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GI NewsSeptember 2014

Sugars, sweeteners and tooth decay;

Dr Alan Barclay on alternative sweeteners for weight loss and BGLs;

Prof Jennie Brand-Miller on low-carb diets;

Emma Sandall talks to Wes Doyle about personal training benefits;

Nicole Senior checks out honey and Anneka Manning bakes a batch of honey and nut

muesli (granola) bars for lunch boxes;

Ottolenghi's roasted sweet potatoes and fresh figs.

GI News

Editor: Philippa Sandall

Management and design: Alan Barclay, PhDContact:info@gisymbol.com

Technical problems or faults: smb.ginewstech@sydney.edu.au

GI testing: sugirs.manager@sydney.edu.au

Food for Thought

Keeping it off.From high protein to low-fat, from eating right for your type to eating like a caveman, any

calorie deficit diet (burning more calories than you eat) will help you lose weight. The main

game is maintaining that weight loss converting your old eating and lifestyle patterns intonew and healthy ones you can live with for a lifetime.

Dont be tempted to measure success by the number of dress sizes dropped or belt notches

tightened. Its a real achievement to lose 5% of your initial weight in whatever time it takes.

If you do want to lose a bit more, take the pressure off for 3 months before you restrict

calories again. This will give your body time to adjust to its new engine size. And it will give

you practice in learning to listen to your bodys natural signals for feeling hungry and feeling

full. An alternating weight loss/weight maintenance pattern like this will help you become a

full-time weight maintainer. In theory, preventing weight regain should be a lot easier than

losing weight. But, if anything, it is the most critical stage. Regaining weight after you have

been on a diet is all too easy. Heres why.

Your body fights back. Food-seeking behaviour is wired into our brains to make sure we

survive when our energy intake is low. So, despite your good intentions, hormones fly into

action to stimulate your appetite and encourage food intake.

At your new weight, your body is a smaller engine and it needs less fuel (calories) to run.

And if you lost weight rapidly and without exercising, then chances are you also lost

proportionally more muscle, making your engine size even smaller.

Another reason why it can be so hard to maintain weight loss is that your resting metabolic

rate (RMR) has dropped so your energy expenditure declines by as much as 10%. This is hownature helps animals adapt to the environment in which they live. If food is scarce, the body

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reduces engine revs so it can get by with less fuel.

The aim of the international PREVIEW study currently underway is to find out the best

methods (through diet, exercise and behavioural modification) of helping people with pre-

diabetes maintain weight loss and keep diabetes at bay. Volunteers for this study will have

their own team of professionals dedicated to their weight loss and weight loss maintenance,all free of charge, says Prof Jennie Brand-Miller. If you live in Sydney (Australia) and are

interested in taking part, see below for details for applying or for finding out more about it.

What's new?

Obesity in grizzlies, a natural adaptation to hibernation.

Researchers writing in Cell Metabolism(www.ncbi.nlm.nih.gov/pubmed/25100064) report

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that as grizzly bears become obese in preparation for winter and hibernation, they respond

normally to insulin which prevents the breakdown of fatty tissue. But during hibernation,

their insulin effectively stops working. This insulin resistance allows the bears to break down

their fat stores throughout hibernation (they don't eat, drink or defecate for up to seven

months). They survive on their fat. When they wake up and start eating again, they respond

normally to insulin.

The insulin levels in their blood do not change. The cells that insulin communicates with turn

on and off their ability to respond to insulin. When the bears are most obese, they are also the

most insulin sensitive, and they become this way by shutting down the activity of a protein

called PTEN in their fat cells. This is in contrast to the common notion that obesity leads to

diabetes in humans, says Dr. Kevin Corbit, of Amgen, Inc. The researchers also found that

grizzlies somehow store all of the fuel they need during hibernation in fat tissue, not in liver

and muscle, which are common places for fat to accumulate in other animals with obesity.

Chew on this.

People with diabetes are at greater risk of developing gum disease (gingivitis and periodontaldisease) than people who do not have diabetes. Gum disease is a bacterial infection in the

mouth can cause blood glucose levels to rise. The link is inflammation. The build-up of

inflammatory substances in the blood can worsen chronic health conditions.

A recent study (www.sciencedirect.com/science/article/pii/S0749379714001536) that

involved checking the health and dental insurance records of 338,891 people with one of five

conditions (type 2 diabetes, heart disease, cerebrovascular disease, rheumatoid arthritis and

pregnancy), found that periodontal therapy can improve health. The researchers report that

within 4 years, people who had treatment for gum disease had lower medical costs and fewer

hospitalisations compared with people who didnt have treatment. For example, people with

cardiovascular disease and diabetes who had the gum disease treatment had health-care costs

that were between 20% and 40% lower.

Gum disease is usually caused by a build-up of plaque on teeth. One of the common signs is

bleeding gums. Tips for maintaining healthy teeth and gums include:

Brushing twice a day with a soft, small-headed toothbrush.

Carefully flossing each day.

Visiting your dentist every six months for a check up and clean.

Eating a healthy diet including plenty of low GI whole grains.

Managing your blood glucose levels if you have diabetes. Quitting smoking if you do people who smoke are 4 times more likely to develop

gum disease than people who dont.

Sugars, sweeteners and tooth decay.

This is an edited extract from the Ultimate Guide to Sugars and

Sweeteners (http://theexperimentpublishing.com/catalogs/fall-2014/sugars-and-sweeteners)

reproduced courtesy The Experiment Publishing (New York).

Sugars and starches (highly fermentable carbohydrates) can all contribute to tooth decay,

but overall, with the exception of lactose, sugars appear to be more likely to promote tooth

decay (be cariogenic) than starches. Whether or not a sugary food or drink will cause toothdecay depends on:

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How much and how often you consume the food or drink

The foods acidity and its buffering power (thats the foods ability to minimize the

overall acidity)

The foods consistency (texture) and its retention in your mouth

Your overall eating and drinking pattern (i.e., how much and how often you eat and

drink).

Your susceptibility to developing tooth decay also depends on your mouth bacteria, the flow

rate and composition of your saliva, and whether or not you live in an area that has a

fluoridated water supply and/or use fluoride toothpaste.

Consuming added sugars and foods high in added sugars frequently, is clearly associated with

an increased risk of developing dental caries, independent of the actual amount you eat or

drink. Rather than nibble or sip on them throughout the day, you are probably better off

downing them in a single sitting and then brush your teeth with fluoride toothpaste.

Polyols (sugar alcohols) are not well fermented by oral bacteria, nor do they have theacidifying impact on plaque that most sugars do and they generally do not promote tooth

decay. Some studies have even suggested that xylitol may be anti-cariogenic, as it has

antibacterial properties that act on some of the fermenting bacteria found in plaque.

Nonnutritive sweeteners (NNS) from aspartame to steviaare also not well fermented by

oral bacteria, nor do they have the acidifying impact on plaque that most sugars do. So,

generally they do not promote tooth decay. However, it comes down to how they are used.

For example, diet soft drinks that contain NNS are acidic, which means they can still, in

theory, contribute to dental erosion. In addition, because they are usually so sweet, most NNS

are diluted and bulked up for tabletop use. The bulking agent is frequently maltodextrins,

which can be used as a fuel by oral bacteria. So, in theory, some nonnutritive tabletop

sweeteners may contribute to tooth decay.

Nicole's Taste of Health

Honey-bunch (you know I love you).

Honey is made by bees after gathering nectar from flowers. Its a beautiful image and a

lovely example of the generosity of Mother Nature (or the greed of man, depending on your

world view). Its also a great example of how food can be regional. Much like winemakers

talk of the terroir (soil, climate, topography) influencing the characteristics of wine, the

characteristics of honey are influenced by the flowers within gathering distance of the hive.Honey aint honey, and aficionados will tell you there are as just as many tasting notes in

honey as there in wine. But even the least honey-curious will know there are mild honeys and

strong honeys, despite many common brands producing a consistent middle-of-the-road

flavour profile through blending.

Honey, as they say, is so hot right now due to the trend of growing your own food. From

the mega-trend of growing veggies and herbs in your backyard or balcony is emerging the

DIY apiculture (bee-keeping) movement. There are now services

(www.theurbanbeehive.com.au) such as Sydneys Urban Beehive that will install a hive at

your place and help keep your buzzing friends healthy, happy and producing your own honey

la maison. And there is this book(www.allenandunwin.com/default.aspx?page=94&book=9781743361719) for beginners on

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the subject. Unfortunately, small scale beekeeping is also encouraged to help save our honey

bees, which are under threat from all sides: primarily from colony collapse disorder, but there

are other problems as well such as varroa mite and in Australia the risk of Asian bees

breeching our borders. Suffice to say were all in trouble if the bees disappear because of

their pivotal role in pollinating food crops.

From a health perspective, overall honey is no better than table sugar (sucrose) and

nutritionally they are very similar. Regular sugar has a glycemic index (GI) or around 65,

while the GI of honey can vary quite a bit depending on the proportion of fructose (higher

fructose levels means lower GI) and the presence of phytochemicals (including flavonoids)

from the flower nectar that appear to slow down absorption and lower the GI. Generally,

darker coloured, stronger flavoured honey contains more phytochemicals. Most common

blended honeys can have the same or higher GI than cane sugar (sucrose), but some pure

wildflower honeys (where bees collect nectar from only one type of flower) have a lower GI,

probably due to higher fructose content. For example, Australian eucalyptus honeys such as

red gum, yellow box or ironbark have low GI.

The clever thing about honey is that besides tasting wonderful it has all kinds of medicinal

uses. Its great for soothing sore throats (traditionally mixed with lemon juice), more

effective than over-the-counter medicines for childrens coughs, and special active honeys

such as Manuka from New Zealand are used to treat wounds, stomach ulcers, gastroenteritis

and fungal infections.

In terms of culinary uses, the options are many and varied, but sometimes the simple things

are the best. Fresh wholegrain toast with honey is a reliable classic, as is porridge with a

golden drizzle. Personally, I think peanut butter is wonderful with honey on toast. Chinese

honey soy chicken is a lovely dalliance between sweet and savoury and exemplifies how

honey goes so nicely with meats of all kinds: honey glazed ham is but one famous example

(although strangely I cant come at honey served on bacon as they do in Canada). Naturally

honey is gorgeous in baked goods and delicious in hot or cold drinks such as smoothies,

cordials, teas and coffee. All this delight from an insect: how wonderful.

Buon appetito!

Nicole Senior is an Accredited Nutritionist, author and consultant who strives to make

healthy food taste terrific. You can follow her on Twitter or Facebook or checkout her

website (www.nicolesenior.com.au)

In the GI News Kitchen

Family Baking.

Anneka Manning, founder of Sydneys BakeClub(www.bakeclub.com.au), shares her

delicious better-for-you recipes for snacks, desserts and treats the whole family will love.

Through both her writing and cooking school, Anneka teaches home cooks to bake in

practical and approachable yet inspiring ways that assure success in the kitchen.

Honey and Nut Muesli Bars.

This recipe is based on one from Supergrainsby Chrissy Freer, published by Murdoch Books

it is a particularly popular recipe that we teach in our Healthy Kids Lunch BoxesBakeClasses. Knowing what is going into your muesli bars is the key it makes them so

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much healthier and tastier. For a nut-free version, substitute the almonds with 1/3 cup

sunflower seeds or pepitas (pumpkin seeds).

Makes: about 24

Preparation time: 15 minutes

Baking time: 45-55 minutes

cup good-quality honey

cup sunflower oil or light olive oil

2 cups traditional rolled oats (oatmeal)

1 cups puffed millet

cup desiccated coconut

1 teaspoons ground cinnamon

1/3 cup sweetened dried cranberries

cup currants

cup raw almonds, coarsely chopped (see Bakers Tips)

Preheatthe oven to 140C/320F. Lightly grease a shallow 20 x 30cm (8 x 12in) baking tin

and line the base and sides with non-stick baking paper.

Putthe honey and oil in a small saucepan over medium heat and stir until well combined and

heated through. Set aside.

Putthe rolled oats, millet, coconut, cinnamon, cranberries, currants and almonds in a large

bowl and mix to combine evenly. Add the honey mixture and stir to combine. Using damp

hands, press the mixture firmly into the lined tin. Press the mixture with the back of a spoon

to make the surface smooth and even.

Bakefor 4555 minutes or until the surface is dark golden brown all over. Cool completely

in the tin before cutting into 24 bars.

Store: These muesli bars will keep in an airtight container for up to 1 week. For extra-crisp

muesli bars, store in an airtight container in the fridge.

Per serve(one piece)

725kJ/ 173 calories; 2g protein; 8.5g fat (includes 2g saturated fat; saturated:unsaturated fat

ratio 0.3); 21g available carbs (includes 12.5g sugars and 8.5g starch); 2g fibre

Anneka's extra tip for using honey in your baking

If you would like to replace the sugar (such as granulated white, caster or brown) with honey

in a baking recipe, simply use the same amount in weight. However, also remember to reduce

the amount of liquid ingredients (such as milk or water) in the recipe by 1 tablespoon forevery cup sugar to account for both the higher moisture level in the honey as well as its

intense sweetness.

Ottolenghi

Roasted sweet potatoes and fresh figs.

This unusual combination of fresh fruit and roasted vegetables is one of the most popular at

Ottolenghi. It wholly depends, though, on the figs being sweet, moist and perfectly ripe. Go

for plump fruit with an irregular shape and a slightly split bottom. Pressing against the skin

should result in some resistance but not much. Try to smell the sweetness. The balsamic

reduction is very effective here, both for the look and for rounding up the flavours. To save

you from making it you can look out for products such as balsamic cream or glaze. Serves 4.

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Everyone is different. Most people are on a journey, so we work with where they are at, and

what encourages them to put one foot in front of the other each day. Were here to give

honest feedback and help them develop ways to move forward. Currently I train clients from

26 to 78. My personal passion is training businessmen. They are always too busy to look after

their health.

How do you filter fitness fads and the fact/fiction of new information?Always have the clients readiness to change, goals, and capabilities front of mind. A 45-

year-old mother of two wont want to be doing a clean and press.

What is the most important tip about fitness you can give someone?

Eat less, move more. It doesnt have to be hard work, it needs to be smart. This is why we

focus on education. PS dont Google, there are millions of confusing pages.

Emma Sandallis an ex-ballerina turned fitness and health guru. She teaches and coaches

dance, fitness and Pilates and writes and produces video for all things movement related.

Emma runs Body Playground, a space to activate and inspire body and soul. Email:emma@bodyplayground.com.au

Update with Dr Alan Barclay

Sweet nothings?

Artificial or non-nutritive sweeteners (NNS) have been around for over a century, helping

people to enjoy sweet foods and drinks without the unwanted calories or carbohydrate that

can contribute to weight gain on the one hand and raise blood glucose levels on the other

when consumed in excess. Few would argue that NNS do not raise blood glucose levels.

Some are suggesting that non-nutritive sweeteners may not actually help people lose weight.A new systematic review helps shed some light. First of all, let's look at the two major kinds

of research study designs.

Randomised controlled trials (RCTs) are considered the gold standard research design as

they can prove that intervention A causes health outcome B, while all other known factors

(known as confounders) have been accounted for by randomisation. For example, two groups

of people are given two different diets (X and Y) and their health status is measured over a

period of several years. Individuals consuming diet X, which has a low GI, have a decreased

risk of developing type 2 diabetes but individuals consuming diet Y, which has a high GI,

increase their risk of developing diabetes. Using this example, we can conclude that high GI

diets cause type 2 diabetes.

Observational studies. In these, large groups of people have a medical check-up, their

dietary patterns are measured, and they are followed up regularly for long periods of time

(e.g., 5-20 years). Unlike RCTs, observational studies can only provide evidence of statistical

associations between foods/nutrients/dietary patterns and health they cannot prove that

something is actually caused by a particular food/nutrient/dietary pattern. Also, it is not

possible to control for all confounders in observational studies, and our tools of observation

(e.g., a food frequency questionnaire for measuring a persons usual food intake) are

imperfect.

Sweeteners and soft drinks.The recent systematic review by Paige Miller and VanessaPerez (www.ncbi.nlm.nih.gov/pubmed/24944060) in the United States looked at all published

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randomised controlled trials and observational studies and body weight. They found that use

of low/no calorie sweeteners led to small but statistically significant improvements in body

weight, body mass index (BMI), fat mass and waist circumference in randomised controlled

trials. In prospective cohort studies, however, use of low/no calorie sweeteners was not

associated with improvements in body weight or fat mass, but was in fact significantly

associated with slightly higher BMI. They concluded that substituting LCS [low/no caloriesweeteners] options for their regular-calorie versions results in a modest weight loss, and may

be a useful dietary tool to improve compliance with weight loss or weight maintenance

plans.

Overall, the evidence from the randomised controlled trials is more powerful than the

evidence from the observational studies.

Along similar lines, a new systematic review (www.ncbi.nlm.nih.gov/pubmed/24932880)

investigating the association between regular and NNS sweetened drinks in observational

studies found that both were modestly associated with the risk of developing type 2 diabetes,

with regular varieties being slightly more strongly associated than their NNS alternatives.The reason that NNS sweetened foods and drinks are associated with weight gain and risk of

type 2 diabetes could be that people usually drink regular or NNS beverages when consuming

other highly processed foods (crisps, chips (French fries), pizza, fried fish, chicken, burgers,

savoury snacks, pastries, etc...), or alcohol (scotch and diet coke anyone?), and that its the

overall poor dietary pattern that's really to blame, not the sweeteners themselves.

The bottom line.Current scientific evidence indicates that non-nutritive sweeteners are safe

to consume in moderate amounts, and that they can be useful for reducing some people's

consumption of added nutritive sweeteners, helping them to lose weight, provided they do not

treat themselves with other highly processed foods and drinks as a reward for avoiding the

added sugars!

GI Symbol ProgramDr Alan W Barclay PhD,

Chief Scientific Officer,

Glycemic Index Foundation (Ltd):

alan.barclay@gisymbol.com

www.gisymbol.com

GI testing

Fiona Atkinson,

Research Manager,

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Product News

Worlds Best Diet.

This is a diet without deprivation thats designed to satisfy the senses as well as the stomach.

The book is based on the Diogenes study (http://ginews.blogspot.com.au/2010/12/gi-symbol-

news-with-dr-alan-barclay.html), one of the worlds largest dietary studies, and combines a

higher protein intake with low-GI carbs, which has been proven to prevent weight regaincreep. Explaining how it works, the authors say: Our research, and that of other nutrition

scientists, has shown that the bodys food regulation mechanisms are quite complicated, but

that one thing is quite simple: in order to sustain our weight over periods of months and

years, we have to stay satisfied and enjoy food preferably three times a day. A food culture

that leaves out whole food groups is simply too restrictive for enjoyment and long-term

sustainability ... The less restrictive a dietary change is, and the less prohibitive of common

foods it is, the easier it is to stick to. The state of slim requires enjoyment, and this is

wonderful news for dieters everywhere.

The authors have carried out numerous studies over the past 20 years looking at ways to

create greater satiety with fewer calories and without eliminating entire food groups. Theywrite: If we can eliminate constant hunger pangs and create enjoyable satiety, we have the

best defence against overeating. In other words, the solution to successful long-term weight

control is to feel full and satisfied at the end of eating, and then hunger should take hours to

return. The five key principles of Worlds Best Diet are:

Eat fewer carbohydrates and more protein than you currently eat. The ideal ratio of

carbs to protein is 2:1.

Opt for low-GI carbohydrates instead of high GI ones.

Limit your intake of saturated fat.

Choose low-fat dairy products.

Eat whole-grain products, the less refined the better.

Worlds Best Dietby Christian Bitz and Professors Jennie Brand-Miller, Arne Astrup and

Susan B. Roberts (Penguin Australia) is available from bookshops and online. It includes

menu plans and 92 recipes and is fully photographed throughout.

Backyard Bees.

Beevangelist, Doug Purdie, has written a comprehensive guide to keeping bees. He reckons

that once introduced to the charms of beekeeping and the taste of warm honeycomb direct

from the hive, youll be hooked. His book covers installing and maintaining a hive through

the seasons and includes stories from enterprising beekeepers from all walks of life plus 20recipes for all that honey youll be harvesting. Doug, along with his partner at The Urban

Beehive, maintains more than 50 beehives on city rooftops, balconies, backyards and in

community gardens around Sydney. He runs beginner beekeeping courses and is president of

the Sydney branch of the Amateur Beekeepers Association.

Backyard Beesby Doug Purdie (Murdoch Books) is available from bookshops and online.