Food & Nutrition Update

Glycemic Index: A Tool for everyone

Does a common man need to know what glycemic index (GI) is? In what way is it important to our daily existence? With diabetes, heart problems and obesity looming large over middle class population of India it is essential for us to know what is GI of the foods we consume. It will empower us to make the right choice when we choose food for our families. Most of us know that GI has something to do with the sugars/carbohydrates in our food. And it is very important for people who have diabetes to know what GI of different foods is to stay healthy. Newspapers, magazines and TV shows talk about GI all the time and though most know or heard the term not many know what exactly it is. GI is not just important for diabetic people but also for people who want to lose weight and for those who are at a risk of developing heart problems. GI is a measure of the ability of carbohydrate containing foods to raise blood sugar levels after being eaten or drunk. In other words GI is a numerical system of measuring how much of a rise in circulating blood sugar a carbohydrate RICE triggers. The higher the number, the greater the blood sugar response. A low glycemic food will cause a small rise, while a high glycemic food will trigger a dramatic spike. A GI of 70 or more is high, a GI of 56 to 69 inclusive is medium and a GI of GI - 64 GI - 55 55 or less is low. White Brown Different carbohydrate containing foods have different GI numbers. It depends on the type of monosaccharide present in the food mostly but it also is influenced by the protein, fat, fiber and processing of the food. Fiber and fat seem to slow down the digestion process and thus can lead to lower GI. Certain types of fiber can become viscous and slow down the digestion of carbohydrate there by slowing down the absorption of monosaccharides, that in turn reduces the rise in glucose in circulating blood. There are some amino acids in proteins that increase the level of insulin that is released in response to carbohydrate consumed. This in turn leads to decrease in glucose

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levels in the blood and also the GI. In wheat based foods such as pasta the starch molecules get trapped within the net work of gluten in the dough. Even though wheat based pasta is a high starch containing food it has relatively lower GI compared to rice or corn based starch that do not contain gluten. How is GI measured? Glucose (50 gm) is fed to fasting people and blood glucose is measured over the next 2 hours. On a different day the same people (fasting condition) are fed with food in quantity to allow 50 gm of digestible carbohydrate and blood glucose is measured over the next 2 hours. If the blood sugar is raised by 50 % of the rise caused by glucose then the GI of that particular food is 50. The GI scale using pure glucose is 0 to 100. What is glycemic load? It is not enough if one knows what the GI of a particular food is because typically we do not eat the amount we eat to determine the GI. In simple words glycemic load is a GI adjusted for a standard serving size. For example, carrots GI is 90, which is multiplied by 4 (grams of digestible carbohydrate) and divided by 100 gives a glycemic load of roughly 4. Who should keep track of glycemic index and glycemic load? Ideally all of us would benefit if we know and incorporate this knowledge in our daily diet planning but for some people it is extremely important.
Soybean GI - 18 to 25

Diabetic and prediabetic people would benefit immensely if they keep track of the GI's and glycemic load of the foods they consume. It will help them to manage their blood sugar levels and controlled sugar levels will mean less medication to keep blood sugar in check. People who are thinking of losing weight which includes almost everyone will benefit from knowing about glycemic index and load. Lower glycemic foods are said to be associated with satiety which means less hunger pangs therefore less snacking and less overeating. This in turn would aid in shedding extra kg's of weight. Lower glycemic index foods are also associated with reduced risk of heart diseases. Consumption of increased amounts of high GI foods would most likely cause increase in weight which is a risk factor for heart

disease. Diabetics who do not keep their sugar levels in check are also at a risk of getting heart diseases. There are also several limitations listed for GI such as individual variations (the same person may respond differently on separate days) and insulin response to carbohydrates which are factors not considered. GI is also altered by the type of food, variety, its stage of ripening, what processing it has been subjected to and so many other parameters. There may be limitations to use Table 1: Glycemic index and loads
Level Low Medium High Glycemic index Glycemic load 55 or less 56 to 69 70 or more 10 or less 11 to 19 20 or more Glycemic load/day Less than 80 80 to 120 More than 120

Table 1: Glycemic index and loads

Food Bread, white Bread, whole wheat Rice, white Milk, skim Chick peas Lentils Apple Apple juice, unsweetened Banana Grapes Baked potato Carrots Glycemic index 71 67 60 32 33 22 39 41 46 43 60 92 Serving Size 30 gm 30 gm 120 gm 250 ml 150 gm 150 gm 120 gm 250 ml 120 gm 120 gm 150 gm 80 gm Glycemic load 10 8 24 4 10 4 6 12 12 7 18 5

Table 2: Glycemic index of some commonly consumed foods

Food Fruits Apple Banana Grapes Water melon Vegetables Green peas Potatoes (new) Carrots Grains/Legumes Rice - White Rice - brown Wheat Rajma Soybeans Green gram (mung) Chick peas 64 55 41 19 18-25 38 33 Glycemic index 39 46 43 72 48 57 92

Carrots have a high GI, almost as high as glucose. But they have only 4 g m o f carbohydrate in 100gm. And the glycemic load is just 4. And if we think of what a good source of carotene carrots are, they become invaluable. Therefore we need t o l o o k a t everything and remember that the principles of healthy diet are variety, balance and moderation.

certain foods from their diet for example sugar, oil, rice etc. We need to have all the information about our food and not bits and pieces bombarded at us from all sort's of sources. For example watermelon carbohydrate GI is high but the amount of it in watermelon is low and therefore the glycemic load is low. Can we think of leaving out bright and thirst quenching watermelon from of our summer foods just because we read or heard some where it comes under high GI foods? No, we should not. High GI foods also have their uses, for instance they are used as quick sources of energy to help short duration sports performance and recovery. There is nothing in nature which is not good but we just have to judge based on our lifestyle and requirements what is good and what is not for us as individuals. Use the information on GI judiciously and keep in mind that a balanced diet should be full of variety and not to forget consumed in moderation.
References : Robert Wildman, 2009;The Nutritionist-Food, Nutrition, and Optimal Health, Second Edition; Carbohydrates Are our Most Basic Fuel Source 66; Routledge, Taylor and Francis Group, New York and London. Glycemic Index. 192. Foods That Harm Foods That Heal, An A-Z Guide To Safe And Healthy Eating. The Reader's Digests Association Inc. Pleasantville, NY 10570-7000

GI but we cannot ignore the benefits of the information GI provides while planning meal for people who need to monitor their blood sugar levels. The knowledge is there and can be put to good use even if there are limitations. The tool can be put to proper use without getting paranoid about the GI's of the foods we eat. I see at the nutrition awareness workshops I conduct that people sometimes are so worried that they completely remove

About Editor : This News Letter is compiled by Dr. Kavitha Reddy. She has a doctorate in Food Science from CFTRI, Mysore and a Masters in Food and Nutrition from ANGRAU. She worked at Wageningen Agricultural University, The Netherlands and Whistler Center for Carbohydrate Research, Purdue University, USA before returning to India. She has authored several popular and scientific articles and also a cookbook. Dr. Reddy worked as a Nutrition Consultant for national and international organizations for several years. Presently she is In-charge Nutrition at "NutriTech Consulting Services Pvt. Ltd.".

A vegetable-fruit-soy dietary pattern protects against breast cancer among postmenopausal Singapore Chinese women
Background: Prospective epidemiologic studies in Asian populations consistently show that soy is protective against breast cancer. Objective: The objective was to prospectively evaluate whether the protective effect of soy is due to soy isoflavones alone or to their combination with other beneficial dietary factors in an Asian population. Design: Using principal components analysis, we previously identified a meat dim sum pattern characterized by meat, starch, and dim sum items and a vegetablefruit-soy pattern characterized by cruciferous vegetables, fruit, and tofu items in a population-based cohort of Singapore Chinese initiated between 1993 and 1998. Component scores representing intakes of each pattern were used in multivariable Cox regression models to analyze the relation between diet at baseline and breast cancer incidence. Results: As of 31 December 2005, 629 incident breast cancer cases had been diagnosed among the 34,028 women. With greater intake of the vegetable-fruit-soy dietary pattern, we observed a dose dependent trend (P , 0.01) for decreasing breast cancer risk among post menopausal women [hazard ratio (HR): 0.70; 95% CI: 0.51, 0.95 for the fourth compared with first quartile]. A stronger association for the vegetable-fruit-soy pattern was observed among postmenopausal women with _5 y of follow-up (HR: 0.57; 95% CI:0.36, 0.88; P for trend ,0.01). No trend was observed for a greater intake of the meat dim sum dietary pattern and increased breast cancer risk. Conclusion: Our findings support the hypothesis that a diet characterized by vegetables, fruit, and soy has an early-acting protective effect on breast carcinogenesis.
Reference : Lesley M Butler, Anna H Wu, Renwei Wang, Woon-Puay Koh, Jian-Min Yuan, and Mimi C Yu. American Journal of Clinical Nutrition, 2010;91:10139.

Journal Abstract

The authors of the study report that they observed a trend of decreasing post-menopausal breast cancer risk with greater intakes of cruciferous vegetables, fruit and soy in diet. The protective effect they attributed to the moderate soy isoflavone intake. Their findings support the beneficial effect of a diet characterized, in part, by soy and in cruciferous vegetables and fruit on early stages of breast carcinogenesis.

What are cruciferous vegetables? And are they helpful in preventing cancer?
Cruciferous vegetables are one of the dominant food crops in the world. These are healthy foods and contain vitamin C and soluble fiber. There is evidence that it is helpful to include Cruciferous or Brassica vegetables in diet to support prevention of cancer. The cruciferous group of vegetables include broccoli, Brussels sprouts, cabbage, cauliflower, kale, kohlrabi, mustard, turnips, bok choy, Chinese cabbage, wasabi, horse radish and watercress. These vegetables contain antioxidant vitamins and minerals. Apart from these the cruciferous vegetables are rich sources of glucosinolates. Glucosinolates are sulphur containing compounds and they are responsible for the unique sharp taste and pungent aroma characteristic of these cruciferous vegetables. Chopping and chewing of these vegetables leads to the breakdown of glucosinolates which give rise to indoles and isothiocyanates which may help in prevention of cancer. Keck and Finley (2004) observed that these vegetables contain non-nutritive components such as glucosinolate hydrolysis products, sulforaphane, and indole-3-carbinol. The concentration of glucosinolate in crucifers can vary more than ten-fold depending on the species, cultivar and environmental conditions. Their review describes the anticarcinogenic bioactivities of glucosinolate hydrolysis products, the mineral selenium derived from crucifers, and the mechanisms by which they protect against cancer. A diet rich in crucifers, such as Brussels sprouts and broccoli, is inversely associated with the risk of many common cancers. They also mention that epidemiological studies show that cruciferous vegetables provide an even greater protection against cancer than a diet high in a general mixture of fruits and vegetables.
Reference : Keck,A. and Finley,J.W. Cruciferous Vegetables: Cancer Protective Mechanisms of Glucosinolate Hydrolysis Products and Selenium. Integrative Cancer Therapies 3(1); 2004 Robert Wildman, 2009; The Nutritionist-Food, Nutrition, and Optimal Health, Second Edition; Nutrition, Heart Disease and Cancer 334; Routledge, Taylor and Francis Group, New York and London.

The mango (Mangifera indica L) is indigenous to India. Cultivated in many tropical and subtropical regions and distributed widely in the world. The mango is known as the King of fruit all over the world. India is the largest producer of mangoes and it is also India's national fruit. The colour and size of the ripe mango fruit varies based on the variety. They can be yellow, orange, red or green and they all have an oblong, flat and single pit which has a single seed. There are hundreds of varieties and the size varies from anywhere between 100 gm to 1.8 kg a mango. Alphonso, Benishan (Banganpalli in Telugu and Tamil) and Kesar mango varieties from south and Dessehri and Langda from north are most popular in India. Nutritive value of mango (100 gm) Energy Carbohydrate Protein Fat Carotene Vitamin C 74 kcal 16.9 gm 0.6 gm 0.4 gm 2743 g 16 mg

Nature's Gift - Mango

Mangoes are exploited in many ways for food. They are used to eat as such, juices, ice creams, beverages, fruit bars, for the pulp, for its beautiful colour and flavour etc. Can we forget the spicy and mouth watering mango pickles from South of I n d i a especially the avakaya from Andhra. India is popular for the range of pickles and chutneys that can be made from green mangoes such as aam ka achar, magaaya, thokku etc. Who can forget the aam ras eaten with puris in summers! For most of us the only nice thing about the summer is the availability of luscious, sweet and delicious mangoes. And mango pulp served with a dollop of vanilla ice cream makes a heavenly dessert!
Nutritive Value of Indian Foods, National Institute of Nutrition, ICMR, 1971

Recipe - Mango Lassi

Ingredients Plain Yogurt (Curd) Milk Optional Mango pulp or cut ripe mango pieces Sugar 4 cups 1 cup 1 Cups to taste Mangoes may take upto 1 week to ripen. If mangoes are not quite ripe, storing them in a paper bag for a few days will help them along. The size can vary, but larger mangoes will have more fruit in relation to the pit. Mango fruit matures in 100 to 150 days after flowering. The fruit will have the best flavor if allowed to ripen on the tree. Commercial marketability requires 13% dissolved solids (sugars). When the first fruit shows color on tree, all of that size fruit or larger may be removed; the same is repeated when remaining fruit colors. The fruit ripens best if placed stem end down in trays at room temperature and covered with a dampened cloth to avoid shriveling.

Method: Blend all the ingredients together. Chill in a refrigerator. Serve the cool delicious Mango Lassi over crushed ice. Tips: Ripe mangoes can be kept in the refrigerator for up to 2 weeks. They can be frozen, dried, cooked in syrup or pured. In many tropical countries, mangoes are peeled and sliced on an angle in a crisscross fashion down to the seed and then served on a stick or a fork.

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Publisher, Printer and Editor : Editor - Dr. Kavitha Reddy on behalf of NutriTech Consulting Services Pvt. Ltd. Printed at I.A. Printing Press, C-25, New Brij Puri, New Delhi - 110 051 and Published from NutriTech Consulting Services Pvt. Ltd., Flat No. 601 Plot No. 4, DDA Building, District Centre Laxmi Nagar, Delhi - 110 092