Feedback—Your FAQs Answered

‘I have recently been diagnosed with type 2 diabetes. I am trying to eat a healthy low GI diet, but find it hard to say no to occasional treat foods like crisps and chocolate. Which is better for my blood glucose?’

Most people with diabetes would see the chocolate bar as taboo, but by measuring the blood glucose rise after different foods scientists have proved this to be unfounded. Potato crisps and chocolate have an almost identical effect on blood glucose. Why? The carbohydrate in chocolate is sucrose, which is 50 per cent fructose (which has little effect on blood glucose levels) and 50 per cent glucose (high GI), giving it a medium GI overall. In potato crisps the carbohydrate is cooked (swollen) starch, which is readily digested to yield 100 per cent glucose molecules. So fully cooked starch will have twice the impact on blood glucose levels as the same quantity of sugar.

‘I have been following a low GI diet for years to combat hypoglycemia and I’ve been very happy with the results (more even energy levels, easy weight maintenance). I am about to introduce my baby to solids and have been advised to start with rice cereal. I worry about giving Baby rice cereal as her first food especially since I (and most of my family) are so GI sensitive. What is the current guidance on GI for babies and young children?’

In The New Glucose Revolution Guide to Healthy Kids, Dr Heather Gilbertson, a specialist dietitian educator with many years experience in management with children with diabetes says:

‘The aim of anyone involved in feeding kids is a happy healthy child and a diet that lays the foundation for a healthy future. There are many nourishing foods with a low GI that are suitable for any age beyond infancy. By incorporating more low GI foods as part of a well balanced diet for children along with encouraging regular physical activity you are laying the groundwork for a long and healthy life. In terms of nutrition, children are not simply little adults. One big difference is that they are growing all the time (from birth to puberty, for example, a child’s skeleton increases sevenfold!). At different ages children have very specific energy and nutrient needs. High fibre diets, which are bulky and filling, and very low fat diets are not suitable for young children because they make it too difficult for them to eat enough food to meet their energy and nutrient needs. The current Australian dietary guidelines (which are similar to such guidelines for children around the world) include the following points:

• Encouraging breastfeeding
• Offering children a wide variety of nutritious foods to eat especially foods containing calcium and iron
• Giving children plenty of breads, cereals, vegetables (including legumes) to eat
• Aiming to include only a moderate amount of sugars or foods containing added sugars in children’s diets

However, infants have special needs. Occasionally, some infants are born with an endocrine disorder which causes problems with hypoglycemia (low blood glucose level). This is when the blood glucose levels often fall below the normal level and needs to be monitored and managed carefully.

Dr Gilbertson told GI News ‘Introduction of rice cereal for infants with hypoglycemia should not cause any problems. I would generally recommend mixing it with expressed breast milk to modify the GI effect. Rice cereal is an important introductory food for babies as it is iron fortified. Infants need additional iron intake at six months of age to meet their requirements. The main key to management of infant hypoglycemia is to ensure the baby has a regular intake of carbohydrate throughout the day (frequent feeds/meals and snacks) and avoids long periods of fast. Foods high in added or natural sugars (fruit juices) should also be avoided as these may aggravate the hypoglycemia. Deliberately avoiding or limiting the carbohydrate-containing foods will also cause the blood glucose levels to drop low in an infant with a diagnosed hypoglycemic disorder. Mum also needs to encourage baby to try a wide range of tastes and textures of the fruit and vegetable variety (focusing on either low GI or combination of low with high to modify the effect). As the child gets older, Mum can introduce the dairy foods that of course all have a low GI and other breads and cereals. Any parent who has a child with a hypoglycaemic endocrine disorder should seek out individual professional nutritional advice from their local pediatric dietitian or contact their local APD (Accredited Practicing Dietitian) (www.daa.asn.au)’.

‘Is there a GI Plan for nursing mothers?’

We thought that GI Group member, Joanna McMillan-Price, co-author of The Low GI Diet and The Low GI Diet Cookbook, and a new Mum breastfeeding and trying to get back into shape would be the best person to answer this.

‘A low GI diet is ideal for while you are breastfeeding,’ says Joanna. ‘Breastfeeding requires a lot of energy and theoretically this additional energy comes from the body fat we laid down during pregnancy. Of course in reality it doesn’t all get used up and most of us have to make a concerted effort to work off the baby weight. To do this though it is important that you don’t go on a low calorie diet or any sort of extreme measure such as the low carb diets popular in the press. Since breastfeeding tends to increase your appetite (the body’s way of ensuring you have the energy required to produce milk) this is good news as staying on such a diet would be a nightmare! This is what makes the low GI approach so successful—forget about trying to count calories or even your portions of food. First and for most focus on the sorts of foods you are eating. Low GI foods are the wholegrains, fresh fruit and vegetables and legumes. By eating these foods as the mainstay of your meals you can trust your appetite and eat to satisfaction while you are breastfeeding. Also get back to some exercise—even if it’s just a daily walk with the pram. You should then find that the weight slowly starts to shift—realistically give yourself at least that first six months to get back to your pre-pregnancy weight.’

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