1 September 2017

GI News - September 2017

GI News

GI News is published by the University of Sydney, School of Life and Environmental Sciences and the Charles Perkins Centre

Publisher:
Professor Jennie Brand-Miller, AM, PhD, FAIFST, FNSA
Editor: Philippa Sandall
Scientific Editor/Managing Editor: Alan Barclay, PhD
Contact GI News: glycemic.index@gmail.com

Sydney University Glycemic Index Research Service
Manager: Fiona Atkinson, PhD
Contact: sugirs.manager@sydney.edu.au

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FOOD FOR THOUGHT

ALTERNATE DAY FASTING IS NO BETTER THAN ANY OTHER FAD DIET
In his Obesity Notes blog, Dr Arya Sharma recently reviewed a year-long randomised controlled study by John Trepanowski and colleagues that showed alternate day fasting is evidently no better in producing superior adherence, weight loss, weight maintenance, or cardio-protection compared to good old daily calorie/kilojoule restriction (which also produces modest long-term results at best).

“It seems that every year someone else comes up with a diet that can supposedly conquer obesity and all other health problems of civilization. In almost every case, the diet is based on some “new” insight into how our bodies function, or how our ancestors (read – hunters gatherers – never mind that they only lived to be 35) ate, or how modern foods are killing us (never mind that the average person has never lived longer than ever before), or how (insert remote population here) lives today with no chronic disease. Throw in some scientific terms like “ketogenic”, “gluten”, “anti-oxidant”, “fructose”, or “insulin”, add some level of restriction and unusual foods, and (most importantly) get celebrity endorsement and “testimonials” and you have a best-seller (and a successful speaking career) ready to go.

Hunter gatherers
Source

The problem is that, no matter what the “scientific” (sounding) theories suggest, there is little evidence that the enthusiastic promises of any of these hold up under the cold light of scientific study. Therefore, I am not the least surprised that the same holds true for the much hyped “alternative-day fasting diet”, which supposedly is best for us, because it mimics how our pre-historic ancestors apparently made it to the ripe age of 35 without obesity and heart attacks.

The alternate day fasting group in the year-long randomised controlled study published in JAMA Internal Medicine had significantly more dropouts than both the daily calorie restriction and control group (38% vs. 29% and 26% respectively). Mean weight loss was virtually identical between both intervention groups (around 6kg).

Purists of course will instantly criticize that the study did not actually test alternative-day fasting, as more people dropped out and most of the participants who stayed in that group actually ate more than prescribed on fast days, and less than prescribed on feast days – but that is exactly the point of this kind of study – to test whether the proposed diet works in “real life”, because no one in “real life” can ever be expected to be perfectly compliant with any diet. In fact, again, as this study shows, the more “restrictive” the diet (and, yes, starving yourself every other day is “restrictive”), the greater the dropout rate.

Unfortunately, what counts in real life is not what people should be doing, but what people actually do. The question really is not whether or not alternate-day fasting is better for someone trying to lose weight but rather, whether or not “recommending” someone follows an alternate-day fasting plan (and them trying to follow it the best they can) is better for them. The clear answer from this study is “no”. So why are all diets the same (in that virtually all of them provide a rather modest degree of long-term weight loss)?

My guess is that no diet (or behaviour for that matter) has the capability of fundamentally changing the body’s biology that acts to protect and restore body fat in the long-term. Irrespective of whether a diet leads to weight loss in the short term and irrespective of how it does so (or how slow or fast), ultimately no diet manages to “reset” the body-weight set point to a lower level, that would biologically “stabilize” weight loss in the long-term. Thus, the amount of long-term weight loss that can be achieved by dieting is always in the same (rather modest) ballpark and it is often only a matter of time before the biology wins out and we put all the weight back on.

Clearly, I am not holding my breath for the next diet that comes along that promises to be better than everything we’ve had before. My advice to patients is: do what works for you, but do not expect miracles – just find the diet you can happily live on and stick to it.”

Read more:

Dr Sharma 
Dr Sharma is Professor of Medicine and Chair in Obesity Research and Management at the University of Alberta, Edmonton, Canada. He is also the Clinical Co-Chair of the Alberta Health Services Obesity Program. He has authored and co-authored more than 350 scientific articles and has lectured widely on the etiology and management of obesity and related cardiovascular disorders and is regularly featured as a medical expert in national and international TV and print media and maintains a widely read obesity blog at www.drsharma.ca.

WHAT’S NEW?

FUDGING CONCLUSIONS ABOUT CHILDHOOD OBESITY PREVENTION 
“We have a pretty good idea of how to curb childhood obesity.” Such convictions run deep. And because of those convictions, prevention is a frontline strategy for dealing with childhood obesity. So, it’s especially dispiriting when we see the scientific literature stained by a paper that fudges conclusions about childhood obesity prevention into “some evidence of effectiveness” reports ConscienHealth’s Ted Kyle.

children playing at school

In the Australian and New Zealand Journal of Public Health, Mary Malakellis and colleagues published a report on a large obesity prevention program called “It’s Your Move”. Deep in the bowels of their paper, you will find that the sum of all their data showed no effect. But, the authors did not stop there. They picked apart the data to look for subgroups with an effect. They found it in two of the schools they studied. So, their abstract failed to mention finding no effectiveness in the overall results. And their conclusion claimed “some evidence of effectiveness.”

Ted Kyle asked biostatistics expert, Professor David Allison, about this study. Despite the claims of effectiveness in the paper’s abstract says Allison, the body of the paper clearly describes the findings as null. The authors state “Models to Compare the Intervention and Comparison Groups (i.e. All Three Intervention Schools Combined Compared to All Three Comparison Schools Combined) … showed No Statistically Significant Interaction Effect on Weight, Height, BMI, BMI-z and Proportion of Overweight/obesity.” The contrary statements in the abstract are an inappropriate use of spin as defined by Boutron et al. They lead to distortion of the scientific record and propagation of myths and presumptions which are all too common in the obesity domain. Authors and journals should hold themselves to higher standards of accurate reporting.

Null findings offer golden opportunities for learning. You do a study and the data tells you, you were wrong. That intervention – perhaps a wonderful prevention program – didn’t work the way you thought it would. Maybe the study was flawed. Or maybe the intervention just doesn’t work. Perhaps we need a new approach. But if you ignore that null finding, you’re kidding yourself. You might deceive others. And you get in the way of progress. 

FASTING BLOOD GLUCOSE AND INSULIN NEW BIOMARKERS FOR WEIGHT LOSS Fasting blood glucose and/or fasting insulin can be used to select the optimal diet and to predict weight loss, particularly for people with prediabetes or diabetes say researchers from the Department of Nutrition, Exercise and Sports at the University of Copenhagen reporting the findings from a weight loss biomarker study published in the American Journal of Clinical Nutrition (AJCN). The findings suggest that for most people with prediabetes, a diet rich with vegetables fruits and wholegrains should be recommended for weight loss and could potentially improve diabetes markers. For people with type 2 diabetes, the analysis found that a diet rich in healthy fats from plant sources would be effective for achieving weight loss. These diets could also be effective independent of caloric restriction.

“Recognizing fasting plasma glucose as a key biomarker enables a new interpretation of the data from many previous studies, which could potentially lead to a breakthrough in personalized nutrition,” said Prof Arne Astrup. “The beauty of this concept is its simplicity. While we are looking into other biomarkers, it is quite amazing how much more we can do for our patients just by using those two simple biomarkers. We will continue to participate in and support research to explore additional biomarkers such as gut microbiota and genomics approaches, which may offer more insights and help to more effectively customize the right diet for specific individuals.” 

PERSPECTIVES WITH DR ALAN BARCLAY

KETONES 
No. Not a music group. But ketones are creating a lot of noise. They are a kind of fuel our liver produces from fatty acids (from what we eat or body fat stores), when glucose is severely restricted. Dietary regimens that stimulate the production of ketones are known as “ketogenic diets”. What are their health effects?

Randomised controlled trials give us some clues. Ketogenic diets typically require people to limit their total carbohydrate intake to less than 10% of energy (less than 50g a day for an adult), and recommend fat provides around 80% of energy. This means severe restriction of: 

  • most fruits 
  • starchy vegetables (carrots, corn, peas, pumpkin, potatoes, etc) 
  • cereal-based foods (bread, breakfast cereals, pasta, rice, etc) 
  • legumes (beans, chickpeas, lentils, etc) 
  • milk and yoghurt. 
For a typical adult, 10% of energy, or 50g of carbohydrate a day, is equal to 2 slices of bread plus 1 piece of fruit. Instead of carb-containing foods, people on a ketogenic diet mostly eat: 
  • meat, seafood, poultry 
  • eggs 
  • cheese 
  • butter and cream 
  • fats and oils 
  • low-carb vegetables (greens, onions, peppers, etc) 
  • low-carb fruits (berries). 
As it’s difficult to get all of the essential nutrients eating this way, people on a ketogenic diet need supplements.

Fatty meats  
Epilepsy A ketogenic diet has been trialled in children with chronic epilepsy. Children are typically given a diet that provides 80% of daily energy from fat, and the remainder from protein and carbohydrate (typically, 10% from each). A recent Cochrane review determined that after following a ketogenic diet for 3 months, seizure rates may decrease by up to 85% in some (but not all) children. But all studies included in the review also reported adverse effects – vomiting, constipation and diarrhoea plus other adverse effects. A recent study determined that while medically effective “The study did not find any improvements in quality of life”. So, while a ketogenic diet may help some children with epilepsy, it’s no panacea. However, if you have a child with severe, frequent seizures, you may wish to try a ketogenic diet under very careful medical and dietetic supervision.

Cancer therapy Certain kinds of cancer cells prefer to use glucose as a fuel. Therefore, in theory, reducing blood glucose levels may help in the management of certain kinds of cancer by starving them of fuel. A recent systematic review examined all the available evidence in people (not rats). No randomised controlled trials were identified, but 15 other lower-quality clinical studies, case-control and cohort studies incorporating 330 people were available. The authors concluded “In contrast, to the considerable attention from researchers, physicians and the media for its potential role in cancer treatments, evidence on benefits [of ketogenic diets] regarding tumor development and progression as well as reduction in side effects of cancer therapy is missing.” The bottom line – despite the hype, much more research is needed.

Ketogenic diets for weight loss While not new, ketogenic diets are at present one of the most popular weight loss diets around the world. Fortunately, over the past 2 decades, there have been a significant number of randomised controlled trials comparing (high-fat) ketogenic diets to low fat diets, and a systematic review and meta-analysis was published recently. It identified thirteen studies incorporating 1415 people and determined that over 1–2 years (medium-term), people consuming the ketogenic diet lost more body weight, and their blood pressure and fats improved compared to people consuming a low fat diet. The authors concluded “... in the long term and when compared with conventional therapy, the differences appear to be of little clinical significance, although statistically significant.”

So while the ketogenic diet may be an alternative to other diets under certain circumstances it is not necessarily superior in the long-term; we must as usual keep in mind the simple fact that one size does not fit all. Because food plays such a pivotal role in our family and social lives, ketogenic diets can be disruptive and long-term adherence and enjoyment of food (one of life’s pleasures) are frequently issues. And there are side effects, especially in the beginning until the body adjusts, including constipation, headache and fatigue.

You can listen to Alan discuss ketogenic diets on Health Professional Radio, here.

 Dr Alan Barclay  

Alan Barclay, PhD is a consultant dietitian. He worked for Diabetes Australia (NSW) from 1998–2014 . He is author/co-author of more than 30 scientific publications, and author/co-author of  The good Carbs Cookbook (Murdoch Books), Reversing Diabetes (Murdoch Books), The Low GI Diet: Managing Type 2 Diabetes (Hachette Australia) and The Ultimate Guide to Sugars and Sweeteners (The Experiment, New York).

VIEWPOINTS FROM THE CHARLES PERKINS CENTRE, SYDNEY UNIVERSITY

YOGHURT IS A LOW GI FOOD
The Sydney University GI Research Service (SUGiRS), established in 1995 to provide a reliable commercial GI testing laboratory, has tested a variety of yoghurts over the past 20 years – plain, flavoured, full fat, and diet. Over the same period of time, numerous studies in peer-reviewed journals have shown that high yoghurt intake is associated with a reduced risk of type 2 diabetes. Although several mechanisms could explain this association, Prof Tom Wolever recently addressed the glycemic and insulinemic impact of yoghurt in Nutrition Today.

Yoghurt

“There is evidence that low GI and low GL (glycemic load) diets are associated with a reduced risk of type 2 diabetes. The 93 GI values for yoghurt in the University of Sydney’s GI database have an average of 34 and most (9 out of 10) of the yoghurts are low GI. The 43 plain yoghurts in the database have a lower GI (average GI = 27) than the 50 sweetened yoghurts (average GI = 41). This difference is not explained by sugar, per se, but rather by the higher protein-to-carbohydrate ratio in plain yoghurt. Although yoghurt has a low GI, its insulinemic index is higher than its GI. High insulin responses may be deleterious because hyperinsulinemia is associated with an increased risk of type 2 diabetes. Nevertheless, this may not be a concern for yoghurt because, although its insulinemic index is higher than its GI, the insulinemic index of yoghurt is within the range of insulinemic index values for non-dairy low-GI foods. In addition, mixed meals containing dairy protein elicit insulin responses similar to those elicited by mixed meals of similar composition containing non-dairy protein. Because the GI of yoghurt is lower than that of most other carbohydrate foods, exchanging yoghurt for other protein and carbohydrate sources can reduce the GI and GL of the diet, and is in line with recommended dietary patterns, which include whole grains, fruits, vegetables, nuts, legumes, fish, vegetable oils, and yoghurt.”

What’s the Insulinemic Index? Prof Jennie Brand-Miller explained this recently.

“One of insulin’s many functions is to act as a growth hormone designed to drive nutrients into cells – not just glucose but also amino acids, the building blocks of new tissue. When we eat carb-rich foods our blood glucose levels rise and our pancreas then releases insulin (a hormone) that drives the glucose out of our bloodstream and into our body’s cells where our body can use it as an immediate source of energy or store it as glycogen. What many people don’t realise is that protein foods (meat, fish, eggs and dairy foods) also stimulate insulin secretion – that’s why you may see them described as insulinogenic.”

Scientists at the University of Sydney have been researching the food insulin index or FII for more than 20 years. “The FII looks at how much insulin the body normally releases in response to a whole food or meal (its carbohydrate and the quantity and quality of its protein and fat). Some foods need more insulin to help utilise them, while other foods need much less. Choosing foods with a lower FII can help reduce your overall insulin demand on your pancreas or insulin requirements,” says dietitian and diabetes educator Dr Kirstie Bell. 

FOOD UN-PLUGGED

THE FAUX MEAT PHENOMENON 
Faux (fake) meats have progressed in leaps and bounds since the days of Tofurky roasts. Even devoted meat lovers are being drawn over to the veggie side of life by convincingly tasty ‘not-meats’. Is facon better than bacon? Or are we better off sticking with the real deal?

What’s in them? Vegetarian ‘meats’ are made from a variety of non-animal foods such as beans, fungi, grains and nuts, and mostly the protein parts. The result is a mass of chewy textured plant proteins with meat-like savoury flavours. Some faux meats are designed to resemble their animal food counterparts, such as soy-protein shaped to look like prawns or even pork belly with the layer of fat and crispy skin to boot- which is pretty amazing work by food technologists although vegans don’t like it much, preferring not to eat anything that even looks like an animal.

Lab meat Food scientists are working on lab-grown meat and have produced convincing burger patties with meat cells grown in a test tube, removing the need to raise or kill livestock. While this futuristic scenario is now a reality on a small scale, it is super expensive and won’t be meeting the world’s needs for meat anytime soon.

Nutrition With the rise in popularity of plant-based diets, faux meats are now finding a wider market with people wanting a healthy and sustainable option. However, although they are made from plants (or fungi) their nutritional composition can fall short of ‘superfood’ expectations. Like real bacon and sausages, some faux meat products are highly processed and contain high levels of sodium (salt) and other food additives.

Faux meat table

We compared 2 faux meat products and one vegan ‘bacon’ recipe with their real meat equivalents to give you their nutrient profiles. Just a few mouthfuls of Coconut Bacon will use almost your entire daily saturated fat allowance (21.4g out of 24g). The two commercial products we looked at had no Vitamin B12 added, which is a problem for vegans as fortified foods are the only source in a vegan diet.

Sustainability Some say vegetarian diets are more sustainable because plant foods require fewer inputs (e.g. water, feed, energy etc) than meat to produce; however, there is more to this story. Highly processed foods require more energy and have long supply chains that add transport inputs and emissions. Smaller animals have a lower eco-footprint than larger ones, and even cattle and sheep can be raised on land than can’t be used for cropping. Not to mention the social benefits of keeping farming communities around the world viable. Eating some animal foods within a plant based diet produced with more sustainable and fair farming practices can be better for people and the planet.

If you want to eat more sustainably, there are much lower hanging protein solutions. We could eat the whole animal (not just the prime cuts); swap some meat for legumes; and choose more sustainable meat sources. In Australia we are catching on to eating our national emblem, kangaroos as a wild and free-range source of lean meat rich in iron. And of course we could waste less food generally, which is simply throwing away everything that went into producing it, and creating greenhouse gases from food rotting in landfill.

The un-plugged truth 

  • You do not need to go meat-free to be healthy; lean unprocessed meats are rich in essential nutrients. 
  • Faux meats can have more fibre but can contain more saturated fat and sodium than unprocessed meats - check the label. 
  • Be a more sustainable consumer by eating just enough meat, eating nose-to-tail, and don’t waste food. 
Thanks to Rachel Ananin AKA TheSeasonalDietitian.com for her assistance with this article.

Nicole Senior  

Nicole Senior is an Accredited Nutritionist, author, consultant, cook, food enthusiast and mother who strives to make sense of nutrition science and delights in making healthy food delicious. Contact: You can follow her on Twitter, Facebook, Pinterest, Instagram or check out her website.

KEEP GOOD CARBS AND CARRY ON

YOGHURT CULTURE 
Yoghurt has long been a part of the human diet. The word seems to come from come from the Turkish yo─čurmak, to thicken, coagulate, or curdle, which is what its beneficial bacterial cultures do as they feed on milk’s natural lactose and turn it into the lactic acid that gives yoghurt its characteristic taste and texture. At the same time, they transform a nutrient-rich food (milk) into an even better one by making it easier for us to digest and by promoting health by restoring levels of beneficial probiotic bacteria in the gut.

Yoghurt is a great source of calcium for healthy bones and contains significant amounts of vitamins A, B12 and riboflavin, as well as potassium and other minerals. Its low GI is thanks (mainly) to the combination of acidity and high protein and the fact that lactose itself has a naturally low GI.

Production has taken off in a big way. When shopping, look for products with live cultures and few (if any) additives. We like pot-set Greek-style yoghurt, especially those that are strained so they’re naturally thicker and higher in protein. As dietitian Nicole Senior says: “These products have beautiful mouth-feel and flavour as well as better cooking properties, although all yoghurts are best added after cooking or at the last minute rather than cook in the dish as they will separate.”

Yoghurt

Natural (unflavoured) yoghurt can be a star in savoury dishes says Nicole. It makes a great base for dips, such as baba ganoush or cucumber raita, not to mention beetroot kiz guzeli. Pumpkin soup lovers will know the pleasures of a dollop of yoghurt on top, as will those who enjoy the cooling and creamy addition on Indian curries. What else?

  • Dollop on porridge or muesli along with some nuts and a drizzle of honey or date syrup 
  • Add to fruit and milk to make smoothie 
  • Use as a topping on desserts instead of cream 
  • Tuck into as a snack to get you through to your next meal. 
WHAT ABOUT LACTOSE INTOLERANCE OR LACTASE DEFICIENCY? 
Lactose, the sugar that occurs naturally in milk and yoghurt, is digested into glucose and galactose by the enzyme lactase found in the small bowel of all mammals at birth (apart from those born with lactase deficiency). A person without enough lactase has digestive problems when they consume foods and drinks that contain lactose. About a third of the world’s population continues to produce lactase throughout life. The rest don’t. However, there are many lactose-free milks and yoghurts on the market, so there’s no need to go without calcium-rich dairy foods. Some people who are lactose intolerant find they can enjoy yoghurt because the micro-organisms added to milk to make yoghurt are active in digesting lactose during passage through the small intestine, in other words, the “bugs” help do the job of lactose digestion for you. People with lactose intolerance can eat cheese because it is made from milk solids (curd); the lactose-rich whey has been drained off during the early stages of processing.

IN THE GI NEWS KITCHEN

A DOLLOP OF YOGHURT
A dollop of yoghurt makes a difference as you’ll see in our recipes this month – Quinoa Crusted Veggie Cakes with Horseradish Yoghurt, Vegetable Frittata with Black Sesame and Herb Yoghurt, and Sumac Lamb Fillet with Tzatziki.

DO A DOLLOP
Inspired by the flavour, colour, texture and taste of the vegetable garden, Jalna has developed a range of recipes to up veg intake with a dollop of their pot-set Greek yoghurt toppings. You’ll find more recipes in Inspired by Nature along with the two shared with GI News

QUINOA CRUSTED VEGGIE CAKES WITH HORSERADISH YOGHURT
Horseradish yoghurt is a great way to add oomph to veggie fritters. Add other vegetables such as wilted kale, grated eggplant, zucchini or corn and substitute wasabi for horseradish and amaranth for quinoa if you wish. Serves 6

QUINOA CRUSTED VEGGIE CAKES WITH HORSERADISH YOGHURT

400g can cannellini beans, rinsed and drained
400g can chickpeas, rinsed and drained
1 cup coriander leaves
1 medium red chilli, seeded and chopped
1 clove garlic, crushed
1 egg, lightly beaten
1 tbsp Greek yoghurt
1 cup cooked quinoa
⅓ cup edamame, blanched
⅓ cup green peas, blanched
1 green onion, finely sliced
⅓ cup quinoa flour
2 eggs, lightly beaten with 2 tbsp Greek yoghurt
1½ cups quinoa flakes
Vegetable oil or oil spray
Lemon wedges to serve

Horseradish yoghurt
1 cup Greek yoghurt
1½ tbsp prepared horseradish
1½ tbsp lemon juice
Salt and cracked pepper, to taste

Preheat oven (220°C/200°C fan forced) and line a baking tray with baking paper • Puree cannellini, chickpeas, coriander, chilli, garlic, egg and yoghourt in a food processor until coarsely mashed but mixture holds together. • Place mixture in a large bowl and add quinoa, edamame, green peas, green onion, and salt and pepper to taste if desired. Shape approx ¼ cup of mixture into balls and flatten slightly. Dip in flour, dust off excess, dip in egg and yoghurt mix, then roll in quinoa flakes. • Spray or lightly brush with oil and bake, for 20 minutes or until golden, turning halfway through. • To make horseradish yoghurt, place all ingredients in a bowl & whisk to combine. • Serve fritters with horseradish yoghurt and lemon wedges.

Per serve
2025kJ/485 calories; 25g protein; 10g fat (includes 2.5g saturated fat; saturated : unsaturated fat ratio 0.33); 64g available carbs (includes 15g sugars and 49g starches); 15g fibre; 465mg sodium; 943mg potassium; sodium : potassium ratio 0.49

VEGETABLE FRITTATA WITH BLACK SESAME AND HERB YOGHURT
Don’t be shy about adding other veggies, such as shredded kale leaves, zucchini or broccolini. The more the merrier. You may also like to substitute the red potatoes with lower GI Carisma potatoes and the sweet potato (which has a moderate GI) with low GI butternut pumpkin (winter squash). Serves 4

VEGETABLE FRITTATA WITH BLACK SESAME AND HERB YOGHURT

1 tbsp olive oil
250g (9oz) red baby potatoes, skins on, very thinly sliced
250g (9oz) sweet potato, very thinly sliced
1 red onion, peeled, thinly sliced
2 medium chillies, seeded, finely chopped
125g (4oz) broccoli florets
1 cup green peas
12 large eggs, whisked
⅓ cup Greek yoghurt
½ tsp ground turmeric
Zest of 1 lemon
1 tbsp black sesame seeds, toasted

Herb yoghurt
1 cup Greek yoghurt
½ cup chopped mint leaves
1-2 tsp lemon juice, to taste

Make the herb yoghurt by combining all ingredients. • Preheat grill to high. • Heat the oil in a large ovenproof heavy based frying pan over a medium heat. Stir in the potatoes, sweet potato, onion and chilli, and season to taste. Cover and cook until the potatoes are nearly tender, scraping along the bottom of the pan occasionally, 5-7 minutes. • Add the broccoli and peas and cook a further 2-3 minutes, covered. • Whisk the eggs, ⅓ cup yoghurt, turmeric, zest, and pepper and pour over the potato mix. Reduce heat to moderately low and cook until the eggs are just set, carefully lifting the frittata and tilting the pan so the uncooked egg runs to the underside. • Place pan under a hot grill for a few minutes, until the top of the frittata has puffed up and set. • Serve in the pan, warm or at room temperature, dolloped with herb yoghurt and sprinkled with black sesame seeds.

Per serve
2015kJ/480 calories; 32g protein; 24g fat (includes 7g saturated fat; saturated : unsaturated fat ratio 0.41); 30g available carbs (includes 16g sugars and 14g starches); 8g fibre; 315mg sodium; 1163mg potassium; sodium : potassium ratio 0.27

STICKS, SEEDS, PODS and LEAVES
Kate Hemphill is a trained chef. She contributed the recipes to Ian Hemphill’s best-selling Spice and Herb Bible. You will find more of her recipes on the Herbies spices website. Or you can follow her on Instagram (@herbieskitchen). Kate uses Herbies spices and blends, but you can substitute with whatever you have in your pantry.

SUMAC LAMB FILLET WITH TZATZIKI
This light summer dish is ideal for the barbecue. It’s quick and easy to whip up for one, or simply double quantities for two. Complete the meal with steamed or baked butternut pumpkin (winter squash) wedges. We appreciate that lamb fillet can be pricy, so try it with chicken tenderloins if you prefer. Prep: 5 mins • Cook: 15 mins • Serves: 1

SUMAC LAMB FILLET WITH TZATZIKI


150g (5oz) lamb tenderloin
1 tsp sumac
1 tsp rice bran oil
½ Lebanese cucumber
1 small clove garlic, crushed
½ tbsp lemon juice
¼ cup plain yoghurt
Small handful baby spinach
150g (5oz) cherry tomatoes, quartered
½ tsp olive oil
½ tsp sumac

Coat the lamb fillet with 1 tsp sumac by pressing it all over, and set aside at room temperature. • Grate the cucumber on a large setting and place in a sieve to drain with a pinch of salt. • Heat rice bran oil in a heavy based pan or heat a barbecue. Cook lamb for 4 minutes each side (for medium rare), then set aside to rest (5 minutes) while preparing tzatziki. • Stir drained cucumber with garlic, lemon juice and salt and pepper to taste. • Toss cherry tomatoes with baby spinach, sumac and olive oil. • Slice rested lamb thinly and serve on the spinach and tomato salad with tzatziki on the side.

Per serve
1850kJ/ 440calories; 53g protein; 18g fat (includes 6g saturated fat; saturated : unsaturated fat ratio 0.5); 12g available carbs (includes 10g sugars and 2g starches); 5g fibre; 590mg sodium; 1275mg potassium; sodium : potassium ratio 0.46

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1 August 2017

GI News - August 2017

GI News

GI News is published by the University of Sydney, School of Life and Environmental Sciences and the Charles Perkins Centre

Publisher:
Professor Jennie Brand-Miller, AM, PhD, FAIFST, FNSA
Editor: Philippa Sandall
Scientific Editor/Managing Editor: Alan Barclay, PhD
Contact GI News: glycemic.index@gmail.com


Sydney University Glycemic Index Research Service
Manager: Fiona Atkinson, PhD
Contact: sugirs.manager@sydney.edu.au

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FOOD FOR THOUGHT

FOOD AND FAKE NEWS
There’s a bit of a myth doing the rounds that ours is an era of fake news. There’s nothing new about fake news. Certainly not when it comes to food and health. Most old wives’ tales were “fake news” back in the day. “An apple a day keeps the doctor away” is a maxim that likely started as marketing promo for Welsh apples in the mid nineteenth century. The first mention seems to be in Notes and Queries magazine (February 1866) which cites a so-called Pembrokeshire (Wales) proverb. “Eat an apple on going to bed, and you'll keep the doctor from earning his bread.”

It would be nice to think there’s a grain of truth in “an apple a day,” after all, they are rich in soluble fibre and vitamin C and deserve star billing. Sadly, the findings of a study based on actual nutrition data collected from nearly 8400 men and women — 753 of whom ate an apple a day — and that followed rigorous study methods concludes: “Evidence does not support that an apple a day keeps the doctor away; however, the small fraction of US adults who eat an apple a day do appear to use fewer prescription medications”.

How about “carrots help you see in the dark”? After all, they are seriously rich in beta-carotene that converts to vitamin A in the body and a deficiency of vitamin A does cause night blindness. Promoting carrots as a Super Veg with power to improve night-time vision was British wartime propaganda to get people to grow more veg and eat more carrots (they are easy to grow) because there were food shortages. “Somewhere on the journey the message that carrots are good for your eyes became disfigured into improving eyesight,” says John Stolarczyk, curator of the virtual World Carrot Museum (yes, there is one and it’s well worth looking at).

Carrot promotions

What is new, is that fake news, urban myths and misinformation spread farther and faster than ever before thanks to “lightning-quick news cycles and algorithm-determined social media feeds” says Rachel Visontay in an Opinion piece in the Sydney Morning Herald. “There is no simple cure once we are exposed [to fake news],” she says “because the effects cannot be fully overcome by just promoting fact. Hanging on to mistaken beliefs or fictions occurs not just when people don't want to change their minds – our brains are actually bad at updating information even when we’re trying to. Using the terminology of some researchers, misinformation is really ‘sticky’.”

What to do about it? “When a myth has been so oft- and long-repeated, it will be called to mind very easily. To have any chance of winning out, facts need the same repetitive treatment,” she says. “We can never fully eliminate the impact of misinformation. People and institutions in positions of influence should try harder to put out only truth, because we are much better at learning than unlearning. But there will always be those who knowingly dress fiction as fact. Science tells us how to loosen their grip on us.”

Read more:

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WHAT’S NEW?

MILK OR FAKE MILK?
In June, European courts settled the matter. Only milk can be called milk in Europe, not those plant concoctions. In the US, the dairy industry is fighting to get FDA to enforce its regulations about what is milk and what is not. The FDA says it’s gotta come from cows, but the USDA is not cooperating. They say that “soy milk” is plain language in everyday use. And over the objections of FDA, they’ve insisted on using it in consumer nutrition education materials. No wonder consumers are confused. Here’s a responsible government agency “knowingly dressing fiction as fact” as Rachel Visontay would say.

Milking a cow

The range of white, non-milk liquids calling themselves milk could make your head spin. Soy milk, almond milk, cashew milk, rice milk, coconut milk, hemp milk, barley milk, quinoa milk. The list goes on. Dairy producers don’t like it one bit when all these fake milks try to pass themselves off as some sort of holy water super milk. Early in the 20th century, FDA started setting standards for genuine foods. And for milk, FDA’s standard says the real thing comes from a cow’s udder. Anything else is fake. – Thanks to ConscienHealth’s Ted Kyle for this report.

PS: According to Australia and New Zealand Food Standards. “Milk means the mammary secretion of milking animals, obtained from one or more milkings for consumption as liquid milk or for further processing but excludes colostrum. Skim milk means milk from which milkfat has been removed.”

RUN RODENT, RUN
Here at GI News we are wary of publishing the results of rodent studies. First, the poor animals are typically force fed, overfed and then killed; and after all that unpleasantness, the relevance of the study’s outcome is questionable because rats and mice aren’t people. However, because there are biological similarities, research scientists find them valuable trial subjects. What scientists working in diabetes research have found is that sometimes pharmacological treatments that work in mice fail without an explanation in humans. They now know why this may be.Milking a cow

Writing in ScienceAlert Signe Dean explains. “New medicines come to our pharmacies through a rigorous process that begins in the lab and ends with multiple trials in humans. Along the way there can be animal studies, such as trials of type 2 diabetes drugs in mice. Researchers from Lund University in Sweden and King's College London have found that mice and humans have previously unknown differences when it comes to having G protein-coupled receptors (GPCRs) on insulin-producing beta cells in the pancreas. GPCRs are found on the surfaces of many cells, where they receive chemical messages via various molecules called G proteins. We have nearly 1000 different GPCRs, each finely tuned to react to a particular molecular signal. These receptors have a laundry list of jobs in the body, including detection of certain tastes and smells, immune system regulation, transmission of nerve signals and many more. That's why pharmaceuticals can be used to target specific GPCRs. This avenue of delivering drugs is so popular, it is estimated that around 40 per cent of all modern prescription meds target this receptor type. But when it comes to developing GPCR-targeted drugs for type 2 diabetes, we've had little success. And that could well be because the receptors in mouse and human beta cells just don't match up.”
FREE-FROM FADS, FODMAPS AND FIBRE
“Free-from” is totally trendy with a just touch of fake. For example, while avoiding FODMAPs may be helpful for some of us, it’s not such a good idea for all of us. In fact, Prof Fred Brouns suggests we may be throwing the baby out with the bathwater as people adopting free-from FODMAPs diets are often adopting a diet that is low in dietary fibre – the long-standing driver of good gut health. It is well established that diets rich in dietary fibre reduce our risk of bowel cancer along with numerous other chronic diseases.

FODMAPs, rapidly fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, do seem to exacerbate intestinal discomfort in people who suffer from irritable bowel syndrome (IBS) and prescribing a FODMAP-free diet (carried under medical or dietetic supervision) has proven beneficial for reducing symptoms for many people. But as Fred Brouns points out in The Dietary Fibres–FODMAPs Controversy, there is an increasing perception that FODMAPs which are a problem for some, can be detrimental to everyone’s gut health leading to the worldwide development and commercialization of low-FODMAP diets and products. All very concerning in light of the actual body of evidence that clearly shows we need at least 25 grams and optimally more than 35 grams of nondigestible carbohydrates (including FODMAPs) every day for good gut health.
HOW MUCH PROTEIN?
New research presented at the European Congress on Obesity (ECO) in Porto, Portugal in May 2017, shows that a high intake of protein in early childhood, particularly from animal food sources, is associated with a higher body mass index (BMI) due to increased body fat and not to increases in fat-free mass (internal organs, bones, muscles, water and connective tissue). The study was conducted by Dr Trudy Voortman and colleagues at the Erasmus University Medical Centre, Rotterdam, the Netherlands.

The authors conducted a population-based cohort study of 3564 Dutch children whose dietary intake was assessed using food-frequency questionnaires at age 1 year. From that, the researchers calculated intakes of total protein, protein from different sources; of total carbohydrates, polysaccharides, monosaccharides, and disaccharides; and of total, saturated, monounsaturated, and polyunsaturated fat.

Participants had their height and weight repeatedly measured between the ages of 1 and 10 years, while fat (fat mass index – FMI) and fat-free masses (fat-free mass index – FFMI) were assessed using dual x-ray absorptiometry (DXA) scanning at age 6 and 10 years. The data were adjusted to take account of variables such as maternal age and education, child's ethnicity, total energy intake, physical activity levels and whether the child was breastfed or not.

The study found that a higher intake of both total and animal protein (from dairy and non-dairy sources) was associated with being taller, heavier, and having a higher BMI up to the age of 10. This was true regardless of whether protein was replacing carbohydrates or fats in the diet. The authors say: "Our results suggest that high protein intake, particularly from animal food sources, in early childhood is associated with higher body fat mass, but not fat-free mass … Future studies are needed to examine the optimal range of protein intake and macronutrient composition of the diet for infants and young children and translate these findings into dietary guidelines targeted at this specific age group.”
GOT PRE-DIABETES? FIVE THINGS TO EAT OR AVOID TO PREVENT TYPE 2 DIABETES
“Pre-diabetes is a call to action,” says Prof Clare Collins, writing in The Conversation. “It’s diagnosed when blood glucose levels are higher than normal, but not high enough to be classified as having type 2 diabetes. What you choose to eat, or avoid, influences this risk. We know from the findings of numerous diabetes prevention program studies that people can reduce their risk of developing type 2 diabetes by eating more healthily, losing 5–10% of their body weight, and walking for 30 minutes a day, five days a week. The results of a self-directed diabetes prevention program for men with pre-diabetes our team has just published in the American Journal of Men’s Health found that improved eating patterns were associated with an average weight loss of 5.5kg and better blood glucose regulation. So, what are these improved eating patterns to help prevent type 2 dibetes? Eat more vegetables and fruit, ditch soft drinks, eat a plant based diet, make use of the glycemic index, drink more coffee.”
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PERSPECTIVES WITH DR ALAN BARCLAY

CAN WE CUT OUR AVERAGE DIETARY GI AND GL?
In July GI News, I made the point that: “We now know that glycemic load is the most powerful predictor of blood glucose and insulin levels. You can lower GL by substituting low GI foods for high GI foods, or by consuming less carbohydrate, or by a bit of both.” There is also a rapidly growing body of evidence that low GI or GL diets assist with weight loss, weight maintenance and chronic disease prevention and management. In this issue, I look at a good news health literacy education story: how Australians successfully lowered the average dietary GI of their diets between 1995 and 2011/12 and as a flow-on effect, the GL.

First, a bit of background. David Jenkins and colleagues introduced the glycemic index (GI) in 1981 by comparing the postprandial blood glucose incremental area under curve of different carbohydrate foods. Numerous studies were then conducted to test the GI of different foods and the first International GI Table was published in 1995 followed a year later by the popular book, The GI Factor, giving consumers clear, accessible and authoritative information on the glycemic index, why it mattered and how to go low GI (“learn to love lentils” was a catchphrase). The free database of GI values on the University of Sydney GI website (www.glycemicindex.com) went live late 2000 (or early 2001) thanks to Assoc Prof Gareth Denyer; and in July 2005, GI News arrived on the scene as an online newsletter (http://ginews.blogspot.com.au) thanks to Dr Scott Dickinson.

GI Symbol

But it was clearly time to involve food manufacturers. In Australia, the Glycemic Index Foundation, a not-for-profit health promotion charity, developed the GI Symbol Program (a front-of-pack food endorsement program) in 2002 to help consumers make healthy low GI choices when grocery shopping easier. Foods that carry the Symbol have been GI tested at an accredited laboratory and meet strict category-specific nutrient criteria consistent with international dietary guidelines for kilojoules, saturated fat and sodium, and where appropriate, fibre and calcium. Since then a range of “good carbs” have carried the Symbol including breads, breakfast cereals, pasta, rice, noodles, apples, pears, potatoes, milk (the real stuff) and yoghurt.

But did Australian consumers actually make use of all this information about the GI of foods? A study in the American Journal of Clinical Nutrition suggests that they did (Australian are good adopters and early adopters). Using data from Australia’s most recent national nutrition surveys, the researchers set out to see if dietary GI and GL had changed between the years 1995 and 2011/2. They found that dietary GI decreased from 56.5% to 53.9%. They put this down primarily to a reduction in the intake of added sugars (primarily sucrose in Australia), honey and syrups, sweetened beverages, juices and potatoes. But low GI breads and breakfast cereals (many with the GI Symbol) have been very successful product ranges in Australia. These results are encouraging. There is no reason why this cannot be achieved elsewhere in the world.

What next? Here at GI News, we would like to see the GI (and GL of a serving) included on Nutrition Information Panels/Nutrition Facts Labels to help consumers manage their weight and reduce their risk of chronic disease; and to help those with diabetes manage their blood glucose levels. It’s estimated that around 50% of food purchasing decisions are made at the point of sale, so let’s give consumers the information they need to make better choices.

 Dr Alan Barclay

Alan Barclay, PhD is a consultant dietitian. He worked for Diabetes Australia (NSW) from 1998–2014 . He is author/co-author of more than 30 scientific publications, and author/co-author of  The good Carbs Cookbook (Murdoch Books), Reversing Diabetes (Murdoch Books), The Low GI Diet: Managing Type 2 Diabetes (Hachette Australia) and The Ultimate Guide to Sugars and Sweeteners (The Experiment, New York).

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FOOD UN-PLUGGED

CAN YOUR BREAKFAST CLEANSE YOUR LIVER?
Remember the lemon detox diet – that tear-jerking lemon, cayenne pepper and sugar water concoction? Or those liver cleansing diet books? No matter how often you gently and persistently point out that detoxing your body is what the liver and kidneys do (it’s their job), the notion that you need a special pill, potion or diet to detox and cleanse has entered the seriously sticky misinformation realm. And stuck.

We recently came across a liver cleansing muesli developed by a naturopath and thought we’d check it out.

Liver cleansing muesli Nutrition Information

The ingredients – oats, sunflower seeds, almonds, barley bran, psyllium, barley bran, linseeds, and pepitas – are nutritious, high-fibre foods good for bowel health. There’s also an “added botanical for digestive support”, which we assume is the “0.5% slippery elm” – a herbal remedy from the bark of the slippery elm tree.

Slippery elm (Ulmus rubra Muhl.) was an important medicinal plant for Native Americans who used it in a decoction as a laxative and to aid delivery in childbirth. We’re not herbalists, so to find out more, we checked professional texts including Herbs and Natural Supplements - an evidence based guide by Lesley Braun and Marc Cohen (Elsevier). Slippery elm has traditionally been used to treat wounds and skin irritations, sore throats, coughs and gastrointestinal conditions they say. The bark contains mucilages capable of trapping water and forming a gel thought to have soothing properties. However, scientific research is lacking and the therapeutic effectiveness of slippery elm has not been investigated under clinical conditions in people, so reported beneficial effects are anecdotal, or from in-vitro and animal studies. “Safety data is lacking, so slippery elm is not recommended during pregnancy and lactation and in children and adolescents under 18” says Sarah Edwards et al in Phytopharmacy: An Evidence-Based Guide to Herbal Medicinal Products.

What about dosage? The amount of slippery elm is 0.5% of the total, which works out at 0.25g (or 250mg) per 50g serve – a bit like a drop in the therapeutic ocean when you read that the typical dose of slippery elm recommended by herbal manufacturers is 1 teaspoon three times daily (15g).

While the grains and seeds in this muesli product deliver the good gut benefits of dietary fibre, there’s no evidence its small amount of slippery elm will soothe your gut, let alone cleanse your liver. The bigger product picture here is the manufacturer’s health claims (“slippery elm powder contains a gel-like substance that acts as a protective layer for the digestive tract … you can’t taste it in the muesli, but they’re in there working for your liver!”) and such claims are strictly regulated in many countries. Under consumer law it is not permitted to make false or misleading claims about a product and a case could be made this product does not deliver on its liver-cleansing promise.

How to look after your liver To keep your liver in tip top condition, eat plenty of plant foods such as wholegrains, legumes, fruits, vegetables, nuts and seeds; exercise regularly; maintain a healthy weight and drink water. Limit alcohol, caffeine and fatty processed foods.

The un-plugged truth

  • You don’t need to buy detox products or follow detox diets. Liver cleansing is a fallacy.
  • Muesli can be a healthy breakfast choice (depending on the brand).
  • To care of your liver, drink less alcohol, exercise regularly, enjoy a healthy plant-based diet, maintain a healthy body weight and drink plenty of water.
Thanks to Rachel Ananin AKA TheSeasonalDietitian.com for her assistance with this article.

Nicole Senior
Nicole Senior is an Accredited Nutritionist, author, consultant, cook, food enthusiast and mother who strives to make sense of nutrition science and delights in making healthy food delicious.

Contact: You can follow her on Twitter, Facebook, Pinterest, Instagram or check out her website.

Want more on detoxing? Dr Nick Fuller recently took a look at liver detox or liver cleanse products in GI News where he dealt with the question: can the liver be “cleansed”?

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KEEP GOOD CARBS AND CARRY ON

CAULIFLOWER
In our new book, The Good Carbs Cookbook, there’s a profile of each of the forty foods that made the final cut. We chose cauliflower (a member of the Brassica or cabbage family) for a few reasons. It’s a great source of dietary fibre and other nutritional goodies and we love it and like to cook with it.

And seemingly so do advocates of paleo and “clean food” diets and various free-from grains or low-carb diets who suggest recipes like cauliflower rice. However, while our hunter-gather forebears may have tugged the odd wild cabbage ancestor from the ground, they certainly never tucked into anything like the creamy curds of the cauliflower we enjoy as it wasn’t around. In fact, like so many of our popular veggies, cauli’s origins are a bit of a mystery. It’s thought it originated in the eastern Mediterranean. Cauliflower was certainly described by the early Arab botanists, known to the Romans, and appeared in Italy towards the end of the 15th century, possibly making landfall in Sicily which has numerous delicious, trad recipes making the most of its creamy curds that soak up flavour. Here’s what you are getting with cauliflower.
CAULIFLOWER

THE CAULIFLOWER PROFILE
This three-in-one veg gives you an edible head of creamy curds and crunchy white stems encased by tender green leaves. Forget the substitute-for-potatoes-or-rice scenario and make the most of this affordable, versatile, mild-mannered member of the cabbage family that stir-fried, steamed, boiled or raw takes on the bold flavours of sharp cheeses, biting mustards, spicy curries, Asian sauces and tangy pickles. It makes excellent soups from the simple and soothing to the sublime and delicate.

By concentrating its sweetness, roasting puts cauliflower in a class of its own as side dish, salad or finger food with dips. The best cauliflower for roasting whole should have snowy white, tightly packed florets (curds) nestling in bright green leaves. Blanching before roasting gets rid of strong odours, keeps the florets tender after roasting and shortens the roasting time. Instead of blanching the cauliflower in water, you can steam it if you prefer.

The milky head is the one we are all most familiar with, but these days you’ll find orange, green (broccolflower) and purple caulis that hold their colour when cooked making for a rather spectacular dish.

Choose heads (or half heads) with tight, firm, creamy-white curds, steering well clear of any with black, slimy spots – signs of mould. Check the stems too and make sure there are no cracks or splits. Frozen florets will be fresher than those pre-packed plastic trays of florets that are often way past their best-by date. A head of cauli will keep in the fridge for a few days in a plastic bag.

WHAT’S IN THEM? Half a cup of cooked cauliflower florets (about 90g or 3oz) has around 90 kilojoules (21 calories), 2g protein, no fat, 2g carbs (2g sugars/ 0g starches), 2g fibre, 13 mg sodium, 284 mg potassium. Because it is so low in carbohydrate, it is not possible to measure its GI, and therefore it does not have a GL either.
—Reproduced with permission of the publisher, Murdoch Books.

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IN THE GI NEWS KITCHEN

BRILLIANT BRASSICAS
Brassica veggies are consumed in enormous quantities around the world from salad plants such as rocket (arugula), mustard and cress; to Oriental leafy veg such as pak-choi, bok choy and choy sum and their European cousins – cabbage, kale, cauliflower, broccoli and kohlrabi. We opted for the flowery Brassicas this issue: cauliflower and broccoli.

GO CAULI
Two low GI recipes that show how versatile this delicate veg is: Spiced Cauliflower and Lentil Soup and Crispy Cauliflower with Buckwheat and Pinenuts. Don’t be surprised if everyone lines up for seconds.

SPICED CAULIFLOWER AND LENTIL SOUP
It’s an easy recipe to ring the changes. Try using Moroccan spice powder and 1 tablespoon of harissa paste instead of the ground cumin and coriander. Or substitute diced orange-fleshed sweet potato or butternut pumpkin for the lentils with. Prep: 10 mins Cook: 40 mins Serves: 2
SPICED CAULIFLOWER AND LENTIL SOUP

olive oil spray
1 leek,
pale part only, chopped
2 garlic cloves, chopped
1 long green chilli, seeded and chopped
2 tsp ground coriander
2 tsp ground cumin
¼ tsp ground turmeric
350g (12oz) cauliflower florets
½ cup green lentils, rinsed
1 tbsp reduced-fat coconut milk
1 tbsp toasted slivered almonds
1 small handful coriander (cilantro) leaves

Spray a large saucepan with olive oil and place over medium heat. Add the leek and cook, stirring, for 2 minutes or until softened. Add the garlic, chilli, ground coriander, cumin and turmeric, and stir for 1 minute or until aromatic. • Add the cauliflower florets, green lentils and 4 cups water. Cover the pan and cook for 30–35 minutes or until the cauliflower and lentils are tender. • Using a stick blender, blend the soup until smooth. • Ladle the soup into bowls and serve topped with the coconut milk, almonds, coriander leaves and freshly ground black pepper.

Per serve
1295kJ/ 308 calories; 22g protein; 7g fat (includes 0.5g saturated fat; saturated : unsaturated fat ratio 0.08); 32g available carbs (includes 10g sugars and 22g starches); 16g fibre; 70mg sodium; 1350mg potassium; sodium : potassium ratio 0.05.

Reversing Diabetes
This recipe is from Reversing Diabetes (Murdoch Books), and is available from good bookshops and online.

CRISPY CAULIFLOWER WITH BUCKWHEAT AND PINENUTS
The earthy, nutty and slightly smoky flavour of buckwheat’s amazing tiny pyramid shapes, makes a robust addition to dishes. Prep: 10 mins • Cook: 30 mins • Serves: 6

CRISPY CAULIFLOWER WITH BUCKWHEAT AND PINENUTS

1 medium cauliflower
2 tablespoons olive oil
sea salt flakes
¾ cup raw buckwheat groats, rinsed
⅔ cup medium pitted black olives,
roughly chopped
2 tbsp salted capers, rinsed and drained
3 tbsp toasted pine nuts
2 tbsp currants

Dressing
1 garlic clove, crushed
1 handful parsley, chopped
⅓ cup olive oil
2 tbsp lemon juice
sea salt flakes and freshly ground pepper

Preheat the oven to 190°C/375°F (fan 170°C/325°F). Line a baking tray with baking paper. • Rinse the cauliflower and cut through the thick core into quarters. Cut each quarter into thick slices and put into a bowl. If you prefer, cut them into large florets. Pour over the oil, sprinkle with a little salt and toss. Arrange the cauliflower on the tray and roast for 20–25 minutes, or until crispy and slightly charred. Set aside to cool. • While the cauliflower is roasting, bring a pot of water to the boil, tip in the buckwheat and simmer for 8–10 minutes, or until al dente. Drain, rinse and leave to cool to room temperature. • Whisk together the dressing ingredients, adding salt and pepper to taste, to make a chunky thick dressing. Watch the amount of salt you use, as both the capers and olives will provide a briny tang. • Put the cauliflower, buckwheat, olives, capers, pine nuts and currants in a bowl. Pour over the dressing and lightly tumble together. Serve at room temperature.

Per serve
1505kJ/ 360 calories; 6g protein; 27g fat (includes 3.5g saturated fat; saturated : unsaturated fat ratio 0.15); 21g available carbs (includes 5.5g sugars and 15.5g starches); 5.5g fibre; 255mg sodium; 505mg potassium; sodium : potassium ratio 0.5.
The Good Carbs Cookbook
This recipe is from The Good Carbs Cookbook (Murdoch Books), and is available from good bookshops and online.

STICKS, SEEDS, PODS and LEAVES
Kate Hemphill is a trained chef. She contributed the recipes to Ian Hemphill’s best-selling Spice and Herb Bible. You will find more of her recipes on the Herbies spices website. Or you can follow her on Instagram (@herbieskitchen). Kate uses Herbies spices and blends, but you can substitute with whatever you have in your pantry.

BARRAMUNDI AND BROCCOLI FISH CAKES

Served here with wilted spinach and lemon wedges. Choose a lower GI potato like Carisma if you can. Substitute the barramundi fillets for a firm white fish such as snapper, hake, ling, perch, cod, seabass or coral trout. Herbie’s Spices Fish Cake Spice Mix is a tangy combo – coriander, sumac fennel, mace, ginger, lemon myrtle, dill, parsley and Australian native pepperberry. Substitute with 1 tsp lemon zest and 1–2 tbsp of chopped fresh parsley. Prep time: 15 mins • Cook time: 45 mins • Serves: 4

BARRAMUNDI AND BROCCOLI FISH CAKES

3 barramundi fillets (approx 400g/14oz total)
2 cups milk
6 florets broccoli, cooked until tender and drained
2 potatoes (450g/1lb total)
1 tbsp butter
1 egg, beaten
1 tsp finely grated lemon zest
1 tbsp Herbies fish cake spice mix
¼ cup breadcrumbs, plus extra for coating
rice bran or vegetable oil, for cooking

Place fish fillets skin side up in a deep pan and cover with milk. Bring to a gentle boil over low-medium heat then turn off heat and allow fish to continue cooking for 10 minutes. • Peel and cut the potatoes into chunks and cook until tender. Mash with butter and season to taste. • Chop the cooked broccoli finely and stir into the mash along with the egg, lemon zest, spice mix and ¼ cup breadcrumbs. • Remove cooked fish from milk and discard skin. Flake the fish into the mash mixture, removing any bones. • Stir to combine well then shape into 12 medium fish cakes. Once shaped, toss in extra breadcrumbs. Fish cakes can be placed on a lined baking tray, covered and refrigerated for up to 24 hours before cooking. • To cook, heat oil in a large frying pan and cook fish cakes for 3–4 minutes per side, until golden then drain on kitchen paper towel before serving.

Per serve
1990kJ/ 475 calories; 30g protein; 25g fat (includes 6g saturated fat; saturated : unsaturated fat ratio 0.32); 29g available carbs (includes 9g sugars and 20g starches); 4g fibre; 228mg sodium; 1302mg potassium; sodium : potassium ratio 0.18.

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COPYRIGHT AND PERMISSION


This website and all information, data, documents, pages and images it contains is copyright under the Copyright Act 1968 (Commonwealth of Australia) (as amended) and the copyright laws of all member countries of the Berne Union and the Universal Copyright Convention.Copyright in the website and in material prepared by GI News is owned by Glycemic Index Foundation. Copyright in quotations, images from published works and photo libraries, and materials contributed by third parties including our regular contributors Alan Barclay, Jennie Brand-Miller, and Nicole Senior is owned by the respective authors or agencies, as credited.

GI News encourages the availability, dissemination and exchange of public information. You may include a link to GI News on your website. You may also copy, distribute, display, download and otherwise freely deal only with material owned by GI News, on the condition that you include the copyright notice “© GI News, University of Sydney” on all uses and prominently credit the source as being GI News and include a link back to ginews.blogspot.com.au. You must, however, obtain permission from GI News if you wish to do the following:

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To obtain such permission, please contact glycemic.index@gmail.com

This permission does not extend to material contributed and owned by other parties. We strongly recommend that you refer to the copyright statements at their respective websites and seek their permission before making use of any such material, whether images or text. Please contact GI News if you are in doubt as to the ownership of any material.

Nutritional analysis To analyse Australian foods, beverages, processed products and recipes, we use FoodWorks which contains the AusNut and Nuttab databases. If necessary, this is supplemented with data from www.calorieking.com.au and http://ndb.nal.usda.gov/ndb/search.

Disclaimer GI News endeavours to check the veracity of news stories cited in this free e-newsletter by referring to the primary source, but cannot be held responsible for inaccuracies in the articles so published. GI News provides links to other World Wide Web sites as a convenience to users, but cannot be held responsible for the content or availability of these sites. All recipes that are included within GI News have been analysed however they have not been tested for their glycemic index properties by an accredited laboratory according to the ISO standards. 

© ®™ The University of Sydney, Australia

1 July 2017

GI News - July 2017

GI News


GI News is published by the University of Sydney, School of Life and Environmental Sciences and the Charles Perkins Centre

Publisher:
Professor Jennie Brand-Miller, AM, PhD, FAIFST, FNSA
Editor: Philippa Sandall
Scientific Editor/Managing Editor: Alan Barclay, PhD
Contact GI News: glycemic.index@gmail.com

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Contact: sugirs.manager@sydney.edu.au

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FOOD FOR THOUGHT

Carbs 101
As you can imagine, we have been asked many questions about carbs over the 12 years we have been publishing GI News. In Food for Thought it’s back to basics as we share our answers to some common FAQs: what are carbs, where do they come from, why are the good ones important, and why the GI matters.

What are carbs?
The word “carbohydrate” comes from chemistry and means “watered carbon” (or carbon with water molecules). Sometimes you will see it shortened to CHO which stands for carbon, hydrogen and oxygen. Here’s what the chemical formula of glucose looks like: C6H12O6 (which stands for six carbon atoms and six water molecules – H2O = water).

Carbs are one of four major molecules in our foods, and like two of the others – protein and fat – they provide us with the energy (calories or kilojoules) to power our lives. Water, the fourth major molecule, has no calories. Most foods are a mix of these molecules. Take half a cup (about 95g/3oz) of cooked quinoa. It provides 400 kilojoules (96 calories), 4g protein, 2g fat, 15g carbs (1g sugars, 14g starches), 2g fibre, 4mg sodium, 150mg potassium, and has a low GI (53) and GL (8).

They come in a number of guises. Sugars are carbs, so are starches and the bonus indigestible dietary fibres and resistant starches that nourish the gut, feed the friendly bacteria and keep things moving along nicely on the inside.

Where do they come from?
Mostly plants. One way or another, green plants provide us with the energy that fuels our lives from the fossil fuels formed millions of years ago to the foods we grow. Carbohydrate energy comes from plant photosynthesis. To put it as simply as possible, the green cells (chlorophyll) in a plant’s leaves use sunlight’s energy to convert the carbon dioxide they absorb from the air and the water they draw up through their roots into the sugars and starches they need to grow and produce the roots, tubers, stems, leaves, flowers, fruits and seeds. They also use it to make their (indigestible to us) cell wall materials such as cellulose, hemicellulose and lignin, along with various gums and pectins. And there’s more, there’s the oxygen they release into the atmosphere so we can all breathe easy.

Photosynthesis

Why are they important?
Good carbs are multi-talented molecules that play key roles in our body. Our brains, nervous system, red blood cells, kidneys and muscles during exercise prefer carbs as their energy source. Carbs also give our cells structure, form part of our genes and play a part in the function of some proteins. On top of this, good carbs serve up a swag of the micronutrients we need for good health including vitamins B, C and E; minerals such as magnesium, potassium and calcium and antioxidants including the carotenoids that play a protective role in eye health.

Why does low GI matter?
Here at GI News, we recommend putting good carbs on the plate, and where possible, choose those with a low GI or GL. Why? There’s high-level evidence that switching to low GI good carbs that trickle the glucose into the bloodstream can help us cut cravings; feel fuller for longer; stay in shape better by minimising body fat and maximising muscle mass; and decrease our risk of some chronic diseases such as type 2 diabetes and heart disease.

When we eat carb-rich foods (fruit, starchy vegetables, legumes, grains, or dairy products such as milk or yoghurt) our bodies convert their sugars and/or starches into glucose during digestion. However, our bodies do this at very different rates and this is where using the glycemic index (GI) helps us make better choices for long-term health and wellbeing. The GI is particularly useful for people who need to manage their blood glucose levels (BGLs). Think of it as a carbo speedo that gives us an idea how quickly our bodies will digest particular carb foods and how fast and high our BGL is then likely to rise.

High GI: 70 and over • Medium or moderate GI: 56 to 69 • Low GI: 55 and under

Why does it matter how high our BGLs go?

As with blood pressure, there’s a healthy range and a risky range. Having BGLs in the normal range over the day is good for our bodies because it also will lower our day-long insulin levels. Having high BGLs from eating too many high GI foods can put pressure on our health, because it means that our pancreas has to work extra hard producing more insulin to move the glucose into the cells, where it provides energy for the body and brain. It’s never a good idea to overwork or overstress body parts. They can wear out or stop functioning properly. It’s not easy to replace a pancreas.
 The Good Carbs Cookbook
This edited extract from The Good Carbs Cookbook (Murdoch Books Australia) is reproduced with permission. Hugh Ford created the illustration. For more information contact: Isabelle O’Brien, Marketing and Communications Associate, Murdoch Books: isabelleo@murdochbooks.com.au 

The Good Carbs Cookbook: Available online and in store in Australia now. Publishes 13 July in the UK and can be pre-ordered online from Amazon and Book Depository. It should also be available on www.amazon.com for interested US readers to pre-order from June 1.

WHAT’S NEW?

I AM NOT A DIABETIC 

National Diabetes Week 2017 kicks off on July 9 in Australia to raise awareness and understanding about this chronic condition. We thought we would do something different on the awareness-raising front with a poem by our UK colleague, Jim Young.

I am not a diabetic.
I have diabetes – you see?
I am not obese,
I do not smoke or drink,
I am a hungry vegetarian,
and I swim in the sea each day.

Then you shouldn't have diabetes?
But unfortunately, it doesn't work that way.
My Dad had diabetes and
it was his parting gift to me.
So, I have made friends with my condition,
it calls me Son and I call it Pop,
as I pop another pill.

I treat him with every consideration
and we do love to get it right.
My doctor treats him with reverence
and prescribes only the best wrapped gifts,
to assuage his temper, and hopefully one day
will inject some realism into my insinuation
and oft repeated question,
"Oh why Dad, why? Oh why?".

Now it ought to be OK? You say.
But these bloody auto-antibodies
go hunting in a pack.
So another pill for cholesterol,
another for BP,
I know these rustling popper packs
will be the life of me.

But I am not a diabetic!
Repeat that after me,
and then maybe you will see,
that whatever my glucose status,
it is me you see – yes me.
So please don't stick a label
for now you know the truth.
You know that I suffer from diabetes,
as you might do,
one day.

Jim Young is Editor-in-chief of Glycosmedia, an independent online newsletter reporting latest developments in diabetes research. You can read more of Jim’s poems here.

KEEPING AN EYE ON EYESIGHT 

Protecting our eyesight is one of the most important things we can do to ensure quality and enjoyment of life. Ophthalmologist Dr Shanel Sharma explains why for anyone with diabetes it’s vital to be vigilant and why the eye is vulnerable to damage from the complications of diabetes.
Dr Shanel Sharma

“Diabetes is the most common cause of blindness for people between 20 and 65 and diabetic eye diseases can affect anyone with diabetes whether type 1 or type 2,” she says. Chronically high blood glucose levels over time damage blood vessels throughout the body. Our small blood vessels are the most vulnerable and are affected first. These include the small blood vessels supplying our eyes, kidneys and our peripheral limbs (toes). People with chronically elevated blood glucose levels have substantially more, and more severe, retinopathy than those with lower blood glucose levels.

What happens in the eye is that the blood vessels become damaged and develop micro-aneurysms, start to bleed causing haemorrhages and stop carrying blood, resulting in retinal ischaemia. Ischaemic retina causes the release of a protein (VEGF – vascular endothelial growth factor), resulting in the development of sick and abnormal blood vessels, which can bleed or cause tractional retinal detachment and loss of vision. The other major way people lose sight is from diabetic macular oedema, from leaking of blood product into the macular. The macular is the part of the eye that allows one to read, look at people’s faces, or do any fine detailed work.

As there is usually a 10–15-year delay in chronically high BGLs and appearance of diabetic eye diseases, it is important to control BGLs well from the start. Although the damage to the eye is irreversible, early detection and treatment can reduce the risk of blindness by up to approximately 95%.

If you are diagnosed with diabetic retinopathy, don’t despair. Good blood glucose control can reduce its progression. Aim for an HbA1c of 6.05% (people with HbA1c levels less than 6.05%, generally develop slowest rate of retinopathy). Studies have shown that with every percentage point reduction in your HbA1c, you can reduce progression of diabetic retinopathy by 33%.

Reducing blood pressure helps too. A 2015 Cochrane review concluded that the available evidence supports ‘a beneficial effect of intervention to reduce blood pressure with respect to preventing diabetic retinopathy for up to 4 to 5 years’.

As diabetic eye diseases most commonly have no symptoms, it is essential to ensure that you are being screened regularly by your GP, optometrist or your ophthalmologist. Symptoms that are associated with diabetic eye diseases can include intermittent blurred vision, difficulty with focusing, loss of contrast, double vision or distortion to your vision. Additionally, diabetes is an independent risk factor for developing other eye diseases such as cataracts and glaucoma.”

Studies 

Diet and diabetic retinopathy 

Clinical trials have found that people with diabetes who follow healthy eating principles can reduce their HbA1c levels by 1 to 2 percentage points. If they are also following a low GI diet, they can reduce their HbA1c levels by another 0.5 percentage points. While this may not sound significant, a decrease of just 1 percentage point in HbA1c levels will decrease the common complications of diabetes by 19% to 43%.

Study: Dietary hyperglycemia, glycemic index and metabolic retinal diseases

Diet and AMD 

A recent review in Nutrients critically evaluates the evidence about lutein and zeaxanthin (the predominant carotenoids which accumulate in the retina of the eye) intake and age-related macular degeneration. “Current evidence suggests that higher dietary intakes of lutein and zeaxanthin are likely to play an important role in protecting against age-related macular degeneration (AMD)” conclude the authors. “A diet high in a variety of foods is important for achieving adequate dietary levels of lutein and zeaxanthin (as well as other nutrients). Moreover, such a diet should include plenty of leafy green vegetables, in keeping with dietary guidelines. There is also value in including a range of other foods to increase variety and improve the bioavailability of lutein and zeaxanthin, such as eggs and selected nuts,” they say.

Study PDF: Lutein and Zeaxanthin—Food Sources, Bioavailability and Dietary Variety in Age-Related Macular Degeneration Protection 

Contact: vicki.flood@sydney.edu.au or victoria.flood@health.nsw.gov.au

FRUCTOSE AND BGLS 

A new systematic review and meta-analysis in the American Journal of Clinical Nutrition concludes there’s strong evidence that substituting fructose for glucose or sucrose in food or beverages lowers peak postprandial blood glucose and insulin concentrations without a substantial increase in blood triglyceride concentrations. Not so surprising when you look at the GI values of these sweeteners: Fructose (Fruisana brand) = GI 19; Sucrose (table sugar, average) = GI 65; Glucose = GI 100.

Study: Fructose replacement of glucose or sucrose in food or beverages lowers postprandial glucose and insulin without raising triglycerides: a systematic review and meta-analysis