1 October 2017

GI News - October 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

DON’T CONFUSE CORRELATION WITH CAUSATION 
In an entertaining and informative piece in The Conversation, Jon Borwein and Michael Rose look at the dangers of making a link between unrelated results. “Here’s an historical tidbit you may not be aware of,” they write. “Between the years 1860 and 1940, as the number of Methodist ministers living in New England increased, so too did the amount of Cuban rum imported into Boston – and they both increased in an extremely similar way. Thus, Methodist ministers must have bought up lots of rum in that time period! Actually no, that’s a silly conclusion to draw. What’s really going on is that both quantities – Methodist ministers and Cuban rum – were driven upwards by other factors, such as population growth. In reaching that incorrect conclusion, we’ve made the far-too-common mistake of confusing correlation with causation.”

Rum

As we are reporting on a number of large prospective studies and their correlations (otherwise known as associations) in this issue of GI News, we thought we would kick off with an extract from a post by Prof Arya Sharma (Even Correlations Based on Billions of Data Points Do Not Prove Causation, Obesity Notes, August 23, 2017) reminding us of the very serious limitations of such studies.

Even Correlations Based on Billions of Data Points Do Not Prove Causation 
Readers may have already heard about a recent study by Tim Althoff and colleagues from Stanford University, published in Nature, that analyses physical activity data collected from smart phones consisting of 68 million days of physical activity for 717,527 people, in 111 countries (only 46 of which were included in the study). As one may expect, not only do activity levels vary widely across countries but also substantially within countries (which in general terms, the authors refer to as “activity inequality”). It turns out that activity inequality and not actual levels of activity predict obesity rates (based on BMI).

The authors discuss [in their paper] various limitation of their study but fail to mention the biggest limitation of all, the simple fact that correlations, no matter how strong or how large the data set, simply cannot prove causality.

Thus, while the data does prove the point that you can do all sorts of interesting analyses when you have large data sets, it simply does not prove that activity levels (or activity inequality for that matter) actually has much to do with obesity at all. Indeed, one could think of a number of confounders that would otherwise differentiate countries with high activity inequality that happen to have high obesity rates from countries that have low activity inequality and low obesity rates (let’s not even mention reverse causality).

Thus, as nice as the figures presented in the paper may be, it is really hard to follow the authors’ conclusion that, ‘Our findings can help us to understand the prevalence, spread, and effects of inactivity and obesity within and across countries and subpopulations and to design communities, policies, and interventions that promote greater physical activity.’

This is not to say that designing communities, policies, and interventions would not be of substantial health benefits – given all of the known benefits of physical activity. Unfortunately, whether or not, these policies would do anything to prevent or reverse obesity is another matter altogether and remains as unclear after this study as before. 

 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?

PROTEIN AND THE PROSPECT OF DIABETES 
There have been a couple of prospective studies or what we are now going to call “Methodist ministers and Cuban rum” studies recently on protein intake and risk of type 2 diabetes.

Nuts - plant protein

  • The findings of the University of Eastern Finland study in the British Journal of Nutrition suggest the source of dietary protein may play a role in the risk of developing type 2 diabetes. The researchers found that replacing animal protein with plant protein was associated with a lower risk of type 2 diabetes. 
  • The findings of a prospective study and meta-analysis of the Melbourne Collaborative Cohort published in the American Journal of Clinical Nutrition showed that higher intakes of total and animal protein were both associated with increased risks of type 2 diabetes, whereas higher plant protein intake tended to be associated with lower risk of type 2 diabetes. 
What the researchers have found are actually correlations not “findings” in the sense of answers or causation. Certainly, diets high in plant protein such as wholesome whole foods like beans, chickpeas and lentils seem to be protective of a number of chronic diseases including type 2 diabetes. They are also generally low GI. Diets rich in animal protein don’t seem to convey the same advantage and numerous prospective studies over the years show this. Perhaps the saturated fat in meat has something to do with it. Saturated fat does contribute to insulin resistance making the poor old pancreas work harder pumping out more insulin. It’s also worth remembering that the Insulin Index of Foods published in the American Journal of Clinical Nutrition showed that any type of meat (beef, chicken, and pork) produced substantial insulin secretion.

What next? Prospective studies like these are useful for developing hypotheses that can then be put to the test with randomised controlled trials.

The studies 

SUGAR’S SWOON IS GOING GLOBAL 
A new industry analysis by Rabobank suggests sugar’s swoon appears to be passing a tipping point reports ConscienHealth’s Ted Kyle. Food marketers are bowing to consumer pressure and driving sugar out of products, even in developing markets. For more than a decade now, the reputation of sugar as the primary culprit behind obesity trends has been growing. U.S. consumption of added sugars and sugar sweetened beverages peaked at the turn of the millennium. But the market for sugar continued to grow in developing markets. That refuge for marketing sugary foods is fading away.

Sugar

The Rabobank report describes a cycle of consumer preferences. At its heart, this is a story of steadily rising global obesity rates, finger pointing, and the repercussions of consumers cycling through a love/hate relationship with the three macronutrients – carbohydrate, fat, and protein – and, in the process, demonizing certain foods. Currently, protein is on the rise (certainly in North America and Europe), as sugar, sugar-containing products, and other highly refined carbohydrates are increasingly cast as the main villain in the unremitting rise in obesity and metabolic syndrome rates. A “clean label” with a short ingredient list is the imperative that food companies are chasing. Added sugar will drop out. Artificial sweeteners are scary, so they aren’t coming back, either.

Now that global food makers are bowing to the storm of pressure that started with public health advocates, what are those advocates saying? Tom Farley, Philadelphia’s health commissioner, says it will take many years before any of this has an impact on public health. He says: “Sugar is a problem, but sugar is not the only problem.” In responding to doubts about the impact of Mexico’s sugar sweetened beverage tax, Barry Popkin and colleagues recently wrote: “The obesity epidemic will take decades to slow down, stop, and finally reverse itself, but other benefits might be seen sooner.” In other words, don’t hold your breath for health miracles from declining trends in sugar consumption.

To read more 
Ted Kyle is a healthcare professional experienced in collaborating with leading health and obesity experts for sound policy and innovation to address health needs and the obesity epidemic in North America. Through ConscienHealth, he works to advance changes in policy and public opinion that will allow new approaches to be developed and put into use.

NEW GI VALUES 18 EMIRATI FOODS

Azmina Govindji

“I welcome this unique set of data, which provide local populations with a practical and more effective way of controlling their blood glucose levels,” says award-winning Registered Dietitian Azmina Govindji (a media spokesperson for the British Dietetic Association and NHS Choices who was Chief Dietitian to Diabetes UK for 8 years).

“Eating well is about enjoyment, nutritional balance, and also cultural appropriateness. There is a growing incidence of diabetes in UAE and up until now, we’ve only had nutritional and GI information on Western-style foods.

Accurate analysis of the glycaemic impact of locally available produce, as well as dishes cooked using traditional methods, can help people with diabetes make more informed choices about local cuisine. This new research will fill an important gap, enabling healthcare professionals to have a more effective means of providing tailored dietary advice.

The data shows, for example, that foods like khameer bread and beef harees perform well on the GI scale, whereas regag bread and beef thareed are best saved for special occasions.”

GI values of 18 Emirati foods

Test method: For each test food, at least fifteen healthy participants consumed 25 or 50g available carbohydrate portions of a reference food (glucose), which was tested three times, and a test food after an overnight fast, was tested once, on separate occasions. Capillary blood samples were obtained by finger-prick and blood glucose was measured using clinical chemistry analyser. A fasting blood sample was obtained at baseline and before consumption of test foods. Additional blood samples were obtained at 15, 30, 45, 60, 90 and 120 min after the consumption of each test food. The GI value of each test food was calculated as the percentage of the incremental area under the blood glucose curve (IAUC) for the test food of each participant divided by the average IAUC for the reference food of the same participant.

Study 

PERSPECTIVES WITH DR ALAN BARCLAY

PURE BUT NOT SO SIMPLE 
Most nutrition experts have been recommending that we enjoy traditional healthy eating patterns like the Mediterranean and Okinawan diets for many years now, rather than focusing on single nutrients, ingredients or food groups. After all, we eat foods, not nutrients, and the one-nutrient-at-a-time approach is fraught with unintended consequences as nutrition scientists such as Dr David Katz have enumerated very clearly on numerous occasions. However, the old fat versus carbohydrate debate still seems to attract media attention and the recent publication of the results of the PURE (Prospective Urban Rural Epidemiology) study are another example of hype over serious dietary substance.

High fat meal

The PURE study followed over 135,000 people living in 18 countries (three high-income (Canada, Sweden, and United Arab Emirates), 11 middle-income (Argentina, Brazil, Chile, China, Colombia, Iran, Malaysia, occupied Palestinian territory, Poland, South Africa, and Turkey) and four low-income countries (Bangladesh, India, Pakistan, and Zimbabwe) for over 7 years and found that death rates were highest in those who reported having the highest carbohydrate intakes, and conversely were lower in those with higher fat intakes. “Global dietary guidelines should be reconsidered in light of these findings,” they proclaim.

While the PURE study may sound impressive, like all observational studies, it can only show associations (like the Methodist minister and Cuban rum story). It also has a number of significant limitations, including the fact that the associations were only observed in the extreme levels of consumption (43% and 78% of energy from carbohydrates and 11% and 38% of energy from fats), and that diabetes diagnosis was self-reported (so we don’t know how many people really had diabetes). Many people in the low-income countries may have had diabetes but didn’t know it. This would significantly confound the results. However, one of the most significant limitations is how they estimated people’s food and nutrient intakes.

At the very beginning of the study (seven years in the past), a food frequency questionnaire was used to assess people’s food intakes. That was the only time people were asked what they ate. Food frequency questionnaires ask you to recall all the foods and drinks you consumed over the previous 12 months – a difficult task for most of us at the best of times (what did you eat last week?). These questionnaires also have to be carefully designed to reflect the food preferences of the people being studied – it’s not wise to use a questionnaire designed for one country in a different country, as food preferences and the food supply are usually very different. And finally, food frequency questionnaires need to be validated to see how well they measure actual food and nutrient intakes. There are many different ways of doing this. Overall, it’s highly unlikely that the protein, fat and carbohydrate estimates used in the PURE study are very accurate, which of course has profound implications for the results and their interpretation.

Finally, the study looked at the different kinds of fat (saturated, mono and polyunsaturated) but for some reason was not able to look at carbohydrate quality – not even examining the effect of dietary fibre, let alone refined carbohydrates (both starches and sugars), glycemic index or load. Like fats, all carbohydrates are of course not the same, and it is not very useful to lump them all together.

Despite all these significant limitations, and taking the study’s results at face value, we must consider how relevant they are in comparison to what the average person is eating today. In Australia, for example, our most recent national nutrition survey determined that the average adult consumed 43.5% of energy from total carbohydrate and 30.9% from fat. The nutrient reference values that underpin Australia’s dietary guidelines recommend that Australians consume 45-65% of energy from carbohydrates from carbohydrates and 20-35% of energy from fats. These ranges are very similar to what are recommended in the PURE study – our dietary guidelines therefore do not need updating based on this. We are already eating the minimum amount of carbohydrate and close to the upper end of the recommended range for fat. We therefore need to be eating better quality (minimally refined, high fibre, low GI) carbohydrates, not less, and similarly we need to be eating more poly and mono-unsaturated fat, not more saturated fat.

This is all very academic. We eat foods not nutrients. Most people don’t know what percent of energy they get from protein, fat or carbohydrate. Patterns of eating are much more useful, which is what most modern dietary guidelines focus on: recommending that we eat mostly “good carbs” like fruits, vegetables, legumes, wholegrains, milk and yoghurt and save refined carbohydrates like sugar-sweetened beverages, confectionery, savoury starchy snacks (e.g., chips, crisps), etc for special occasions. Keep it relevant. Keep it simple.

Study 


 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).

FOOD UN-PLUGGED

GLUTEN-FREE
In August, the Medical Journal of Australia published an article questioning the existence of non-coeliac gluten or wheat sensitivity. The article was hot media fodder, with most stories including a medical expert suggesting that most people avoiding gluten without being diagnosed with celiac disease didn’t need to do so. The article also concluded that gluten-free diets carry risks, are socially restricting and are costlier. We were glad to see this article published and pleased to see this issue being raised because we’ve being saying something similar for years.

While a gluten free diet is the only treatment for people with coeliac disease, there are many that claim going gluten-free is the magic bullet to weight loss and optimum health for everyone. While there is no good evidence to back this up and a growing number of studies now suggesting it might have adverse effects in the long run, the marketing horse has already bolted and gluten-free foods are a large and growing category. We thought we’d take a closer look at them.

Gluten is a stretchy protein found in grains such as wheat, rye, oats, barley and triticale. This protein gives bread the ability to rise and form a light airy loaf. Gluten-free food alternatives are often made with starches and additives rather than wholegrain flours. It is perhaps no surprise that one review found that gluten-free diets are often lower in fibre and higher in saturated fat. This review also noted that gluten-free diets tend to have a higher glycemic index (GI). This is not helpful for overall metabolic health and may leave you feeling hungrier sooner.

We compared the nutritional value of a muesli bar, mixed grain bread, and a flaked breakfast cereal compared with their gluten-free variants.

 Gluten Free Foods Comparison

Because the serve sizes aren’t the same, it’s hard to make direct comparisons about kilojoules/calories, but there’s not a lot in it. Two significant differences stand out. When it comes to protein, regular trumps gluten free by a significant margin. The same goes for dietary fibre (something most of us need a lot more of).

The down sides of gluten-free
Another factor to consider is the glycemic index (GI) of food. While the glycemic index of the bread we refer to above has not been tested, another similar gluten-free multigrain bread on the market was found to have a high GI (79). Many regular wholegrain breads have a low-medium GI, including this one with a low GI (53). Low GI foods give you more stable blood glucose levels following your meal.

Gluten-free diets tend to be low on grains that are an important source of B vitamins. For example, folate is essential prior to and during pregnancy to help reduce the risk of neural tube defects, and folate is also important for heart health.

Studies have shown that eating wholegrains regularly protects against type 2 diabetes and coronary heart disease. Avoiding gluten unnecessarily in the pursuit of good health may have the opposite effect.

The un-plugged truth 

  • The gluten-free diet is essential for people with celiac disease, but unlikely to be of benefit for the rest of us. 
  • A gluten-free diet should only be undertaken after a confirmed diagnosis and best managed with the help of a qualified dietitian. 
  • Gluten-free foods can be less healthy: lower in protein and fibre, and higher GI.
Thanks to Rachel Ananin AKA TheSeasonalDietitian.com for her assistance with this article.

Nicole Senior    
Nicole Senior Nicole Senior pulls the plug on hype and marketing spin to provide reliable, practical advice on food for health and enjoyment. She 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

CAPSICUMS (SWEET PEPPERS) 
Speedy underestimates the rate at which the Old World embraced the New’s zesty chilli. Try these hot peppers (pimiento) said Columbus proudly introducing them in 1493 – after all pepper (pimento or black pepper) was what he was looking for (well, he possibly said something like that). Within two hundred years they were widely cultivated throughout Europe, Asia and Africa as the tongue-tingling spice we know today. At the same time a mild, sweet variety of capsicum was also evolving. And what a veg. Red, orange, yellow, green, purple: capsicum’s crisp, juicy flesh sets the taste bar high. It’s no wonder they have made themselves at home in kitchens around the world sliced or diced into salads, or stuffed, stir fried, roasted, and often peeled which is not as hard to do as it sounds. Just hold them over a gas flame with metal tongs or place under a very hot grill or on a lightly oiled tray in a hot oven until the skin is charred then drop into a plastic bag and seal. When cool, the skin will slip off easily. If you don’t have time to do this, you can buy them ready prepared from your favourite deli counter. There are numerous good brands of jarred “fire-roasted” peeled strips in olive oil.
CAPSICUMS

What to look for Red, orange and yellow capsicums are not only sweeter than regular green ones, but they keep their colour better when cooked. Select well shaped, firm and glossy capsicums with bright, taut skins and their stems fresh and green. Watch out for soft spots, wrinkled skin or blemishes (that means they are starting to dry out). Select capsicums that are firm and glossy with a uniform colour. Avoid any with dull or wrinkled skin, spots or blemishes. Store unwashed capsicums in a plastic bag in the fridge so they keep their crunch and sweetness. If you have picked up a plastic wrapped tray for a bargain price, unwrap them when you get home as they need to breathe a bit.

What’s in them? A medium raw capsicum (about 90 g or 3 oz) has about 80 kilojoules (19 calories), 1.5g protein, 0g fat, 3g carbs (sugars), 1g fibre, 2mg sodium, 135mg potassium and a low GI (estimated) as they have no starch. They are one of the best sources of vitamin C around.

Some like it hot The hot comes from capsaicin, which is found in its highest concentration in the chilli’s seeds and fleshy “placenta” material that is joined to the seeds says Spice and Herb Bible guru Ian Hemphill. It blows your mind because it releases endorphins which create a sense of wellbeing and stimulation. In spite of the inordinate preoccupation with heat in chillies, the tremendous flavour contribution made by dried chillies should not be overlooked says Ian. And there’s more. Research in recent years has provided some evidence that capsaicin can raise your metabolic rate. A meal containing freshly chopped chilli may also help reduce insulin levels. What’s not to like?
The Good Carbs Cookbook
Extract from The Good Carbs Cookbook published by Murdoch Books and available online and in good bookstores.

IN THE GI NEWS KITCHEN

SPICE IS NICE 

This month Kate Hemphill showcases three spice blends – sambar curry powder, paella spice mix and Creole seasoning – from the Herbies range that transform simple, relatively inexpensive family meals – a burger, a one-pot stew and stuffed peppers – into something you could serve for a more special occasion.

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.

STUFFED CAPSICUMS LOUISIANA STYLE 
The Louisiana-style seasoning works amazingly with this healthy and flavoursome dish, giving the rice, beans and corn a huge lift. For meat lovers, serve alongside beef, lamb or chicken grilled with a sprinkle of the seasoning. Prep time: 10 mins • Cook time: 1 hour • Makes: 6

STUFFED CAPSICUMS LOUISIANA STYLE

1½ cups low or lower GI brown rice (such as Doongara or brown basmati)
6 capsicums, top cut off and seeds removed
1 red onion, finely chopped
2 cloves garlic, finely chopped
2 tbsp Creole seasoning
2 ripe red tomatoes, peeled and diced
½ cup corn kernels
400ml (14oz) can black beans, rinsed and drained

Pre-heat oven to 170C (340F). • Rinse rice and cook until tender, drain. • Meanwhile, sweat onions in a little olive oil until soft, then add garlic and spices. Stir for one minute, then add tomatoes, cooked rice, corn and black beans. Combine well and taste for seasoning. • Firmly stuff the capsicums with rice mixture, place lids on top, and bake for 40 minutes, or until capsicum is tender when pierced.

Per serve 
1445kJ/345 calories; 14g protein; 2.5g fat (includes 0.5g saturated fat; saturated : unsaturated fat ratio 0.25); 60g available carbs (includes 14g sugars and 46g starches); 13g fibre; 455mg sodium; 967mg potassium; sodium : potassium ratio 0.47

INDIAN LAMB BURGER 
These burgers make great picnic or party food cooked bite-size and served with raita. You can use any of Herbie’s many Indian spice blends in these burgers, depending on your mood. The mild sambar powder used here is perfect for younger children. Prep time: 15 mins • Cook time: 10 mins • Serves: 6

INDIAN LAMB BURGER

500g (1lb 2oz) lean lamb mince
1½ tbsp sambar powder
½ tsp salt
1 egg
1 tbsp grated brown onion
1 tsp grated fresh ginger
1 garlic clove, crushed
1 cup Greek yoghurt
1 small cucumber, diced
8 mint leaves, finely chopped

To serve
Turkish bread or burger buns
½ cup mango chutney
2 cups mixed salad leaves
fresh onion and mint for garnish, optional

For burgers, pulse all ingredients in a food processor, or mix well in a large bowl with your hands. Shape into 6 burgers and refrigerate until ready to cook (up to 24 hours). • Combine the yoghurt, cucumber and mint to make the raita and season to taste. • Heat a grill or barbecue and cook burgers for 5–6 minutes per side. Allow to rest for 2 minutes before assembling burger. • Lightly toast bread or bun, if desired, and top with raita, chutney, salad leaves, burger and garnish fresh onion rings and mint leaves.

Per serve (with Turkish bread) 
1200kJ/290 calories; 23g protein; 9g fat (includes 4g saturated fat; saturated : unsaturated fat ratio 0.8); 28g available carbs (includes 18g sugars and 10g starches); 3.5g fibre; 450mg sodium; 580mg potassium; sodium : potassium ratio 0.78

SPANISH CHORIZO and BEAN STEW
One pot stews are perfect for cooler days, and this dish benefits from a long, slow cook. This is a great dish to prepare ahead and it reheats well after storing in the fridge or freezing. Tip: check how hot your chorizo is, you may like to add some chilli powder if it is mild. Prep time: 10 mins • Cook time: 2 hours • Serves: 8

SPANISH CHORIZO and BEAN STEW

1 tbsp olive oil
2 red onions, finely chopped
4 cloves garlic, crushed
2 red bell peppers (or red capsicum) cut into 2cm pieces
¼ cup sherry vinegar
2 tbsp paella spice mix
2 x 400ml (14oz) cans crushed tomatoes
2 x 400ml (14oz) cans cannellini beans, drained
4 small semi-dried chorizo sausages (cooking chorizo), approx 400g (14oz), cut into ¾in (2cm) thick slices
flat leaf parsley

Preheat oven to 120C (300F). • Sweat onions in olive oil in an ovenproof dish on the stove top over low heat. Add garlic and capsicum once onions are soft. Pour in sherry vinegar and stir until evaporated, then add spice mix, tomatoes, beans and 1½ cups water. • In a large frying pan over high heat, briefly brown chorizo then add to stew. • Bring stew to a simmer, stirring, then place in the oven with a lid. Cook for 1½–2 hours until chorizo is meltingly tender. Check for seasoning and serve with parsley.

Per serve
1400kJ/335 calories; 20g protein; 15.5g fat (includes 5g saturated fat; saturated : unsaturated fat ratio 0.48); 22g available carbs (includes 11g sugars and 11g starches); 12g fibre; 790mg sodium; 840mg potassium; sodium : potassium ratio 0.94

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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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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 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
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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.”

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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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