Optimum Nutrition - Winter 2021 - PREVIEW

IN THIS ISSUE
08
COULD RETHINKING SUGAR STEM AN UNSEEN EPIDEMIC?
Alice Ball finds out why some experts believe an unseen epidemic of insulin resistance is driving obesity and disease. On p13,
Catherine Morgan reflects on early morning blood sugar spikes from an ‘iced latte’ habit
14 SEVEN DAY MENU
17 INTERVIEW
20
Start the year with an energy supporting
7-day meal plan from registered
nutritional therapist Catherine Jeans
22
FEATURE
Dr Megan Rossi answers questions on
gut health and shares recipes from her
new book Eat More, Live Well
30
ON YOUR PLATE
Three warming “wok to wonderful”
recipes from The Noodle Cookbook by
Damien Lee
38
KITCHEN CHEMISTRY
Elettra Scrivo looks at why cooking
methods and food pairings can affect
how food impacts our blood sugars
Food historian Dr Annie Gray talks to
Alice Ball about the highs and lows of
British food through time
ALL ABOUT
Travelling or changing shifts, our body
clock bears the brunt. Louise Wates
looks at whether nutrition can help
STORECUPBOARD HERO
Nutritious and versatile, chickpeas
are a handy staple — and not just for
hummus. Judith Orrick writes
44 FOOD FACT FILE
MOVE IT
50
White, milk, dark or raw? Alice Ball
weighs up the potential benefits of
chocolate for our health
24
33
39
IN SEASON
Try a leek & pumpkin rosti recipe and
discover why leeks can be a nutritious
addition to everyday cooking
48
If low mobility gets in the way of
exercise, there can be other ways to get
fi t . Alice Ball writes
FEATURE
04 COMMENT & NEWS | 26 KIDS’ PAGES | 34 FROM ION | 40 BOOK THERAPY | 47 QUIZ
Quitting sugar isn’t easy with a sweet
tooth. Alice Ball finds sustainable ways
to retrain our taste buds
28
LITTLE LIVES
If your child doesn’t eat meat, can
traditional diets offer inspiration beyond
readymade veggie bangers and burgers?
36
DIFFERENT STROKES
Best selling author CJ Daugherty tells
Louise Wates how writing helped her
deal with stress and anxiety
42
WORLD CUISINE
Whether served on a banana leaf
or plate, an Indian thali offers taste
sensations, from sweet to sour
GRADUATE STORY
Why, after gaining a PhD in public
health, Dr Kirstie Lawton decided to
study nutritional therapy at ION
OPTIMUM NUTRITION | WINTER 2021/22
3

Feature
IS INSULIN RESISTANCE
THE HIDDEN EPIDEMIC
DRIVING MODERN DAY
DISEASE?
Image: Lightwise © 123rf.com
Could focusing on how food affects our blood sugars — even when we aren't diabetic — be key
to beating chronic disease as well as obesity? Alice Ball writes
“
I
nsulin resistance is the epidemic
you’ve never heard of,” writes
scientist and researcher
Benjamin Bikman, PhD, in his 2021
book Why We Get Sick. And he could be
right; because with another New Year
behind us, how many of us — without
understanding the role that insulin plays
in obesity — will once again succumb to
the prevailing narrative that if we just eat
less and move more, the post-Christmas
weight gain will take care of itself?
8 OPTIMUM NUTRITION | WINTER 2021/22

Feature
IN BRIEF
• Research suggests insulin
resistance rather than overeating is
the primary cause of obesity.
• Insulin resistance can also be
driven by stress and poor sleep.
• Insulin resistance drives chronic
diseases including heart disease,
dementia and type 2 diabetes.
• A low carb diet can support insulin
sensitivity and reverse type 2
diabetes in some instances.
• Glucose tolerance (i.e. the amount
of carbohydrate your body can
handle) varies between individuals.
Growing evidence suggests that our
bodies do not act like bank accounts
for calories. One recent paper,
published in the American Journal of
Clinical Nutrition, suggests that insulin
resistance, rather than overeating, is
the primary cause of obesity. It also
lays the blame for obesity on excessive
consumption of foods with a high
glycaemic load (GL); in other words,
rapidly digestible carbohydrates. These
foods, the researchers propose, cause
changes to the hormone insulin, which
changes metabolism, and drives fat
storage, weight gain and obesity. 1
So this January, rather than focusing
on how much we’re eating, could
focusing on what we’re eating and how
it affects our insulin be the key to losing
weight?
Lock and key
Insulin is a vital hormone, with the
essential job of getting rid of sugar in
our bloodstream after we eat. Think of
it like a lock and key mechanism. Sugar
(glucose) in the blood is trying to get
through the door of the cell. But to get
inside, it must have a key to open that
door. Insulin is that key.
But what happens if you have too
much sugar in your bloodstream? Then,
the doors of the cell become resistant
to the insulin — think of the keyhole
getting rusty through over-use. This
means that the pancreas has to pump
out more insulin to try to get the cells to
unlock, thus elevating levels of insulin.
Excess sugar can also get pushed
into belly fat and the liver. The latter
is what’s known as non-alcoholic fatty
liver disease (NAFLD); a condition
that affects around a quarter of
the developed world. NAFLD also
interferes with the action of insulin
itself, which means the pancreas has to
produce even more insulin to get rid of
all the sugar from your blood.
Insulin acts as a key for opening cells to store glucose away as energy (left); when cells
become 'insulin resistant', glucose remains in the blood, raising blood sugars (right)
Insulin resistance can be considered
a spectrum as, over time, more and
more cells become resistant to insulin.
Eventually, the pancreas gets worn out
and can no longer produce enough
insulin to overcome the cells’ resistance.
The result is type 2 diabetes.
The driver of disease
Whilst not all of us might be diagnosed
as diabetic, Bikman’s book raises the
question as to whether many of us are
somewhere on this insulin resistant
spectrum, and that this is driving
chronic disease.
“People don’t die from insulin
resistance,” Bikman tells Optimum
Nutrition. “They die from the diseases
that insulin resistance is causing.
Alzheimer’s disease, heart disease; those
are the complications that are arising
from the insulin resistance, which
ultimately prove lethal.”
When it comes to heart health, for
example, Bikman says that insulin
resistance promotes higher blood
pressure. “It does this through several
different mechanisms. One is forcing
the kidneys to hold onto more salt than
normal, which means they’re forced to
hold onto more water as well. And if
they’re holding onto more water, blood
pressure starts to climb.”
Insulin also helps to promote the
dilation of our blood vessels, he adds.
However, when the blood vessels
become insulin resistant, they stay
constricted and can’t move as much
blood as they did before, causing blood
pressure to increase.
“People don’t die from insulin resistance…They die from the diseases
that insulin resistance is causing…"
Image: Elyomys © 123rf.com
Image: Simpson33 © 123rf.com
OPTIMUM NUTRITION | WINTER 2021/22
9

Interview
HISTORIAN ANNIE GRAY
DELIVERS A LESSON ON
BRITISH FOOD
Food historian and Radio 4 regular Dr Annie Gray talks to Alice Ball about why the current
adage to ‘eat what your great grandmother ate’ for healthier nutrition may, in fact, be misguided
Y
ou may have heard experts
say: ‘Don’t eat anything your
great-grandmother wouldn’t
recognise as food’, but Dr Annie Gray
(PhD) isn’t so convinced. According
to the food historian, eat how your
ancestors ate and you could end up
with gout — an arthritic condition
considered something of a “disease de
jour” in the 18th century.
“People romanticise the past,” she
says over a video call. “They think we
all lived in harmony with everything,
but they forget that the diet of the poor
was awful — and in many ways, the diet
of the rich was too.”
The 19th century is another case
in point. “You’ve got the poor reliant
upon bread,” she says. “That in itself
isn’t that bad — a good loaf of bread is
pretty good for you — but the trouble
is the bread wasn’t good quality. It was
always made from white flour, which
has got the wheat germ taken out, and
then if you’re dirt poor you’re probably
putting sweetened condensed milk on it
which is largely just sugar.”
Malnutrition also takes many forms,
she says. “You can be malnourished
in the 19th century and it will show
OPTIMUM NUTRITION | WINTER 2021/22
17

Interview
Image: Rrraven © 123rf.com
because you’re incredibly thin and
you’re not getting the nutrients you
need, or you can be malnourished
in the 21st century and be grossly
overweight. Those two are just two sides
of the same coin.”
Gray, a broadcaster, writer and cook,
has specialised in the history of food
and dining in Britain for more than a
decade, focusing on the 17th century
onwards. You name it, she’s eaten it;
from kangaroo brain cakes (“tasted
a bit like spam, to be honest”) to an
“epic” boar’s head during a Tudor
feast. Since 2012, she’s been a regular
panellist on BBC Radio 4’s The Kitchen
Cabinet, and her latest book of the same
name (fully titled The Kitchen Cabinet:
A Year of Recipes, Flavours, Facts, &
Stories for Food Lovers), which delves
into Britain’s culinary past and present,
was published in September 2021.
So she is perhaps well qualified to
declare that insults thrown at British
cuisine (or, perhaps, Britain’s lack of
cuisine) are “total baloney”.
“Britain has a really good food
heritage both in terms of British dishes
— roast meat, fish and chips, and pork
pie — and our own food culture going
backwards,” she says. “Yes, French
cuisine was what ruled the roost in
terms of the aristocracy for much of the
past 500 years, but that was true right
across the world — certainly among
English speaking and European areas.”
She does, however, believe that
British food suffered after the Second
World War — another reason why
modelling your grand- or greatgrandmother’s
diet mightn’t be the best
approach.
“I think a lot of people don’t realise
that during the war, rationing was bad.
But after the war it became worse,” she
says. “And when you think about kids
growing up, you’re eight when the war
breaks up, but you’re probably married
“I think a lot of people don’t
realise that during the war,
rationing was bad...but after
the war, it became worse...”
“We’ve both reduced the number of things we eat, but also in
some ways we’ve got too much variety in others. You can get 20
different varieties of pasta or five different types of ketchup...”
with kids by the time rationing ends.
That chance to learn, that transition
of knowledge [about good food], isn’t
really there.”
It’s perhaps an ironic statement,
considering that during her own
teenage years, Gray survived on
microwave meals. “My mother really
couldn’t cook and my dad sort of
could, but it was classic 1980’s family
fare,” she says.
This changed when the family moved
to France during her A-levels, and Gray
boarded with a French family. “It’s
a bit of a cliché, but it was this total
epiphany where I suddenly realised that
food could be incredible.
“My mother’s omelettes were always
awful — you could bounce them off
the ceiling. But I had one in France
and was like ‘This isn’t an omelette’,
because it was cooked in so much
butter and unbelievably good.
“I think it was at that point I realised
if you’re going to eat three times a
day, you should make it count.” At the
University of Oxford, where she studied
modern history, she was “the person
who was roasting pheasant and making
[her] own pasta”, despite a lack of
cooking facilities.
Yet after graduating, she still had no
idea what she wanted to do and ended
up “getting sacked from basically every
job”.
“I decided I would go back and do
a masters [in historical archaeology]
because I still loved history,” she says.
“Then I left, got sacked a few more
times and did a PhD. By this time I
knew I wanted to study food and I
knew I wanted to work with museums.
The PhD allowed me to do those
things.”
“Greater choice…all an illusion”
According to Gray, one of the biggest
differences between historic and
modern day diets is the variety of
what we eat. With advances in trade,
technology and travel, it can often
appear like we have greater choice over
our diets. But this, she says, is “all an
illusion”.
“There were 3,000 varieties of apples
in the Victorian era, but today you walk
into the average supermarket and get
five, and they’re all enzyme treated.
“We’ve both reduced the number
of things that we eat, but also in some
ways we’ve got too much variety in
others. You can get 20 different varieties
of pasta or five different types of tomato
ketchup.”
Certain vegetables have also
disappeared from modern day diets
completely; skirret (a root vegetable),
scorzonera (similar to parsnip) and
salsify (a root vegetable with an oysterlike
taste).
Jerusalem artichokes, which are
beneficial for gut health, were also
eaten habitually, and when it came to
meat, every part of the animal would be
eaten.
Yet meat was “very much for the
rich”. Historical cookbooks tend to
draw attention to meat consumption,
but this is only because the “food that
gets the publicity is the stuff the rich
ate”, she says.
“We get this skewed idea that
everybody ate loads of meat, very
plainly done with some vegetables on
Image: Torky © 123rf.com
18 OPTIMUM NUTRITION | WINTER 2021/22

World Cuisine
cooking techniques and spices that also
set them apart. For example, cooking
with fennel and black pepper in Tamil
cooking dates back centuries as both are
locally grown.
“When we think of Andhra Pradesh,
the misconception of the local food
being searingly hot couldn’t be [further]
from the truth. My favourites are the
Andhra lamb chops curry with tamarind
and ginger, from the lamb chapter in
Thali, and also an Andhra thali which
gives an insight into how the food from
this region is diverse, full of flavour and
simple to cook.”
KERALA FISH MOILEE (CLASSIC COCONUT FISH CURRY)
Maunika says:
“A classic fish curry with chilli, pepper,
curry leaves and turmeric simmered
in coconut milk, this southern Indian
fish curry is a staple in every household
because it is so simple to cook. I like to
serve it with rice and cucumber salad.
Ask your fishmonger to cut the fish into
steaks, as they will do it expertly and
ensure that the steaks still hold together
with the help of a central bone.”
Ingredients
• 1 tsp ground turmeric
• Pinch of salt
• Juice of ½ lime
• 600g cod, monkfish or sea bass, cut
into 3.5cm steaks
• 60g white onion, roughly chopped
• 4 cm ginger root, roughly chopped
• 4 garlic cloves, roughly chopped
• 2 tbsp oil
• 1 tsp black mustard seeds
• 5 green cardamom pods, whole
• 2 green chillies, slit lengthways
• 5–7 curry leaves
• 100ml water
• ½ tsp sugar
• Salt, to taste
• 400ml coconut milk
• 1 heaped tsp tamarind paste
• ½ tsp freshly ground black pepper
• Coriander
For the garnish
• 2 tbsp chopped coriander leaves
Method
Mix ½ tsp of the ground turmeric,
with the salt and lime juice, rub into
the fish steaks, then set aside. Add the
onion, ginger and garlic to a blender
and blend to a smooth fine paste with
a splash of water. Set aside.
Heat the oil in a heavy-based, nonstick
saucepan over a medium heat.
Add the mustard seeds and as they
begin to sputter, work quickly to add
the cardamom pods, green chillies
and curry leaves. Add the onion,
ginger and garlic paste and fry for 1–2
mins, then add the remaining ground
turmeric, along with the water, sugar
and salt. Mix well, then simmer for 1
min.
Reduce the heat to low, then add
the fish steaks and let them cook for
a further minute. Add the coconut
milk, cover and simmer gently for
4–5 mins until the fish is moist and
cooked through. Give the pan a gentle
swirl a couple of times to make sure
everything is mixed but the fish pieces
don’t break up.
Add the tamarind, black pepper
and fresh coriander and stir well,
simmering for 1 min. Serve with plain
basmati rice and a cucumber salad.
Optimum Nutrition tip:
Try using ghee or coconut oil instead
of vegetable oil, and swap white rice
for wholegrain or cauliflower rice.
How important is nutrition when
serving a thali?
“A lot of what gets served over a thali
includes pulses, grains, dairy and even
fresh fruit — ingredients that are high
in protein, carbohydrates and rich in
vitamins…
“Thalis are a complete meal
experience and brimming with
vegetables, lentils, wholemeal breads and
aromatic curries that bring warmth and
flavour to our meals.”
Recipe reproduced with
kind permission.
Extracted from Thali by
Maunika Gowardhan,
Hardie Grant Books.
OPTIMUM NUTRITION | WINTER 2021/22
43

Food for thought:
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