops or from Amazon.

Low GI Recipes of the Month

Veronica Cuskelly is our guest chef this month and shares one of the recipes from her new book Heart Food. Enjoy this as a light meal or serve it up with fish fillets or chargrilled or barbecued prawn (shrimp) skewers and rocket and tomato salad for a more substantial meal.

Lemon spaghetti with walnuts
This dish would also be delicious made with hazelnuts and hazelnut oil.
Makes 4 serves (Each serving contains 1 serve of vegetables)



160 g /5½ oz wholemeal spaghetti
1 bunch (160 g/5½ oz) asparagus, sliced
1 cup frozen peas
3 teaspoons walnut oil
1–2 tablespoons lemon juice
1 clove garlic, crushed
1 tablespoon chopped dill
½ cup (60 g/2¼ oz) walnut pieces, toasted
1 medium red chilli, sliced thinly

• Cook the spaghetti according to the directions on the packet, without adding salt or oil. Drain and set aside.
• Meanwhile, place the bottom ends of the asparagus in a saucepan, cover with water and bring to the boil over a medium heat. Add the asparagus tips and cook, uncovered, until almost tender, about 2–3 minutes. Watch the time as the thickness of asparagus spears varies. Add the peas and cook until they are bright green and cooked – just a few minutes.
• To make the dressing, whisk the oil, lemon juice and garlic in a small bowl.
• Drain the asparagus and peas, return to the saucepan with the spaghetti and add the dressing and dill. Mix together well and serve sprinkled with the walnuts and chilli.

Per serve
Energy: 1225 kJ/ 293 cals; Protein 10 g; Fat 15 g (includes 1 g saturated fat); Carbs 29 g; Fibre 8 g

Low GI fare from Johanna’s kitchen: In GI News American dietitian, Johanna Burani shares her recipes photographed by husband Sergio.


Johanna Burani

Little cabbage ‘suitcases’ (Valigini)
‘Valigini’ means ‘little suitcases’ in Italian. That’s what my mother-in-law called this recipe because of the way the cabbage leaves enclose the meat filling. You may be surprised to find ground nutmeg mixed in with chopped meat but wait until you taste this combination – you’ll love it! In northern Italy, nutmeg partners well with a variety of ingredients. Instead of steamed cabbage leaves, try putting this mixture into the cavity of steamed zucchini, sliced lengthwise with pulp removed.
Makes 12, serves 6 (2 valigini per person)



12 savoy cabbage leaves (carefully removed from base of cabbage)
1 lb (450 g) 90% lean chopped meat
7 large sprigs parsley, leaves only
1 large celery stalk, thinly sliced
1 tablespoon extra virgin olive oil
1 clove garlic, minced
½ teaspoon salt
1/8 teaspoon pepper
1/8 teaspoon nutmeg
½ cup plain bread crumbs
½ cup grated parmigiano reggiano cheese

• Wash and steam the cabbage leaves for 2–3 minutes or until they appear wilted. Set aside.
• Place the chopped meat in the bowl of a food processor and pulse for 15 seconds (25 pulses). Add the parsley and celery and process for another 15 seconds.
  
• In a large, heavy skillet heat the oil and garlic, add the meat mixture (press with fork to break up mixture into very small crumbled pieces) and sauté for 5 minutes on medium-high heat taking care it doesn’t burn. Add in the spices and mix well.
• Return the meat mixture to a clean food processor bowl. Whiz for 1 minute adding the breadcrumbs and grated cheese through the food tube as it is processing.
• Line up the cooked cabbage leaves on the counter, place a rounded tablespoon of the meat mixture (about 1¼ oz/35 g) on the lower half of each leaf and gently roll up, taking care to close in sides as you roll. Secure with a toothpick.
• Add ½–1 cup homemade tomato sauce to a large Dutch oven or sturdy casserole and heat gently. Arrange the pieces to cover the bottom. Cover and simmer for 15 minutes, turning each piece over after 7–8 minutes. Serve hot.
  

Per serve (2 pieces)
Energy: 1268 kJ/ 302 cals; Protein 25 g; Fat 17 g (includes 6 g saturated fat and 67 mg cholesterol); Carbs 12 g; Fibre 3 g

Visit Johanna’s website: www.eatgoodcarbs.com.

Healthy Kids with Susie Burrell

Lifestyle Lesson 5: Save your pennies – cool, clear water is the best drink for kids
Supermarket shelves and refrigerated cabinets are literally groaning with beverages targeting young people these days, but save your pennies and invest in your kids’ health because water is the default setting when it comes to quenching thirst and should always be the number one drink of choice for children (and grownups). In fact, recent recommendations from childhood obesity experts writing in the Journal of the American Dietetic Association suggest that to help prevent obesity, sweetened beverages (fruit drinks, cordials, soft drinks, flavoured mineral water and the latest in the list of colourful tempters, vitamin water) should be limited to just twice each week. They are ‘sometimes’ drinks not everyday options.



Children don’t need any of these to be healthy – in fact gulping down these beverages they can make them picky about eating more nutritious foods at mealtimes and contribute to tooth decay. This is because sweetened drinks contain what nutritionists refer to as ‘discretionary’ calories, meaning they offer little in the way of nutrition and are easily over consumed, especially since they are frequently sold in super sized portions. Some sugar sweetened beverages also contain preservative 211 (sodium benzoate) as well as a number of artificial colours (some of which have actually been banned from use in some European countries).

What about 100% unsweetened fruit juice? Well, yes it does have some vitamin C and phytochemicals, but for the most part juice just contributes to excess calories and tooth decay. It’s much better to give kids orange or apple segments. To quench thirst, stick with the one that’s free and that nature provides – cool, clear, water. Try keeping ice cold water in the fridge or a filter water jug on the bench, always encourage your children to carry their water bottle with them (one that they can refill) and, most importantly, set a good example and drink water yourself.

Susie Burrell APD is a specialist Weight Management Dietitian at The Children's Hospital at Westmead. In her private practice, she balances her clinical work with writing for print and electronic media. For more information check out: www.susieburrell.com.au


Susie Burrell

Busting Food Myths with Nicole Senior

Myth: Low-carb beer is healthier


Nicole Senior

Fact: Low-carb beer is a classic case of wishful thinking, or perhaps more fittingly an example of ignoring the elephant (or the elephant beer*) in the room. Yet, low-carb beers were the ‘it’ beer in 2008. In fact, only this morning I received a media release from an Australian brewing company claiming they have made the first no-carb beer in the land, and the consumer demand for such a product was too hard to ignore. How could so many people have deluded themselves into thinking a beer with less carbs is healthier WHEN IT’S THE ALCOHOL CONTENT THAT’S THE PROBLEM! Please excuse my capitals but this subject rather inflames my passion for the whole truth on matters of food and drink.



The first rather obvious thing to point out is beer contains very low levels of carbohydrates (sugars) in the first place. The average lager-style beer contains only 2% carbohydrate by volume, or 7.5 g in a 375 mL can. It’s good to remind ourselves that carbohydrates are not especially fattening either, although sugars in drinks are not a nutritious source. I like beer, and I recently brewed some myself as a treat with the two main men in my life: my husband and my dad. I learned the sugars added to the initial mix from malted grains are gobbled up by the brewer’s yeast which then converts them into alcohol and bubbles of carbon dioxide. Beer is not a high-carb drink; this label is well-earned by soft drinks which contain 40 g (8 teaspoons) of sugar per 375 mL can.

The real nail in the coffin of the creative marketing behind low-carb beer is they contain the same level of alcohol as regular beer, and the alcohol is the kilojoule (calorie) culprit contributing 75% of the total energy content. Alcohol contains 29 kJ per gram; nearly twice that of carbohydrates at 16 kJ per gram. If you really want to curb the kilojoules, then drinking low alcohol, or ‘light’ beer makes much more sense.

So what’s really going on behind the low-carb beer phenomenon? I’m sure you’ll have your own ideas, but I go back to my original assertion that it’s all just wishful thinking. As hedonistic souls prone to excess (especially during the holidays), perhaps low-carb beers give us permission to drink more? Savvy marketers are just good at finding the soft underbelly of human nature and cashing in on it.

It’s blindingly obvious really, but if you’re interested in a ‘six pack’ stomach rather than a beer barrel body, drink less beer.

*Elephant beer is extra strong with high alcohol content, brewed by the Carlsberg Company

If you’d like great ideas for simple, heart-friendly food made with the goodness of healthy fats and oils with less salt , try Heart Food or Eat to Beat Cholesterol. Both titles available from www.greatideas.net.au.

Move It & Lose It with Prof Trim

Losing weight. Let us count the ways …
If you’re looking to lose weight, there’s no shortage of ‘experts’ around to help. But it’s usually only weight off the wallet they take. Not off the body. So how do you know who to believe? Well, a recent publication which backed up Government guidelines on this, have listed the ways – and how successful each is. Here’s a summary:



Herbal products: These are bought ‘over-the-counter’ and include a wide range of products ranging from seaweed to horseradish. There’s no evidence that any work without a diet and exercise program though. So save your money.
Alternative treatments: Weight loss claims are made for everything from acupuncture to hypnosis to body wrapping. But again, there’s no real proof that any of these work. Hypnosis may have some slight impact on changing food intake in someone who is able to be hypnotised, but the effect is hardly worth it.
Do-It-Yourself (DIY) diets: It’s difficult to gauge this one because something obviously worked for many people (otherwise we would all be fat). However, while any diet will work over the short term (by decreasing food intake) very few can be sustained over the long term. It’s better to make a lifetime commitment to eating right than waste time and effort on special diets.
Commercial diet-based weight loss programs: There are two or three big ones of these depending on the country – Weight Watchers being the biggest. They work best as a support group (and hence usually better for women) – but be prepared to continue paying. The success rate is not clear because data are unpublished, but WW (one of the few that do publish results) claim a success rate of around 20% over 1 year. (Men seem to do much better according to published data on GutBusters – now Professor Trims)
Exercise-based programs: These include fitness centres and personal trainers as well as do it yourself ways of getting fit. The first thing to say about exercise is that it doesn’t strip the weight off as quickly as dieting. The second is that it does it better over the long term – so it should be a part of any program.



Counselling: You can get this from a good doctor, dietitian, psychologist or exercise physiologist (or now a combination of three through your GP). Look for the ones who specialise in weight control and see this person only as helping you – not doing it for you.
Pre-Packaged meals: These are whole meals packaged and frozen for re-heating. In general, they provide low calorie, healthy meals and (provided you don’t add a profiterole and ice-cream dessert) can help reduce food intake.
Meal Replacements: These can be used once or twice a day (rarely three times) instead of meals. Hence they only work if they delay hunger, and while there have been some dodgy versions around for years, there are now some very effective ones. They can be used for up to 3 meals a day. But experienced guidance is recommended. The recognition of the value of these by obesity groups has now also meant a proliferation of products on the market. Look for those with good professional support.
Medication: There are a couple of drugs available from the doctor that can help add to the benefits of a lifestyle program. You’ll need an experienced doctor to advise you on what is best. Also, don’t expect these to work without a change in lifestyle.
Surgery: It used to be the last resort, but modern surgical techniques (particularly laproscopic banding) have now made it one of the most effective weight loss techniques available – provided it is followed up, again with the proper lifestyle change and with a team of experts including a psychologist, dietitian and exercise specialist.
Lifestyle modification: No matter what you do it comes down to this. Nothing will work without some form of lifestyle change, so why not do it all in one go. Programs like Professor Trim’s for Men can help you do this.


Dr Garry Egger aka Prof Trim

For more information on weight loss for men, check out Professor Trim.

Curly Questions

I have been diagnosed with insulin resistance. My dietitian told me that it is important to eat within one hour of waking otherwise the body starts to use muscle instead of fat.
Here’s what Dr Joanna McMillan Price says about breakfast and the body using muscle instead of fat. ‘The body only starts to break down muscle for fuel when stored carbohydrates (in the form of glycogen) are low and immediate energy is needed faster than body fat can be broken down. This isn't going to happen within one hour of waking, unless you are exercising on low carb stores. However we do agree wholeheartedly that breakfast is a good idea, and that the meal you choose should be low GI as this impacts on your whole day. Set yourself up with a low GI wholesome breakfast and you will eat less for the rest of the day, avoid a mid-morning slump in blood sugars that can lead to a sweet craving or pick-me-up and you need to produce less insulin to process the meal. This will all help you to burn body fat and reduce your insulin resistance. Finally the most important things you can do to avoid breaking down muscle is eat carbs, just the right ones (ie low GI) and exercise – if you don't use muscle you lose it.’



I am 53 year and have always been healthy and active (aerobics and all). At my last physical I was told my blood glucose was 108 – pre-diabetic. I completely changed my diet – read about the GI and only have dessert once a week now. I was eating a lot of sugar! Is it realistic to think I can reduce this number through my diet?
‘I’d recommend you give it a go,’ says Kaye Foster-Powell. ‘You have nothing to lose after all and there’s a chance (about one in three) that your blood glucose level could return to normal. Maintain your aerobic activity if you can and incorporate some strengthening/resistance exercise about three times a week to enhance your insulin sensitivity. Put your all into eating a low GI diet, but keep in mind that this doesn't mean cutting out sugar. Fruit and low fat dairy-based desserts could be a healthy inclusion.’

Email your curly question about carbs, the GI and blood glucose to: gicurlyquestions@gmail.com

Your Success Stories

‘Eating low GI has helped me maintain a reasonable blood glucose level.’ – Peter
‘I am a health professional and worked shifts until July of this year when I turned 50. Over the past 18 months I was diagnosed as being diabetic and my controlled hypertension was becoming increasingly uncontrolled. Being horizontally displaced (around the abdomen) made future health prospects look bleak. I had yo-yoed on different diets such as the Atkins Diet where I lost weight but felt ill and irritable. (How can less than 40 g of carbs be good for you when your brain requires more to function adequately?) I tried other carb-cutting diets but felt continuously hungry and tended to snack. A low GI diet has helped me maintain a reasonable blood glucose level. HbA1c was 7.9 and in the past six months has been 6.8. Another benefit is better sleep – I don’t have to get up 5–7 times a night to pee!

I am still fighting the BMI thing but have realised that what I put on over 20 years won’t come off overnight so I am aiming for 20 months to reach an acceptable weight. I now read labels and am eating more legumes then red meat which I restrict to about once a week. So a low GI diet has improved my health prospects and has motivated me to carry on this scientific evidence based pathway. Thanks low GI.’

GI Symbol News with Alan Barclay

Sustainable energy


Alan Barclay

Until recently, it was generally believed that high GI foods cause blood glucose levels to rise rapidly to relatively high levels, before dropping back to fasting levels, in an equally short period of time, providing a quick ‘spike’ of energy. Low GI foods, on the other hand, were thought to cause blood glucose levels to rise gradually over a relatively longer period of time, reaching a modest peak, before gently returning to baseline over a longer period.

The ‘Healthy Curves’ story in this issue of GI News not only suggests that the normal response depends on what carbohydrate food has been consumed, but that the notion that a low GI food has a uniquely long tail or extended glucose profile is not correct. Although a slowly digested starch or sugar may represent a slow-release form of energy, this does not automatically imply that a low GI food produces a sustained glucose response, as their metabolic energy can be released through alternative energy pathways.

What Brand-Miller’s study shows is that blood glucose levels tend to return to the baseline sooner after consuming sugary foods such as soft drinks and juices, regardless of their GI. These findings can be explained by the fact that commonly consumed sugars such as sucrose, lactose and fructose – regardless of their source – contribute fewer glucose molecules than the same weight of starch. Fifty grams of sucrose, for example, contains only 25 g of glucose versus 50 g of glucose in starch.

Does that mean you can still obtain sustained energy from lower GI sugars?
We have to get a bit technical here, so please forgive us. While lower GI sugars may have a negligible affect on blood glucose levels, the 25 g of fructose or galactose from a 50 g serve of sucrose or lactose still provide the body’s cells, tissues and organs with energy it can metabolise. After reaching the liver, fructose is rapidly removed from the blood stream, phosphorylated, and enters the glycolytic pathway, usually ending up as pyruvate and adenosine triphosphate (ATP), our body’s main energy ‘currency’. Similarly, galactose is extracted from the blood and converted to glucose in the liver, and again converted to pyruvate and ATP, just like dietary glucose. Under normal aerobic conditions, pyruvate is converted via the citric acid cycle to ATP, producing more energy. Therefore, ingestion of low GI sugars such as sucrose or lactose may have a negligible affect on blood glucose levels, but this does not mean they do not still help provide our body’s cells, tissue and organs with a sustainable source of energy. And there is considerable evidence linking the consumption of meals with a low GI to sustained physical and improved mental performance in humans. Please contact me for the references to these studies if you wish. Email: alan@gisymbol.com



Contact
Dr Alan W Barclay, PhD
CSO, Glycemic Index Ltd
Phone: +61 2 9785 1037
Mob: +61 (0)416 111 046
Fax: +61 2 9785 1037
Email: mailto:alan@gisymbol.com
Email: alan@gisymbol.com
Website: www.gisymbol.com.au

The Latest GI Values with Fiona Atkinson

Shopper's Guide to GI Values 2009
After the feast of new GI values over the past couple of months, we have a bit of a famine for January. The good news, however, is the The New Glucose Revolution Shopper's Guide to GI Values 2009 is now available with the values for over 1000 foods and beverages and there are special editions for Australia and New Zealand and for the US and Canada. These handy pocket guides are available from bookshops and the US/Canada edition from Amazon. We would love to be telling our UK readers that we have a special edition for them too, but sadly we don't have a UK publisher for this pocket book.



Where can I get more information on GI testing?
North America
Dr Alexandra Jenkins
Glycemic Index Laboratories
36 Lombard Street, Suite 100
Toronto, Ontario M5C 2X3 Canada
Phone +1 416 861 0506
Email info@gilabs.com
Web www.gilabs.com

Australia
Fiona Atkinson



Research Manager, Sydney University Glycemic Index Research Service (SUGiRS)
Human Nutrition Unit, School of Molecular and Microbial Biosciences
Sydney University
NSW 2006 Australia
Phone + 61 2 9351 6018
Fax: + 61 2 9351 6022
Email sugirs@mmb.usyd.edu.au
Web www.glycemicindex.com

New Zealand
Dr Tracy Perry
The Glycemic Research Group, Dept of Human Nutrition
University of Otago
PO Box 56 Dunedin New Zealand
Phone +64 3 479 7508
Email tracy.perry@stonebow.otago.ac.nz
Web glycemicindex.otago.ac.nz

See The New Glucose Revolution on YouTube

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GI News—December 2008

• 32 chews: why slowing down could help you slim down
  
• Squelch hunger pangs with low GI low-energy-dense foods
  
• Prof Trim on alcohol and weight
• Celebrate with dealcoholised wines and beers
  
• Johanna's sensational Spiced Pears with Zabaglione Sauce
  

This issue of GI News is packed with tips to help you keep the pounds at bay over the festive season from eating slower and leaving the table feeling as though you still had room for a little more, to choosing low-energy-dense foods and cutting back on alcohol. News Briefs looks at glycemic control: how tight is right and how to get there while Alan Barclay reminds us that treating diabetes is a team effort and the most important member of the team is you. With four delicious recipes and a new low GI chocolate treat from Canada, there's plenty for good eating, good health and good reading.

Season's greetings.

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

Food for Thought

Slow down and you could slim down
When Uncle Percy came to dinner, we always found it hard to keep a straight face with the inevitable lecture on chewing each mouthful 32 times! We later discovered he was a huge fan of The Great Masticator, Horace Fletcher, who believed that ‘prolonged chewing precluded overeating, led to better systemic and dental health, helped to reduce food intake, and consequently, conserved money.’ (J. Hist. Dent. 1997 Nov.) At 45, Fletcher had been ‘overweight, short of breath and in poor condition’. At 60, thanks to his new regimen, ‘he outdid college athletes in gymnasium tests of endurance, went on long tramps and climbed mountains with the vigour of youth. He had considerably reduced his weight and was living on a much smaller ration than formerly,’ according to his bio in The American Journal of Public Health.


Horace Fletcher

The evidence is piling up that Percy, Horace and Grandma were all onto something when they told us to sit down to eat (elbows off the table), chew our food properly (the mouth is where digestion begins), and to leave the table feeling as though we still had room for a little more rather than stuffing ourselves until we were FTB (full to the brim).

In the Journal of the American Dietetic Association, Researchers Ana M. Andrade and her team report that eating slowly may help to maximise satiation (basically how quickly and to what extent we feel full while we eat) and reduce energy intake within meals. In their study, 30 young, healthy volunteer women ate around 70 fewer calories (294 kJ) in a meal when they slowed down. They also felt fuller and more satisfied after eating. The women tucked into the same meal (pasta with tomato-vegetable sauce and grated parmesan cheese, plus a glass of water) on two separate occasions. They ate ‘meal one’ as fast as they could with no pauses between bites, and took their time over ‘meal two’ with small bites, chewing each mouthful 20–30 times and putting their spoon down between bites. Check out the difference. They put away an average of:

• 646 calories (2713 kJ) in about 9 minutes when eating fast.
• 579 calories (2432 kJ) in about 29 minutes when eating slowly.

A recent study published in the British Medical Journal reports that people who wolf down their meals until they are full to the brim are more likely to be overweight. Koutatsu Maruyama and colleagues measured the BMI of some 3,300 adults in Japan and asked them to complete questionnaires about their eating habits over the previous month. After adjusting for confounders including calorie intake, they found that those who reported eating until they were full had roughly twice the odds of being overweight, compared with those who stopped eating sooner. Those who ate quickly were also about twice as likely to be overweight as those who ate more slowly. Being overweight was especially common among those who ate fast and until bursting. However, because it’s difficult to estimate cause and effect in a cross-sectional survey like this, further studies are needed to ‘validate these associations between eating behaviour patterns and being overweight,’ say the researchers.



In an editorial in the same issue of the British Medical Journal, Drs Elizabeth Denney-Wilson and Karen Campbell, suggest how eating patterns might be contributing to the obesity epidemic. On the one hand fast food and fewer families eating together may promote speed eating, while the availability of inexpensive energy-dense foods served in larger portions may encourage eating beyond satiety. So what’s the good news? Speaking to GI News, Dr Denney-Wilson says there’s evidence that we can learn to eat more slowly. Here’s how:

• Make sure your meals include plenty of 'chew foods' such as lean meat, crunchy salads and vegetables, wholegrains like brown rice and pearl barley.
• Put your fork down between mouthfuls.
• Take small bites. Cut your meat into tiny bites, before you begin eating.
• Pace yourself. Don’t take your lead from the ‘bolters’ at the table.
• Take a break between second helpings or dessert to let your stomach have a good chat to your brain.
  
• Don’t get so hungry you could eat the proverbial horse. Wolfers are often skippers. Have a healthy snack between meals to keep the pangs at bay.
• Eat meals as a family (or with partners/friends/flatmates) with the TV off – look at mealtimes as a time to catch up and enjoy the company you keep.

As for eating until you are not quite full, let your plate be your guide while you learn to listen to your tummy for starters. Don’t fill it to the rim. Amanda Clark compares a modest, 350 calorie (1470 kJ) dinner plate with a rim-to-rim, 450 calorie (1890 kJ) dinner plate in her new book, Portion Perfection. And parents, don't force your children to eat more than they want to – let them learn to recognise the cues from their bodies that tell them when they are full.

News Briefs

How tight is right and how to get there
With the explosive development of new classes of blood glucose-lowering medications offering an increased number of treatment choices, the question for physicians and for people with diabetes is how tight is right and how to get there. In an editorial in Archives of Internal Medicine, Dr David Nathan says: ‘For now, the approach to the type 2 diabetes epidemic should include attempts to prevent the disease and to treat it with the medications known to be safe and effective. Given the magnitude of the epidemic and the central and demonstrated role of glycemic control in ameliorating the toll of microvascular and neuropathic complications, we should continue to emphasise a goal of HbA1c levels of less than 7.0% for patients likely to benefit and the aggressive application of other interventions that reduce cardiovascular disease risk as demonstrated in clinical trials.’



Step 1 in treating new-onset type 2 diabetes and reducing the risk of complications, according to the American Diabetes Association and the European Association for the Study of Diabetes in its 2006 consensus statement, is lifestyle interventions to improve glucose, blood pressure, and lipid levels and to promote weight loss or at least avoid weight gain – and lifestyle interventions should remain an underlying theme throughout the management of type 2 diabetes, even after medications are used. The 2008 update published in Diabetes Care (PDF) advises that:

• People with diabetes should strive to achieve and maintain hemoglobin A1c (2–3 month average blood glucose) levels under 7%.
• Physicians should begin treatment with lifestyle intervention and metformin (because of its effect on glycemia, absence of weight gain or hypoglycemia, good tolerability profile, and relatively low cost).
• If that does not achieve or sustain the glycemic goals, then step 2 is adding another medication (eg, sulfonylureas, basal insulin) within 2–3 months.
• If the above therapies do not work, then step 3 is starting or intensifying insulin therapy.

GI Group: Treating diabetes is a team effort and the most important member of your team is you.



‘Working with a healthcare team is the best way you can avoid the serious complications that diabetes can cause,’ says Dr Alan Barclay, coauthor of The Diabetes & Pre-diabetes Handbook (New Glucose Revolution for Diabetes in the US and Canada). ‘That’s the clear message from numerous studies of people with diabetes in recent years. Make sure you know as much as possible about your diabetes, are involved in the decisions about treatment and act on the advice that you are given. If the combination of weight loss (if necessary), a healthy diet, physical activity and medication delivers near normal blood glucose levels, your diabetes is well managed and your risk of complications is much lower. Knowledge is your best defence. Working with your healthcare team, here’s what you need to aim for:

• Hemoglobin A1c – under 7%
• Blood glucose levels 4–8mmol/L (72–144 mg/dL)
• Blood pressure – under 130/80
• Cholesterol – under 4 mmol/L (156 mg/dL)
• A healthy weight
• A healthy eating plan
• Regular exercise
• Regular eye checks, and
• Regular foot examinations.
  

Australia/New Zealand: The Diabetes & Pre-Diabetes Handbook
USA/Canada: New Glucose Revolution for Diabetes

Squelch hunger pangs with low GI low-energy-dense foods
In October GI News, Catherine Saxelby reported that researchers from Johns Hopkins Bloomberg School of Public Health found they could drop the calorie (kilojoule) content of a lunch meal by half if they substituted ground (minced) white button mushrooms (a low calorie, low-energy-dense food) for beef mince (much higher in both departments) in familiar dishes like lasagna, ‘sloppy Joe’ (a kind of savoury mince) and ‘chili’ (as in con carne). The study participants didn’t rate the taste of the mushroom meals any differently from the beef meals. And despite consuming fewer calories with the mushroom meals, they didn’t compensate by eating more later in the day.

‘Energy density’ simply means how many calories there is in each mouthful of a food.

• A food that is high in energy density has a large number of calories in that mouthful. Most modern-day snacks for example are energy-dense. They pack a lot of energy (the scientific term for calories/kilojoules) into a small volume (your mouth).
• A food that has a low energy density has fewer calories for the same mouthful of food.

It’s not rocket science to work out that tucking into too many energy-dense foods will pile on the pounds. This is because most of us tend to eat roughly the same weight of food each day regardless of calories. If we can choose foods that offer fewer calories for the same amount of food, we will be able to manage our weight more effectively. We may also reduce our risk of type 2 diabetes according to a large prospective study published in Diabetes Care that suggests that the energy density of our diet may itself be a risk factor for diabetes, regardless of BMI, total energy intake and other known risk factors for diabetes.

The bottom line: Don’t worry about calculating numbers or investing in another diet book. A healthy, low GI diet rich in fruit and vegetables, unprocessed or minimally processed fibre-rich grain foods (the low GI ones of course) and lean protein – legumes, fish, skinless poultry, low-fat dairy foods – is a low-energy-density way of eating that squelches those hunger pangs and helps you manage blood glucose levels.

What's new?
Hot Flashes, Hormones, and Your Health
Dr JoAnn E. Manson with Shari Bassuk, McGraw-Hill



Although subtitled ‘Breakthrough findings to help you sail through the menopause,’ this book is more a guide to the latest scientific evidence on the risks and benefits of hormone therapy and whether you should start or stop from the Professor of Medicine, Harvard Medical School and Chief, Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital. Chapters cover treating the symptoms of menopause; the rise, fall and (cautious) return of hormone therapy; evaluating the risks and benefits; and how to calculate (and reduce) your risk of five health outcomes associated with hormone therapy.

Regarding type 2 diabetes, here’s the ‘bottom line’ according to Manson: ‘Hormone therapy may lower the risk of type 2 diabetes. However, many women at risk for diabetes are also at heightened risk for developing coronary heart disease and stroke and therefore are not good candidates for hormone therapy.’ So check it out and talk to your doctor.

Dr Neal Barnard, The Reverse Diabetes Diet
Australian lecture and book signing tour
All lectures will be followed by a book signing and are free and open to the public.
To RSVP to any of these events, please e-mail: contact@zeitgeistmediagroup.com

Brisbane Monday, Dec. 1, 6:30 pm
Where: State Library of Queensland Cultural Centre Auditorium 2
Sydney Wednesday, Dec. 3, 6:30 pm
Where: State Library of NSW, The Dixson Room
Melbourne Thursday, Dec. 4, 6:30 pm
Where: The University of Melbourne, Elisabeth Murdoch Building, Theatre A, Building 134
(Gate 3 entry off Swanston Street)

Food of the Month with Catherine Saxelby

Chocolate – pleasurable indulgence or antioxidant-rich super food?


Catherine Saxelby

Chocolate is the world's favourite flavour for ice cream, cakes, sweet sauces and milk shakes and those who say they don't like it are few and far between. Each new study on the alleged benefits of chocolate’s antioxidants is greeted with glee (and headlines), and has given chocoholics and health-conscious consumers the green light to indulge. Is it any wonder sales of dark premium-end chocolate are booming and trendy chocolate cafes from Guylian, Max Brenner and Lindt are springing up in our city centres?

The good news on antioxidants Cocoa and dark chocolate have been found to be abundant in a class of antioxidants known as procyanidins (OPCs). You’ll also see these referred to as flavonols or polyphenols (which is the general term for this whole class of related antioxidants including those found in tea and red wine). These cocoa flavonols are platelet inhibitors which research now shows have a mild anti-coagulation effect as well as being anti-inflammatory. They can also keep arteries elastic, lower blood pressure, prevent cholesterol from being oxidised and even prevent cancer. But it’s still early days in the research department. And not all chocolate is created equal. This research applies to dark chocolate (where the level of cocoa solids is high from 35–70%). Milk chocolate has much less (and the milk may actually interfere with the absorption of the antioxidants into the body); white chocolate has none. Some manufacturers have modified their dark chocolate so it’s less bitter with slightly lower cocoa solids but still high in the important flavonoids (eg, Mars Cocoapro, Nestle Club).



Guiltless sweet? Antioxidants aside, chocolate remains a rich, high-fat/high-sugar (30% fat and 50% sugar), concentrated food that packs a lot of calories into a very small piece – which explains why hikers take it on long treks and soldiers are never denied a bar in army survival rations. Take the average 50 g (just under 2 oz) bar of chocolate. It supplies 1100 kJ (260 cals). This is twice as much as you get from 50 g of steak (410 kJ/98 cals) or even 50 g of fried potato chips at 500 kJ/120 cals). That 50 g bar slaps on 15 g of fat plus 25 g sugar. The good news is that even though the fat is mainly saturated, much of the saturated fat is in the form of stearic acid, which has little effect on blood cholesterol. So even those wanting to follow a ‘heart healthy’ diet can still happily eat a piece in moderation.

But, however much some people would love to hear it, chocolate does not qualify as a super food alongside vegetables, fruit and whole grains. It’s a treat food, and even then you need to keep the doses small. And small means SMALL, about 20 g or 3 squares a day as part of a healthy diet.

For more information on super foods and healthy eating, visit Catherine’s website: www.foodwatch.com.au



Zest: The Nutrition for Life Cookbook Offer
Dietitian and nutritionist Catherine Saxelby has a TWO FOR ONE offer with copies of her popular cookbook Zest from now until Christmas from her online nutrition & health bookshop. Buy one, get one free to give to a friend or relative. Last delivery to make it in time for Christmas is Monday 15th December.

Low GI Recipes of the Month

Our chef Kate Hemphill develops deliciously simple recipes for GI News that showcase seasonal ingredients and make it easy for you to whip up healthy, low GI meals and snacks. For more of Kate’s fabulous fare, check out her website: www.lovetocook.co.uk. For now, prepare and share good food with family and friends.


Kate Hemphill

Cardamom & blueberry smoothie
It might seem obvious to throw a few things together for a smoothie, but this is such a great combination I thought I'd share it. If are a lassi fan, you'll like the addition of spices. If you're not using frozen berries, add a couple of ice cubes for a nice chilled smoothie. This is very much a summertime smoothie, when nectarines aren’t in season, use half a pear, peeled of course.
Serves 2

1 large ripe banana (about 200 g/7 oz), peeled and chopped
5 tablespoons fresh or frozen blueberries
1 ripe nectarine, peeled, stoned and cut into chunks
1½ cups (375 ml) semi-skimmed milk
1 teaspoon runny honey
1/4 tsp ground cinnamon
1/4 tsp ground cardamom

• Combine all ingredients in a blender or blitz with a hand blender until smooth. Drink within 30 minutes or the solids will separate.

Per serve
Energy: 1030 kJ/ 245 cals; Protein 6 g; Fat 3 g (includes 1.5 g saturated fat and 13 mg cholesterol); Carbs 43 g; Fibre 5 g

Low GI fare from Johanna’s kitchen: In GI News American dietitian, Johanna Burani shares her recipes photographed by husband Sergio. (Adapted with permission from Good Carbs, Bad Carbs, Da Capo Lifelong Books, New York.)


Johanna Burani

Baked spiced pears with zabaglione sauce
Pears with cinnamon and cardamom are a marriage made in culinary heaven. Adding the most ‘divine’ of all Italian sauces, zabaglione, makes this dessert a truly ethereal experience. This full-bodied dessert relies exclusively on the wholesome flavours of its ingredients and not added fats, making it an excellent finish to a hearty holiday meal – or even Christmas dinner.
Serves 4



2 ripe Bosc pears
2 tablespoons sugar, divided
¼ teaspoon ground cinnamon
¼ teaspoon ground cardamom
1 egg yolk
2 tablespoons marsala wine

• Preheat the oven to 180ºC (350ºF).
• Peel, halve and core the pears. Place them cut side down in a rectangular baking pan with just enough water to cover the bottom of the pan.
• Combine 1 tablespoon of the sugar with the spices, and sprinkle half of this mixture over the pears. Bake the pears for 5 minutes in the preheated oven. Turn the pear halves over, sprinkle with the remaining sugar-spice mixture and continue to bake for another 5 minutes. Pears are done when they are easily pierced by a fork but still hold their shape. Large pears may take a little longer to cook. Remove from the oven, place in individual dessert dishes and set aside.
• To make the sauce, combine the egg yolk and remaining tablespoon of sugar in a very small saucepan and mix vigorously for at least 5 minutes with a wooden spoon. Slowly add the marsala and mix well. Heat over low heat stirring constantly for approximately 1 minute or until the mixture thickens WITHOUT COMING TO A BOIL. Pour the sauce over the pear halves and serve warm or at room temperature.

Per serve (Serving size: ½ pear with 2 tablespoons of sauce)
Energy: 416 kJ/ 99 cals; Protein 1 g; Fat 2 g (includes less than 1 g saturated fat and 55 mg cholesterol); Carbs 21 g; Fibre 2 g

Visit Johanna’s website: www.eatgoodcarbs.com.

The following recipes from The Low GI Family Cookbook are perfect for the festive season.



Australia/New Zealand: Low GI Family Cookbook
USA/Canada: The New Glucose Revolution Low GI Family Cookbook

Frozen Berry Yoghurt
Anneka Manning's frozen yoghurt is easy to prepare and perfect for summery desserts. You can refreeze it in single serve containers in Step 3 rather than 1 large container if you prefer and have it on hand as an after-school snack.
Serves 6 (see photo above on the Family Cookbook)

250 g (9 oz) fresh or frozen
mixed berries
3 x 200 g (7 oz) tubs low fat
vanilla yoghurt
2 egg whites
2 tablespoons pure floral honey

• Place the berries and yoghurt in a food processor and blend until smooth. Transfer to a medium-sized bowl and set aside.
• Whisk the egg whites in a clean, dry bowl until stiff peaks form. Add the honey a tablespoon at a time, whisking well after each addition until thick and glossy. Fold into the berry yoghurt mixture until just combined.
• Pour the mixture into an airtight container and place in the freezer for 4 hours or until frozen. Use a metal spoon to break the frozen yoghurt into chunks. Blend again in a food processor until smooth. Return to the airtight container and refreeze for 3 hours or until frozen. Serve in scoops.

Per serve
Energy: 540 kJ/ 129 cals; Protein 7 g; Fat 0.3 g (includes less than 0.1 g saturated fat and 6 mg cholesterol); Carbs 22 g; Fibre 1.4 g

Vegetable roasties
Make the most of moderate and low GI root vegies. They are packed with vitamins, antioxidants and fibre and simply scrumptious roasted this way as a side dish with a roast dinner. We promise you won’t miss the baked spuds.
Serves 6



1 medium orange sweet potato (about 500 g/17 oz)
2 medium parsnips (about 400 g/14 oz)
2 medium carrots (about 250 g/9 oz)
1/2 medium butternut pumpkin (about 700 g/24 oz)
3 teaspoons olive oil
Pinch salt (optional)
Freshly ground black pepper
4 sprigs rosemary, thyme or oregano, leaves removed from stems

• Preheat the oven to 220ºC (440ºF) and line a roasting pan with non-stick baking paper.
• Peel all the vegetables, deseed the pumpkin and cut the vegetables into 2.5 cm (1 in) chunks. Place them in the prepared roasting pan, drizzle with the olive oil and a tiny sprinkle of salt (if using), pepper and herbs. Use your hands to toss the vegetables to coat with the oil and seasonings.
• Bake for 1 hour, or until golden and tender, tossing the vegetables about 3 times during cooking so that they brown and crisp evenly. Serve immediately.

Per serve
Energy: 762 kJ/ 181 cals; Protein 6 g; Fat 3 g (includes 0.3 g saturated fat and 0 mg cholesterol); Carbs 29 g; Fibre 6.5 g

Busting Food Myths with Nicole Senior

Myth: Sea salt is healthier


Nicole Senior

Fact: All salt contains sodium harmful to your health
Not to be too dramatic, but the saying “pure, white and deadly” is quite fitting for this ubiquitous food ingredient. If it’s good luck you want, you’re better off throwing a pinch of salt over your shoulder than into your dinner. Professor of Medicine at Sydney University Bruce Neal, chair of the Australian division of World Action on Salt and Health (www.awash.org.au) says, “reductions in dietary salt consumption have greater potential to avert death and disability than stopping smoking”. His comment, surprising to many, arises from an investigation published in The Lancet medical journal exploring the costs and benefits of salt reduction and smoking cessation for chronic disease prevention. In short, the study showed we can save lives if we desalinate our food. The problem is, too much salt increases blood pressure and high blood pressure increases the risk of heart attack and stroke: our biggest killers.



Sea salt is not healthier Sea salt oozes natural food cred, while exotic and expensive gourmet sea salt is revered in the foodie world. Kosher salt and many other weird and wonderful kinds jostle for our attention. A quick online search revealed extraordinary claims for sea salt that take unhealthy marketing hype to new levels such as: ‘one of God’s gifts,’ ‘salt-deficiency is the cause of many diseases,’ ‘evidence for healing,’ and ‘contains 80 mineral elements the body needs’. The fact is, while sea salt (or any other kind) may add subtle differences in flavour and texture, it contains just as much harmful sodium as regular table salt. In terms of mineral content, the amounts are so small you would need to poison yourself with sodium in order to obtain useful quantities of minerals otherwise found in nutritious foods. For instance, one posh French sea salt with the highest amount of magnesium I could find only contained 0.71g/100 g. If you were to add a very generous 1 teaspoon (5 g) of this stuff to your food on a single day, you would obtain a paltry 0.0355 g (35 mg) of magnesium. This is around 8–11% of the Recommended Dietary Intake of magnesium for adults, but comes with a hefty 2400 mg of sodium: one and a half times the 1600 mg a day Suggested Dietary Target (SDT, Australia and New Zealand). Cheaper sea salts would offer an even worse sodium bang for your magnesium buck.

The bottom line is to add as little salt as possible and recent advice suggests using salt with added iodine (‘iodised’ salt) in order to increase your intake of this essential but hard-to-get trace element. Importantly, check the label of processed food to find the lowest in sodium as this is where the majority of the salt in our diet comes from. If you’d rather starve than cut back on salt, you’re underestimating the marvelous ability of human taste buds to adapt to less salt over time. If you reduce the salt in your diet gradually, the suffering will be minimal. Get into taste sensations offered by garlic, onion, lemon, herbs and spices and soon a whole world of real food flavour will open up.

For more interesting food facts and great tasting heart-friendly recipes with less salt, go to eattobeatcholesterol.com.au . If you’d like great ideas for simple, heart-friendly food made with the goodness of healthy fats and oils with less salt , try Heart Food or Eat to Beat Cholesterol. Both titles available from www.greatideas.net.au.

Healthy Kids with Susie Burrell

Lifestyle lesson number 4: Christmas is just one day!
Christmas and the school holidays can be a challenge for families with too many high calorie, high fat foods in the home along with all those hours to be filled as structured activities go on hold, friends go away for the holidays and screens (TV, computer, movie) beckon. Not surprisingly, weight gain is common for parents and kids. In fact, the average weight gain for adults in Australia over the summer holiday period is 1–2 kg (2–4 pounds)!



Remember, Christmas is just 1 day, not 6 weeks. Here are some tips to help you keep yourself and your kids a healthy weight over the break.

• Over the festive season, place a limit on treats your children eat each day – for example 1–2 chocolates a day so children are aware they can have extras but not overeat.
• Don't buy too much food – if it's there and in the fridge or on the pantry shelf, it will be eaten.
• Buy treats in small amounts only.
• Structure in treats each week over the holidays so your children know when they will be having them. And remember, treats don't have to be food! Doing things and having fun together as a family can be a real treat.
  
• Use your veto power. Ask family and friends not to give your family food gifts or treats like cookies, lollies (candies) or chocolates.
• Choose water instead of high-calorie soft drinks and fruit juices which can pile on the pounds quick smart.
• Look as the holidays as a time to do more activity not less. Children need to be active for at least 1–2 hours every single day. Enjoy a daily family walk or bike ride or ball game in the park, or trip to the beach or local pool.
• Have firm limits on the amount of television your children watch and computer time you allow. Aim for 1–2 hours each day. Discuss it beforehand so everyone knows where they stand.
  
• Enrol the kids into as many structured holidays activities as you can afford. Check out your local council website or school holiday camp websites to see what's on offer.
• Stick to standard meals times (at the table, TV off) to avoid constant grazing, which promotes overeating.
  
• Eat before you head out to the mall or the movies, so that the kids don't get hungry.
• Make a pre-emptive strike if you are going to be out for a long time – have a chat before you leave the house about what food you are prepared to buy.
• Pack a snack pack to deal with hunger pangs – keep apples and healthy wholegrain snack bars in your bag along with a bottle of water.
• Low fat smoothies, sushi, burgers (with one meat pattie), wraps and low fat muffins are the best options when eating out. Try and avoid deep fried fries, pies and pizza as well as soft drinks at all times.

Susie Burrell is a specialist Weight Management Dietitian at The Children's Hospital at Westmead. In her private practice, she balances her clinical work with writing for print and electronic media. For more information check out: www.susieburrell.com.au


Susie Burrell

Curly Questions

Any tips for enjoying a low GI Christmas dinner without piling on the pounds? The roast turkey is non negotiable!
Putting on weight over the Christmas period is a problem for many of us – all that eating with family and friends. But, it’s more likely to be all the trimmings and treats that pile on the pounds rather than The Dinner itself. A word of warning: a single mince pie contains about 250 calories! Here’s what the British Dietetic Association suggests:



‘Turkey is a low fat meat – most of the fat is stored in the skin, so remove the skin and you cut down on fat. Adding plenty of seasonal vegetables such as unbuttered Brussels sprouts, peas and carrots will contribute to your 5-a-day fruit and vegetable intake … Smoked salmon makes a good starter and is a source of omega-3 fatty acids, which helps keep your heart healthy; alternatively try a hearty vegetable soup or a refreshing melon starter. Christmas pudding is rich so a small portion should be satisfying enough, or you could go for fresh fruit salad or baked apples as a virtuous alternative … (For snacks) have healthy options to hand, such as fresh or dried fruit like dates, figs and apricots. Satsumas (type of plum) are handy, so keep a large bowl of these other fruits close by. Chestnuts are lower in fat than most nuts so roast a few and leave the salted peanuts to one side.’

All we would add is ditch the Yorkshire pud, cut back on the roast potatoes and include some lower GI options like roasted pumpkin, sweet potato and parsnips along with carrots and onions. And keep those portions moderate, eat slowly and say no thanks to seconds – remember Grandma’s words: ‘you should leave the table feeling as though you still have a little room in your tummy’.

I have seen a number of articles now suggesting that drinking fruit juice is not a good idea for those of us trying to maintain a healthy weight and glucose levels. I know we are encouraged to drink water, but it’s not always what you want when you sit down with friends on a summer’s evening or join colleagues for that after-work drink.
It’s a great idea to choose non-alcoholic alternatives to enjoy the spirit of the occasion without the side effects and (possibly) half the calories. You don’t have to toss a coin to decide between energy-dense juice or soda with a dash of lime or verjuice. There are plenty non-alcoholic beers and wines to choose from, although you may have to BYO, as they aren’t widely available in restaurants and bars. You can, however, pick up a bottle from your supermarket, maybe your local liquor store, and of course online.



Non-alcoholic wines are actually de-alcoholised wines. The wine is made the traditional way (even ‘aged in oak’ at times, and then the alcohol is removed. The legal definition of a non-alcoholic beverage means it has less than 0.5 percent alcohol. This is because it is just not possible to remove 100% of the alcohol. It’s a pricey process and the end result isn’t the same as regular wine or beer so it’s best not to compare them. But do check them out, you’ll be surprised at the range on offer and you are sure to find one that appeals. Joe Timmins of Clearmind who distribute dealcoholised beverages such as Ariel wines and Lowenbrau Alkoholfrei in Australia and New Zealand says that the market isn’t niche at all – it is growing in leaps and bounds and includes large numbers of people who don’t drink for religious or health reasons including pregnant women and, he says, ‘there are many people who simply want an alternative because they are on duty or on call like doctors or airline pilots, or simply want an alcohol-free option’. Joe agrees that there’s a big range in the quality of what’s on offer in the supermarket, so it pays to be choosy, just as you would with any wine or beer. ‘I really love the Ariel reds as my favourite food is Italian,’ he says. For more information on dealcoholised wines or beers (or to opt for a clear head over Christmas/New Year and order some), check out Clearmind.

In The Diabetes and Pre-diabetes Handbook (The New Glucose Revolution for Diabetes in North America), dietitian Dr Alan Barclay says: ‘Low alcohol and alcohol-free beers contain roughly the same amount of carbohydrate as the alcoholic varieties and will have little effect on your BGLs if you drink them in moderation. Many low- and non-alcoholic wines, on the other hand, are based on grape juice, and give you about 10–15 g of carbohydrate per 100 mL (a bit under ½ cup) serve (do check the label). They probably won’t cause your blood glucose levels to rise rapidly, but just because they are alcohol free, don’t think you can drink them freely if you are watching your BGLs or your weight. If you want something a bit more exotic, you could always try a mocktail.’



Email your curly question about carbs, the GI and blood glucose to: gicurlyquestions@gmail.com

Move It & Lose It with Prof Trim

Why alcohol is not totally innocent in the lard production department
Of the three biochemical means of metabolising alcohol, none result in its direct conversion to fat. However, research from several centres shows that our inhibitions go down when we have a drink. Hence those fattening salted peanuts look more appealing, and the means of resisting are less after a few drinks. Food intake also tends to increase when alcohol is drunk with a meal. Some studies show this could be as much as 200 calories (840 kilojoules) per meal, which could mean an extra kilo (couple of pounds) every month or so. This is particularly so if the meal is preceded by high fat pre-dinner snacks and alcohol (eg, beer and peanuts or chips/crisps).



It’s also true that too much alcohol (ie, a binge) is not only bad for the overall health, but tends to cause changes in eating behaviour the next day. How often have you felt like a salad and fruit, rather than bacon and eggs the morning after for example? So while the odd drink may not be a cause of concern (except in those aggressive types), there’s no reason to take it up if you are a nondrinker. If you like a tipple, here’s some advice for the health (and weight):

• Drink small amounts frequently (rather than binge infrequently)
• Have a couple of AFDs (alcohol free days) per week
• Avoid high energy mixes (soft drinks, fruit juice etc.)
• Watch what you eat when you drink
• Be conscious of how much you are eating when drinking with meals.

Dr Garry Egger aka Prof Trim

For more information on weigh loss for men, check out Professor Trim.

Your Success Stories

‘How I Lost 80 Pounds (36 kg) with Smart Carb Eating.’ – Richard Price
‘I became a type 2 diabetic about 15 years ago, and have learned how to control my weight and blood glucose with diet and exercise. I lost 80 pounds (36 kg) and am a member of the National Weight Loss Registry (US). Two of my secrets are eating food with a low energy (calorie) density and eating food with a low glycemic impact. Energy density is a measurement of calories per gram of food. Researchers at Pennsylvania State University, led by Barbara Rolls, concluded that we eat by weight volume and not by calories. I did a twist on these two principles, by coming up with the concept of Glycemic Density which is a measurement of glycemic load per gram of food. Eating carbohydrate dense foods with a low Glycemic Density allows us to maximize hunger satisfaction while minimising glycemic impact. As I am not a professional, I am not able to further examine this concept other than on a philosophical basis. I do not have the resources of a university or major nutritional clinic. I would love for someone who has these resources to pursue this concept further.’

GI Symbol News with Alan Barclay

Oh what a difference your bread choice can make!


Alan Barclay

‘A lack of satisfying, filling foods is a hurdle for many people when trying to maintain a balanced, healthy diet. There are a lot of diets and food fads that claim to improve satiety – which is why we were keen to conduct a study in this area,’ said Prof. Jennie Brand-Miller. ‘We found that your daily bread choice can play a role in satisfying hunger and decreasing food intake at a subsequent meal.’

Researchers in the Human Nutrition Unit at Sydney University carried out the lab-based study for George Weston Foods from January–March 2008. Twenty healthy weight (BMI 18-25) volunteers aged 18–45 who were non smokers and had normal glucose tolerance took part in the study. All completed a restrictive-eater questionnaire to ensure only those with normal eating habits were taking part.

On two separate occasions, the researchers randomly asked the volunteers to eat either two slices of Burgen Wholemeal & Seeds bread (83 g) or two slices of standard white sandwich bread (74 g) with margarine and jam and a glass of water as a breakfast meal and rank their feelings of fullness. They also had to list their subsequent meal’s food intake. There was a washout period of at least three days in between test sessions.



The volunteers felt fuller for longer after the Wholemeal and Seeds bread breakfast and, on average, reduced their intake at the next meal by 500 kilojoules (120 cals) and 4 g of fat compared with the standard white bread breakfast. They also had a lower glycemic response to the meal with the low GI (39) Wholemeal and Seeds bread compared with the white bread meal, which may have contributed to keeping hunger pangs at bay. The Wholemeal and Seeds bread is also a good source of dietary fibre and provides protein – both of which may have also helped to provide the greater satiety response.

Email us for more information: alan@gisymbol.com

Contact
Dr Alan W Barclay, PhD
CEO, Glycemic Index Ltd
Phone: +61 2 9785 1037
Mob: +61 (0)416 111 046
Fax: +61 2 9785 1037
Email: mailto:alan@gisymbol.com
Email: alan@gisymbol.com
Website: www.gisymbol.com.au

The Latest GI Values with Fiona Atkinson

Chocolate #9 GI 46
This tasty chocolate treat was GI tested by GI Labs in Toronto. It is thick gel that’s a blend of organic low GI agave and Belgian-style dark chocolate. Although it’s much lower in fat and calories than the equivalent amount of dark chocolate, remember it’s still a ‘sometimes’ food, especially for anyone watching their weight. Packaged in 29.5 g (around 2 tablespoons) single serve foil pouches, it is suitable for people on vegan and vegetarian diets. For more information and the nutrition facts about Chocolate #9, check out the manufacturer’s website.



Where can I get more information on GI testing?
North America
Dr Alexandra Jenkins
Glycemic Index Laboratories
36 Lombard Street, Suite 100
Toronto, Ontario M5C 2X3 Canada
Phone +1 416 861 0506
Email info@gilabs.com
Web www.gilabs.com

Australia
Fiona Atkinson



Research Manager, Sydney University Glycemic Index Research Service (SUGiRS)
Human Nutrition Unit, School of Molecular and Microbial Biosciences
Sydney University
NSW 2006 Australia
Phone + 61 2 9351 6018
Fax: + 61 2 9351 6022
Email sugirs@mmb.usyd.edu.au
Web www.glycemicindex.com

New Zealand
Dr Tracy Perry
The Glycemic Research Group, Dept of Human Nutrition
University of Otago
PO Box 56 Dunedin New Zealand
Phone +64 3 479 7508
Email tracy.perry@stonebow.otago.ac.nz
Web glycemicindex.otago.ac.nz

See The New Glucose Revolution on YouTube

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