Saturday, December 31, 2005

GI News—January 2006

collage

In This Issue:
  • Why Nutrition Changes
  • Tesco Tests
  • Getting Satisfaction
  • What Kids Want

  • What’s Cooking? And How?
  • Pulses (Legumes) Help Fight Diabetes
  • Fresh Plum and Ricotta Strudel

  • Success Stories—Sarah and Felix
  • Nutrition for Life
  • I have recently been diagnosed with type 2 diabetes. I am trying to eat a healthy low GI diet, but find it hard to say no to occasional treat foods like potato chips (crisps) and chocolate. Which is better for my blood glucose?
  • I am about to introduce my baby to solids and have been advised to start with rice cereal. What is the current guidance on GI for babies and young children?
  • Is there a GI Plan for nursing mothers?
If you have posted a question 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.

We receive a great deal of FEEDBACK from readers and visitors to our website about how a low GI diet has made a real difference to their lives along with some inspiring weight loss and blood glucose control stories. If you feel you have a SUCCESS STORY that will inspire or help others and you are prepared to give permission for it to be published in GI News, please send it to us HERE.

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We would like to wish all our readers a happy and HEALTHFUL NEW YEAR.

‘A side salad tossed with a vinaigrette dressing with your meal,
especially a high GI meal,
will help you keep your blood glucose levels under control.’

jbm
Jennie Brand-Miller

GI News Editor: Philippa Sandall
GI News Graphics & Web Design: Scott Dickinson

Food for Thought

Why Nutrition Changes
By Catherine Saxelby

People often ask me why we nutritionists keep changing our minds! One year, carbohydrate is wonderful, the next year it’s not. One year, fat is a no-no, the next year, it’s only saturated fat the we should worry about, the other fats are ‘good’ fats that are OK to eat and enjoy. Protein was ‘forgotten’ for some years, now it’s back and considered important for satiety and weight loss. And the same happens with foods. Eggs make a good example. They were off the acceptable list for many years due to their high cholesterol. Anyone with a high cholesterol was advised to limit them to only 2 a week. Now it’s OK to eat an egg a day if you wish. As long as you don’t drown it in butter or cream! The body regulates the cholesterol it makes in response to what you eat. But it can’t cope with the saturated fat that’s already a big problem in our daily diets.

However I rationalise and justify these paradigm shifts, there’s no doubt that nutrition changes. It evolves, it twists and turns, it often swings back to an earlier position. This is confusing for consumers but hardly surprising for a new science that is blended from biochemistry, physiology, medicine, food science and the culinary arts. As new terms and new discoveries keep popping up, there are shifts in thinking on many issues.

Just 5 years ago, we dietitians were still talking ‘simple’ and ‘complex’ carbohydrates. How naive was that thinking?! Thanks to the GI research, we now have a better understanding of what happens to foods like bread, potato, rice and pasta once we’ve ingested them. Some are fast, some are slow. It’s got nothing to do with simple or complex – it’s much more complex than that.

So should you NOT take on board the latest advice? Even though nutrition changes at the edges, the basics remain similar and I often remind people of those ‘golden rules’ or ’10 commandments’ as I like to call them. For a healthy diet:
  • Aim to eat plenty of vegetables and fruit (note the order)
  • Cut back on sugar
  • Cut back on salt
  • Choose whole grains
  • Go easy on fat
  • Steer clear of overly-processed and refined foods
  • Aim for more fresh and home-prepared meals
  • Be moderate with alcohol
  • Eat a little of what you like, and (last but not least)
  • Moderation in most things
Sound familiar? It’s probably your Grandma would have told you.
—Catherine Saxelby is a dietitian and author of Nutrition for Life (Hardie Grant $29.95). For regular updates on nutrition as it happens, you can join her popular Foodwatch Club at www.foodwatch.com.au

cath
Catherine Saxelby

GI News Briefs

Tesco Tests
tesco

The results of GI testing of 140 foods commercially available in the UK for the supermarket giant Tesco are published for the first time in the British Journal of Nutrition. The testing, conducted by the Oxford Brookes team led by Prof. Jeya K. Henry, found that the majority of GI values of UK foods compared well with published values of foods in the International Table of Glycemic Index and Glycemic Load Values (2002). However, there were a few exceptions such as fruit loaf (higher) and bran flakes (lower), highlighting the importance of testing foods in their country of consumption wherever possible. The number of ready-to-eat meals (24) in the list make this report a welcome addition to the GI database. Most of the mixed meals had a low GI. Cottage pie, shepherds pie and sausage and mash which all include plenty of mashed potato had medium GI values. In his conclusion Henry emphasises that ‘it is important to test the GI of composite meals, instead of trying to calculate the GI from GI tables.’
British Journal of Nutrition (2005), 94, 922–930

Comment from Professor Jennie Brand-Miller: The decision making behind the common cut-offs for high and low GI (70 or higher, 55 or lower) was based on the scatter of GI values among single foods. These cut-offs are probably not appropriate for mixed meals. If the future holds more testing of composite meals, then the cut-offs need to be redefined, specifically for mixed meals, taking into account the observed range. It’s important to remember that the GI was introduced to rank the glycemic nature of the carbohydrate in individual foods. The purpose was to exchange one carbohydrate source with another in a mixed meal situation. That application remains valid and shifts the focus away from lowering glycemia at all costs (not a good idea), towards overall nutritionally balanced meals.

Getting Satisfaction
Feeling satisfied isn’t what you normally expect on a diet. Hunger is a pretty big challenge—which is why overly restrictive diets are so hard to stick to. Few of us have the long-term grit to ignore that gnawing feeling in the gut. However, more than 25 studies around the world have already confirmed that low GI foods are more filling, delay hunger pangs for longer, and/or reduce energy intake for the remainder of the day compared with their high GI counterparts.

weighwatch

Now a new Weight Watchers International Germany study in a real life setting led by F. Bellisle of Nutrition, Hotel-Dieu Paris adds weight to the evidence. Sixty-five women were recruited as they started the Weight Watchers points program. One group of 30 followed the regular program for 12 weeks. The other group of 35 followed a modified program, with special emphasis on low GI foods. Over the 12 weeks the researchers asked the women to rate hunger and desire to eat (they used visual analogue scales on one day per week, several times a day: before and after each meal or snack, and in between). The women in the low GI group consistently revealed a lower intensity of hunger and desire to eat, especially during the afternoon! The researchers conclude that: ‘The subjective benefits of the low glycemic index diet may be a worthwhile contribution to the motivation of dieters, even though they did not predict improvement in objective outcome measures.’
Obesity Reviews 2005; 6 (Suppl 1)

scales

In a more academic setting, CSIRO diet gurus Manny Noakes and Peter Clifton with J Bowen also report that the GI affects acute satiety in a small cross over study with 19 obese men. The men were given four liquid ‘breakfast’ preloads (80% energy from whey, calcium, lactose or glucose). For the next three hours subjective appetite ratings and plasma glucose, insulin, amino acids, cholecystokinin (CCK), ghrelin and gastric emptying were measured. At a buffet lunch that followed the researchers then assessed how much the men ate. They found that energy intake, appetite ratings and ghrelin were greater three hours after the high GI ‘preload’ compared with the low GI and protein preloads.
—CSIRO Health Sciences and Nutrition.

What Kids Want
Thanks to vigorous low fat campaigns, many kids have been consuming more carbs and less fat in recent years. But the result hasn’t quite been what the health professionals expected. The highly processed high GI convenience foods and soft drinks has increased the glycemic load in children’s diet and can be linked to the increase in child obesity and risk of metabolic syndrome. Anette E Buyken and her colleagues at the Research Institute of Child Nutrition in Dortmund looked at the diets of healthy German school children aged 7–8 to see how much the GI and GL of diets in 2002 had changed from 1990 and 1996. They also looked at the kinds of carbs the kids were eating to see how much (if at all) they had changed.

kids

They found that compared with 1990, the 2002 children’s diet was slightly higher in GI (56.5 vs 55.1) and GL (17.5 vs 16.7). According to Buyken ‘the most important finding is that the ‘tolerated food groups’ comprising sweets, sweetened soft drinks, cakes and cookies, and salty snacks had the largest impact on the overall dietary GL, even exceeding the impact of bread and rolls. We had expected bread and rolls, the most important carbohydrate source in Germany, to contribute the most to the dietary GL. Another interesting finding is the small impact of potatoes on the overall dietary GL in all three time periods.’ They also found that generally speaking the children in the lowest GI tertile, but not those in the lowest GL tertile, had a better dietary nutrient profile and made more favourable food choices.

She concludes that: ‘partial replacement of high-GI ‘tolerated food groups’ for foods with a low dietary GI, especially fruits and vegetables, may help to reverse the observed slight increases in the GI and GL since 1990, and to enhance the overall dietary quality in children.’
British Journal of Nutrition (2005), 796–803

GI Values Update

What’s Cooking? And How?
Critics like to complain about the fact that the GI of a food can change with the way you cook it or prepare the food and the overall GI of a meal can vary depending on what you serve. But if they gave this a bit of thought, they would see that this is a plus (in more ways than one) and not a minus. It actually increases the number of foods we can eat and recipes we can enjoy that will keep our blood and insulin levels on an even keel. Not only that, food is more nutritious and delicious cooked and prepared the ‘low GI’ way (you haven’t boiled away all the goodness) or served with healthful ingredients that will help lower the overall GI of a meal (a jacket potato topped with baked beans, corn or chickpeas).

Let’s start with the ever-popular potato. As we said in last month’s GI News, boiled, mashed, steamed or fried, just about everybody loves potatoes. Unfortunately, a low GI variety of potato is hard to come by and it’s going to take a while for every variety of potato to be tested! The good news for potato lovers is that a potato salad made the day before, tossed with a vinaigrette dressing and kept in the fridge will have a much lower GI than potatoes served steaming hot from the pot. There are a couple of simple reasons for this. The cold storage increases the potatoes’ resistant starch content by more than a third and the acid in the vinaigrette whether you make it with lemon juice, lime juice or vinegar will slow stomach emptying. ‘That's good news about eating acidic potato salad for us genetic potato lovers (i.e., Germans),’ said one of our regular readers. ‘One of our national dishes is (what is called in English) German Potato Salad. It's made ahead of time with vinegar, carrots, garlic and bacon bits, and is available in many standard U.S. supermarkets.’ Another great ingredient to toss into a potato salad are crispy green beans just cooked al dente. But don’t go overboard, keep the portion size moderate!

potatoes
photo: Scott Dickinson

What about pasta? Pasta in any shape or form has a relative low GI (30 to 60) but it needs to be cooked al dente (‘firm to the bite’). And this is the best way to eat pasta—it’s not meant to be soft. It should be slightly firm and offer some resistance when you are chewing it. Overcooking boosts the GI. Although most manufacturers specify a cooking time on the packet, don’t take their word for it. Start testing about 2–3 minutes before the indicated cooking time is up. But watch that glucose load. While al dente pasta is a low GI choice, eating too much will have a marked effect on your blood glucose. But a cup of al dente pasta combined with plenty of mixed vegetables and herbs can turn into three cups of a pasta-based meal and fits easily into any adult’s daily diet.

pasta

To lower the GI of a meal or recipe, simply add vinegar or lemon or lime juice to dressings, marinades or sauces. The effect appears to be related to the acidity, because other organic acids (such as lactic acid and propionic acid) also have a blood-glucose-lowering effect, but the degree of reduction varies with the type of acid. Essentially, the acidity in food puts the brake on stomach emptying, slowing the delivery of food to the small intestine. Digestion of the carbohydrate in the food is therefore slowed and the final result is that blood-glucose levels are significantly lower. And as we reported last month, Swedish researchers have found that vinegar may also help dieters eat less and reduce cravings brought on by sugar spikes after meals. The more vinegar consumed (up to 2–3 tablespoons before a meal), the more satisfied people felt.

salad

Low GI Food of the Month

Pulses (Legumes) Help Fight Diabetes
By Rosie Schwartz
Using your bean is definitely one of the smartest nutritional moves you can make. In the battle against diabetes, pulses (beans, chickpeas and lentils) appear to offer a wide range of weapons. Firstly, because of their effects on weight control, they provide a front line defence. Achieving and maintaining a healthy weight is one of the major strategies in halting the epidemic of diabetes. Increasing body weights and sedentary living are partnering to drive up the odds of developing diabetes in all age groups.

Rosie
Rosie Schwartz

Adding pulses to the menu may not only reduce the risk of diabetes due to their effects on girth control, but they also work against the disease in other ways. The type of fibre as well as the starch they contain leads to a slow rate of digestion and therefore more gradual rises in blood sugar and insulin readings, making them a boon for both diabetes prevention and blood sugar control in those who have the disease. While eating bean quotas may help those with type 2 diabetes control their blood sugar readings without taking medication, research shows that for those with type 1 or insulin-dependent diabetes, consuming pulses may lessen the amount of insulin required to control blood sugar levels. This slow rise in blood sugar gives pulses the distinction of being a low GI food.

Yet even though many people are aware of the health perks of consuming pulses, they're not what you would call a regular visitor at the dinner table in most homes. Here are some tips for palate-pleasing pulses, keeping in mind that they partner wonderfully with seasonings from every cuisine and can be part of any course of any meal.
  • Pureed pulses, seasoned with a variety of herbs and spices, make for wonderful dips and spreads. Keep cans of chickpeas or beans on hand for a snack in a flash. Rinse and drain them and give them a whirl in the food processor with cumin, garlic, tahina (sesame seed paste) or olive oil and lemon juice for a speedy hummus or bean dip for vegetables.
  • Add pulses to pasta sauces for a change of pace. And for youngsters, or even adults who aren't yet fans of beans or lentils, puree a small amount with some of the sauce and then add the mixture back into the entire sauce. Over time, as tastes adjust, puree smaller quantities of the pulses, keeping them intact.
  • Add pulses to homemade or prepared vegetable soups before serving. Simmer for at least a few minutes.
  • Add white or red kidney beans or chickpeas to a mixed salad or toss with tuna, sliced red onion and tomatoes and an olive oil and vinegar dressing for a taste of the Mediterranean.
—Source: National Post (www.nationalpost.com). Reproduced with permission of the author and the National Post.

wholefood

Rosie Schwartz is a Toronto-based consulting dietitian in private practice and is author of The Enlightened Eater's Whole Foods Guide: Harvest the Power of Phyto Foods (Viking Canada).

Low GI Recipe of the Month

Fresh Plum and Ricotta Strudel
Plums and other blue-red fruit such as cherries, blueberries and cranberries, are rich in a particular type of antioxidants known as anthocyanins. Here’s a low-fat version of the strudel Catherine Saxelby makes using plums instead of apples. From Eating for the Healthy Heart and also reproduced in The Low GI Diet Cookbook.

strudel
Photo: Ian Hofstetter, The Low GI Diet Cookbook

Serves 6
Preparation time: 20 minutes
Cooking time: 45 minutes

30 g (1 oz) monounsaturated or polyunsaturated margarine
½ cup (40 g) fresh wholemeal breadcrumbs (about 3 slices)
1/3 cup (80 g) brown sugar
½ teaspoon cinnamon
425 g (15 oz) can plums, drained well (or 6 fresh plums about 250 g/9 0z)
6 sheets filo pastry
olive oil spray
125 g (4½ oz) reduced fat ricotta cheese

1. Melt the margarine in saucepan over medium heat. Add the breadcrumbs and sugar (reserving 2 teaspoons of sugar) and cook for 15 minutes stirring well to break up any lumps. Remove from heat. Stir in the cinnamon. Allow to cool.
2. Halve the plums, removing stones and slice the flesh thinly.
3. Preheat the oven to 190°C (375°F). Lightly grease a baking tray. Lay two sheets of filo pastry on top of one another spraying the upper most sheet with oil. Sprinkle with one-third of the crumb mixture and top with two more sheets. Spray top layer with oil and add another one-third of the crumb mixture. Top with the remaining two sheets and sprinkle with final third of the crumbs.
4. Spread ricotta along edge of pastry. Arrange plums on top of ricotta. Sprinkle with reserved 2 teaspoons of sugar. Roll up pastry as for a Swiss roll, tucking in the edges. Transfer to a lightly oiled baking tray. Bake for 10 minutes. Reduce heat to moderate (180°C/350°F) and bake a further 20 minutes until crisp and brown. Serve warm with low-fat vanilla ice cream

Per serving
Low GI, kilojoules 865/calories 205, fat 6 g (saturated 2 g), protein 5 g, carbohydrate 30 g, fibre 3 g, sodium 260 mg

Your Success Stories

Sarah
‘I want to share with you about how applying the “GI factor” to what I eat has changed my life! I was always slim until I reached about 15, then over a period of three years I put on more and more weight. I do not really know why this was, maybe pressure from school, personal problems. When I started university, I became conscious of my weight and attempted to lose weight through various means and methods for about 5 years. Sometimes, it was a planned diet such as the ‘Greenlane’ eating plan, but more often than not it was trying to control or lessen the amount of kilojoules (calories) I was taking in and increasing my exercise. Seems, sensible, but in hindsight I can see that following the traditional ‘food pyramid’ I was eating a lot of low calorie but high GI products. For example, I would have one salad sandwich or bread roll for lunch and then a muffin for afternoon tea, toasted bread for breakfast etc. Sometimes, I did manage to lose quite a bit of weight but then I would ALWAYS yoyo back up to my original weight or more. Everyday, I battled with the scales and it almost became and obsession, I could not figure out where I was going wrong. Also—I was always hungry! I associated diets with being hungry.'

'Anyway, after doing Atkins (successfully losing weight but then putting it back on) a friend recommended the GI book. I read it and started applying the principles (e.g. I ate Bran cereal instead of white bread in the morning, pasta instead of a sandwich, fruit for a snack instead of a muffin). Slowly, but surely (and with a bit of exercise) the weight fell off to the point where I lost more than 10 kg—and got down to about 52 kg (I am short). Even better, I was not suffering from the same energy drain, constant hunger etc. Now, sometimes I eat—just because it is dinnertime—but not because I am hungry! My self esteem has picked up as a result etc. too. I bought a GI cookbook and have tried out a few recipes. The best thing is, this is not a fad but a way of eating that I will always stick too.’

Felix
‘Well, my story goes a bit like this. Back in late 2003, at age 41, although my general health appeared OK, I began to notice that my weight was inexplicably starting to drop, and I was starting to drink a lot of water and felt the need to urinate quite a lot. By early 2004 things had worsened considerably. Basically I began to feel very unwell. Dizzy, extreme lethargy, blurry vision and the weight loss continued. Although I realised that something was clearly wrong with my health and yes I was worried, I was extremely reluctant to visit my GP! In the end, urged by family, I did and the blood tests that followed showed a very high blood sugar level of 23. Yes I was diabetic Type 2.’

‘It was all rather a shock, and I was immediately placed on the usual diabetic medication, and I began to learn all about type 2 diabetes in the hope of managing my condition. Not long after, a Ham Radio friend, (thank you Ron), told me about the ‘GI’. I had vaguely heard of the term, but knew nothing really about it. Searching around on the net I found this excellent web site and my knowledge of the GI began to grow. I went out and bought some of the books and began eating in accordance with low GI principles. It has been a most interesting road of discovery ever since. During my growing up years, my mother, although well intentioned, had been feeding us some of the worst possible foods in terms of high GI, things like plenty of white bread, white rice potatoes and these were essentially the staples of our diet. And yes at first sight, they are nutritious foods.’

‘In retrospect, it is now obvious to me that I was borderline diabetic for some years prior to being officially diagnosed. Looking back now I realise I had all the symptoms. Back to early 2004, my initial success with low GI eating was quite spectacular. My blood sugar levels were rapidly brought back until control, to the point where I was able to give the medication away completely by mid 2004. I preached the low GI message wherever I went. I even did a well received radio studio interview on ABC radio in Townsville preaching the virtues of low GI eating only a month or so after commencing to eat the ‘low GI’ way. The best thing was that I had never felt better.’

‘Perhaps the one thing that clearly shows the value of low GI eating, is the fact that prior to official diagnosis of type 2 diabetes, I had already begun a regular exercise program, mainly walking, in the hope of improving my general fitness. However that didn't prevent the appearance of type 2 diabetes with all the worst symptoms! I still do the same kind of regular exercise, the only thing different now is strict adherence to low GI eating! Need I say more? My mother is a convert to GI eating and likewise, she has seen clear health benefits. My father, well, he still likes his refined white bread, but he mostly eats the ‘right stuff’ in terms of low GI.’

‘For me anyway, the road to good diabetes control and good health has been quite an adventure, and admittedly there have been some low points where I've done the wrong thing and paid the price, but as long as I do the ‘right thing’, all is fine. In all honesty, it isn't that hard to stick to the ‘straight and narrow’. Temptation is always there. But all I have to do, is remember what happens when I do the ‘wrong thing’ (extreme dizziness, confusion, hallucinations and being basically feeling very ill), and the temptation simply disappears, and they are just the short term effects of a very rapid blood sugar rise! My only regret to all this is the fact that I didn't know about the GI twenty years ago! Still, I can say that despite the effects of time, I can say without any doubt at all, that my general health now is better than it's ever been, thanks to low GI eating. Long may it continue.’