GI News—November 2009

• Mediterranean diet and diabetes management
• Health headlines: don’t believe all you read
• Don’t eat when you should be sleeping
• Why the humble Greek salad is a winner
• Why not the Australian Aboriginal diet for health and weight loss?
• Discover low GI pearl couscous

‘Eat for Goals [a new book] shows young players and football fans how to cook and eat like champions,’ says Steven Gerrard, captain of Liverpool FC and England International. In this fun cookbook, 13 top international footballers (including Lukas Podolski, Ruud van Nistelrooy, Frank Lampard, Barry Ferguson and Kelly Smith) share tips on what they love to eat to play well and give recipes for their favourite dishes. With simple ingredients and easy recipes, the kids will soon be rustling up a quick rice cubana just like Thierry Henry, a power omelet (Miroslav Klose) or crunchy sea bream with herbs (Steven Gerrard). The Union of European Football Associations will donate €1 from the sale of each book to support World Heart Federation programs encouraging children to be active. You can order a copy online from Amazon or pick one up from your bookseller. What a tasty Christmas present.



Good eating, good health and good reading.

Editor: Philippa Sandall
Design: Scott Dickinson, PhD
Web management: Alan Barclay, PhD

Food for Thought

How to read articles about health and healthcare
By Dr Alicia White

‘If you’ve just read a health-related headline that’s caused you to spit out your morning coffee (“Coffee causes cancer” usually does the trick) it’s always best to follow the Blitz slogan: “Keep Calm and Carry On”. On reading further you’ll often find the headline has left out something important, like “Injecting five rats with really highly concentrated coffee solution caused some changes in cells that might lead to tumours eventually. (Study funded by The Association of Tea Marketing.)”



The most important rule to remember: “Don’t automatically believe the headline”. It is there to draw you into buying the paper and reading the story. Would you read an article called “Coffee pretty unlikely to cause cancer, but you never know”? Probably not.

Before spraying your newspaper with coffee in the future, you need to interrogate the article to see what it says about the research it is reporting on. Bazian (the company I work for) has interrogated hundreds of articles for Behind The Headlines on NHS Choices, and we’ve developed the following questions to help you figure out which articles you’re going to believe, and which you’re not. It’s not possible to cover all the questions that need to be asked about research studies in a short article, but we’ve covered some of the major ones.

• Does the article support its claims with scientific research?
• Is the article based on a conference abstract?
• Was the research in humans?
• How many people did the research study include?
• Did the study have a control group?
• Did the study actually assess what’s in the headline?
• Who paid for and conducted the study?

For more, go to Behind the Headlines at http://www.nhs.uk/for news for daily breakdowns of healthcare stories in the media. Read the whole article HERE.

News Briefs

Mediterranean diet and managing diabetes
Consuming a Mediterranean style diet is more effective for diabetes management than a low-fat diet, reports a new study published in Annals of Internal Medicine. ‘Participants assigned to the Mediterranean-style diet lost more weight and experienced greater improvements in some glycemic control and coronary risk measures than did those assigned to the low-fat diet,’ wrote the researchers led by Katherine Esposito from the Second University of Naples. In addition to improvements in blood glucose management, the Mediterranean-style diet also delayed the need for anti-hyperglycemic (blood glucose lowering) drug therapy. ‘Perhaps most important, the findings reinforce the message that benefits of lifestyle interventions should not be overlooked despite the drug-intensive style of medicine fueled by the current medical literature,’

Esposito and her co-workers recruited 215 overweight people with newly diagnosed type-2 diabetes and randomly assigned them to consume the Mediterranean-style diet or a low-fat diet. After four years, only 44% of people in the Mediterranean-style diet group required anti-hyperglycemic drug treatment, compared to 70% in the low-fat diet group.

What did they eat? The Mediterranean diet was rich in vegetables and whole grains and low in red meat, which was replaced with poultry and fish. The low-fat diet was based on American Heart Association guidelines; it too was rich in whole grains and restricted additional fats, sweets, and high-fat snacks. The researchers note two primary limitations of their study: 1) it was not double-blind, and 2) dietary intakes were self-reported.



GI Group: We know that you are going to be asking exactly the same questions we did: what exactly did the people on the Mediterranean diet eat? We have tried to contact the authors, but at time of publication, had not had a reply. So we asked Johanna Burani who spends a great deal of time in Italy for some comments. ‘I think they are recommending LOTS of vegetables (all kinds) and LOTS of beans (pinto, chickpeas, kidney, garbanzo) and fruit. Under normal conditions, people in Italy wouldn't willingly choose wholewheat pasta or brown rice but maybe the authors got them to eat these whole grains for the study. I really think the thrust would be towards vegetables and beans -– at least for everyone out here in the trenches.’

Meal timing and weight gain
A new study published in Obesity (in mice) suggests that it’s not just how much you eat, but when you eat it, that influences weight gain. ‘How or why a person gains weight is very complicated, but it clearly is not just calories in and calories out,’ said Prof Fred Turek, director of the Center for Sleep and Circadian Biology at Northwestern University. ‘We think some factors are under circadian control. Better timing of meals … could be a critical element in slowing the ever-increasing incidence of obesity.’

To test whether ‘when you eat’ can affect body weight, the researchers studied two groups of mice and found simply modifying their feeding time alone greatly affected their body weight. Over the six-week study period, the group of mice that ate as much as they liked of a high-fat diet during their normal sleeping hours (our day time) gained significantly more weight than the mice eating the same type and amount of food during their naturally wakeful hours (our night time) although both groups of mice had actually consumed about the same amount of calories and performed the same amount of exercise over the six weeks.

Of course human studies are needed to determine if timing of food intake influences our body weight, but this study suggests that late-night eating may be worse, in terms of weight gain, than eating during normal waking hours says Fred Turek.

GI Group: This study, while only in mice, may also have implications for shift workers.

Age difference and low GI diets
A study published in Diabetologia reports that the benefits of a low GI diet appear to be more pronounced in young adult mice (16 weeks) than in older mice (44 weeks). The dietary intervention involved ‘wild type’ mice and (sorry to be technical here) specially bred mice whose glucose-dependent insulinotropic polypeptide receptor had been knocked out. The study calls them ‘Gipr genotype mice’.

Compared with the young mice on a low GI diet, the young mice on a high GI diet gained a significant amount of weight along with more body fat and reduced insulin sensitivity. With the older mice, the story is more complicated. Though body fat also slightly increased in high GI vs low GI older ‘wild type’ mice, there were no significant changes in their body weight and estimated insulin sensitivity. However, the older Gipr genotype mice on a high GI diet showed significantly lower cumulative net energy intake, increased locomotor activity and improved markers of insulin sensitivity suggesting, say the authors, that inactivation of GIP signalling in aged animals on a high-GI diet could be beneficial.

New GI Symbol The GI Symbol has been given a facelift. When you choose a food that carries this Symbol, you can be sure that the GI value stated near the nutrition information panel is accurate and the product meets the Symbol Program’s strict nutrient criteria. For more information email: alan@gisymbol.com or stephanie@gisymbol.com

Foodwatch with Catherine Saxelby

In search of the ultimate Greek salad ... and purslane



On holiday in the sunny Greek islands in peak season, the Greek salad turned out to be my best option for getting my daily fix of greens and providing the perfect counterfoil to our meals of barbecued octopus, lamb souvlaki or grilled fish. It was invariably reasonably priced and I ended up chowing down on one each day, sometimes two, so I had ample opportunities to critically analyse them.

The salad typically comprised the usual base of tomato pieces but these were red, ripe and full-flavoured. Mixed in were rounds of cucumber plus capsicum, purple onion, black or green olives in oil, topped with a slab of Greek fetta and a sprinkle of dried oregano. It was served at room temperature with little bottles of Greek olive oil and vinegar to dress it. The fetta was a real surprise. Not salty/briny fetta as we find in Australia but softer lightly salted fetta that had a creamy texture somewhere between firm tofu and thick Greek yoghurt.



Each island offered its own variation on the basic ingredients. On Santorini, large home-grown capers were added, sometimes with pickled caper bush leaves, which added a pleasant tang, sometimes fresh oregano leaves. On Rodos, we dined on one with cherry tomatoes and finely-sliced fennel which was delicious. On Crete, baby rocket was mixed in. Another had a huge garnish of purslane (pigweed) sitting on top.

Nutritionally the humble Greek salad is a winner and a god-send for tourists. It’s an easy light meal in itself with bread or an accompaniment to barbecued fish or meat. It gives you at least three serves of vegetables, adds the super power of tomatoes with their lycopene and vitamin C, is high in fibre and antioxidants. If you add olive oil, this will boost the absorption of the fat-soluble antioxidants (I always did – it made a nice ‘sauce’ for the crusty bread to soak up).

Its only drawback is of course the higher than usual salt level thanks to the olives and fetta. Based on Australian figures, I estimate this to be around 900 mg from 5 black olives and 80 g of fetta but of course it will depend on the make (the fetta I sampled in Greece tasted decidedly mild in salt). This sodium figure is on par with a 50 g snack pack of pretzels so it’s up there with other salted foods. Of course you can reduce this at home by using fewer olives (just slice into slivers so you get a hint of olive without the full salt hit) and buying a salt-reduced fetta.

I visited Crete in search of the traditional Med Diet and one of its chief ingredients, purslane, a native wild green that grows wild on Crete and is a rich source of ALA, one of the simpler omega-3 fatty acids. Researchers have hypothesised that purslane is one of the reasons why the Med Diet is so beneficial to health. But I was disappointed. Despite my queries around Heraklion and Rethymo, I never managed to find any in markets or cafes. Waiters looked blankly at me. All was not wasted as it turned up in Turkey (another Med Diet country with more olive trees than I’ve ever seen growing on every spare metre of land). There it was in a simple salad with a light creamy dressing at a roadside taverna. Served with three other vegetable dishes as a mixed entree before our main course. It had a delicious flavour, crunchy and a tangle of green tuberous stems and bright green leaves. I enjoyed every mouthful.

Catherine Saxelby is an accredited dietitian and nutritionist and runs the Foodwatch Nutrition Centre. Her latest publication is The Shopper's Guide to Light Foods for Weight Loss (available as a PDF). For more information, visit foodwatch.com.au.

In the GI News Kitchen

American dietitian and author of Good Carbs, Bad Carbs, Johanna Burani, shares favourite recipes with a low or moderate GI from her Italian kitchen. For more information, check out Johanna's website. The photographs are by Sergio Burani. His food, travel and wine photography website is HERE.

Matteo’s chickpea soup
My son, Matteo, who lives in Friuli, was visiting us recently. He loves to cook, so I asked him to suggest a recipe off the top of his head that I could develop for GI News. Being a creative cook, Matteo just thinks in terms of good, fresh ingredients and then invents something scrumptious. So he gave me a list of eight ingredients that he uses to make a chickpea soup. I worked out the quantities and cooking times and added a few personal touches of my own. The recipe below is our combined effort. I prepared two versions of the soup, one with dry and the other with canned chickpeas. Italians never use canned beans. But for those unaccustomed to cooking with some advanced preparation (albeit minimal), I wanted to present a quicker version. Surprisingly, the tastes were quite similar to each other, with the dried chickpea version tasting a bit more earthy.
Servings: 7 (approx. 1 cup each)

225 g (8 oz/1 1/3 cups) dried chickpeas or 1½ x 600 g (19 oz) cans chickpeas, rinsed and drained
2 medium carrots, cut into ½ cm (¼-inch) horizontal slices
1 small onion (yellow or red), sliced
1–2 cloves garlic, minced
4 sprigs flat-leaf parsley, leaves only
1 heaping tablespoon fresh rosemary, needles only
1 tablespoon extra virgin olive oil
1 cup crushed canned tomatoes, San Marzano type
6 cups vegetable broth (homemade if possible) for the dried chickpeas; 3 cups for the canned chickpeas
1 tablespoon kosher salt or sea salt (or to taste)
30 g (1 oz) medium pasta shells

• If using the dried chickpeas, rinse and place them in a bowl with abundant water. Cover the bowl and set aside overnight.
• Place the next five ingredients (carrots through rosemary) in a food processor. Pulse 25 times (15 seconds) or until all ingredients are coarsely chopped. Set aside.
• In a large pot, heat the oil and add the chopped ingredients. Saute over moderate heat for 4 minutes, stirring frequently. Add in the chickpeas (soaked and drained, or canned), tomatoes, broth and salt, mix well. Bring to a boil, then reduce to low heat, cover and cook as follows: the dried chickpeas for 1 hour; the canned chickpeas for 30 minutes.
• Remove from heat. In small batches, blend the soup until smooth (30–40 seconds). Return to the pot and keep warm.
• Meanwhile, cook pasta according to package directions. When cooked, drain and add to the soup. Serve hot with freshly grated cheese (optional).

Per serving
Energy: 560 kJ/ 140 cals; Protein 6 g; Fat 3 g (includes 0 g saturated fat and 0 mg cholesterol); Carbs23 g; Fibre 5 g.

Cut back on the food bills and enjoy fresh-tasting, easily prepared, seasonal, satisfying and delicious low or moderate GI meals that don’t compromise on quality and flavour one little bit with Money Saving Meals author Diane Temple. People often say to me, ‘I’d love to eat more fresh fish or seafood, but it’s too expensive.’ To celebrate the 20th anniversary of the Sydney Seafood School this November, Roberta Muir the School’s Manager, suggested this relatively inexpensive seafood dish. For more money-saving recipes, visit Diane’s website.

Barbecued chilli octopus with red capsicum & tzatziki
‘You can use calamari, cuttlefish or squids (cut into strips), large green prawns/shrimp (omit the boiling water) for this dish if you prefer,’ says Roberta. Although the recipe uses 1/2 cup of olive oil for the marinade, this isn't actually cooked with the octopus. In our recipe analysis we have assumed a couple of tablespoons of oil sticks during cooking. We haven't priced this one as the cost of seafood can vary from place to place and week to week.
Serves 4

500 g (1 lb 2 oz) baby octopus, cleaned and quartered
½ cup extra virgin olive oil, for marinating
2 cloves garlic, finely sliced
3 small red chillies, seeded and finely chopped
1½ teaspoons chopped oregano leaves
2 red capsicums, seeded and cut into chunks

Tzatziki
1 small Lebanese cucumber
1 clove garlic, crushed
200 g (7 oz) tub Greek-style plain yoghurt (reduced fat)
Salt and freshly ground black pepper, to taste

• Pour boiling water over octopus, leave to stand for 1–2 minutes then drain.
• Combine the olive oil, garlic, chilli, oregano, and capsicum in a bowl. Add octopus, cover and marinate for at least 30 minutes.
• Make the tzatziki: halve the cucumber, discard the seeds and grate coarsely. Place in a clean tea towel and squeeze to remove any excess moisture. Combine with garlic, yoghurt, salt and pepper. Refrigerate until ready to serve.
• Heat a barbecue or char-grill plate. Arrange the capsicum on the grill, skin-side down. Cook until the skin starts to blister, turn, cook for another minute or 2 until it colours, then remove and set aside.
• Remove the octopus from the marinade and cook on the grill for 2–5 minutes, turning occasionally, until the skin is brightly coloured. Arrange capsicum on a serving platter, pile the octopus on top and serve with tzatziki on the side.

Per serving
Energy: 1050 kJ/ 250 cals; Protein 26 g; Fat 12 g (includes 2.5 g saturated fat and 249 mg cholesterol); Carbs 9 g; Fibre 2 g.

Recipe supplied by FISHline, Sydney Fish Market’s free consumer advisory service. Visit the FISHline pages at http://www.sydneyfishmarket.com.au/ for more great seafood recipes, advice on seafood purchasing, storage and cooking, species information and answers to frequently asked seafood questions.

Busting Food Myths with Nicole Senior

Myth: The Mediterranean diet is healthy because of the olive oil.


Nicole Senior

Fact: The Mediterranean diet is healthy because it contains of variety of protective foods.
Everybody has heard good things about the Mediterranean diet. Typically we hear it’s good for the heart, and this is true as evidenced by the lower rates of heart disease experienced in countries surrounding the Mediterranean Sea. However most people when asked what’s healthy about it almost always say olive oil. This is an oversimplification because the traditional Mediterranean diet – predominantly plant food based – contains a bounty of foods with known protective effects: vegetables, fruits, grains, legumes, nuts, herbs and spices, fish and small servings of alcohol and red meat. The mechanism of protection is still not fully understood, and there are likely to be many different protective effects offered by different foods. And there are non-diet factors. For many traditional communities around the Mediterranean, their lives are simpler, more active and religion is central to everyday life. One could postulate that religion is crucial to the health benefits of Mediterranean diet!

Why the question ‘what’s healthy about the Mediterranean diet?’ is important, is because foods of the Mediterranean are not universally available or liked. I’ve met people who just don’t like the taste of olive oil. While olive oil is a healthy choice, it may actually have a neutral effect on heart health by displacing bad fats rather than actively protecting by itself. Olive oil is primarily monounsaturated and the Heart Foundation Australia’s evidence-based position on monounsaturated fats is “there is little evidence that mono-unsaturated fat has an independent effect on coronary endpoints”. In simple terms, this means don’t rely on mono-unsaturated fats alone to prevent a heart attack. Another component of olive oil often mentioned is the antioxidants (polyphenolic compounds), particularly high in extra-virgin olive oil. These are likely to be beneficial, however not unique to olive oil. Thousands of phytochemicals exist across all plant foods.

An even better result may be achieved with a modified Mediterranean diet using sunflower or canola oil. This is because polyunsaturated fats have greater cholesterol lowering effects, and because of the known benefits of omega-6 and omega-3 fats. This idea of a Mediterranean-style diet using different oil – namely canola oil and margarine – yielded spectacular results in the famous Lyon Heart Study. This seminal study showed an impressive 76% reduction in risk of death or major coronary events (e.g. heart attack, stroke etc) in patients who had previously had a heart attack (and thus at high risk) after following a modified Mediterranean diet for 27 months. While a Mediterranean diet with olive oil attracts passionate supporters, it’s not the only cardio-protective diet.

If you want to eat a healthy diet, then try to take all the leaves out of the Mediterranean diet book rather than just the page on olive oil or you’re bound to come up short on benefits. A heart-healthy diet is a whole rather than one or two parts, and can be adapted to suit individual and cultural preferences.

If you’d like to learn more about heart-friendly foods and how you can combine them in ways to suit you, check out Nicole’s books at http://www.eattobeatcholesterol.com.au/

Talking Turkey with Prof Trim

Why not the Australian Aboriginal diet for health and weight loss?
The Mediterranean diet; a mixture of fruit, nuts, vegetables, seafood, pasta and olive oil has been sold so much as the healthy diet by nutritionists and the medical profession in recent years, that many people think they have to move to Crete or Italy to survive. But as usual, the Professor is here to throw a spanner into the works.

Not only does the real Mediterranean diet hardly still exist in the Mediterranean in its real form, but it’s probably no more healthy than the traditional Aboriginal diet, the Nordic diet, the Hunza diet, the Okinawa diet – or any of a number of other forms of ‘native’ diet eaten traditionally by inhabitants of a particular region before the advent of industrialisation of foods, domestication of animals and proliferation of ‘fast’ foods.

People (including scientists) get carried away with specific diets and components of diets, which they consider to be the elixir for good health, based on the fact that they have been eaten for thousands of years. But humans have existed in all parts of the world for thousands of years and have eaten a wide variety of localized foods. Hence, it’s the common ingredients of such ‘native’ foods that are likely to have the positive benefits, rather than the particular foods themselves. For example, it’s known that native Australian fruits and vegetables are high in anti-oxidants, and the native fish and animal meats are lean and extremely low fat (i.e. healthy).

Recently, your own humble Professor has been involved in a study comparing inflammation markers in the bloodstream of a number of people after a meal of kangaroo (a ‘native’ food), compared to a meal of wagyu beef (a domesticated animal food). Wagyu was only bred into existence about two decades ago. It is reasonably high in fat (although not as bad as some other meat breeds on the market). Kangaroo, on the other hand, has been around for eons, and is very low in fat (in fact hardly any). In the Australian study (yet to be published), kangaroo didn’t increase inflammation, whereas wagyu did.

So why bother with the Mediterranean diet, when here in Australia we have possibly one of the world’s healthiest diets on our doorstep. Although it’s not likely to exist, except in trendy middle class restaurants these days, here is a sample of what you might have expected in the traditional Australian Aboriginal diet:

Land food	Water food	Sky food
Kangaroo (now marketed as ‘Kroo’), wallaby, emu, goanna, snakes and grubs	Fish, crayfish/yabbies, lobster, prawns/shrimp, crabs, octopus, squid	Duck, goose, native pigeon, mutton bird, swamp fowl, pheasant
Natives berries and fruits, native vegetables, yams and seeds	Water plants	Bats

Photo: Kangaroo fillet with quandong confit courtesy Dining Downunder Promotions chefs Benjamin Christie and Vic Cherikoff

For more information on weight loss for men, check out Professor Trim's website HERE.

Want to find out more about Australia’s wild foods?
Check out a copy of Vic Cherikoff’s Super Foods for Super Health (with George Kowalski) and read all about Kakadu plum (the world’s highest fruit source of vitamin C), wild rosella, Illawarra plum, mountain pepper, quandong and Australian native herb extracts. If you are inspired to try these wild foods, you won’t find them in your fruit shop – they aren’t available in commercial quantities. ‘Kakadu Juice which is packed with anti-oxidants is the only way we can easily add these wild foods to our diet,’ says Vic.