Category Archives: Glycemic index

Whole30, Goldilocks and evil carbses

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Back to posting after long silence.

Things have been downright crazy here at primalmeded/Whole9SouthPacific HQ. Jamie and I have successfully held our first ever W9SP workshop in Cairns. I expect this to be the flashiest workshop we will ever have since it was conducted in the Shangri-La rather than in a Crossfit gym surrounded by pull up bars, chalked up weights and breathing in the sweat the smell of victory. But hey, we can talk to people about nutrition anywhere as long as nobody decided to punch out 20 burpees when they get bored of our ramblings. The Paleo Cafe in Cairns were awesome organisers and they will be conducting a Whole30 in February and we will get to judge the winner. Our next stop is Crossfit Toowoomba which is getting close to being booked out!

Jamie dropping some knowledge bombs to a full house in Cairns

Jamie dropping some knowledge bombs to a full house in Cairns

Me, with my "d'er" slide

Me, with my “d’er” slide

The obligatory glam shot: me and Julianne Taylor from Paleo Zone Nutrition who was our special guest. Post workshop dinner at Cairns marina

The obligatory glam shot: me and Julianne Taylor from Paleo Zone Nutrition who was our special guest. Post workshop dinner at Cairns marina

This post is mostly about Whole30 and random thoughts on troubleshooting. This is my 4th whole30 and yes, I’m getting pretty good at this. Plus I have the benefit of being intimately familiar with the book, knowing the references and also presenting that material. Not to blow my own trumpet but I think it’s fair to say it gives me a little bit of an insight. But in spite of all this, I found myself wide-eyed and amazed at how much I learnt this time around.

A little bit of personal background to put this into perspective. I have been eating low carb/primal/Paleo for over 2.5 years now. I don’t have any medical conditions or an overt food intolerance. Junk food (sugar, grains, processed food) gives me pimples, makes me bloated and pushes me to the sarcastic bitch end of the spectrum. When I eat well I contain my natural impatience with stupidity a lot better. I never thought I had problems with dairy but I have been having less and less of it in the last few months and my skin which was already pretty good improved more. Plus I don’t really miss it. I put on some weight this year mostly due to stress, irregular hours and meals, and sleep deprivation. I have made it my priority to improve those areas in the last few months and was already getting good results. We decided to do the January Whole30 to “walk the talk” (so nobody could tell us “eating THIS way is soooo hard”) and see what results we can achieve with perfect focus.

First the results:

  1. My satiety levels are the best they have EVER been. I used to snack occasionally (i.e. daily) and felt no hunger in the morning, then was practically starving by lunch, and again before bedtime. Now I have 3 full meals spaced out at around 6hrs with some gentle hunger around hour 5.
  2. My energy levels improved dramatically. We go to the gym 3 days a week doing basic strength. On the days that we don’t train we go for beach walks, sprints and short hikes. Instead of wanting to collapse into the couch when I come home and play dead, I actually look forward to getting out of the house and dissipating some pent-up energy.
  3. Strength gains. This year my training has been really inconsistent. I remember thinking at my surgical rotation that the only exercise I get is holding the retractors in OT. Last few months I introduced more gymnastics-style training which I hugely enjoyed. I sustained a minor injury in late December and somehow found myself coerced convinced to take a month off gymnastics and do a strength block instead. Never thought I’d say it but I actually do enjoy it and will introduce some deadlifts (gasp!) into my regular program. Ok, ok, I’m loving it. I have no doubt that having extra energy and good recovery contributed to that.
  4. Body composition. If you are expecting the Before and After photos you are out of luck. It ain’t happening. The water weight and some extra insulation (he he) that I picked up over winter started to shift in the last few months. But in the last few weeks I felt like somebody just pushed the right button. I am leaner with the biggest differences in my stomach and waist. I probably could say more but I am going to stop there. Let’s just say I am very happy with the change.

So what did I do differently???

  • More food. Seriously. I have always considered that I eat a lot “for a girl”. I thought I was tired and apathetic because of work, stress, “I am just lazy”. It is practically ingrained in women that they should eat less than a man. Dishing out dinner I would go with the Goldilocks principles: papa bear meal, mama bear meal and a baby bear. And of course, somehow accurately estimating with a trained eye that my portion should be about 30% less than Jamie’s. This time we decided to run an experiment and fill my plate. So now we plate out a portion of protein about 150-200g each and fill the white gaps on the plate with veggies and fruit. Occasionally it’s too much and I don’t finish it. More often than not, I do.

I had a few people ask me recently on Twitter and at the workshop whether it was 200g per day or per meal which caused me a lot of merriment. Get you calculators ready, doubters!
3 eggs at 11g protein each = 33g (breakfast)
Smoked salmon 150g = 32g (lunch)
Lamb chop = 33g (dinner)
Total around 100g protein a day. I weigh 60kg. Which makes it ~1.6g of protein per kilo. Hardly a huge amount for a young active female. Don’t forget, you have eliminated snacks with “healthy” sources of useless protein, a.k.a. gluten, like Nutrigrain cereal bars. 3 meals of between 25 and 40g each does not add up to a whole lot.

 

Very typical dinner: lamb chop (of course!), sweet potato+orange+pecans in olive and ginger marinade, braised cabbage with garlic

Very typical dinner: lamb chop (of course!), sweet potato+orange+pecans in olive and ginger marinade, braised cabbage with garlic

Just in case you think I used an entree plate. Palm size is a minimum, ladies!

Just in case you think I used an entree plate. Palm size is a minimum, ladies!

So yeah, I lost MORE body fat eating MORE food. Still think calories count?

  • More vegetables. When Dallas and Melissa said “Fill the rest of your plate with veggies” they weren’t joking. When I talk to people about vegetables I normally get this slightly guilty shifty look: “Yeah yeah I know they are good for me…” and the voice trails into the distance. Yes, they are bloody good for you. Eat them. I don’t go into throws of ecstasy over broccoli and bok choy. But I eat it. I am a grown up, FFS. I love how people who dislike them find all sort of reasons to avoid them. I know there are many with autoimmune conditions etc. who genuinely need to avoid nightshades or FODMAPs. But something tells me that it’s all too easy to use that excuse to avoid “boring” veggies. Which actually undermines the distress of those who actually cannot tolerate these veggies. Needless to say, all our veggies are cooked in fat (I don’t just want to chew fibre, I actually want to absorb some micronutrients here). And try not to spot diagnose yourself with intolerance to <coconut, onions,=”" radishes=”"> after 1 week just because your gut is not used to that amount of fibre and you feel a little bloated. Don’t blame the food. Give it some time to adjust then reassess.
  • Whole30 Meal Template. One of the mistakes that I see often in the newcomers (and sometimes old-timer paleos) is focusing on Whole30/Paleo-approved ingredients. People tend to forget about the fact that these ingredients still need to add up to a MEAL. So yes, almonds, blueberries and cocoa are technically all Whole30-approved but it is still not a meal. Swapping your protein+veggie lunch for a “light” soup with some nuts may sound like a good idea but you are shortchanging yourself on nutrition and will likely crumble like an almond meal cookie in a day or two. The Whole30 Meal Template does not just apply for dinner (most of us are down with that) but also to your Meal1 and Meal2. We successfully melted a few brains at our Cairns workshop suggesting slow cooked lamb and stir-fried veggies for breakfast. For us every single meal but 2 (caught out at Brisbane airport)  followed the protein and veg (and some fruit) format.
Breakfast: 3 eggs, slow cooked lamb and random veggies. Oh and an apple

Breakfast: 3 eggs, slow cooked lamb and random veggies. Oh and an apple

Work lunch sitting on my lap

Work lunch sitting on my lap

  • More starchy vegetables. Oh boy. I am in the process of actively opening a Pandora’s box and I know it. Let’s get one thing straight: “starches” are vegetables. I am not talking about tucking into potato starch with a tablespoon or sprinkling flour over steak. They are VEGETABLES. Since when are vegetables bad for us? News flash: they have more than strings of glucose held together by glycosidic bonds: vitamins, minerals, nutrients. They are cellular carbohydrate sources (if you haven’t yet read this paper you must!)

For those concerned about their glucose tolerance. The glycaemic effect of a meal hugely depends on its fat content. And if you were a diabetic who decided to tuck in a bowl of plain white potato on its own on an empty stomach your BSL may indeed shoot up. But why would you do that unless you were getting paid by a sugar company keen to sell their low GI sugar? If you incorporate the same potato into a normal size meal containing meat/fish and a decent source of fat to slow the stomach emptying I betcha you will see some different numbers.

But of course, everything is a spectrum. And as much as this applies to the middle of the bell curve there are always outliers. I have seen people get a BSL of 18 after a piece of fish and 10 after a bowl of pasta, making me swallow the pill of humility and bite my tongue. If your glucose tolerance is indeed shot to pieces you may have to watch your sweet potato “allowance”. AND you need to look at your activity level and building some good muscle where you can sink some glucose. If you are bed/couch-ridden you will tolerate less. If you get yourself a decent muscle sink and empty it regularly you will tolerate more.

What I find infinitely more frustrating is not the glucose intolerant individuals who have to have a little less sweet potato because they are sick, unable to exercise, their pancreas is on its last legs and they are trying to minimise the damage. It is those who claim that a piece of pumpkin with dinner sends them into hyperglycaemic coma and goes straight to their thighs but pumpkin gluten-free pancakes/cookies/muffins on the other hand are totally “Paleo”. I’m sorry, what? Sure, I like to let my hair down from time to time, I am not some boring Paleo prune who never has fun, I want to give some treats to my child and help her grow up well adjusted. So I will bake her some nut flour/maple syrup/honey/cocoa concoction but will vilify half a sweet potato? Holding onto paleofied sugar methadone with a death grip will prevent you from assessing your real starchy vegetable tolerance. Those evil carbses might actually work for you if you let go of the dessert addiction.

Argh. Ok. This is turning a little more ranty than I intended. I’ll get off my soap box and stop my preaching. Take from it what you want. There is no need to send me BSL measurements to prove that beetroot gets you higher than cocaine. This may not be you. But I sure do see this a lot from people who then go: “This Paleo thing doesn’t work for me!!!!!! I tried it, was tired all the time, couldn’t lose weight, got weak in the gym. It’s a fad people, get over it”.

Anyways.

Good luck with your Whole30.

What the @#$! do I feed my child?

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A blackboard used by Albert Einstein in a 1931 lecture in Oxford. Source: Creative Commons

I find maths and science quite soothing. There is something beautiful about straight numbers and clear cut conclusions. You must have already picked up on my love of graphs and diagrams. They got me through med school.

However, once you finish a beautifully straightforward equation or reach a perfectly logical conclusion using an algorithm you hit a little snag. How do you translate all these numbers to real life?

In the last few weeks I have read somewhere around 30+ journal articles on child metabolism alone. The numbers are simple, the graphs are straightforward but as we very well know the applications to child nutrition can be vastly different. For all the parents out there the only biochemical pathway they are likely to be interested in is the one between the fridge and the pantry.

Here is a short summary of my last few slightly dry posts on child metabolism (on conventional advice, BMR, malnutrition and catch up growth) and MY conclusions.

1. Children grow. Therefore children are not in “energy balance” in simple terms. The energy cost of growth is high including both the energy density plus quality nutrients to ensure lean body mass increase.

2. Energy quantity (calories) is important but ultimately you cannot build muscle and bone with broccoli or worse, orange cordial. The quality of nutrients needs to be concentrated to provide more bang for your buck: high nutrient density in a small volume fit for a small stomach.

3. Children regulate their energy needs with their appetite. No calorie calculators required. When the nutrient quality has been addressed the appetite will take care of the rest. If they are hungry they will eat.

4.  Babies, infants and children have less reserves to cope with malnutrition. Even a minor infection may potentially result in muscle loss.

5. Point 4 makes it obvious that it’s not a good idea to put children (=growing bodies) on calorie restricted diets for weight loss.

6. A decrease in activity is a pretty good marker for malnutrition especially for small children. This should give some worried-well parents some confidence, especially where breastfed babies are concerned. If you baby is happy and active it is likely that they are getting enough energy.

7. When children recover from even a minor infection their energy requirements are 4-5 times what they were before. They are going to be very hungry. Feed them. A lot.

8.The period of catch up growth during recovery puts children in a slightly vulnerable metabolic state. They seem more likely to develop insulin resistance (in skeletal muscle), sensitivity to glucose and store abdominal fat.

9. Point 8 makes you think that the post-recovery window is crucial for providing good nutrition for longer term gains. Maybe it is not a good time to provide sweet treats or let children laze around. My thoughts go towards fatty chewable chunks of meat and providing plenty of opportunities for spontaneous activity.

10. My personal way of identifying junk food: if a child is willing to have it after a steak dinner it’s junk. Nobody makes room for more meat or pumpkin when they are stuffed. But there is always stomach space to be found when lollies, cakes, milkshakes and ice-cream are on offer.

The diet recommended by our health authorities always confuses me. I assume (perhaps naively) that they read the same studies and they study the same physiology books. I’m stumped at how they arrive at their conclusions. Today Cancer Council NSW, backed by the Obesity Policy Coalition and the Parent’s Jury, announced the latest villains in the child obesity epidemic: Toucan Sam

and the Paddle Pop lion:

The research by Cancer Council NSW and the University of Sydney found  that 74% of supermarket products adorned with bright cartoon packaging are not up to our healthy nutritional standards. The specific complaints were high-sugar, high-salt and high fat. Apparently the adorable visages of cartoon characters and chiseled jaws of our sporting heroes are just too much for the little kiddies (and their parents) to resist.

“Although stopping short of calling for plain packaging (???) Cancer Council nutritionist Kathy Chapman said regulations around the marketing of foods to children were urgently needed.”

Deep breath. I am not defending sugary cereals. (Not entirely sure how the high-fat monster has slipped into the discussion since the foods in question are mostly low in fat to the point of deficiency. But that’s another matter). In fact, I’m happy to wear a t-shirt: “Friends don’t let friends eat cereal”.  I am more concerned about the whiff of a new scare campaign and propaganda. Plus, when it comes to my own child, I’m the one with a wallet, sorry kiddo.

The second issue is that we rely on these guys for their interpretation of science to tell us which foods are healthy and which are not. I hope we all agree that Froot-Loops are not exactly health food. Nobody buys those because they think that the multiple colours are indicative of the high antioxidant and phytonutrient content. On the other hand Kathy Chapman “welcomes cricketers fronting Weet-Bix” presumably because she thinks that this brand of bland cardboard-like blocks of processed wheat is a healthy alternative. Never mind that most children cover it with malt, sugar, fruit and honey just to make it palatable.

And because the University of Sydney (the home of GI) is involved in this story I’ll throw in a GI reference:

Froot-Loops 69
Weet-Bix 69

Ha.

P.S. I have a very special guest post coming up for you next time. The guest is currently in the middle of the creative process and I am not sure how long before we see the final result. But I know it is going to be something.

The crooked house of GI

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Krzywy Domek, Sopot, Poland

GI is in. Considering its young age, it has managed to get ingrained into our subconsciousness much like “fat makes you fat” and “it takes 5 seconds to contaminate a food particle once it has fallen on the ground”. But what exactly is it?

According to the official glycemic index website, GI (glycemic index) measures the extent to which carbohydrate foods raise blood sugar level (BSL from now). Glucose was nominated to have a GI of a 100. High GI (>70) means that this particular food raises BSL fast, giving you a “glucose spike”. Anybody with a brain knows that spikes are not good: they are nasty sharp things. This is the beauty of language: you can use a word that evokes vivid images in your head, helping you make an immediate judgement. But I digress. Low GI (55 and under) is supposedly better because these foods result in slow sustained release of blood glucose (mind picture: a calm and steady flowing river). Low GI was initially recommended to diabetics, then the advice was expanded for weight loss, followed by the publication of a very successful book “The New Glucose Revolution” . Now food manufacturers fall over themselves to have a Low GI symbol on their product (for a fee, of course)

I have quite a few problems with recommending a Low GI diet, as advocated by Jennie Brand-Miller, the author of the book.

The initial studies showed a great variation in glucose response to common foods. For example carrots were shown to have a glycemic index of 92 in the first study, then 37 in a later study. This fact becomes a little less surprising when you find out that the testing groups consisted of 5-10 people (!). 

The studies measured the effect of carbohydrate foods alone. Even the authors of the book concede that we do not eat “carbohydrates” for dinner, we have some spag bol. Other components of the meal affect the glycemic index by regulating the rate of absorption. Protein, fat and fiber all slow down the Glucose release effectively lowering the GI. This is why the GI of super supreme pizza is lower than the GI of watermelon: pizza is high in fat and protein, watermelon is pure carb. In addition, the composition of your previous meal also affects GI, this is why the studies were done after an overnight fast.

One of the major flaws of the diet, in my opinion, is that it makes two assumptions: 1. blood glucose levels are easily compared between individuals 2. insulin release predictably follows the rise in blood glucose. Even between healthy individuals (free from diabetes type I or II), the variation in the amount of insulin released after the same meal can be enormous. However this diet is recommended to DIABETICS. Their glucose metabolism is screwed up already. Type II diabetics and those with pre-diabetes have a higher BSL reading and therefore more insulin required after consuming the same meal as a healthy person. Let’s say I have a bowl of “heart-healthy” muesli (you will have to pay me a lot of money first!) and measure my blood glucose after 1 hour. My fasting BSL is around 4.2, my BSL after the cereal will be lucky to hit 5. Type II diabetics will start with a higher fasting BSL and their response to muesli might range anywhere between 11-20mmol. 

Can this get any more confusing? A bowl of All-Bran cereal bought in Australia (caveat 1), weighing at 30 g (2) has a GI of 30 if eaten in isolation (3), by a healthy individual (4), on an empty stomach (5), for breakfast (6). If you happen to be Canadian, your All-Bran has a GI of 51. There is no way of telling what the GI would be if you change any of the other 5 variables.

GI supporters are probably shaking their heads at me. I must misunderstand the principles of low GI eating. People are just supposed to swap their unhealthy high GI meals for healthier low GI version. Like ditching their Cornflakes (77 in Oz) for Frosties (55)?  Yay! I am liking my new diet!

The next line of defence for the GI crowd is Glycemic Load, which now takes into account the quantity of carbohydrate in your meal (something you would like to know if you are diabetic and about to jab yourself with insulin). OK, let’s see how that works.
Glycemic load values for 150g of potato. (Low<10, Medium 11-19, High >20)
Potato, non-specified, boiled, Australia – 11
Potato, sebago, peeled, boiled for 35 min, Australia – 14
Potato, Pontiac, peeled, boiled for 30 min, Australia – 14
Potato, Pontiac, peeled, boiled for 35 min, Australia – 16
Potato, Desiree, peeled, boiled for 35 min – 17
Potato, boiled in salt water, India – 26

 WTF? (Why The Face, for the fans of the Modern Family)

 I think that the problem with GI  is that it is based on a faulty concept. Like a building sitting on a shaky foundation, you have to

Does this count as GREEN?

keep tinkering with a top structure just to keep it standing. Now the ceiling caves in, now the top story goes wonky. It is based on a premise that we have to eat 55%+ of our energy from carbs. The foundation is now laid and suddenly you realize that carbs raise blood sugar (not good for diabetics) and insulin (not good for weight loss). You have no choice but to play the cards you are given! So we are told to make the carbs low GI in an attempt to minimize the damage. Is eating vegetables (low GI) better than eating a muffin (medium GI)? Yes! Does it have anything to do with GI?  

I can make the same argument by telling you to only eat GREEN food. You will probably eat healthier, stabilise your blood sugar and lose weight. Does it mean that the colour GREEN has unique properties? Nope, it’s just most green foods happen to be vegetables, with an exception of an occasional peppermint candy.

 

How about taking down this crooked building of GI and starting with a new base? If you are a diabetic or weight loss is your goal, maybe eating so many carbs is not a great idea (a radical concept, I know). Do you know what has a GI of zero? Eggs, beef, lamb, pork, chicken. Most green vegetables have a GI<30. That’s what I call a true low GI diet!

References: