GI News—October 2005

In This Issue:

• Waist Not, Want Not.
• Just a Spoonful of Dressing …
• From Flab to Fab
  
• Is There More to Fibre than Crunch
• Low Sat Fat + Low GI = Prevention of Heart Disease

• ‘Cherries, Ripe Cherries’
• The Versatile Tortilla—Perfect for Wrapping, Scooping and Dipping
• Conchiglie with Pesto Balsamico
  
  
• What Makes My Blood Glucose Go Up and Down?
• Why do many high-fibre foods still have a high GI value?
• I was surprised to find that the American Diabetes Association has taken a position that is not supportive of your research. The comments I read in a Guest Editorial of their Sept 2005 issue of Diabetes Forecast suggest your approach may be more of a fad than a useful tool.
  

If you have posted a question on one of the stories in our newsletter, be assured that the GI Group will answer this as soon as possible. We welcome your views about our articles and other reader’s suggestions. Please POST your comments on the site.

If you want to print a copy of just one article (ie. the recipe from the newsletter, simply click on the recipe or article name in the right-hand column under PREVIOUS POSTS. You will arrive at the page you have chosen. Select PRINT and you will find that you can print just the information you want.

To receive our free newsletter each month, click the SUBSCRIBE link in the right-hand column. Your email address will be kept strictly confidential and that you can unsubscribe at any time.

‘People who eat three or four serves of fruit a day

(particularly apples and oranges)

have the lowest overall GI and the best blood glucose control.’

Jennie Brand-Miller

Food for Thought

Waist Not, Want Not— By Maggie Alderson
I can get my skinny jeans off without undoing them … This waistband revolution is the result of two months on the GI diet—which stands for ‘glycaemic index’, meaning how fast foods break down into sugars in your bloodstream. The lower the GI, the slower it breaks down - which is good, because you feel full longer.

In that time, following a diet I have found effortless—even enjoyable—to stick to, I have lost five kilos. That might not be much on a big bloke, but when you're just a little squirt like me, it means you're down a full dress size, a bra size and all your belt notches. More importantly, I am also down below the non-negotiable, crucial waist measurement which medical opinion now prescribes for women as being essential for long-term heart health: 88 centimetres.

… the thing that really inspired me to embark upon it - quite apart from general fashionista vanity and horror of the elasticised waistband - is that my dear old dad had his first heart attack at the age of 50. I am now at the stage in my own life when that birthday is no longer looking like something that only happens to other people. I can see it on the horizon now - without a telescope. And I was all too aware that I was carrying my excess weight in the worst place you can for heart disease risk; around the middle, like a lifebelt.

I was only 10 years old when Doug had that first heart attack and I remember it all too clearly. Characteristically, he was watching sport on TV at the time. Over the next few years he had several more and he was in and out of hospital - with that pitiless monitor going beep beep beep - his health gradually declining, until he died of heart failure at 63.

His last few years weren't that much fun for a man who used to play serious rugby union. So out of respect for his memory - and in the understanding that I have inherited his excitable ‘A-type’ personality, which is another heart-risk indicator - I felt I had to turn that apple-shaped abdomen into something more closely resembling a healthy violin. Or at least a cello.

And it's happened. I'm not Jessica Rabbit yet (I would like to lose another three kilos...) but, my goodness, I'm looking - and feeling - better than I did two months ago. But the real revelation of this diet journey for me—and I've been on every fad diet that has come out in the past 25 years - is that this is the only one of any of them that has actually lived up to all the breathless hype in the opening chapters.

You know where they all say: You won't feel hungry! You can eat delicious meals! The whole family can eat the same food and not notice! You can eat out in restaurants! You can break it occasionally for special occasions and carry on losing! You are going to want to carry on eating like this for the rest of your life! Well, for this diet, it's all true. A-m-a-z-i-n-g.

I'm not spruiking one particular diet book here—there are loads of different versions of the GI system on sale now and I have several. They differ in details, but the message is the same. And the message is some kind of a miracle. I commend it to you. I just wish it had been around when my dad was still alive.

—This piece is reproduced with permission of the author. It was first published in Good Weekend, the Saturday magazine of the Sydney Morning Herald and The Age, where Maggie Alderson writes each week. Her columns have also been collected into two books, Shoe Money and Handbag Heaven (Penguin). She's still doing well on the low GI diet ...


Maggie Alderson
Photo: Derek Henderson

GI News Briefs

Just a Spoonful of Dressing …
One of the biggest challenges to losing weight is ignoring that gnawing feeling in your gut. Hunger. To date, more than 20 studies around the world have confirmed the remarkable fact that low GI foods, in comparison to their nutrient-matched high GI counterparts, are more filling, delay hunger pangs for longer, and/or reduce energy intake for the remainder of the day.

Now Swedish researchers report in the European Journal of Clinical Nutrition that vinegar (acetic acid) may also help dieters eat less and reduce cravings brought on by sugar spikes after meals. They found ‘a direct relationship between increased acetic acid and satiety’ according to the study’s lead author, Elin Ostman from Lund University. After an overnight fast, volunteers were given vinegar diluted in water with a portion of white bread containing 50 grams of available carbohydrates. The reference meal was bread without the vinegar. Satiety was measured on a subjective rating scale at 30, 90 and 120 minutes after the meal. The more vinegar they consumed (up to 2-3 tablespoons), the more satisfied the volunteers felt. Olstrom notes that the study could explain why some people feel a benefit of drinking a glass of vinegar and water before a meal.



—Reported in the European Journal of Clinical Nutrition (vol 59, issue 9, pp983−988)

Alternatively, try a spoonful of vinaigrette dressing (2 parts red or white vinegar to 1 part oil) with salad. It can lower the blood glucose response of a meal by up to 30 per cent according to Brand-Miller and her co-authors in The New Glucose Revolution.

Is There More to Fibre than Crunch?
A recent Danish study reported in Diabetes Care, the official journal of the American Diabetes Association, shows dietary fibre, but not the glycemic index, is important in prevention of insulin resistance.’ Using baseline data from the Danish population-based ‘Inter99 Study’, Catherine Lau and her team estimated dietary intake (total carbs, GI, GL, fibre and sucrose) from self-administered food frequency questionnaires of 5,675 non-diabetic Danish men and women aged between 30 and 60. They conclude that: ‘the present study does not support the hypothesis that habitual intake of diets with a high glycemic index and high glycemic load is associated with insulin resistance.’ They also point out that ‘intake of simple sugars in itself is not associated with an increased insulin resistance.’ However, the authors don’t give the reader any idea of the average in GI or GL in this population. It’s possible that the range is just too narrow. Their findings contrast with those of the Framingham Offspring Study reported in Diabetes Care in 2004.

—Reported in Diabetes Care, Volume 28, Number 6, June 2005

From Flab to Fab
‘When you lose weight through severely restricting your food intake, you lose some of your body’s muscle mass. Over the years this form of dieting will change your body composition to less muscle and proportionately more fat, making weight control increasingly difficult. Your body’s engine requires less and less energy to keep it ticking over. In fact it is sad but true that most people regain the weight they lost. A good diet does not require a lot of sacrifice or discipline—it’s sustainable over the long term because it’s enjoyable,’ say Brand-Miller and her co-authors in The Low GI Diet.

A reduced energy diet, the traditional treatment for obesity, has been only partially successful, write Austrian researchers in Diabetes, Obesity and Metabolism. Poor adherence long term and a significant loss of lean body mass resulting in a decrease of energy expenditure are contributing factors. Based on the growing body of evidence of the benefits of low GI carbs, the research team undertook a 24-week feasibility study to evaluate the effect on weight loss, body composition changes and dietary compliance of a low-fat diet with unrestricted low GI carbs. They found that combined with advice by a dietitian and bi-weekly one-hour group meetings, the low-fat, low-GI diet led to a significant reduction (-15%) of fat mass but only a small decrease in lean body mass (just -5%). Not only that, 109 of the 120 patients who took part stuck to the diet losing an average 8.9 kg (that’s around 370 grams a week on average). Lead author Babak Bahadori says that the diet may have benefited patients ‘by promoting satiety; and by promoting fat oxidation.’

—Reported in Diabetes, Obesity and Metabolism, 7, 2005, 290–293

Low Sat Fat + Low GI = Prevention of Heart Disease
Reduce blood sugar levels and you’ll reduce the risk of coronary heart disease say US researchers in Archives of Internal Medicine. According to lead author Elizabeth Selvin, ‘… lifestyle modifications, such as increased physical activity, weight loss and eating a healthful, low-glycaemic index diet rich in fibre, fruit and vegetables, may not only help prevent diabetes, but also reduce the risk of heart disease.’ The research team reports that elevated hemoglobin A1c—a measure of long-term blood glucose level that hovers between 4% and 6% in most people—is an independent risk factor for CHD even in those without diabetes. Their study was based on a prospective analysis of 1321 adults without diabetes and 1626 adults with diabetes from the Atherosclerosis Risk in Communities Study. Assessing the relationship between HbA1c level and CHD during 8 to 10 years of follow-up, they found that heart disease risk was almost doubled in people with HbA1c levels of 6 per cent or higher compared with people with an HbA1c level below 4.6 per cent.

—Reported in Archives of Internal Medicine, September 2005 (165, pp1910-1916).

GI Values Update

‘Cherries, ripe cherries …’
Summer just wouldn’t be the same without juicy, cheerful cherries. Well supplied with nutrients—vitamin C, beta-carotene, potassium, a little iron and some fibre—they are also high in phytochemicals such as anthocyanins (the pigments responsible for the red and blue colours of fruits and vegetables). And quercetin, an antioxidant that may have anti-inflammatory properties making cherries (particularly cherry juice) of interest to people who suffer from gout.



There are numerous varieties, but two basic types: sweet cherries (Prunus avium) and sour (also called tart or pie) cherries (P. cerasus). Buy fresh sweet cherries with the stems intact and store unwashed and loosely packed in plastic bags in the refrigerator. They should keep for up to a week, but it is a good idea to check occasionally and remove any that have begun to go mouldy. You can extend the all-too-short cherry season by freezing them. Rinse and drain thoroughly, then spread the cherries out on a baking tray, freeze, then place the cherries in a plastic container or freezer bag. They should keep for up to a year.

Although you can find fresh sour cherries in produce stores and markets (usually without stems), commercially grown sour varieties are usually canned, dried or frozen for use in throughout the year.If you can’t find dried sour/tart cherries in your supermarket, look for them in specialist produce stores. They are not widely available in Australia, for example, but well worth tracking down. One supplier is Dry Ideas, an innovative fruit drying company based in Tasmania that’s been developing preservative free (no sulphur) dried sour cherries, blueberries and apricots for the past 10 years. For more information go to http://www.scientifichorticulture.com.au/. North American readers can check out availability at http://www.usacherries.com/ (Where To Buy).

Because cherries are a good source of carbohydrate, they can be glycemic index tested. The original GI for cherries (22) was based on an early European study that may not have been reliable. Later tests of red ripe Australian cherries, with 6 per cent glucose and 4 per cent fructose, produced a higher GI (65). Dried and frozen Montmorency tart cherries have recently been tested by Glycemic Index Laboratories in Toronto (www.gitesting.com) for the Cherry Marketing Institute in the US.

Montmorency tart (sour) cherries

• Frozen tart cherries GI 54
• Dried tart cherries GI 58

Fire-Roasted Corn and Cherry Salsa

Serve this medium-hot salsa from the Cherry Marketing Institute with grilled chicken, pork or fish. Use fewer or more chipotle chillies to make salsa milder or hotter. For more cherry recipes go to to http://www.usacherries.com/

Makes 3 cups



1 cup (180 grams/6 1/4 oz) dried tart cherries
1/2 cup (125 ml/4 fl oz) water
3 fresh corn ears, shucked
1 small red (Spanish) onion, chopped
1 tablespoon finely chopped garlic
1/4 cup (15 grams/½ oz) chopped coriander (cilantro)
2 to 3 whole chipotle chillies in adobo sauce, finely chopped
1/2 cup (125 ml/4 fl oz) lemon or lime juice
Salt, to taste

1) Heat the cherries and water in a small saucepan. Simmer for about 5 minutes, or until the cherries have plumped and water is slightly syrupy. Set aside to cool.
2) Meanwhile, roast each ear of corn directly over gas flame on the stovetop or over a gas grill or barbecue (just as you would for a roasted capsicum/pepper). Turn the corn until each ear is slightly charred all around. Set aside to cool. Cut corn kernels from cobs.
3) Combine corn, cherries with liquid, onion, garlic, coriander, chillies and lemon juice. Season with salt to taste and serve.

Cook’s Tips

• Use 2 or 3 dried chipotle chillies rehydrated in a little water if chipotle chillies in adobo sauce aren’t stocked at your local supermarket or corner store.
• Adobo Sauce is a spicy tomato sauce made with ancho (poblano) chillies, cumin, oregano, cayenne and tomato sauce. There’s a great recipe for it in The Wholefoods Market Cookbook.

Low GI Food of the Month

The Versatile Tortilla—Perfect for Wrapping, Scooping and Dipping
Tortillas are a flat (unleavened) bread traditionally made from corn (maize) flour. A staple of Mexican cuisine, they are quite different from the Spanish tortilla, which is a type of omelet. And when made in the traditional Mexican way, whether from corn or wheat flour, they have a low GI.


Photo: Ian Hofstetter, The Low GI Diet Cookbook

Almost any kind of food that does not contain too much liquid—beans, corn or chicken, chilli or salsa—can be placed on or wrapped in the versatile tortilla for a complete meal. Make the most of them with your favourite recipes for burritos, enchiladas, fajitas and quesadillas (but hold the creamy dips) or use as rolls, wraps or scoops. Corn tortillas are also a good alternative to bread if you are gluten intolerant.

To make bean and corn burritos, preheat the oven to 180°C (350°F/gas mark 4). Combine a 400 gram (14 oz) can of corn kernels, drained, a 400 gram (14 oz) can of red kidney beans, rinsed and drained, 2 large ripe tomatoes, chopped, 2 shallots, finely sliced and 75 g (2½ oz) prepared taco sauce in a bowl. Wrap four 15 cm (6-inch) white corn tortillas in foil and warm in the oven for 5 minutes. To assemble, spread shredded lettuce over a warmed tortilla, and top with the bean mixture and a little grated fat reduced cheese. Fold the bottom of the tortilla over the filling, and roll up to enclose. Serve immediately. Makes 4.

Low GI Recipe of the Month

Conchiglie with Pesto Balsamico
Dietitian, diabetes educator and author, Johanna Burani, cooked up this quick and easy pasta recipe especially for GI News! We wanted something simple and convenient and ‘very Italian’. ‘This pasta is nourishing, easy to prepare and something Italian cooks serve regularly to their families,’ says Johanna. Try it with salads on the side such as rocket and Parmesan, tiny vine tomatoes drizzled with good quality balsamic vinegar and a little olive oil.

Makes 4 servings


Photo: Jennifer Soo, The New Glucose Revolution Life Plan

250 g (8 oz) conchiglie (shell), farfalle (bowtie) or your favourite pasta shapes
1 cup (250 g) part skim ricotta cheese
2 tablespoons good quality pesto sauce
3–4 teaspoons good quality balsamic vinegar

1) Bring 2 litres (4 quarts) of salted water to a boil in a large pot. Add the pasta and stir. Cook approximately 12 minutes; the pasta should be al dente.
2) In the meantime, mix the ricotta and pesto in a small bowl until smooth. Set aside.
3) When the pasta is cooked, drain and return it to the pot. Quickly add the vinegar and mix well.
4) Pour the prepared sauce and toss. Serve immediately. Grated pecorino cheese is optional.

Per serve (1 cup)
1453 kJ (346 Cal) 11 g, 16 g protein, 45 g carbohydrate 2 g fibre

Johanna Burani MS, RD, CDE is a registered dietitian and certified diabetes educator in private practice in northern New Jersey. She counsels and lectures on healthful low glycemic eating. She particularly enjoys sharing recipes from her international background with her patients. She is the author of Good Carbs Bad Carbs and the American co-author with Prof Jennie Brand-Miller and Kaye Foster-Powell of The New Glucose Revolution Life Plan. She can be reached at: jburani@gmail.com

New Books

What Makes My Blood Glucose Go Up and Down?
In the foreword to the UK edition of What Makes My Blood Glucose Go Up and Down:
Sir Michael Hirst, Chairman, Diabetes UK (http://www.diabetesuk.org/) says:

‘One of the most challenging problems for people with diabetes, particularly the recently diagnosed, and their carers, is trying to maintain good glycaemic control. When my daughter, diagnosed with type 1 diabetes at the age of five, was younger, we were often mystified as to why her blood sugar levels varied for no apparent reason. There was often the suspicion that an unauthorised visit to the sweetie jar had taken place! More challenging still was to find out the effect of particular foods and drinks on blood glucose levels in the days when food labelling was very much less sophisticated. Such books and periodicals as we could access never really provided all the answers we wanted, and it was thus hard to add to our knowledge base.



‘This books provides a wealth of information to enable the patient, carer and family to be much better informed about the circumstances in which blood glucose levels vary. As such it is a vital support for self-management and an excellent reference book, not least for the parents of younger people with diabetes. As food and drink producers become more sensitive to the demand from the public—and not just those with diabetes—for the information on glycaemic index and glycaemic load and improved labelling on food and drink, an informed and independent guide, written for members of the public, is much to be welcomed.

‘Every professional involved in diabetes care, reinforced by a huge weight of clinical research evidence, knows that good glycaemic control is vital in maintaining continuing good health in the person with diabetes, and avoiding the serious, unpleasant and costly complications which can arise. In explaining the many reasons why blood glucose levels vary, and in offering related advice on diet and glycaemic control, care professionals will find this a most useful book to recommend to those who want to be, and remain, healthy.

‘What Makes My Blood Glucose Levels Go Up…and Down? is written in straightforward terms that patients and carers can readily understand and offers a lot of sound advice, by authors who have extensive knowledge and practical experience. From their separate standpoints as scientist, dietitian and person with diabetes, Jennie Brand-Miller, Kaye Foster-Powell and David Mendosa have covered all angles and have produced a definitive guide which is all the more helpful because it stands above the often conflicting welter of commercially inspired information about diets, blood glucose levels and health.’

UK: Vermillion
USA: Marlowe & Company
Taiwan: The Eurasian Publishing Group
Australia/New Zealand: Hachette Livre Australia

Feedback—Your FAQs Answered

Why do many high-fibre foods still have a high GI value?
Dietary fibre is not one chemical constituent like fat and protein. It is composed of many different sorts of molecules and can be divided into soluble and insoluble types. Soluble fibre is often viscous (thick and jelly-like) in solution and remains viscous even in the small intestine. For this reason it makes it harder for enzymes move around and digest the food. Foods with more soluble fibre, like apples, oats, and legumes, therefore have low GI values.

Insoluble fibre, on the other hand, is not viscous and doesn’t slow digestion unless it’s acting like a fence to inhibit access by enzymes (eg the bran around intact kernels). When insoluble fibre is finely milled, the enzymes have free reign, allowing rapid digestion. Wholemeal bread and white bread have similar GI values. Brown pasta and brown rice have similar values to their white counterparts.

After reading your book I thought the idea of finding and eating low GI carbs seems very logical. So I was surprised to find that the American Diabetes Association has taken a position that is not supportive of this research. The comments I read in a Guest Editorial of their Sept 2005 issue of Diabetes Forecast suggest your approach may be more of a fad than a useful tool.
Our response: We found this Guest Editorial rather odd because the American Diabetes Association has given cautious endorsement to the glycemic index. In its September 2004 Statement on carbohydrates one of the final recommendations is ‘the use of this technique can provide an additional benefit over that observed when total carbohydrate is considered alone.’ (Nancy Sheard et al. Diabetes Care 2004; 27: 2266).

Our advice? In Low GI Eating Made Easy, dietitian Kaye Foster-Powell says: ‘On a day-to-day basis, low GI foods can minimise the peaks and troughs in blood glucose that make life so difficult when you have diabetes. Since they are slowly digested and absorbed, low GI foods reduce insulin demand—lessening the strain on the struggling pancreas of a person with type 2 diabetes and potentially lowering insulin requirements for those with type 1 diabetes. Lower insulin levels have the follow-on benefit of reducing the risk of large blood vessel damage, lessening the chance of developing heart disease. There isn’t any one optimum diet for all people with diabetes. Whether you eat higher fat, low fat, high protein, high carb or whatever, certain characteristics are desirable. They are to eat:

• Regular meals and choose slowly digested carbs with a low GI
• Plenty of vegetables and fruits
• Only small amounts of saturated fat
• A moderate amount of sugar and sugary foods
• Only a moderate quantity of alcohol
• A minimum amount of salt and salty foods

GI News—September 2005

In This Issue:

• The Low GI Diet—More Than Just “The Next Big Thing”
• Vegetarian Women Are Less Likely to Get Fat
• Whey to Health
  
• No Mixed Message About GI and Mixed Meals
• Added Risks

• Breakfasts That Sustain You Through the Morning
• Chickpeas
• Syrupy Oranges with Yoghurt
• The Low GI Diet Cookbook
  
  
• What connection is there between acne and GI?
• I have been reading What Would Jesus Eat? Would this be a low GI diet?

If you have posted a comment or question on one of the stories in our newsletter, be assured that the GI Group will answer this as soon as possible. Sometimes we need to do some research first, and this may take a little time.

If you want to print a copy of just one article (ie. the recipe from the newsletter), simply click on the recipe or article name in the right-hand column under PREVIOUS POSTS. You will arrive at the page you have chosen. Select PRINT and you will find that you can print just the information you want.

To receive our free newsletter each month, click the SUBSCRIBE link in the right-hand column and send us an email. Be assured that your email address will be kept strictly confidential and that you can unsubscribe at any time if you wish.


Jennie Brand-Miller

GI News Briefs

Vegetarian Women Are Less Likely to Get Fat
Vegetarian and vegan women are less likely to be overweight than meat-eaters even accounting for age, exercise and total kilojoule/calorie intake according to a new study. PK Newby and researchers at Tufts University report their study of 55,459 healthy, middle-aged and older Swedish women who were surveyed about their eating habits, weight and other health and lifestyle factors in the June issue of the American Journal of Clinical Nutrition. They found that 40 per cent of the women who said that they ate meat, poultry, fish, eggs and dairy products as well as plant-based foods were overweight or obese (a BMI of 25 or more) compared with 29 percent of the vegans (no animal products) and semi-vegetarians (dairy foods and fish occasionally). Lacto-vegetarians (dairy products but no meat, poultry, fish or eggs) were the leanest group with 25 percent identified as being overweight or obese. ‘In the present study, energy intakes were higher and fiber intakes were lower as more animal products were included in the diet,’ they said.

‘Notably, all the vegetarian groups had higher intakes of fruit, vegetables and fiber and lower intakes of fat and protein,’ the researchers write. ‘That vegetarians are leaner and have a reduced risk of overweight or obesity despite higher total carbohydrate intake points to the importance of differentiating between types of carbohydrate when selecting diets including weight-loss diets. Current fad diets that emphasize low carbohydrate intakes ignore the fact that whole and refined carbohydates evoke different metabolic responses. This study and others suggest that a high carbohydrate diet may be protective against obesity if the carbohydrates come from fiber-rich foods such as fruit, vegetables and whole grains,’ they said. ‘The advice to consume more plant foods and less animal products may help individuals control their weight.’
—Reported in American Journal of Clinical Nutrition (Vol. 81, No. 6, 1267–1274, June 2005)

Whey to Health
For people with type 2 diabetes, adding whey protein, not any old protein, to a high GI meal with rapidly digested and absorbed carbohydrates can stimulate insulin release and reduce blood glucose spikes after meals according to Dr Mikael Nilsson of Lund University, Sweden writing in the American Journal of Clinical Nutrition. In a small study, Nilsson and his team gave fourteen people with type 2 diabetes a high-GI breakfast (white bread) followed by a high-GI lunch (mashed potatoes with meatballs) both supplemented with either whey protein or ham. They report that when whey was included in the meals, insulin responses were higher, but the rise in blood glucose after the lunch was significantly reduced. In other words, whey protein had the same action as some of the drugs that are frequently added to diabetes therapy. Increasing insulin responses with whey protein ‘might improve glucose homeostasis in type 2 diabetic patients and could possibly postpone the introduction of medical treatment,’ states Nilsson.
—Reported in American Journal of Clinical Nutrition (Vol 82, No. 1, 69–75, July 2005)

No Mixed Message About GI and Mixed Meals
Because most GI testing involves single foods, the question is often asked whether the GI can be applied to mixed meals. ‘The GI concept can be successfully applied to mixed meals that would be consumed in a real life setting,’ report Dr Emma Stevenson, Prof Clyde Williams and Maria Nute in The British Journal of Nutrition. The Sport and Exercise Nutrition Group at Loughborough University investigated the effects of changing the GI of high-carbohydrate mixed meals. Nine recreationally active men took part in two randomised trials. For one they ate a low GI breakfast (GI 44) and lunch (GI 34); and for the other a high GI breakfast (GI 76) and lunch (GI 73). After a three-hour rest they did a 60-minute treadmill run. The researchers found not only that blood glucose and insulin levels were significantly lower after the low GI meals, but also that the utilisation of fat was greater during the 3-hour rest. This could have important implications for weight control.
—Reported in The British Journal of Nutrition (2005; 93, 885–893)

Added Risks
Insulin resistance is an important risk factor for congestive heart failure independent of diabetes, reports Dr Erik Ingelsson in the July issue of the Journal of the American Medical Association. Heart failure's main causes are high blood pressure and coronary artery disease. Smoking, obesity, high blood fat levels, diabetes, valve-related heart disease, and a thicker-than-normal left ventricle in the heart may increase the risk of developing heart failure. The new Swedish study adds insulin resistance to the risk factor list. Ingelsson of the public health and caring sciences departments at Sweden's Uppsala University and his team studied more than 1100 older men for about nine years, on average. The men were all at least 70 when the study started and none had congestive heart failure at the time. During the study, 104 men developed congestive heart failure. They found that insulin resistance predicted the incidence of heart failure independently of other established risk factors. ‘Our observations may indicate that the risk for congestive heart failure is already increased in the long subclinical phase of impaired glucose regulation that precedes clinically manifest diabetes,’ they write.
—Reported in The Journal of the American Medical Association (2005;294:334-341)

Food for Thought

The Low GI Diet—More Than Just “The Next Big Thing”
According to analysts at the market research/consumer intelligence company, Mintel International, American dieters are beginning to show interest in the glycemic index (GI) diet. ‘With the Atkins diet crashing financially, many consumers are in search of “the next big thing,”’ they report.

But encouraging people to adopt a low GI diet is not about being “the next big thing” for the weight loss industry or a best-seller list. For nutritionists and dietitians, it’s about encouraging people to adopt a way of eating that will make a real difference to their lives helping them to maintain long-term health and wellness and reducing their risk of developing chronic and crippling diseases such as type 2 diabetes and heart disease. The real reward is when someone with diabetes says that the GI has transformed their life—and you can see that it has.

Low GI eating not only has science on its side, it dovetails with the key dietary guideline of countries right around the world: ‘Eat a wide variety of foods.’ Low GI carbs are found in four of the five food groups. There are wholegrains and pasta in the bread and cereal group; milk and yoghurt among the dairy foods; legumes in the meat and alternatives group; and virtually all fruits and vegetables (with potato one notable exception) in the group we should eat the most of!


Photo: Ian Hofstetter, The Low GI Diet Cookbook

The low GI diet is not a restrictive diet. No one has to jump through a hoop or turn themselves inside out (or even buy a book) to adopt this back-to-the-future, commonsense way of eating that delivers taste, nutrition, satisfaction and wellbeing as we eat food closer to the way nature intended. It’s suitable for the whole family as it essentially encourages a ‘this for that’ approach to making some simple changes—such as swapping white bread for a grainy one or cornflakes for natural muesli or porridge.

What are the lifelong benefits?
Low GI eating:

• Reduces your insulin levels
• Lowers your cholesterol levels
• Controls blood glucose levels
• Halves your risk of heart disease and diabetes
• Helps control your appetite

GI Values Update

Breakfasts That Sustain You Through the Morning
Whether you like waking up to cereal and fruit, muesli and yoghurt, or a warming bowl of porridge, a good breakfast can set you up for the day. Given the solid evidence that people who eat breakfast are calmer, happier and more sociable, the number of people skipping breakfast is an alarming trend. In fact skipping breakfast is a counterproductive way to restrict kilojoules/calories. Breakfast skippers, research shows, tend to make up for the missed meal by eating more snacks during the day and more food overall. The habit can leave you feeling fatigued, dehydrated and without energy for the day’s decisions.

Studies regularly show that eating breakfast improves mood, mental alertness, concentration and memory. Nutritionists also know that having breakfast helps people lose weight, can lower cholesterol levels and helps stabilise blood glucose levels. But what you eat for breakfast is critical. Firing up your engine with high GI crispy flakes (even bran flakes) or regular toast provides a short-lived fuel supply that will send you in search of a top-up snack within a few hours. If you want something to nourish your body, boost your fibre intake and sustain you right through the morning, start the day with the right fuel—low GI carbs—muesli, porridge, wholegrain toast etc.


Photo: Ian Hofstetter, The Low GI Diet Cookbook

A world first! Three new breakfast cereals specifically developed to achieve a healthy low GI product were recently launched in Australia. From the makers of the popular low GI Burgen breads, the three new Burgen cereals give Australian consumers more low GI breakfast options with taste, nutrition and satisfaction to sustain them through the morning:

• Burgen Soy-Lin Muesli Cereal GI 51
• Burgen Rye Muesli Cereal GI 41
• Burgen Fruit & Muesli Cereal GI 51

For readers from other countries, remember the power of consumer demand. In a recent ‘Perspective’ in Food Technology (July 2005), Prof S. Jay Olshansky and Dr David Ludwig remind the food industry that ‘there are profits aplenty for companies willing to market, in a socially responsible manner, products that are both healthful and appealing.’ You can encourage them to do this. Tell them to look at the Burgen success story.

Low GI Food of the Month

Chickpeas

GI 28 (home cooked)
GI 40 (canned)

For low GI foods that are easy on the budget, versatile, filling, low in kilojoules and nutritious, look no further than legumes—beans, chickpeas and lentils. They are high in fibre and packed with nutrients, providing protein, carbohydrate, B vitamins, folate and minerals.

Chickpeas, also known as garbanzo beans or ceci, have a nutty flavour and firm texture. Popular in Middle Eastern, Mediterranean and Mexican cuisine, they are the main ingredient in specialties such as hommous and felafel and the basis for many vegetarian dishes. Keep a can in the pantry or cooked chickpeas in the fridge and add them to soups, stews and salads or to a tomato-based sauce served with couscous or rice. After soaking, whole chickpeas can be roasted with salt and spices to make a crunchy low GI snack that’s every bit as more-ish as potato crisps!

Legumes are an important part of a low GI diet which is why it’s a good idea to try to include them in your meals at least twice a week as a starchy vegetable alternative—more often if you are vegetarian.

Salad of Grilled Chicken with Black Sesame

This is one of those recipes where the leftovers are just as delicious if not more so. It’s great for a buffet spread or for a family meal. You could save preparation time by buying a cooked chicken, but remove the skin. Here we give you a lower fat version of the recipe that was originally created by Sean Anderson, National Food and Brand Manager for Compass Group (Australia). It is from Spicery by Ian and Liz Hemphill who run Herbies Spices in Sydney, Australia. If you would like to find out more about Spicery or order a copy, click on this link www.herbies.com.au

Serves 6 with a couple of crispy salads on the side

1 kg (2 1/4 lb) pumpkin or winter squash such as ‘butternut’, peeled and chopped into 1 cm (1/2 inch) dice. You will end up with about 800 g pumpkin or squash
1 large Spanish onion, finely sliced
olive oil spray
1 x 250 g (9 oz) skinless chicken breast
2 x 400 g (14 oz) cans chickpeas, rinsed and drained
sea salt and freshly ground black pepper (optional)
2 teaspoons finely chopped fresh parsley
2 teaspoons finely chopped fresh coriander (cilantro)
1 teaspoon black sesame seeds

Dressing
1/3 cup (80 ml or 2 3/4 fl oz) olive oil
1 teaspoon mustard powder
1/4 cup (60 ml or 2 fl oz) white vinegar
1 1/2 teaspoons pomegranate molasses or balsamic vinegar
1 tablespoon lemon juice
1 teaspoon caster (superfine) sugar

1) Preheat oven to 180°C (350°F). Lightly spray the pumpkin or squash dice and chopped onion with the olive oil spray, mix well and place on a baking tray. Roast for about 20 minutes or until the vegetables are just lightly browned and cooked through. Remove from the oven and set aside.
2) Lightly spray the chicken breast with the olive oil spray and season with salt and pepper if you wish. Place the chicken on a baking tray and roast in the oven for about 10 minutes or until it is just cooked through, turning once. Remove the chicken from the oven. Allow it to cool completely, then slice it finely on an angle, crosswise. Place the chicken slices in a bowl, cover with cling film and refrigerate until you are ready to serve.
3) To make the dressing, whisk the olive oil, mustard powder, white vinegar, pomegranate molasses, lemon juice and sugar together in a medium-sized bowl.
4) To make the salad, put the cooked vegetables and chicken slices in a large bowl with the chickpeas, herbs and black sesame seeds. Gently fold the dressing through until all ingredients are just lightly coated and serve immediately.

Photo: Greg Elms, Spicery. A cook’s guide to culinary spices (Hardie Grant Books)

Cook’s tips

• Black (or golden brown) sesame seeds are simply white ones with their shell or outer husk on, making them a little tougher to bite on, and not quite as nutty in flavour as the better-known white seeds. However, it’s these ones that have the calcium, although it’s not as well absorbed as calcium from milk. You’ll probably have to go to a specialty spice store or Asian food shop for these or buy online.

• Pomegranate molasses is a deep red almost black thick molasses with a rich berry-like fruitiness and citric tang. It is available from Middle Eastern and specialty food stores and does not need to be kept in the refrigerator after opening. However, in winter the ‘liquid’ can get very thick and you may have to sit the bottle in hot water to get it to pour.

Per serve
Nutritional Analysis per Serve
1732 kJ (412 Kcal), 22.1g fat (3.5g sat fat), 22.4g protein, 27g carbohydrate, 10.4g fibre

Low GI Recipe of the Month

Syrupy Oranges with Yoghurt
One orange is something of a personal protection powerhouse, providing you with your whole day’s vitamin C requirement. Oranges are rich in anti-oxidants and are good sources of folate and potassium. Much of their sugar is sucrose, a ‘double’ sugar made up of glucose and fructose. When digested, only the glucose molecules have an impact on your blood glucose levels which along with the high acid content, account for the low GI.

Serves 2

juice of 1 orange
2 tablespoons sugar
2 large oranges, peeled, pith removed
1 tablespoon brandy or Cointreau™ liqueur (optional)
100 g (31/2 oz) frozen low fat yoghurt
4 slices almond bread

1) Combine the orange juice, sugar and 60 ml (2 fl oz/1/4 cup) water in a frying pan. Stir over medium heat until the sugar dissolves. Reduce the heat to low and simmer, without stirring, for 10–12 minutes to reduce the syrup.
2) Cut the peeled oranges into slices about 1 cm (1/2 in) thick and add to the syrup in the pan. Add the brandy or liqueur, bring to a simmer and cook for 3 minutes.
3) Spoon the oranges into bowls and pour over the syrup. Top with a scoop of frozen yoghurt and serve with the almond bread.


Photo: Ian Hofstetter, The Low GI Diet Cookbook

Cook’s tip

• Almond bread is a very thin, slightly sweet crispbread containing whole almonds. It is available in the biscuit or gourmet section of supermarkets.

Per serve
1250 kJ (300 Cal), 4 g fat (saturated 2 g), 6 g protein, 55 g carbohydrate, 4 g fibre, 38 mg sodium

New Books

The Low GI Diet Cookbook
Prof Jennie Brand-Miller, Kaye Foster-Powell and Joanna McMillan-Price

The Low GI Diet Cookbook from the creators of The Low GI Diet is packed with mouth-watering meals, snacks and treats to help you put the GI to work in your kitchen—and throughout your day. The book is filled with low GI recipes that the authors love to cook themselves. They come from their own home kitchens; and the kitchens of their families, friends and favourite celebrity chefs and food writers such as Antonio Carluccio, Margaret Fulton, Julie Le Clerc, Luke Mangan, and Rick Stein.



The Low GI Diet is more than a weight-loss plan. It’s a simply delicious way of eating based on choosing low GI carbohydrates – the smart ones that produce only gentle rises in your blood glucose and insulin levels. Lowering insulin levels is a key factor in helping you shed unwanted kilos, and the secret to long-term health, reducing your risk of diabetes and heart disease.

High in nutrition and full of flavour the low GI recipes here are rich in lean proteins, good fats, vital vegetables and healthy wholegrains. They represent a way of eating that’s part and parcel of many ethnic cuisines. Having stood the test of time, they are naturally and simply delicious. From cook’s tips and serving suggestions, to fitness and shopping tips, there’s never been a better or more attractive way to live the Low GI way.

About the Authors

Prof Jennie Brand-Miller is an internationally recognised authority on carbohydrates and health. She is Professor of Human Nutrition at the University of Sydney.
Kaye Foster-Powell is an accredited practising dietitian providing consultancy on all aspects of health, diet and GI. Together they have authored 17 titles in the worldwide bestselling New Glucose Revolution™ series.
Joanna McMillan-Price is a nutritionist and fitness instructor. She is completing her PhD at the University of Sydney on the links between the glycemic index and weight loss.


The Low GI Diet Cookbook will be published in:

Australia: September 2005 (Hachette Livre Australia)
New Zealand: October 2005 (Hachette Livre New Zealand)
UK: January 2006 (Hodder Mobius)
USA: November 2005 (Marlowe & Company)

Feedback—Your FAQs Answered

What connection is there between a high GI diet and acne?
The jury is still out on the acne diet link. But the debate is ongoing. After Prof Loren Cordain and his colleagues published ‘Acne Vulgaris: A Disease of Western Civilization,’ Archives of Dermatology/Vol 138, December 2002) we have received a number of questions asking where you can read more about GI and acne.

In Cordain’s article, he and his colleagues note the complete absence of acne among the non-westernized Kitavan Islanders living on the Trobriand Islands near Papua New Guinea and the Aché hunter-gatherers of Paraguay. According to Cordain, the perfect skin could not be explained just by genetic factors, but likely was the result of differing environmental factors including diet. The Kitavan diet consists mainly of fruit, fish and tubers and is virtually uninfluenced by Western foods. The Aché diet includes wild (game) and foraged foods, locally cultivated foods (peanuts, maize, rice and sweet manioc, a native root) and a small percentage of Western foods (pasta, flour, sugar, tea and bread).

Cordain believes the Western diet filled with refined carbs permanently boosts the production of the hormone insulin, which leads to acne. By elevating growth factors and hormones, insulin indirectly stimulates the overproduction of oil and skin cells in pores. Clogged pores nourish bacteria, forming infected blemishes.

Follow up research on GI and acne is underway but nothing has yet been published. However, you can read Cordain’s article in full on www.thepaleodiet.com (PDF, 108 kB).

I have been reading What Would Jesus Eat? Would this be a low GI diet?
Our best guess is yes. People living in the Middle East 2000 years ago would have eaten a healthy Mediterranean-style diet that fits naturally into the low GI way of eating with lots of low GI carbohydrates including fruit, vegetables, legumes and cereal grains, plus nuts, plenty of fish and some lean meat. They certainly would have used olive oil in their cooking and their bread (a staple) would certainly not have been made with highly refined flour. Research since the 1980s reveals that a traditional Mediterranean-style diet can lower cholesterol and blood pressure and, therefore, the risk of heart disease. Experts think it is healthy not only because it’s lower in saturated fat and higher in monounsaturated fats, but also because it’s rich in low GI carbohydrates and micronutrients (such as folate) that reduce the risk of heart disease. As long as total fat intake isn’t too high (that is, no more than 30 to 35 percent of total kilojoules/calories), everyone—including people with diabetes—is likely to benefit from a healthy low GI Mediterranean-style diet.

GI News—August 2005

In This Issue:

• Don’t Get Carried Away With Glycemic Load
• Reducing the Risk of Stroke
• Is It the GI that Makes the Difference to Weight control?
  
  
• Carrots
  
• Barley
• Chargrilled Vegetables and Beans with Pasta
  

• The Low GI Guide to Managing PCOS (UK edition)
• The Healthy Shopping Tour (Diabetes Australia CD-Rom)

• Why Is There No GI for Blueberries, Blackberries, and Raspberries?
• I Have Type 2 Diabetes. How Can I Feed a Big Family with Cost-effective, No-hassle Low GI Foods?

We hope that you enjoy our newsblog and look forward to welcoming you back to our website each month. To subscribe to our newsletter, simply click on the "SUBSCRIBE" link in the right-hand column. Your email address will be kept strictly confidential.


Jennie Brand-Miller

Food for Thought

Don’t Get Carried Away with Glycemic Load
‘Glycemic index’, ‘glycemic load’ and ‘glycemic response’ are not the same write Alan Barclay, Prof Jennie Brand-Miller, and Prof Tom Wolever in Diabetes Care (Volume 28, Number 7, July 2005). ‘The evidence as it stands suggests that for preventing type 2 diabetes, we ought to encourage low GI carbohydrate foods but not those that simply have low “net carbs”, low GL or produce a low glycemic response.’

Glycemic load does not distinguish low carbs from slow carbs!
Low GI and low GL are not equivalent, ‘especially in preventing and managing diabetes and cardiovascular disease.’ This is because diets with a lower GL can be achieved either by lowering the GI of the carbohydrate or by reducing carbohydrate intake at the expense of consuming more fat or protein. So, going with GL on its own could mean someone is eating a decidedly unhealthy diet, too low in carbs and full of the wrong sorts of fats and proteins.

When you choose low GI carbs, you are getting a healthy, safe diet with an appropriate quantity and quality of carbohydrate.
When it comes to a low GI diet, however, the evidence to date shows that when people choose low GI carbs, they’re getting a healthy, safe diet with an appropriate quantity and quality of carbohydrate. In fact, they are often increasing their intake of nutritional powerpack foods such as beans, chickpeas, lentils and wholegrains.

In addition, the low GI ‘this for that’ strategy is also an easy option for most people whatever their cultural background or diet. Simply by choosing the low GI foods within a category (breads, breakfast cereals, grains etc) they are automatically choosing lower GL foods, too. Fruit and vegetables play a major role in a low GI diet and, bar potatoes, are not restricted. People are encouraged to eat around 7 serves of fruit and vegetables a day because they are not major contributors of carbohydrate even if, like watermelon, they have a high GI.


The bottom line

• Use GI to identify your best carbohydrate choices.
• Take care with portion size to limit the overall GL of your diet.

GI News Briefs

Reducing the Risk of Stroke
Replacing refined carbohydrates with high fibre, low GI carbs may help reduce the risk of hemorrhagic stroke in women according to researchers including Dr Walter Willett from Harvard University and Brigham and Women's Hospital in the American Journal of Epidemiology. Hemorrhagic stroke (also known as cerebral hemorrhage) occurs when a blood vessel in the brain breaks or ruptures. A high intake of refined carbohydrate may increase the risk of hemorrhagic stroke in women, particularly women who are overweight or obese. These results ‘may have implications for preventing stroke in Asian countries with a higher rate of hemorrhagic stroke and a higher intake of carbohydrate,’ say the authors.
—Reported in the American Journal of Epidemiology 2005; 161:161–169

Is It the GI That Makes the Difference to Weight Control (or Something Else)?
In human studies, it’s hard to control all aspects of a diet. When scientists change the GI of a diet, they often get more fibre and higher food bulk without trying or intending to. Animal studies allow better control of ALL the variables, making the interpretation easier. Harvard researchers report that low GI carbohydrate per se has implications for weight loss, body fat, and risk for diabetes and heart disease. Dorota Pawlak MNutrDiet, PhD and David Ludwig, MD, PhD, director of the obesity program at Children's Hospital in Boston set up experiments in which rats were fed to gain exactly the same amount of weight. After just 18 weeks, the rats on the high GI diet had 70 percent more body fat and 8 percent less lean muscle mass, compared with the rats on the low GI diet. The high GI group also had significantly higher blood glucose and insulin levels and higher triglyceride levels. When the low GI group was switched to a high GI diet they had greater increases in blood glucose and insulin compared with rats switched from a high to low GI diet.
—Reported in The Lancet (August 28, 2004; vol 364: pp 778–785).

Is Once a Day Enough?
‘It could be possible that only one meal a day needs to include low GI carbs for people to achieve improved glucose tolerance,’ reports the University of Nottingham’s Dr Emma Stevenson in the International Journal of Sport Nutrition and Exercise Metabolism. The study was designed to look at the effect of the GI of the evening meal on responses to a high GI breakfast the next day. The researchers found that when the men ate a low GI dinner their glucose tolerance was improved next day compared with when they ate a high GI evening meal. ‘If people can achieve improved glucose tolerance in the short term simply by eating just one low GI meal a day, rather than eating only low GI carbs this could make it easier for them to stick to a diet,’ said Stevenson.
—Reported in International Journal of Sport Nutrition and Exercise Metabolism, 2005 Vol 15 (3) 308-322. (The Effect of the Glycemic Index of an Evening Meal on the Metabolic Responses to a Standard High Glycemic Index Breakfast and Subsequent Exercise in Men; Emma Stevenson, Clyde Williams, Maria Nute, Peter Swaile, Monica Tsui)

GI Values Update

Carrots and Sticks
One of the most repeated criticisms of the GI approach over the years has been the fact that carrots were being excluded from diets simply because of their high GI value. Note to GI critics—carrots were retested and the new values published three years ago (2002) in The New Glucose Revolution and on (www.glycemicindex.com), so you need to find a new stick. When carrots were first tested in 1981, the result was 92, but only five people were included in the study and the variation among them was huge. This was in the early days of GI testing and the reference food was tested only once. When carrots were assessed in 2001, ten people were included, the reference food was tested twice, and a mean value of 41 was obtained with narrow variation. It was clear that this result was more accurate and the other value should be ignored. This is a good example of the need for reliable, standardised methodology for GI testing. It is also another case for not using the GI in isolation. Carrots are rich in beta-carotene, a plant form of vitamin A or retinol, which we need to maintain normal vision (a deficiency in vitamin A produces night blindness—an inability to see in dim light). Carrots also provide some vitamin C and fibre, so add them to soups, salads, stir-fries, stews, casseroles, cakes and puddings or enjoy them as a crunchy snack.

• Carrots, Australian (average) GI 41
• Carrots (average of four studies worldwide) GI 47