Interpretting your TCF7L2 results for those who “don’t eat grains”

With the popularity of low-carb and “paleo” type diets, I’ve often gotten this response from clients who (like me) have the elevated risk variant of the TCF7L2 gene:

“I don’t eat grains/breads/cereals, so I don’t have to worry about my elevated risk.”

However, while grains are a carbohydrates, we also get carbohydrates from fruit, vegetables and some dairy porducts. For those who choose not to eat grains and have the elevated risk variant of the TCF7L2 (as determined in Nutrigneomix testing), it is still important to address the glycemic index or load of your diet to reduce your risk of developing type 2 diabetes.

So what is glycemic index? What about glycemic load? How does one eat a low glycemic diet?

Both glycemic load and glycemic index are measures of the “quality” of carbohydrates in food.

The glycemic index (GI) is a ranking of carbohydrates on a scale from 0 to 100 according to the extent to which they raise blood sugar levels after eating. Foods with a high GI are those which are rapidly digested and absorbed and result in marked fluctuations in blood sugar levels. Low-GI foods, by virtue of their slow digestion and absorption, produce gradual rises in blood sugar and insulin levels, and have proven benefits for health. (http://www.glycemicindex.com/about.php)

The difference between glycemic load and index is that the glycemic load takes into account the typical serving size of a given food.

For several reasons, including the greater availability of glycemic index measures, I usually speak to the glycemic index of foods. So for those with the elevated risk variant of TCF7L2, it is very important to eat a low glycemic diet.

Foods are often categorized as low, medium or high on the glycemic index depending on how much they raise blood sugar levels as compared to a “standard”, usually sucrose, which is assigned a value of 100.

Low                                                        0 – 55

Moderate                                           56 – 69

High                                                       70 or more

I often refer to the University of Australia searchable database at http://www.glycemicindex.com/foodSearch.php to look up foods as the database lists the GI, grams of carbohydrates per serving and GL for thousands of foods. You can even choose ‘Canada’ in the drop down list to view Canadian products.  Note that foods like meat and eggs have negligible amounts of carbohydrates and are therefore not listed in the database.

Here are some tips to lower the glycemic impact of the food you eat:

1. Choose whole, unprocessed versions of fruit, vegetables and grains.

2. Choose less ripe fruit.

3. Cook grains and potatoes “al dente”, or slightly chewy instead of over-cooking.

4. Pair higher glycemic foods (fruit, some grains, potatoes) with lower glycemic foods such as proteins and high-fibre vegetables to lower the overall glycemic impact of your meal or snack.

Here is a yummy, low GI way of getting in healthy carbohydrates for those who choose not to eat grains. This recipe is also high in folate (lentils) and omega-3 fats  (salmon) for those who have the elevated risk gene variant for these nutrients.

 

Salmon with Lentil Pilaf

Makes 4 serving(s)

 Ingredients

  • 4 salmon fillets, (about 6 oz/175 g each)
  • 2 tbsp (30 mL) olive oil
  • 1/4 tsp (1 mL) salt
  • 1/4  tsp (1 mL) pepper
  • 1 1tbsp (15 mL) fresh mint or fresh parsley, chopped
  • Lentil Pilaf:
  • 1 tbsp(15 mL) olive oil
  • 1 onion, chopped
  • 1 stalk celery, chopped
  • 2 cloves garlic, minced
  • 1 sweet red pepper, diced
  • 1tsp (5 mL) ground cumin
  • 1/4 tsp (1 mL) salt
  • 1  cup(250 mL) brown lentils or green lentils
  • 2  cups (500 mL) chicken stock
  • 2  tbsp (30 mL) fresh mint or fresh parsley, chopped

 Preparation:

In saucepan, heat oil over medium heat; fry onion, celery, garlic, red pepper, cumin and salt until onion is softened, about 5 minutes. Add lentils; stir to coat. Add stock; bring to boil. Reduce heat, cover and simmer until lentils are tender and some liquid remains, about 40 minutes. Stir in mint.

Meanwhile, place salmon fillets on parchment paper-lined or greased baking sheet. Brush oil over salmon; sprinkle with salt and pepper. Roast in 425°F (220°C) oven until fish flakes easily when tested, about 12 minutes. Sprinkle with mint.

Arrange lentil pilaf on 4 warmed plates; top with salmon.

 

Nutritional Info

Per serving: about -
cal 570 cal
pro 45 g
total fat 28 g
sat. fat 4 g
carb 34 g
fibre 7 g
chol 84 mg
sodium 770 mg
% RDI: -
calcium 7%
iron 44%
vit A 14%
vit C 97%
folate 142%

 Modified from: http://www.canadianliving.com/food/salmon_with_lentil_pilaf.php

 

What fish to choose for those who need more DHA + EPA

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While my genes tell me that I need more DHA + EPA found in fish and seafood, I’m also aware that all seafood is equal. In my last post I gave a list of seafood and fish that contain DHA + EPA (http://dnadiet.wordpress.com/2012/10/03/here-fishy-here-fishy-lisa-needs-more-dha-epa-here-fishy/). Along with accumulating health omega-3 fats, fish and seafood can also accumulate environmental toxins, which we consume when we eat fish and seafood.  Additionally, modern fishing methods are not all environmentally sustainable and I try to be a responsible consumer when I can. Monterey Bay Aquarium’s Seafood Watch is a resource that I use to help determine which seafood to consume to maximize my omega-3 intake, while minimizing my intake of environmental toxins and environmental impact.

In general, larger fish have lived longer and accumulated more toxins than smaller, younger fish. New to me was the fact that “wild” is not always better than “farmed”, for both nutrition and sustainability reasons.

MontereyBay has posted a “Super Green” list of the best seafood choices based on three criteria:

  • Low levels of contaminants (mercury and PCBs)
  • At least 250 mg/serving of omega-3 fats
  • Classified as a Seafood Watch “Best Choice”, which is a measure of sustainability.

The Super Green list includes Albacore tuna (US or British Columbia), freshwater Coho salmon (farmed, US), farmed oysters, wild-caught pacific sardines and farmed rainbow trout.

Check out the complete list at http://www.montereybayaquarium.org/cr/cr_seafoodwatch/sfw_health.aspx

Here’s a link to a handy table that I printed and bring to the grocery store and fish mongers: http://www.montereybayaquarium.org/cr/cr_seafoodwatch/sfw_alternatives.aspx

Another great source of omega-3s is sablefish (also called black cod). While not easy to find and fairly pricy, I assure you it is worth it, especially if prepared using this simple parchment method for Sablefish with Asian Flavors and Fresh Herb Salad, available from http://www.montereybayaquarium.org/cr/cr_seafoodwatch/recipes/sablefish_asian.aspx

Happy eating!

 

Lisa

 

Here fishy… Here fishy… Lisa needs more DHA + EPA… Here fishy…

DHA + EPA (docosahexaenoic acid plus eicosapentaenoic acid) are a special type of omega-3 fats that are required for brain development and functioning and have been shown to be beneficial in prevention and treatment in a variety of conditions including heart disease, obesity, learning disorder – even gum disease!

Before you read on, here’s a great site to learn more about DHA + EPA: http://www.dhaomega3.org/

In terms of heart disease prevention, it’s been established that DHA + EPA have blood triglyceride-lowering effects. However, research has shown mixed results on the effect of DHA + EPA in lowering triglyceride levels, with some people being more responsive than others to increased DHA + EPA. Nutrigenomix testing now allows registered dietitians (ie. Me) to determine whether someone would benefit from increasing their DHA + EPA intake by looking at the genetic variant of the NOS3 gene.

And wouldn’t you know it – I’m one of those who would benefit from increasing my DHA + EPA intake! (Another way of saying this is that I have an elevated risk of high triglycerides if I do not increase my DHA +EPA intake, but I’m a glass-half-full kinda gal.)

How much do I need each day? Well, a lot more than I was getting!

So here is my strategy:

  1. Consume enough DHA +EPA every day (I opt for salmon).
  2. Forgoing that, supplement.

Seems pretty simple, right? But what about the “toxins” in salmon? Or the different species? Or other foods with DHA +EPA? What type of supplement?

As you can see, my strategy is not quite as simple as it seems.

Let us start with step 1: Eat more DHA + EPA

DHA + EPA are primarily found fish and seafood.

Food Source
  (100 g portion, cooked)

DHA   + EPA
  (g)

Salmon

2.1

Herring

2.0

Mackerel

1.8

Anchovy

1.4

Trout

0.9

Swordfish

0.8

Mussels

0.8

Halibut

0.5

Tuna

0.3

 

Source:

DHA EPA Pmega-3 Institute. Dietary Sources of Omega-3 Fatty Acids. Available from: http://www.dhaomega3.org/Overview/Dietary-Sources-of-Omega-3-Fatty-Acids [October 3, 2012].

 

If you’re concerned about the environmental impact and sustainability of the seafood that you consume, check out this site: http://www.seachoice.org/

 

I’ve been on-the-go this week, so here’s how I’ve been getting in my DHA + EPA (it is also in keeping with my goal of bringing lunch to work).

DHA + EPA Rich Lunch Salad

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Ingredients:

  • 2 cups baby spinach (++ folate)
  • 1 cup chopped veggies (tomato, pepper, cucs)
  • 2-3 tbsp chickpeas (++ folate)
  • 2 tbsp crumbled light feta cheese (++ yummy)
  • ½ can Wild Planet canned Sockeye salmon (shown above)
  • A squeeze of fresh lemon

Directions:

Bring salad ingredients to work with veggies, chickpeas, a wedge of lemon and feta in a large container and the unopened can of salmon. Mix ingredients together at lunch. Save the other ½ can for tomorrow’s lunch.

 Enjoy!

 

Making life a little more balanced

Making life a little more balanced

I’ve let my work life out-weight my personal life. It happens to the best of us.

I’ve noticed my energy levels start to fade in the past few weeks and my training for an upcoming ½ marathon has been less than stellar. Why? Likely due to lack of sleep and not spending enough time on taking care of me. Instead of spending a few hours on Sunday preparing lunches and snack for the week, I’ve been spending the time doing work. This past Sunday, after logging 13.5 miles, I took some time to cook some chicken, steam some veggies, boil some eggs and, well, make brownies – healthy ones of course!

My first goal for the week was to pack and bring my lunch every day this week and so far I am 3 for 3.

My second goal for this week – promote a healthy workplace. We spend 8+ hours per day at work and having a healthy work-life balance includes being healthy at work.

I’ve let my work life out-weight my personal life. It happens to the best of us.

I’ve noticed my energy levels start to fade in the past few weeks and my training for an upcoming ½ marathon has been less than stellar. Why? Likely due to lack of sleep and not spending enough time on taking care of me. Instead of spending a few hours on Sunday preparing lunches and snack for the week, I’ve been spending the time doing work. This past Sunday, after logging 13.5 miles, I took some time to cook some chicken, steam some veggies, boil some eggs and, well, make brownies – healthy ones of course!

My first goal for the week was to pack and bring my lunch every day this week and so far I am 3 for 3.

My second goal for this week – promote a healthy workplace. We spend 8+ hours per day at work and having a healthy work-life balance includes being healthy at work.

Here are my top tips for a healthy workplace:

  1. Make health a priority in your workplace. Whether you are an employee or the boss of a large company or a one-person operation working out of your home office, include health into your workplace. Some ideas include:
  • Address your, your colleagues’ and your employees’ health
  • Schedule meals, snack and activity into your day
  • Invest in extended health benefits
  • Invite guest speakers (like dietitians :-)

2. Change your work environment to promote health:

  • Keep treats out of eyesight
  • Only bring in healthy foods (luncheons, etc., see Black Bean Brownies)
  • Stock your fridge with healthy options
  • For lunch and dinner meetings, choose restaurants with healthy choices

3. Add physical activity to the day

  • Take stairs, walk to appointments, bike to work
  • Walk to the mail box 2 blocks away instead of dropping mail off in the mail room
  • Wake up 10 minutes early and stretch or do yoga
  • Go for a walk at lunch or hit the gym
  • SCHEDULE IT! Put the physical activity breaks into your daytimer

With holiday season right around the corner, many of you may be dreading the endless supply of goodies left in break rooms and kitchens. This year, try something different! Start a healthy workplace food policy – only healthy versions of your favorite treats! Start with the high-fibre, High-protein version of brownies below.

Black Bean Brownies

Makes 40 servings

Ingredients

125 ml egg   whites
2 large egg whole   egg
250 ml pumpkin,   canned
1.5 cups 2% yogurt, plain
540 ml black   beans, canned, drained , mashed
3/4 cup honey,   or agave nectar
250 ml cocoa   powder, unsweetened
5 ml  baking powder
5 ml cinnamon,   ground
250 ml grated dark   chocolate, 60-80%, or 1 cup >70% cocoa chocolate chips
1 cup natural   peanut butter

Directions

1. Mix together eggs, black beans, yogurt, agave/honey, pumpkin and vanila. Blend well. 2. Mix flour, cocoa powder, baking soda and cinnamon together. 3. Pour wet ingredients into dry and mix until just combined. 4. Stir in chocolate and peanut butter. 5. Pour into a large baking dish and smooth top. Bake in centre of 350 F oven for about 15-20 minute or until top starts to show cracks. Do not over-cook. 6. Cool, slice and serve.

Nutrient Facts – per 1 serving

CALORIES (kCal) 121
FAT (g) 6
SATURATED FAT (g) 2.14
TRANS FAT (g) 0
CHOLESTEROL (mg) 12
SODIUM (mg) 46
CARBOHYDRATE (g) 14.08
FIBRE (g) 3.3
SUGARS (g) 7.01
PROTEIN (g) 5.14

The Whole (Grain) Story

As I’ve mentioned in my previous posts, due to my variant of the TCF7L2 gene, it is particularly important for me to choose whole grains over processed grains, as well as ensure that I eat a low glycemic diet.

Well, I may have made choosing whole grains sound a little simpler than it actually is. As appeared in an August article in the Globe & Mail, here is the whole story when it comes to whole grains: http://www.theglobeandmail.com/life/health-and-fitness/health/why-whole-grain-health-claims-arent-always-what-they-seem/article4461182/

Here is my Coles notes version:

  • First: read ingredient labels!
  • “Multi-grain” does not mean whole grain. A multi-grain bagel can have other grains added (oats, etc), but can still have a base of white flour.
  • “Whole wheat” does not mean a product is 100% whole wheat. The definition of “whole wheat” in Canada is misleading. Despite this, try to purchase products that are “100% whole wheat” or “100% whole grain,” meaning that the ingredient list only lists whole grains. The term “whole grain” is not regulated in Canada.
  • Just because a product contains whole grains, doesn’t make it healthy (i.e. double-chocolate chip cookies make with shortening and oodles of sugar can still include whole wheat flour).
  • “Gluten-free” flours and grains can still be processed and therefore not whole grain. Read the ingredient list! (Note: I added this point)

While not mandatory on Canadian products, The Whole Grains Council (WGC) has developed a logo to identify products containing significant amounts of whole grains and these logos are starting to appear on Canadian products. There are two types of Whole Grain Stamps, each showing the amount of whole grains per serving. The basic Whole Grain Stamp can be used on products containing a minimum of 8 g of whole grains per serving and the 100% Whole Grain Stamp can only be used on products that are made entirely with whole grains and that contain a minimum of 16 g of whole grains per serving. While a step in the right direction, I find these stamps a bit confusing as both stamps look alike until you examine the small print. Additionally, this still does not address Canada’s definition of 100% whole grain and I do not personally find that listing the total amount of whole grains helpful.

I eat majority of my grains cooked from the whole grain itself (cooked steel-cut oats, quinoa, millet, etc. instead of breads). Various quinoa salads are a staple in my diet and one of my all-time favorites is Greek Quinoa Salad. I usually make mine using the ingredients that I have on hand, but here is a similar recipe to mine: http://recipes.sparkpeople.com/recipe-detail.asp?recipe=1010769

I use water or low-sodium homemade chicken broth to reduce the sodium content and add chopped spinach for more folate. Make this a complete meal by adding a healthy protein (chicken, fish, legumes, lean meat) and a spinach salad. Use left-overs as a pre-workout snack or next-day lunch.

Enjoy!

Lisa

Resources:

Agriculture and Argi-Food Canada Website. Whole Grain Claims in the Marketplace. Available from: http://www4.agr.gc.ca/AAFC-AAC/display-afficher.do?id=1329944262611&lang=eng [September 20, 2012]

Globe & Mail Website. Why whole grain health claims aren’t always what they seem. Available from: http://www.theglobeandmail.com/life/health-and-fitness/health/why-whole-grain-health-claims-arent-always-what-they-seem/article4461182/ [September 20, 2012].

                                                                  

My Best Frienemy: Carbs!

Carbohydrates have always been there for me, through Sunday morning long-runs to Friday night comfort foods. But my frienemy has many personalities, many of which may not be helping me to achieve my fitness and optimal health goals.

As I mentioned, I have the genotype variant of the TCF7L2 gene that puts me at higher risk of type 2 diabetes if I eat a high glycemic diet, such as having refined grains instead of whole grains. Additionally, a high refined carbohydrate diet is not waistline friendly.

However, this does not mean that I have to eliminate carbohydrates or follow a strict paleo diet. It does mean that I have to eat the right TYPE and AMOUNT of carbohydrates – those that are complex and high in fibre (my true bestie).

So, here is how I make peace with my frienemy:

1. Limit simple carbohydrates. Sugar (natural and added) and refined grains cause a fast rise in blood sugar levels, which is generally not ideal, and for those with the risk variant, may increase their risk of type 2 diabetes. I get most of my simple carbohydrates from berries (on my mooring oats and sometime on Greek yogurt for an afternoon snack), bananas (1/2 banana in my post-work or run shake) and the odd sports drink during long-runs in the heat.

2. Portion grains and starchy vegetables and balance with non-starchy vegetables and protein. Grains, such as quinoa, oats, and barley, are packed with fibre and nutrients, and sweet potatoes and squash are a great source of beta-carotene and potassium. The carbohydrates that these foods supply are also important for refuelling my body for future runs, as well as add balance and variety to strict meat and veg meals. Half-cup serving per meal and at 1-2 snacks works well for me.

3. Load up on fibre-rich carbohydrates. Legumes and non-starchy carbohydrates make my body happy for numerous reasons and make up the majority of carbohydrate containing foods that I eat. Also, the fibre in these foods (particularly the soluble fibre) help to slow down absorption of food, lowering the glycemic impact of a meal. Adding chickpeas to the Shredded Kale, Beet & Apple recipe (below) increases the protein and fibre content and moderates the blood glucose impact of the sugars naturally occurring in beets and apples.

 

Shredded Kale, Beet & Apple Salad

Makes 8 servings

 

 

 

Ingredients:

 

Salad:

  • 2 cups finely chopped kale
  • 4 beets, scrubbed and shredded
  • 2 apples, shredded (keep the skin on for more nutrients and fibre)
  • 2 cups cooked, drained and cooled chickpeas (or BPA-free canned)
  • 1/2 cup finely sliced green onions
  • 2 tbsp lemon zest

Dressing:

  • 2 lemons, juices
  • 1/3 cup olive oil (or use pumpkin seed oil if you have it)
  • 1/4 tsp nutmeg
  • Fresh ground pepper and salt to taste

Directions:

Mix all salad ingredients together in a large bowl. Whisk together all dressing ingredients. Pour dressing over salad and toss to coat. Let marinate 1-2 hours in fridge, mixing a few times, before serving.