Gastric banding caused more complications than weight loss

About 220,000 people underwent weight-loss surgery in 2009, up since 2000 when 36,700 operations were performed, according to the American Society for Metabolic and Bariatric Surgery in Gainesville, Florida. Gastric banding represents about one-third of that total. Almost half of patients undergoing gastric banding for obesity needed to have the device removed, often because of erosion, according to a study that found the treatment caused more complications than weight loss. “I personally no longer perform band gastroplasty, but I think it is defendable for surgeons to continue doing this,” said Jacques Himpens, the study’s lead author who works with the European School of Laparoscopic Surgery at Saint Pierre University Hospital in Brussels. “Patients should not expect too much from the procedure. If they do get the operation, they must commit themselves to lifelong and very tight follow-up.”

US breakfast are often unhealthy for children

According to a statement from the Institute of Food Technologists in the US breakfasts served to children worldwide are often high in sugar and saturated fat and low in dietary fibre. These lack essential vitamins and minerals. It impacts public health and has consequences for personal health. It cites several studies that illustrate the importance of breakfast in improving cognitive function and weight management for children, factors that are critical to curb obesity among children and adolescents. What makes a good breakfast for children? One good example would be an egg, a slice of whole grain toast with nut butter, a piece of fruit and a glass of low-fat milk. Tofu, lean meat and whole grain cereals are also good choices at breakfast. The protein and fiber from the whole grains will keep your child satisfied until lunch time.

BIB balloon can lead to significant weight loss

The so-called BIB balloon system partially fills the tummy, so the patient feels full after eating only small amounts of food. The silicone balloon is inserted into the stomach through the mouth with the help of a gastroscope — a thin hollow tube which is used to feed in surgical instruments. Once in place, the expandable balloon is filled with 500ml of a blue-coloured solution, through a tube in the gastroscope. This acts to reduce the capacity of the stomach by a quarter — the stomach’s maximum capacity normally is two litres. The coloured solution allows a patients to quickly detect any leakage as the liquid will turn their urine blue. The balloon is designed to be kept in place for six months. The balloon can lead to a reduction of 10 percent of body weight over a year, whereas a gastric band, as used by Fern Britton, can help lose up to 30 per cent.

After this, the surgeon uses a gastroscope to remove it if the patient has lost a sufficient amount of weight, or replace it with another balloon. Although the technology has been available for some years, evidence now shows it can be a safe alternative to weight-loss surgery, and more doctors are now turning to the procedure for moderately obese patients. Source: MailOnline

The Three-hour Diet

This diet is simple: eat every three hours and you’ll lose weight. The diet demands that users eat breakfast, lunch, dinner and snacks in between. The author of the three-hour diet claims it can lower your body fat and burn two pounds a week without any exercise. The main meals are very specific and call for fruits and vegetables the size of DVD cases, a deck of cards sized protein, a Rubik’s cube of carbs and fat that fits in a bottle cap. However, the snacks can be anything, even candy, as long as it amounts to around 100 calories. Critics of the diet said eating more often could cause an overload on calories if you have a tendency to overeat at meals.

Read more on KOAT

GI News—March 2011

• Low carb and low GI are not the same
• Low GI diets do increase satiety
• Download Pulse Canada’s gluten-free book
• Low GI porridge for brekkie – new GI values
• The scoop on nuts with Emma Stirling

The new ‘Half-Your-Plate’ approach in the 2010 American Dietary Guidelines wants to make mealtimes easier by dispensing with measuring and counting your veg and fruit serves a day. Now they suggest people simply fill half the plate with fruits and vegetables at each meal rather than worry what a serving of broccoli or carrots looks like. We’d tweak this and say ‘non-starchy veg’ as the starchy ones like potatoes and sweet potatoes belong in the low GI carb corner with pasta etc. But we think it’s a great idea to tell people to make fruit and veg the focal point of meals, it's what we have been saying for years. All you have to do now is keep it colourful (think rainbow on your plate), tuck in and enjoy.

Good eating, good health and good reading.

Editor: Philippa Sandall
Web management and design: Alan Barclay, PhD

Food for Thought

Making a real meal deal of it

If you asked your Mum or Dad or grandparents what’s a meal or what’s for dinner, they’d probably say something like meat and three veg one of which would be potato – and here in Australia the other two might be carrots and peas/beans/broccoli. Life’s not like that any more. ‘Meal’ and ‘dinner’ are pretty meaningless terms and seem to cover anything from a choosing a variety of tapas-style sharing plates to virtually veg-free zones.



For example, a meal in a Sydney steakhouse might be a 650g Angus rib on bone served with red wine jus and your choice of chips, baked potato or mash. Salads or seasonal greens are extra. For family fare, there’s the ‘KFC Mega Meal’ which is (in Australia): ‘12 pieces of Original Chicken Recipe, 1 Maxi Popcorn Chicken or 12 Kentucky Nuggets, 2 Large Chips, 1 Large Potato & Gravy, 1 Large Coleslaw and a 1 Large Drink.’







What we are eating is clearly part of the cause for our expanding waistlines. Looking for a culprit, the food police and pollies found one: fast food chains. And a solution (closing them down not being an option): nutritional labelling so we can make more informed choices. Since February this year all major fast food chains in NSW Australia must display the kilojoule (calorie) counts of their food with the same prominence as the price to help us make better choices. The question is: will we?



Nicole Senior took a look at nutritional labelling in fast food joints in the US last year and reported in GI News that: ‘New York City has a nutritional labelling program which came into full swing in 2009. While it’s too early to say it’s been a flop, initial results have been disappointing. A study by New York University compared fast food purchases in New York City (with calorie counts on menus) and neighbouring Newark (without) and found there was no difference between calorie content of what customers bought in stores with calorie counts compared to those without calorie counts. This, despite the fact that 28% of NY customers said calorie counts had influenced them to order better: a classic case of saying one thing and doing another.’



Wiser heads than ours are probably pondering the whys and wherefores of consumer behaviour. But could it be that we eat food not nutrients. And that throwing numbers at us with nutritional labelling doesn’t give our brains the sort of information they are wired to use to help us make better choices picking a meal in a restaurant, food hall or fast food chain. After all, we didn't evolve eating by numbers. No-one was counting calories when the day's kill was brought back to the cave.



So here’s a thought. Why not go back to basics and make it a rule that every time a food company, restaurant, fast food chain, recipe writer, food stylist etc. tells us that what they are offering is a ‘meal’ or a ‘dinner,’ that’s what it’s gotta be. And here’s where we can make use of those rather long-winded dietary guidelines. The 2010 American ones put it (almost) perfectly recommending Americans fill half their plates with fruits and vegetables at every meal. We’d just tweak that and say ‘non-starchy vegetables’. They go in the low GI carb corner.

News Briefs

‘Glycemic index may not affect appetite: Unilever study.’
The story was published in an online newsletter called ‘Food Navigator’ that’s widely read by the food industry and dietitians etc. We don’t know who wrote it, but it is misleading (to put it mildly) as we discovered when we asked Dr Alan Barclay to check it out. ‘First of all, the study wasn’t testing a solid food’ it was testing drinks and drinks on the whole are thought to be less satiating than solid foods,’ he said.

‘In summary,’ he says, ‘it is a poorly designed single study and it is not about GI. It is about glycemic response (not the same thing at all). There are numerous things wrong. Participants were fed between 22–24g carbohydrate for example while standard GI testing around the world (and there is an International Standard) uses 50g of available carbohydrate. In addition, they did not use glucose as a control, so the actual GI values of the test foods could not be calculated so we do not actually know if the various drinks were low, medium or high GI. Looking at the blood glucose response curves in their ‘Figure 1’ in the European Journal of Clinical Nutrition suggests that differences between the GI of each test drink would be minimal, so it’s hardly surprising that they did not affect appetite.

There is level 1 evidence that low GI diets increase feelings of satiety and facilitate long term weight and body fat loss. A systematic literature review and meta-analysis of GI and appetite in 2009 found that low GI meals significantly increased feelings of satiety compared with high GI meals. (Here's the reference: Wati, P. GI and satiety. MND thesis. University of Sydney). Furthermore, the Thomas et al Cochrane review found that “Overweight and obese people lost more weight on low GI diets than on high GI or other weight reduction diets and their cardiovascular risk marker profile improved as well”.’

Two words not in the 2010 Dietary Guidelines for Americans …
‘Glycemic index.’ But we still think that the new guidelines are heading in the right direction. The notable difference between the US Dietary Guidelines (pretty much the same as guidelines around the world) and previous versions is their new recommendation to limit refined grains – not quite on par with statements like ‘reduce added sugars’. To match this statement they need to say something along the lines of ‘reduce added refined starches’. You can read the guidelines HERE.

Pulse power for gluten-free diets
Pulses or legumes are an important part of the healthy low GI way of eating for everybody. They are especially important if you are on a gluten-free diet as they provide much of the fibre and nutrients found in the gluten-containing grains that you can’t eat any more. Dietitian Dr Kate Marsh recommends you put them on the menu at least twice a week – more often if you are vegetarian.

Looking for recipes? Pulse Canada has published a handy 32-page PDF booklet Pulses and the gluten-free diet put together by Shelley Case RD and Carol Fenster PhD. It covers types of pulses (legumes), health benefits, celiac disease and the gluten connection, nutrition on a gluten-free diet, buying storing and cooking pulses and a really practical section on using pulses in GF baking. There are 26 recipes – all photographed (the black bean pizza is pictured here). They haven’t estimated the recipes GI value. You can download it HERE.



The baked recipes use a variety of gluten-free flours including white and black bean flours and yellow pea flour. We asked Peter Watts who is the Director of Market Innovation at Pulse Canada about the availability of these products. ‘You can purchase a number of different pulse flours in grocery stores including pea flour, bean flour, chickpea flour,’ he said. ‘Chickpea flour and some bean flours are available in bulk. Bob’s Red Mill in the US has some nifty packaging with these products in 500 gram bags and they are quite widely available. You can also order on line – a company in Manitoba called Best Cooking Pulses just started selling pea flour and chickpea flours on Amazon. This is not to say that pulse flours are generally available – they are still usually housed in the specialty food section of grocery stores and not all stores offer them, but they are increasingly present. And consumer demand will help increase supply and distribution.’

We haven't been able to track down these flours in Australia or NZ. Let us know if you know where you can buy them.

eBook update: Nutrition for Life



It’s great to see Australian publishers finally embracing eBooks. This best seller by Catherine Saxelby (an early GI supporter) is now available as a digital download as is her Zest cookbook (with Woman’s Day Food Director Jennene Plummer.) We checked out the eBook formats for her books – Kindle and Apple are our favourites for quality and ease of use. We’d give the rest a miss frankly.

• Got Kindle? Buy Nutrition for Life and Eating for the Healthy Heart (or the US edition titled There’s More to Heart Health Than Cholesterol) from the Kindle bookshop on Amazon HERE
• Got Apple? Buy Nutrition for Life, Zest and Eating for the Healthy Heart from iBooks for the iPad or iPhone HERE

Prof Jennie Brand-Miller's GI books will be available in eBook formats soon they tell us. We’ll keep you posted.