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Carbohydrates and the Glycaemic Index

Diabetes is a widely researched and increasing illness around the world especially in western countries. People who are not insulin dependent are discovering that by altering their dietary intake they are better able to manage their blood sugar levels. Altering diet reduces symptoms such as excessive thirst, frequent urination, low energy, circulatory problems, and excess weight and for some a reduction in blood pressure. Food provides fuel for our body in the form of fat, protein and carbohydrates. Carbohydrates are the body's preferred fuel source. The glycaemic index (GI) is a way to rate carbohydrates according to how quickly they are absorbed and raise the glucose level of the blood. It has replaced classifying carbohydrates as either 'simple' or 'complex'.

Our Body's Attempt to Restore Balance

Insulin is a protein hormone that is released by the body to help regulate glucose metabolism from the carbohydrates, fats and proteins we consume. The majority of glucose is converted to metabolic energy, but sometimes it may be stored as fat. A diet high in refined carbohydrates (high GI) is linked to the development of insulin resistance, obesity and diabetes. The increase in glucose decreases insulin activity and receptor numbers causing a blood sugar imbalance, and has also shown to increase plasma levels of triglycerides (fats). Therefore, too much storage of fat transpires into weight gain and this becomes the link for weight management! Insulin is released in response to rapidly rising blood glucose levels from refined carbohydrates such as white sugar, white breads and cakes. Meals consisting of whole foods and complex carbohydrates such as vegetables and grains support strong insulin activity. Tender Loving Cuisine (TLC Meals) are approved as suitable for people with diabetes and also for weight control management by the Australian Diabetes Council. A complete nutritional analysis is available on their website www.tlc.org.au or by contacting their friendly staff on Freecall 1800 801 200.

Digesting and Absorbing Carbohydrates

The digestive system breaks down carbohydrate-containing foods into simple sugars, mainly glucose. For example, both baked beans and soft drink will be broken down to simple sugars in your digestive system. This simple sugar is then carried to each cell via the bloodstream. The pancreas secretes the hormone insulin, which helps the glucose to migrate from the blood into the cells. Once inside a cell, the glucose is 'burned' along with oxygen to produce energy. Our muscles, brain and nervous system all rely on glucose as their main fuel to make energy. The body converts excess glucose from food into another form called glycogen. This is stored inside muscle tissue and the liver, ready to supplement blood sugar levels should they drop between meals or during physical activity.

The Glycaemic Index

Carbohydrate-containing foods can be rated on a scale called the glycaemic index (GI). This scale ranks carbohydrate-containing foods based on their effect on blood sugar levels over a period of time - usually two hours. The GI compares carbohydrate-containing foods gram-for-gram of carbohydrate. Carbohydrate-containing foods are compared with glucose (although sometimes white bread can be used as reference food), which is given a GI score of 100. Carbohydrates that break down quickly during digestion have the highest glycaemic indexes (GI more than 70). These high GI carbohydrates give a "quick hit". The blood glucose response is fast and high. Carbohydrates that break down slowly release glucose gradually into the bloodstream. They have low glycaemic indexes (GI less than 55). The blood glucose response is slower and flatter, sustaining energy release in the body over a longer period of time helping us to feel healthier and more alert.

Choosing Between High and Low GI Foods

Which carbohydrate foods are best to eat? That depends on the situation. For example, the rate at which porridge and cornflakes are broken down to glucose is different. People with type 2 diabetes or impaired glucose tolerance, have become resistant to the action of insulin or cannot produce insulin rapidly enough to match the release of glucose into the blood after eating carbohydrate containing foods. This means their blood glucose levels may rise above the normal level. Porridge is digested to simple sugars much slower than cornflakes so the body has a chance to respond with production of insulin and the rise in blood glucose levels is less. For this reason, porridge is a better choice of breakfast cereal than cornflakes for people with type 2 diabetes. It will also provide more sustained energy for other people as well.

How Much You Eat is also Important

The amount of the carbohydrate-containing food you eat will also affect your blood glucose levels. For example, even though pasta has a low GI, it is not advisable for people with diabetes or impaired glucose tolerance to have a large serve. This is because the total amount of carbohydrate, and therefore the kilojoules, will be too high. The glycaemic load (GL) is a concept that builds on GI as it takes into account both the GI of the food and the amount of carbohydrate in a portion. GL is based on the idea that a high GI food consumed in small quantities would give the same effect on blood glucose levels as larger quantities of a low GI food. GL is easily calculated by multiplying the GI by the number of grams of carbohydrate in a serving of food.

High GI Foods are Influenced by Low GI Foods

Generally, eating low GI foods slows down the absorption of glucose from any high GI foods eaten at the same time. This is important, as most foods are eaten as part of a meal and this affects the GI value of foods. For example, eating cornflakes (a higher GI food) with milk (a lower GI food) will reduce the effect on blood sugar levels. If a person with diabetes experiences a 'hypo', where the blood glucose levels fall below the normal range of 3.5-8mmol/L, they need to eat carbohydrate-containing foods (preferably those with a high GI) to restore their blood sugar levels to normal quickly. For example, eating five jellybeans will help to raise blood glucose levels quickly.

Factors that affect the GI of a Food

Factors such as the size, texture, viscosity (internal friction or 'thickness') and ripeness of a food affect its GI. For instance, an unripe banana may have a GI of 30 while a ripe banana has a GI of 51. Both ripe and unripe bananas have a low GI. Fat, protein, soluble fibre, fructose (a carbohydrate found in fruit) and lactose (the carbohydrate in milk) also generally lower a food's glycaemic response. Fat and acid foods (like vinegar, lemon juice or acidic fruit) slow the rate at which the stomach empties and so slow the rate of digestion, resulting in a lower GI. Other factors present in food, such as phytates in wholegrain breads and cereals, may also delay a food's absorption and thus lower the GI. Cooking and processing can also affect the GI - food that is broken down into fine or smaller particles will be more easily absorbed and thus have a higher GI.

Tips for Healthy Eating

Some practical suggestions include:
.    Use a breakfast cereal based on oats, barley and bran.
.    Use grainy breads or breads with soy.
.    Enjoy all types of fruit and vegetables.
.    Eat plenty of salad vegetables with vinaigrette dressing.
.    Eat a variety of carbohydrate-containing foods. If the main sources of carbohydrates in your diet are bread and potatoes then try lentils, legumes, pasta, basmati rice.

Note: TLC Meals provide a balanced meal of protein (meat portion), vegetables or grains (such as rice or lentils) in every serve and most meals are endorsed by Australian Diabetes Council as a healthier choice for blood glucose management.

Expert Medical Supervision

If you have a medical condition, such as diabetes, it is important to seek the advice of your doctor or specialist before making any changes to your diet.

Where to get help -
.    Your doctor.
.    An accredited practising dietician or nutritionist.
.    Nutrition Australia www.nutritionaustralia.org .

Maria Mitzikis
Nutrition Consultant

Copyright, Maria Mitzikis, Nutrition Consultant

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Southern Cross Care (Vic) - New Eastern Region Office

Southern Cross Care (Vic) is holding the official blessing and opening of their new Eastern Region Office. It will feature a blessing ceremony conducted by the Very Reverend Father Tony Kerin PP EV.

The new office is located at Suite 8, Level 1, 50 New Street, Ringwood Vic 3134, Contact No. (03) 9722 4600.

Copyright, Southern Cross Care (Vic)

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Tips For Choosing The Best Home Delivered Meals

1.  Make careful selections. If you have intolerances pay attention to the descriptions on the menu. When ordering home delivered meals it is a great idea to read the labels of the ingredients used. A reputable company will list all the components of the ingredients used on the label. If you have allergies and intolerances you can improve your chances of getting high quality food by making wise choices about what to eat and what to order.

2.  Meals labelled deep-fried, pan-fried, basted, batter-dipped, breaded, creamy, crispy, scalloped, Alfredo, are usually high in calories, unhealthy fats or sodium. It can be difficult these days to get healthy wholesome food when ordering home delivered meals, but if you do your research you will find organisations such as Tender Loving Cuisine providing quality meals that are low in salt, vegetarian, gluten free, suitable for people with Diabetes and heart healthy choices.

3.  Look before you leap - check out the supplier?s website. Many large home delivery companies post nutritional information on their websites. These lists are often confusing in their detail but if you frequently order from a commercial company, you may be amazed by the calories, saturated fats and sodium you are consuming. Finding satisfying substitutes is more than worth the time and effort in research.

4.  "Undress" your food. When choosing, be aware of calorie and fat-packed dressings, spreads, cheeses, sour creams, etc.

5.  Don't be afraid to special order. Many menu items would be healthy if it weren't for the way they were sauced or dressed. A dedicated organisation will take the time with you on the phone to help you order what?s right for you.

6.  Watch your salt. To preserve foods most companies tend to be very high in sodium, a major contributor to high blood pressure. Look for an organisation that has won awards for its low salt, fat and sugar content. Don?t add more salt at the table.

7.  Is it Nutritious or made for weight loss? As we age we can?t afford to lose weight. It is more important to build the muscles, brain and bones, as well as look after the heart and bowel function so that we are at our optimum health. The way we do this is through our food mostly, so even though cooking might be something we do less and less, if we have a healthy home delivery meal service option it can take some of the stress away from worrying about what we eat.

8.  Remember the big picture ? Think of eating in the context of your whole diet. A variety of wholesome foods including fish and vegetables as well as legumes will provide a balanced diet. Look for the organisation that has over 80 healthy meals to choose from and you will be healthier and never get bored with your food!

9.  The award winning delicious home delivery meal service that is available in most of NSW and Victorian areas is: Tender Loving Cuisine Website www.tlc.org.au Freecall 1800 801 200.

Maria Mitzikis

Copyright, Maria Mitzikis, Nutrition Consultant

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Salt & Your Health

PROFESSOR BRUCE NEAL Chair of Vascular Epidemiology and Prevention Medicine, The George Institute for Global Health has been quoted as saying: ?Three quarters of the salt in the average Australians? diet will come from processed foods, particularly breads, breakfast cereals, cheeses and processed meats. About ten percent is salt added at the time of cooking and about ten percent is salt added at the table. The salt that people add at the table or while they?re cooking is only a very small proportion ? probably about 20 percent of their daily salt intake ? the other 80 percent comes from processed foods and that?s what we have to target if we?re going to get high salt counts out of the Australian diet.? It is also the aim of TLC to assist those in the community to reduce their salt intake by keeping their meals as unprocessed and as fresh as they can be from their kitchen to your table.

Most vegetables are grown in demineralised soil, thus one feels there is something missing in taste. Instinct has us reaching for the salt to add flavour. Some vegetables have a natural salty taste like sea vegetables and that is because they have a high mineral content. Natural occurring salts found in whole foods have an alkalising effect on the blood, and as the body has to have its acid vs. alkaline ratio in balance, we do need some salt. Processed salt does not have a beneficial effect on the blood, therefore, LESS is BEST.

Salt is a chemical compound (electrolyte) made up of sodium and chloride. It was traditionally used to preserve and flavour foods, and is the main source of sodium in our diet. A small amount of salt is important for good health ? it helps to maintain the correct volume of circulating blood and tissue fluids in the body. However, most people consume much more sodium than they need for good health increasing blood pressure and adding weight through water retention.

Our bodies are designed for a high potassium diet, not a high salt diet. Food processing tends to lower the potassium levels in many foods while increasing the sodium content. So it is better to eat unprocessed foods or foods that are made from a fresh and natural source such as Tender Loving Cuisine meals. Food consultants at Tender Loving Cuisine are constantly seeking the best advice from organisations such as The National Heart Foundation and their dieticians to ensure that sodium levels in their foods are acceptable. At the freezing stage of their food preparation, they are mindful that some salt taste is lost and compensate because food with no salt is bland and TLC meals are not bland. The sodium content of their foods is another reason why TLC is a recipient of the NSW Seniors Achievement Awards for Outstanding Achievement in Health and Wellbeing.

Maria Mitzikis

Copyright, Maria Mitzikis, Nutrition Consultant

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Gluten Intolerance

Coeliac disease is a chronic intestinal disorder caused by a digestive intolerance to the protein, gluten. A common misconception is that someone who is intolerant to gluten automatically has coeliac disease which is incorrect. Many people test positive with few or minor symptoms, and for these people, avoidance is just as important in overall disease prevention.

Gluten is found in some of the grains that make up a major part of many diets, with wheat, rye, spelt and barley being the most common.

Diarrhoea, constipation, cramping, pain, gas and bloating are some of the more prominent symptoms seen by some sufferers, although as the damage to the intestinal lining continues, allergies appear, poor digestion and malabsorption worsen and a condition known as ?leaky gut? develops. Leaky gut is where the sensitive gut mucosal lining erodes, allowing the passage of toxins, microbes and food allergens to absorb into your system.

Left untreated, gluten intolerant folk can suffer from a wide variety of health complications and unfortunately many cases of gluten intolerance also go undiagnosed due to a lack of digestive symptoms. Other clues include unexplained anaemia, tiredness, weight loss, sinusitis, osteoporosis, respiratory difficulties and joint pain.

There is a strong genetic link to having gluten intolerance. The best way to deal with gluten sensitivity is to eliminate gluten from the diet. Gluten is found in many common foods, including bread, cereal, pasta, cakes, biscuits, flours and hidden in small quantities in numerous other foods. Reading food labels carefully and avoiding anything containing gluten is essential for long term control of the condition.

Gluten-free products can be made from rice, millet, buckwheat, polenta, corn, psyllium, sorghum, quinoa, sago soy, gluten-free flours, potato, lupin flour, lentil flour, tapioca, and arrowroot if desired. Whilst oats do contain a gluten-like molecule, they are generally well tolerated by most people with coeliac. All recipes can be modified to suit a gluten sensitive diet and gluten-free products are now readily available.

At Tender Loving Cuisine, we strive with the approval of The Coeliac Society, to create meals that can be consumed by people with all levels of gluten intolerance. Many of our existing customers often tell us how happy they are to be able to satisfy a sweet tooth with our delicious gluten free desserts. Our most popular dinner meals in the gluten free range include Corned Silverside with White Sauce, Roast Lamb with Mint Gravy, Shepherds Pie and Lentil Patties just to name a few. TLC has a wide variety of gluten free options and this is why our recipes have won awards for being healthy as well as affordable.

If you are experiencing Gluten discomfort from your current diet, contact TLC and let our friendly staff help you choose some healthier options.

Maria Mitzikis

Copyright, Maria Mitzikis, Nutrition Consultant

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