GI News—October 2006

In This Issue:

• Food for Thought
  —Something to chew on
  
• GI News Briefs
  —What women athletes need
  —More low fat dairy food, less type 2 diabetes
  —High blood glucose increases coronary artery disease risk
  —Giving children a healthy life
  —Why a low GI diet can help women with PCOS
  
• Low GI Food of the Month
  —Green peas
  
• Low GI Recipe of the Month
  —Gluten-free Apricot Nut Slice
  
• Success Stories
  —‘It is nothing short of a miracle’ – Rose
  
• What's New?
  —Healthy Parent, Healthy Child
  
• Feedback—Your FAQs Answered
  
  1. I have gestational diabetes. What should I choose from the menu at my local Asian restaurant to stick to my daily food guide for carb serves?
     
  2. I love to bake, but want to reduce the GI of the products? Can you answer some questions about this?
     
  3. I have recently been diagnosed with irritable bowel disease and am interested to know if following a low GI diet would be recommended to help control my symptoms.
  4. Look it up in our A–Z: The GI Glossary completed
     

The publishers of the New Glucose Revolution series, Hachette Livre Australia, Hodder Mobius UK and Marlowe & Company New York, have agreed to give away a copy of The Low GI Diet Cookbook to every 1000th subscriber from now on. To subscribe, just click on 'SUBSCRIBE' at the top of the right-hand column.



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

Food for Thought

Something to chew on
Periodontitis is a leading cause of tooth loss in adults – around 30% have it. It’s a serious infection that destroys the soft bone and tissue that support your teeth but it is both treatable and preventable. It’s long been known that daily brushing and flossing and regular professional cleaning can greatly reduce chances of developing gum disease. Findings from the first study to look at wholegrain intake in conjunction with periodontitis risk (American Journal of Clinical Nutrition 2006;83:1395-400) suggest that eating at least 4 servings of wholegrains a day may reduce the likelihood of periodontitis in healthy people possibly by improving their insulin sensitivity suggest the authors. And although it’s still early days, the news is encouraging.

In a prospective study, researchers from McMaster University in Canada tracked more than 34,000 healthy men (those with diabetes, heart disease or a history of stroke were excluded) aged 40–75 years at the start of the study over 14 years. The men eating the most wholegrain foods (around 3 or more servings a day) including brown rice, dark breads, oats, whole grain breakfast cereals, popcorn, wheatgerm, bran and other grains were 23 per cent less likely to develop periodontitis than those who ate less than one serving a day. Although they also found that the men who ate the most cereal fibre were less likely to develop gum disease, they found no link between total dietary fibre and periodontitis risk.

As we have said before, there are countless reasons to include more whole cereal grains in your diet, but it’s hard to go past the fact that you are getting all the benefits of their vitamins, minerals, protein, dietary fibre and protective anti-oxidants. Many wholegrain foods (but not all) also have a low or moderate GI slowing the digestion and absorption of carbohydrates from the gut, keeping blood glucose levels on an even keel. There are a number of studies that show that managing blood glucose levels reduces the risk of periodontitis in people with diabetes, so it may well be that lower blood glucose levels will reduce the risk of periodontitis in non-diabetics.

Take steps to prevent gum disease

• Brush your teeth twice a day and floss once a day.
• Visit your dentist every six months for a check up and clean to remove the build-up of tartar from areas your brush can’t reach.
• Eat a healthy diet including plenty of low GI wholegrains – at least 4 servings a day.
• If you have diabetes, manage your blood glucose levels.
• Do not smoke – people who smoke are four times more likely to develop gum disease than people who don’t.
  

GI News Briefs

What women athletes need
Whether you are a serious endurance athlete or exercising seriously to lose body fat, the results of a study from researchers at Nottingham and Loughborough Universities show that being choosy about your carbs before training or events can help maximise fat oxidation (burning). In a study involving 8 healthy, active, young women Dr Emma Stevenson reports that ‘altering the GI of a mixed meal eaten 3 hours before exercising significantly changed the post prandial hyperglycemic and hyperinsulinemic (see below) responses in the women’. In 2 separate trials the women were given a high GI breakfast (GI 78) or a low GI breakfast (GI 44) 3 hours before a 60-minute run at 65% VO2max on a motorised treadmill. Both breakfasts provided 2 grams of carbohydrate per kilogram of body weight.

The women had a higher rate of fat oxidation during exercise after the low GI breakfast than after the high GI one reports Stevenson. This is because large glycemic and insulinemic responses to a high GI meal lead to increased carbohydrate oxidation and a reduction in the mobilisation and oxidation of free fatty acids. Increasing fat oxidation during exercise is what you need to do to lose body fat. Stevenson and her co-authors make the point that further research needs to look at exercise at different intensities and of shorter duration and also in older women and oral contraceptive users.
– American Journal of Clinical Nutrition 2006;84:354–60



More low fat dairy food, less type 2 diabetes
Older women who eat plenty of low fat dairy foods could reduce their risk of type 2 diabetes reports a new study from Harvard in July Diabetes Care. The researchers looked at the associations between dairy food and calcium intake and incidence of type 2 diabetes in 37,183 women without a history of diabetes, cardiovascular disease or cancer at the start of the study. ‘Each serving-per-day increase in dairy intake was associated with a 4% lower risk of type 2 diabetes, says Liu. While acknowledging that dairy food’s lower GI may contribute to the reduced risk, the researchers conclude: ‘our results show independent associations after adjusting for glycemic load. These data are consistent with the possibility that milk seems to influence glucose tolerance more through its insulinotropic effect (stimulating the release of insulin) than its relatively lower glycemic load.’
– Diabetes Care, 29(7), July 2006



High blood glucose increases coronary artery disease risk
Diabetes is well recognised as a major risk factor for heart disease. Impaired fasting glucose is increasingly common (affecting some 35 million Americans), so the next big question is at what point does elevated blood glucose (often associated with impaired glucose tolerance) in the absence of diabetes become a risk factor? In a retrospective study published in Diabetes Care using the records of 24,160 non-diabetic patients (mostly men) from US Veterans Affairs medical centers, Dr Christopher Nielson and his co-researchers looked for associations between morning glucose and subsequent incidents of heart attack and angina etc. They found that elevated fasting glucose greater than 100 mg/dl (5.5 mmol/L) was associated with a greater incidence of coronary artery disease (CAD) independent of typical risk factors such as age, weight, blood pressure etc. This retrospective study both extends the previous descriptions of the association between glucose and CAD and suggests that the commonly used morning glucose test can provide a useful indication of CAD risk.
– Diabetes Care, 29(5), May 2006



Giving children a healthy life
‘Best estimates are that a white child born in the United States in the year 2000 has a 1 in 3 chance of developing diabetes in his/her lifetime, and a 1 in 2 chance if he she is black or Hispanic’ writes Dr Patrick Hughes and co-authors in the Wisconsin Medical Journal in the introduction to their Wasau SCHOOL Project study. Designed to measure the prevalence and magnitude of known risk factors for heart disease and diabetes in school-age children in Wausau, Wisconsin, the SCHOOL Project was small cross-sectional study of a representative sample of students in grades 2, 5, 8 and 11. Here’s what they found: ‘Of the children studied, 39% had at least 1 lipid (blood cholesterol) abnormality and 22% had 2 or more. Abnormal blood pressure, overweight and cigarette smoking were present in 29%, 16% and 11% respectively. While elevated fasting glucose levels were uncommon, insulin resistance was noted in 25% of the sampled population and nearly 50% of sampled children with a BMI greater than the 85th percentile in the survey … Multiple risk factors rose dramatically with age. By 11th grade, 38% of those surveyed had 2 or more risk factors and 23% had 3 or more.



The authors conclude: ‘Primary prevention of atherosclerotic cardiovascular disease must begin in childhood. At an early age, children will find it easier to learn and adopt healthier lifestyles if the encouragement they receive from parents, teachers and society is reinforced by example and actions.’ Here are some of the healthier lifestyle changes that they suggest. ‘Daily physical education classes at all grade levels, an emphasis on life sports, promotion of nutritious foods in schools and restaurants, freedom from environmental tobacco exposure in public places throughout the community, and widespread, actively promoted, year-round opportunities for physical activity regardless of socioeconomic status.’
– Wisconsin Medical Journal 2006, 105(3)

Why a low GI diet can help women with PCOS
In September, accredited practising dietitian and diabetes educator Kate Marsh addressed the annual polycystic ovarian syndrome conference in Sydney on how diet can help women manage the symptoms of PCOS. The conference was organised by the Polycystic Ovarian Syndrome Association of Australia Inc – www.posaa.asn.au


Kate Marsh

Polycystic Ovary Syndrome (PCOS) is a hormonal (endocrine) disorder that affects 5–10% of women. Symptoms include irregular or absent periods, infertility or reduced fertility, hirsutism (excess hair growth on the face, chest and abdomen), alopecia (scalp hair loss), acne, obesity and difficulty losing weight and increased risk of miscarriage. Many women also complain of excessive tiredness and fatigue, hypoglycaemia (low blood sugar), and poor memory and concentration. We don’t know why PCOS develops, but we do know that there are a number of different causes and that for many women it’s high levels of insulin in the blood resulting from insulin resistance. Having insulin resistance means the body is insensitive to insulin and because the insulin isn’t working effectively, the pancreas pumps out more and more to keep blood glucose levels under control. It’s these high levels of insulin circulating in the bloodstream that cause many health problems including PCOS.

Here’s why. High levels of insulin act on the ovaries to cause increased production of male hormones, which disrupt the normal ovulation cycle and cause many of the symptoms of PCOS. The link between these two conditions also means that women with PCOS are at an increased risk of developing health problems including impaired glucose tolerance (the stage before diabetes), gestational diabetes (diabetes during pregnancy), type 2 diabetes and cardiovascular disease. The good news is that treating insulin resistance significantly improves all or most of the symptoms because it reduces androgen (male hormone) levels and restores ovulation.

Here’s how. You can improve insulin resistance with lifestyle changes such as a healthy eating plan, exercise and weight loss. You may also need medication, but is only effective if used in combination with lifestyle changes. Making these lifestyle changes has restored ovulation in women with PCOS, even with weight losses of as little as 5% of body weight. There are other benefits too. Eating well helps regulate your blood glucose levels, improve your energy levels and reduce your risk of type 2 diabetes and heart disease.

The best type of healthy eating plan is low in saturated fat and high in fibre and includes low GI carbs. Low GI foods are more filling and satisfying, which helps to control hunger and assists with weight loss. They result in lower levels of insulin circulating in the bloodstream, which means fat is less easily stored by the body and is more easily burnt. Lower insulin levels also mean that less male hormones are produced, which can improve many of the symptoms of PCOS, help to reduce the risk of diabetes and heart disease and improve blood fat levels. Spreading your food intake evenly across the day is important too, as this helps prevent spikes in your blood glucose and insulin levels.

But, the most important thing with any eating plan you choose, is that you can actually stick to it long term – short term quick fix weight-loss diets are doomed for failure. If you have PCOS and need help with your diet, make an appointment to see an accredited practising (registered) dietitian who specialises in this area to develop an eating plan to suit your needs.

Diet alone is not enough. You need to combine your healthy eating plan with some regular exercise – at least 30 minutes of activity on most days. It is best to include a combination of both aerobic exercise (walking, running, dancing) and resistance training (weights) – a number of studies have now shown the benefits of lifting weights for improving blood glucose and insulin levels.

– Kate Marsh BSc, M Nutrition Dietetics, Graduate Certificate in Diabetes Eduction & Management

GI Group: To find out more about the PCOS and low GI diets, check out The Low GI Guide to Managing PCOS by Prof. Nadir Farid, Prof. Jennie Brand-Miller and Kate Marsh. This should be available in all good bookshops in Australia, NZ, the US and the UK or from Amazon.

Low GI Food of the Month

Green Peas

I eat my peas with honey
I’ve done it all my life’
It makes the peas taste funny
But it keeps ’em on the knife.
– Anon

There’s nothing like the aroma of shelling and eating fresh, green peas (GI 48) straight from the pod. Today, most of us buy them in frozen packs – the manufacturer has done the hard work. They are rich in fibre and vitamin C and higher in protein than most vegetables.



Although a good source of thiamin, niacin, phosphorus and iron when fresh, cooking will reduce the nutrient levels. If you do buy peas in the pod, you’ll need about 350 grams (12 oz) of pods to fill a cup with shelled peas. And tempting as it is to pick up a pack of ‘freshly’ shelled peas from your greengrocer or supermarket, only do so if you know they really have been freshly shelled and you plan to use them immediately. Boil, steam or microwave peas for about 4–5 minutes (remember, cooking destroys the nutrients) or add to rice dishes such as risottos, pilafs, pasta dishes, frittatas, soups and stews (at the last minute), or combine with a little mashed potato, sweet potato or yams. Peas with edible pods such as snowpeas and sugar snaps (immature pods) only need the minimum of cooking time, too, and are delicious in stir-fries, or steamed or cooked in the microwave for a side dish. Here are some serving suggestions:

• Whip up an omelette with onion, a little lean ham or bacon if you wish, plus corn kernels and fresh or frozen green peas.
  
• For comfort food, purée or mash cooked peas with chicken stock and a little light margarine.
  
• Add blanched snowpeas or sugar snaps to salads or serve with vegetable platters and dips.

– Low GI Eating Made Easy (Hachette Livre Australia, Hodder UK, Marlowe & Company USA)

Individual Frittatas with Capsicum, Sweet Potato, Baby Peas And Feta
Serves 6
Preparation time 15 minutes; Cooking time 30–35 minutes; Cooling time 10 minutes


Photo: Ian Hofstetter

1 tablespoon extra virgin olive oil
1 red (Spanish) onion, halved, thinly sliced
1 red capsicum (pepper), cut into short thin strips
300 g (10½ oz) orange sweet potato, cut into 1 cm pieces
1 garlic clove, crushed
150 g (5½ oz) frozen baby green peas
70 g (2½ oz/1/3 cup) semi-dried tomatoes, finely chopped
100 g (3½ oz) low fat fetta, crumbled
olive oil spray
7 eggs
125 ml (4 fl oz/½ cup) low fat milk or soy milk
freshly ground black pepper
Dressed salad leaves, to serve

1. Preheat the oven to 190ºC (375ºF/Gas 5). Spray a large 6-hole muffin pan with oil.
2. Heat the oil in a large non-stick frying pan over medium-high heat. Add the onion, capsicum, sweet potato and garlic. Cook, stirring often, for 5 minutes. Add the peas and cook for 3 minutes. Remove from heat and set aside to cool a little. Stir in the semi-dried tomatoes and fetta.
3. Whisk the eggs and milk together. Season with pepper. Divide the vegetables among the muffin pan holes. Pour the egg mixture evenly over the vegetables. Bake for 20–5 minutes or until the frittatas are set and lightly golden. Set aside in the pan for 10 minutes before turning out. Serve warm with dressed salad leaves.

Nutritional analysis per individual frittata
Energy 1052 kJ/251 cal, protein 17 g, fat 12 g (sat fat 4 g), fibre 5 g, carbohydrate 16 g

–The Low GI Vegetarian Cookbook (Hachette Livre Australia, Hodder UK, Marlowe & Company USA)

Low GI Recipe of the Month

Gluten-free Apricot Nut Slice
‘Gluten-free recipes I can do. Recipes for people with diabetes I can do,’ said dietitian/home economist Diane Temple, ‘but together it’s a pretty tough challenge.’ And after lots of testing, here’s Diane’s delicious gluten-free slice that’s ideal for school lunch boxes. It is easy and quick to make, contains good fats and is rich in fibre. From our calculations, the GI is likely to be moderate. This is because the GI of the gluten-free biscuits you use and the rice flour will probably be high, but the dried fruits are low. Here’s a tip before you whip up a batch: when baking slices, check the actual base measurement of the pan, you’ll find it may be different from the labelled size – usually a little smaller.



Makes 12 pieces ▪ Preparation time 10 minutes ▪ Cooking time 25 minutes

Base
120 g (4 oz) plain, sweet gluten free biscuits
1/3 cup (60 g/2 oz) brown rice flour
1/3 cup (35 g/1¼ oz) hazelnut meal
40 g (1½ oz) polyunsaturated or monounsaturated margarine, melted
1 egg white

Filling
200 g (7 oz) dried apricots
60 g (2 oz) dried cherries
1 cup (250 ml) water
2 teaspoons caster sugar
30 g (1 oz) flaked almonds

1. Pre-heat the oven to 180ºC (350ºF). Grease 26 x 16 cm/10½ in x 6½ (base measurement) slice pan.* Line the base and the 2 long sides with baking paper and extend the paper a few centimetres above the edge of the pan to help with removing the slice when it is cooked and cooled.
2. To make the base: combine the biscuit crumbs, flour and hazelnut meal in a medium bowl. Whisk the egg white until slightly foamy. Add the margarine and egg white to the crumbs and mix together using your hands to combine. Press the mixture into the base of the prepared pan. Bake for 10 minutes or until base is lightly browned.
3. For the topping: place the apricots, cherries and water in a small saucepan and bring to the boil. Simmer for 10 minutes until the fruit is soft, stirring occasionally to break up the fruit. Mix through the sugar. Spread the filling evenly over the cooked base. Sprinkle the flaked almonds over the top.
4. Bake the slice for 15 minutes or until the almonds are lightly toasted. Leave in the pan to cool. Slice when cold and store in an airtight container.

*Slice pan labelled size is 19 x 29 cm (11½ x 7½ in)

Nutritional analysis per piece
Energy 720 kJ/170 cal, protein 3 g, fat 9 g (sat fat 2 g), fibre 3 g, carbohydrate 21 g

For professional recipe development or testing contact Diane Temple on:
tel 612 9958 3165 ▪ email diane.temple@bigpond.com

Your Success Stories

‘It is nothing short of a miracle’– Rose
My husband had a major stroke in 2004, and was diagnosed with type 2 diabetes, as well. His blood sugar has been like a roller coaster no matter how carefully I monitored his diet, until we accidentally happened upon The Low GI Diet Guide to Diabetes at our local book store. For the past 3 weeks we have followed your 7-days of menus religiously and my husband’s blood sugar has been holding so well it is unbelievable. The calorie and carb levels of your menu plans appear to be absolutely perfectly calibrated as he cannot exercise because he is paralysed.

It is nothing short of a miracle. In just 3 short weeks there's been a remarkable turnaround in his blood sugar and in the way he feels. His blood sugar has been right on target every day and he has lost 6 pounds! It's wonderful to see him feeling so well. Now he has asked if I could come up with 7 more days of menus so that he doesn’t eat the same thing every week!



Send Us Your Success Story!


We'll send you a free copy of The Low GI Diet Cookbook if your story is published.

Books, DVDs, Websites: What’s New?

Weight Watchers Healthy Parent Healthy Child: simple rules for a healthy-weight home
By Karen Miller-Kovach



The sub title says it all. Using insights gained from an ongoing family pilot program being conducted by WeightWatchers in the US, this book gives parents some practical tips to help them navigate today’s fast food, time poor culture and create a healthy-weight home. It’s based on five basic rules and the five special roles that parents need to play to help give their kids a healthy lifestyle. It’s not about nutrition and there are only a few recipes. It’s really about behaviour (eating and activity) and how you can make some little changes about the house that can make a big difference. There are lots of personal stories from the actual families and Weight Watcher ‘coaches’ who participated in the pilot program making it more than just theory. No single book is going to solve the obesity crisis, but you may find this one may a handy guide if you are looking for practical pointers to help you make some changes to your family’s diet and lifestyle. So what are the five simple rules?

1. Focus on wholesome nutritious foods
2. Include treats
3. Aim to keep homework computer or television time at two hours (or less) a day
4. Try and be active an hour a day or more
5. The Rules apply to everyone in the home.

And the five roles that parents play:
Role model ▪ Provider ▪ Enforcer ▪ Protector ▪ Advocate

Australia: Allen & Unwin RRP $29.95