"I don't think of it as being on a diet," Ms. Goddard said. "I just look at the food I eat and what the GI effect will be."

Being a resident of Sydney, Australia, that is quite easy because Australia has become the first country in the world to routinely label food products based on their glycemic index.The glycemic index is a measure of the speed at which food is digested and converted into glucose, the body's source of energy.

Now when she is shopping, Ms. Goddard simply reaches for the foods labelled "low GI" and avoids those that are high GI.

As a result, she has cut down on white breads and replaced them with whole grains. And she is eating more pasta and rice than she ever has, foods that in many diets are shunned because of their high carbohydrate content.

At a time when cereal and pasta makers are reeling from the impact of carb-shunning diets, and consumers are more confused than ever, Jennie Brand-Miller, a professor of human nutrition at the University of Sydney, believes that labelling foods based on GI content is the perfect compromise.

"Low GI foods are the happy medium. They meet everybody's desire to lower insulin levels — and that's one of the main reasons the low-carb diets are promoted — but you can still eat healthy carbs," Dr. Brand-Miller said.

"You can have your cake and eat it too if you use low-GI carbs."

GI labelling began in the summer of 2002, and over the past 18 months, as an ever-growing number of products have begun to carry the circled G symbol, it has become familiar to Australian shoppers. The approach is also actively promoted by Diabetes Australia, which embraced the GI concept after studies showed a low-GI diet worked as effectively as drugs in controlling blood glucose levels.

"The goal of the program is to get people to make healthy food choices and, ultimately, to create a healthier food supply," said Alan Barclay, manager of research and development at Diabetes Australia.

It is also a key component of an aggressive program to tackle the obesity epidemic, one that has been bolstered by the fact that companies who jumped on the GI bandwagon early are being rewarded with sharply increased sales of low-GI products.

Mr. Barclay estimated that Canada is five to 10 years behind Australia in terms of consumer awareness of healthy food choices and thinks labelling for GI would be a big step forward.

While the GI concept was developed in Canada, there are no plans to do labelling for it here. However, the concept is now entering the mainstream.

For example, popular cookbook author Anne Lindsay, in her new book Light Cooking, includes the glycemic index for each recipe that contains more than 10 grams of carbohydrates.

Tom Wolever, a professor of nutritional sciences at the University of Toronto and one of the pioneers of the glycemic index, said one of the problems is that there is not yet an international standard for measuring GI, and that means there are confusing variations in the way products are listed from country to country.

"We have to get it right because if we're going to move forward we need to have something of value which is reproducible and can be relied on to be right," he said.

But Dr. Wolever said the current anti-carb craze is going to speed up this process, as food manufacturers try to show their products are loaded with good carbs, not bad carbs.

"Carbohydrates are here to stay, and glycemic responses are here to stay," he said. "The low-carb approach may not go away very quickly, but it's going to force people who produce carbohydrate foods to start trying to figure out how they can sell their products and show them in a good light. . . . GI is a way to get some ammo on their side."

With reports from Avis Favaro, medical reporter at CTV News, and Jenny Wells, a CTV producer

Last in a series.

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Are all carbs bad for you? (globeandmail.com, March 2, 2004)

ANDRÉ PICARD
PUBLIC HEALTH REPORTER

With three young children, his spouse working full-time, and shift work to juggle, Mark Stewart has a busy life. So there is little hesitation when it's his turn to prepare dinner: He gets the water boiling, cuts the vegetables for the sauce, and has a big batch of spaghetti on the table in no time.

"Pasta is definitely a staple in our family's diet," he says. "It's an easy meal to make; it's healthy, and we enjoy it a lot."

In this anti-carbohydrate era, when it has become gospel that carbs are the express lane to obesity, these are the words of a heretic: doubly so because he shuns red meat and more than half his diet consists of carbs including pasta, whole-wheat breads and fresh fruits and vegetables.

But Mr. Stewart, a Toronto firefighter, has many things that the Atkinsites, the South Beachers, the Zonies and followers of other trendy diets can only long for: a trim, buff body, boundless energy, good blood pressure and rock-bottom cholesterol.

What he has realized is that carbohydrates are not the monolithic evil they are made out to be: There are good carbs and bad carbs.

The good ones are those that break down slowly in the body and provide a steady source of energy. The bad ones give you a quick rush and leave you feeling hungry again not long after.

What he is doing, almost unwittingly, is choosing food based on its glycemic index, a measure of the speed at which food is digested and converted into glucose, the body's source of energy. It is a Canadian theory that has a devoted and growing following in scientific circles, and that is now entering the mainstream as a counterbalance to carbless mania.

GI has also spawned some of the hottest new entries in the diet book wars, with titles including The New Glucose Revolution, by University of Toronto professor Tom Wolever, and The GI Diet, by Rick Gallop, past president of the Heart and Stroke Foundation. What distinguishes GI from its competitors, however, is that it is more a scientific theory than a weight-loss fad.

"It's not a diet; it's a way of thinking of food," said David Jenkins, a world-renowned nutritional scientist and director of the Risk Factor Modification Centre at St. Michael's Hospital in Toronto.

He published the first research on the glycemic index in 1981, but, in his words, "it sank like a stone." Over the years, however, the evidence slowly accumulated as Dr. Jenkins and others published groundbreaking work on how dietary choices influenced rising rates of obesity, diabetes, heart disease and some forms of cancer.

Today, the GI approach is being hailed as the missing piece of the nutritional puzzle, the underlying explanation for why the high-carb, low-fat and carb-free approaches have all failed.

"This is emerging as one of the most promising, if not the most promising nutritional development ever," said Simin Liu, an assistant professor in the department of epidemiology at the Harvard School of Public Health.

The body converts all carbohydrates -- bread and sugar alike -- into sugar molecules that are burned or stored. The faster carbs are broken down by the digestive system, the quicker blood sugar goes up and the higher the GI of a given food. The GI value of pure glucose is set at 100, and every other food is ranked on a scale of 0 to 100 based on the actual effect on blood glucose levels.

Almonds rate a 0, apple juice 30, spaghetti 38, cheese pizza 60, Coca-Cola 63, a white bagel 72, a baked potato 85, and a fruit roll-up 99.

The blast of sugar that comes from high GI foods makes insulin levels go up and stresses the pancreas, our body's insulin factory. Insulin is a hormone that activates cells to absorb sugar in the form of glucose. This, in turn, leads to insulin resistance, a precursor of diabetes and heart disease.

"At least 25 per cent of the population is insulin-resistant, and half are overweight or obese," Dr. Liu said. "This indicates they can't handle the high glycemic load."

In modern times, we have adopted a diet of soft, chewy, processed foods that go down smoothly. We tend to think of these easily digestible foods as good, but in scientific terms, they are not. The body processes them quickly, demanding massive insulin production and leaving us hungry again only hours later.

Over time, this leads not only to unhealthy weight gain but to pancreatic burnout, a key contributor to many chronic diseases.

The glycemic index is the underlying rationale for limiting carbs in popular diets like Atkins, South Beach, the Zone and Sugar Busters, but Dr. Jenkins believes the idea has been perverted.

"To cut out carbs from the diet, that was sad," he said. "But they are revising their statements so that now they are not carbohydrate-exclusion diets but more selective carbohydrate diets."

In fact, most foods on the banned lists of these popular diets are high-GI foods. Low-GI carbs such as peas, beans and lentils are actually encouraged.

While there are now detailed lists of foods based on their glycemic index, Dr. Jenkins doesn't encourage tedious bean-counting. Common sense, he says, is a fairly good guide, and by that he means eating primarily unprocessed, fresh foods, including whole grains, nuts and lots of fruits and vegetables.

"I encourage people to revisit the foods which, over the last 100 years, we've thrown out of our diets: Try some pumpernickel bread, beans, peas, lentils; try a barley stew, or some oat bran muffins."

Jean Dumenil, a Quebec City cardiologist, tried treating patients with a low-GI diet and was amazed by the results.

Within a week, patients' cholesterol and triglycerides dropped sharply, and blood glucose levels remained steady and low. Even though the patients were allowed to eat as much as they wanted, their caloric intake also fell, even compared to an already healthy diet.

"The patients were eating 25 per cent less calories than they were eating on the American Heart Association diet. We were amazed by this," Dr. Dumenil said.

No one is claiming that GI is the magic formula for turning the obesity epidemic around.

But GI is helping us understand why many weight-control methods have failed. It is also proving a key element in understanding how to regulate blood sugar levels and control appetite.

First in a series.

Tomorrow: How breakfast is making today's kids fat.

Thursday: Labelling foods for the glycemic index.

Glycemic facts

A look at what the glycemic index is and the differences between a high and low glycemic meal.

What is the glycemic index?

The glycemic index is the measure of a food's natural or artificial sugar. Carbohydrate sugar, or glucose, is what our bodies use for energy, and our brains use for fuel.

What is the difference between a high and low glycemic meal?

High glycemic meals overwork the pancreas. The pancreas senses blood sugar and sends insulin to pack it away into muscle and fact cells.

If there is a surge or sugar, there is a surge of insulin. And if there is a surge of insulin, there is a suppression of glucagons. That's the hormone responsible for pulling sugar back out of muscles and fact cells to fuel the brain or give the body energy.

Impaired glucagons results in feelings of hunger. Overeating can result. In addition to weight gain, if repeated high glycemic meals are your habit, the repeated spikes of insulin in your bloodstream can create insulin resistance. That's a precursor to diabetes.

Low glycemic meals provide slowly released sugars into the bloodstream. So instead of spikes of insulin, a steady, moderate balance between insulin and glucagons allows for the steady, moderate metabolism of these sugars both into - and out of - their storage cells.

COMPILED BY JENNY WELLS, CTV NEWS

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Folic acid crucial for mothers, research suggests (globeandmail.com, November 17, 2003)

ANDRÉ PICARD
PUBLIC HEALTH REPORTER

Canadian researchers have made a startling discovery about the benefits of folic acid. The nutrient, which is added to foods to prevent neural-tube defects such as spina bifida, also appears to prevent one of the most common forms of childhood cancer.

In fact, the incidence of neuroblastoma, a cancer of the nervous system, has fallen by more than 60 per cent since Canada's fortification of flour and pasta became mandatory in 1998.

"We're very excited by this finding because it's the first time we've prevented a pediatric cancer with a very simple change to maternal diet," said Gideon Koren, director of the Motherisk program at the Toronto Hospital for Sick Children.

He said it also raises the possibility that neuroblastoma could be treated with folic acid, forcing the cancer to disappear.

The research, published in the medical journal Clinical Pharmacology & Therapeutics, will also spur interest in the benefits of folic acid for prevention and treatment of a wide range of conditions.

There is evidence, for example, that folic acid supplementation may also prevent heart malformations in children, prevent some people from developing colon cancer later in life, and even ensure that baby girls are born with healthier eggs, which could reduce the incidence of conditions such as Down syndrome in the next generation.

"Because it's used in the production of DNA, I would not be surprised if it has other implications, including many we have not even yet considered," Dr. Koren said.

Folate -- vitamin B-9 -- is found in leafy green vegetables such as spinach, and in legumes such as lentils and kidney beans. The synthetic version, folic acid, is found in commercially prepared grain products and can be bought in supplements.

The recommended daily dose is .4 milligrams, though many scientists are now suggesting that be raised to 1 milligram. A woman would have to eat about eight slices of white bread daily to reach that minimum level. Because almost half of all pregnancies are unplanned, supplements are recommended for all women of child-bearing age.

Folate is required for the creation of nucleic acids -- the building blocks of deoxyribonucleic acid (DNA). It is particularly important in the first month after conception, when the neural tube forms in the embryo (the neural tube later becomes the baby's spinal cord, spine and brain.)

Without sufficient folate, the neural tube fails to close properly, leaving the brain or spine exposed to amniotic fluid. This, in turn, can lead to neural-tube defects such as spina bifida (when the spinal cord and backbone do not develop properly), anencephaly (when the brain does not fully develop) and encephalocele (when a portion of the brain protrudes from the skull).

Neuroblastoma is a cancer of the nervous system, so it is biologically plausible that it is influenced by folate levels.

Studies have shown that, since the fortification of flour, pasta and cornmeal became mandatory, women have doubled their intake of folic acid and the rate of neural-tube defects in Canada has fallen by half.

The incidence of neuroblastoma has fallen even more sharply, to 6.2 cases per 1,000 births, from 15.7 cases per 1,000 births.

But Dr. Koren thinks the benefits could be even greater if women consumed more folic acid. His research has shown that the majority of Canadian women do not get adequate folic acid from fortified food alone.

"The typical Canadian woman is getting only 200 to 300 micrograms, well below the protection level," he said. "It is perhaps time to consider raising the levels in flour."

While supplements such as a daily multivitamin would do the trick, polling has shown that only about 4 per cent of women who are planning to have a child know they should be taking folic acid to prevent birth defects.

"The benefits are so great, I'm not sure we should be leaving this to chance," Dr. Koren said.

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October 25th is World Pasta Day

Canadian Pasta an Excellent Source of Folic Acid

October 24, 2002 (Ottawa) - Around the world in five continents, millions of consumers who love pasta are celebrating World Pasta Day. Increasingly it is Canadian pasta made from 100 per cent durum wheat, enriched with folic acid, they are enjoying. Canadians themselves have increased their annual consumption of durum wheat pasta to almost nine kilograms per capita over the past decade, making Canada easily among the top ten pasta-consuming countries.

Canada's pasta success story begins with the dry, hot, sunny, summer growing conditions of the Prairie provinces that are ideal for producing a high protein wheat. The resulting pasta produced by Canadian pasta makers -- Ronzoni Foods Canada Corp., Italpasta Limited, Kraft Canada Inc. and Grisspasta Products Limited. -- is a bright, yellow pasta with a firm bite and minimal stickiness that provides a good source of complex carbohydrates and protein containing essential vitamins and minerals.

"Beyond its natural goodness and high quality, Canadian durum wheat pasta is an excellent source of folic acid, an essential nutrient in preventing stroke, cardio-vascular disease and, most significantly, neural tube defects among pregnant women," said Don Jarvis of the Canadian Pasta Manufacturers Association. "In fact, one small serving of pasta, about half a cup or 85 grams, provides close to the recommended daily intake of folic acid."

Recognizing the role of folic acid in preventing birth defects, such as spina bifida, Health Canada - supported by the Canadian pasta manufacturers - made the enrichment of durum wheat flour and pasta with folic acid mandatory in 1998. Folic acid is a B vitamin essential for the healthy development of the baby's spine, skull and brain during the first month of pregnancy.

Health Canada recommends women who could become pregnant should at least double their normal intake of folic acid (equivalent to two small servings of pasta). A study published in August's Canadian Medical Association Journal shows that the rate of birth defects, such as spina bifida, has been halved since the folic acid fortification policy was introduced in Canada.

For centuries pasta has been at the heart of the Mediterranean Diet along with other food from plant sources including fruits and vegetables, breads, rice, beans and nuts. Research has shown that people in countries that border the Mediterranean Sea exhibit striking low rates of heart disease compared to other parts of the world. In fact, data collected from World Health Organization studies in 1996 to 1998 showed mortality rates from cardio-vascular disease were significantly lower in Mediterranean countries than in northern and eastern European countries.

"Canadian pasta from durum wheat is an ideal food: it is nutritious, convenient, tasty, economical and provides consumers with endless recipe variations like whole wheat rotini with zucchini and tomatoes or fettuccine with asparagus and smoked salmon which are featured recipes on the Canadian Pasta Manufacturers website at www.pastacanada.com," added Jarvis.

The Canadian Pasta Manufacturers Association is best known by brands such as Catelli, Italpasta and Primo. The member companies employ 1,500 people across Canada and combined have $340 million annually in export sales over the last three years.

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Folic acid cuts defects by half, study finds (globeandmail.com, August 6, 2002)

ANDRÉ PICARD
PUBLIC HEALTH REPORTER

A little-known government policy that forced makers of flour and pasta to
fortify the foods with folic acid seems to be paying dramatic public health
dividends.

Research published in today's edition of the Canadian Medical Association
Journal shows that the rate of devastating birth defects such as spina
bifida and anencephaly has been halved in Canada since the policy was
introduced.

One study showed that the incidence of neural tube defects -- which tend to
occur when pregnant women don't get enough folic acid in their diets -- has
fallen to 8.6 cases per 10,000 pregnancies in Ontario, down from 16.2 in
1995.

A second study showed similarly remarkable results in Nova Scotia, where the
rate of neural tube defects has fallen to 11.7 per 10,000 from 25.8 per
10,000 in 1995.

"Our results help to validate the decision to have foods fortified with
folic acid," said Vidia Persad of the department of obstetrics and
gynecology at Dalhousie University in Halifax.

Fortification of flour, pasta and cornmeal became mandatory in Canada in
1998. Public health officials and physicians have also been actively
encouraging all women of childbearing age to take folic acid supplements.

Folate, or vitamin B9, is found in such leafy green vegetables as spinach,
and in legumes such as lentils and kidney beans. The synthetic version,
folic acid, is found in commercially prepared grain products. But it takes
about eight slices of white bread to get the recommended daily allowance of
0.4 milligrams.

The only danger of folic acid fortification is that it may mask vitamin B12
deficiency. Folic acid, in high doses, can also interfere with epilepsy
medication.

The real challenge, however, has been to get women to take folic acid when
they need it most -- in the first month after conception. Between the 17th
and 30th day after conception, the neural tube, which later becomes the
baby's spinal cord, spine and brain, forms in the embryo.

Without sufficient folic acid, the neural tube fails to close properly,
leaving the brain or spine exposed to amniotic fluid.

This, in turn, can lead to such neural tube defects as spina bifida (when
the spinal cord and back bones do not develop properly), anencephaly (when
the brain does not fully develop) and encephalocele (when a portion of the
brain protrudes from the skull).

About 40 per cent of pregnancies are unplanned, so many women are not aware
they are pregnant at the time when they need folic acid. In one of the
studies published today, Enza Gucciardi of the University Health Network in
Toronto, reported there were 3,207 NTDs in Ontario between 1986 and 1999. Of
those, 1,503 were detected in live births, 425 in stillbirths and 1,279 in
therapeutic abortions.

During the study period, the number of NTDs fell by almost half, but the
number of children born with the congenital malformations fell even more
precipitously.

Forty-seven per cent of women who are carrying fetuses with NTDs now have
abortions, up from 25 per cent in 1986. NTDs can be detected in a fetus at
between 16 and 20 weeks.

In a commentary also published in today's edition of the CMA Journal, Rezan
Kadir of the department of obstetrics and gynecology at the Royal Free
Hospital in London, said the new research shows the wisdom of fortifying
foods with folic acid, but stressed that women should also be encouraged by
their physicians and in media campaigns to take supplements, because many
women are not aware of the importance of folic acid.

The new research, while demonstrating tremendous progress, also confirms
that the rate of NTDs is highest in Atlantic Canada, and declines as one
proceeds from east to west. This reflects the lower economic status -- and
the poor diet that can result -- in the east.

Genetic factors also play a role, however. People of Irish and Welsh descent
have a much higher rate of NTDs than do other ethnic groups. The incidence
of NTDs is also high among those of Sikh descent.

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Add folic acid to your anti-heart disease plan (Nutrition Alert, November/December 2001)

If you are more than 35 years old, your doctor probably has recommended a blood cholesterol check. Yet, despite the enormous evidence linking elevated homocysteine levels to heart disease, few doctors have added this test to their list of "essentials." Hundreds of studies show that boosting intake of folic acid, vitamin B6, and/or vitamin B12 improves homocysteine levels and lowers the risk of heart disease.

High levels of homocysteine in the blood increase your risk for heart disease, even in the absence of elevated blood cholesterol levels. Excessive homocysteine, in turn, damages blood vessel walls (called endothelial tissue) by generating free radicals that oxidize these tissues. Folic acid lowers homocysteine levels and, according to researchers at the University of Birmingham in the United Kingdom, might help restore endothelial function.

As part of the study, men were given either 5 mg of folic acid or a placebo for 12 weeks, after which endothelial function was measured. Results showed folic acid lowered homocysteine levels and helped return endothelial function to normal. Researchers at the University of Kuopia in Finland report that as folic acid intake increases, the risk for heart disease decreases.

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Historic Prairie sentries saved from extinction (National Post, November 16, 2001)
Les Perreaux
Excerpts

Old-fashioned wooden grain elevators are avoiding extinction after a successful campaign to sell dozens of the Prairie sentinels.

"This is helping me make a living, but a big factor is saving these buildings. They're an important part of our history," said Merv Andersen, one of the real estate agents involved in the sale of the 100 elevators owned by the Saskatchewan Wheat Pool.

In the past few months, the pool and Re/Max Crown Real Estate in Regina have concluded 46 sales, with deals pending on about 50 additional elevators scattered throughout the province. Another 100 elevators were sold in the past two years and the pool gave a half-dozen elevators to community groups and museums for display and other heritage uses.

Farmers purchased most of the elevators to store grain. Some of the elevators were bought by upstart grain handling companies, including some that will compete directly with the pool.

Since the Second World War, thousands of tiny prairie grain elevators have been demolished in favour of larger ones.

In recent years, the turnover has accelerated with the advance of immense cement grain terminals that can handle several times more grain.

In 1933, about 6,000 elevators dotted the Prairies. Today about 1,000 remain.

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Vitamin C in large doses may hurt more than help - Study on DNA damage (National Post, June 15, 2001)
Margaret Munro
Excerpts

Taking large doses of vitamin C, which has long been touted as a cure for colds and cancer, may do as much harm as good, a study suggests.

People would be well advised to forgo vitamin supplements and stick to diets rich in fruits and vegetables, says Dr. Ian Blair, director of the Center for Cancer Pharmacology at the University of Pennsylvania, who headed the study.

"The logic being used for vitamin C supplements is that fruits, vegetables and so on contain vitamin C. These foods prevent cancer and thus vitamin C prevents cancer," Dr. Blair said.

But foods rich in antioxidants are not only high in vitamin C, they are also lower in saturated fats, higher in fibre and contain minerals, flavanoids, indols and carotenoids. "It is the total diet that is responsible for reduced cancer risk, not just a single antioxidant such as vitamin C," Dr. Blair said, noting that a diet rich in fruits, vegetables and grains has been shown to reduce cancer risk by as much as 30%.

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Women are more sickly yet more durable, study finds (National Post, April 27, 2001)
'The health divide'
Tom Arnold

Canadian women experience more chronic illness, more years of disability and more stress at work and home than men do, according to a new national study.

Despite all this, they still manage to live longer.

Even when women are diagnosed with fatal diseases, the study concludes that they are more resilient and survive longer than men.

"We really don't know why this is, but we did see that when men and women who have the same disease and same profile of risk factors are compared, women tend to survive longer, which suggests a higher biological susceptibility among men," said Kathryn Wilkins, a senior analyst with Statistics Canada, which compiled the study.

The data, published yesterday in Health Reports, a quarterly government publication, provide new evidence of differences between men and women in attitudes and behaviours toward health, as well as in illnesses and mortality.

The report, called The Health Divide -- How the Sexes Differ, points out "striking differences" in the way men and women take care of themselves. It found women are more likely than men to have health concerns on their minds as they select foods. About 80% of women were concerned about maintaining or improving their health by choosing the best groceries -- examining labels for fibre, calcium, iron or other vitamin and mineral content -- compared with 63% of men. Women are also more likely to use vitamins regularly and to be an appropriate weight for their height.

"Who shops and organizes the food? Women generally do," said Dr. Gaylene Pron, a clinical epidemiologist at the University of Toronto. The study found men are more likely than women to engage in vigorous physical activity in their leisure time. Still, the study indicates 42% of men were overweight compared with 24% of women.

As household incomes rise, women tend to be thinner, the study says, while men with higher incomes are heavier. Men tend to drink and smoke more.

Men are far more likely to binge drink, in which they consume at least five alcoholic drinks at one sitting.

The study says women have higher levels of stress at home and at the office, which is more likely to bring on chronic diseases such as arthritis, ulcers, asthma and chronic emphysema.

Although life expectancy of women has surpassed that of men throughout the 20th century, the gap began to narrow in the 1990s. This change is associated with the declining death rate of smoking-related respiratory cancers for men while the rate for women continues to rise. Men have a higher risk than women of death before age 75 for most causes, including cancer, stroke, heart disease and motor vehicle accidents.

"Men are a lot more nervous about their health and they would rather ignore problems," added Dr. Pron. "They are very apprehensive about going to a doctor or hospital. They only go if they absolutely have to. Women go a lot earlier."

The data was acquired from Canada's National Population Health Survey, which conducted in-depth interviews with 17,626 Canadians on a range of topics in 1998/99. It was compiled by Statistics Canada and the Canadian Institute for Health Information.

Reasons for these differences remain a matter of speculation. The report suggests women's greater likelihood of being sick may be due to environment influences, such as closer exposure to children.

The socialization of males and females may also account for the difference. It also notes women take more interest in measures to prevent illness and to promote health in general. Genetic or physiological differences may also account for women's greater longevity.

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Better diets helping to cut cancer rate (Globe and Mail, April 19, 2001)
André Picard Public Health Reporter
Sources: Canadian Cancer Society, Health Canada

The death rate from colorectal cancer has fallen by 50 per cent among women and 25 per cent among men since 1972, according to newly released data.

The incidence rate is also declining steadily, and the credit for these improvements goes principally to better dietary habits, particularly among women, the Canadian Cancer Society says in its annual statistical highlights.

"Our sense is that women have been more likely to adopt healthier lifestyles to reduce their risk," said John McLaughlin, a professor of epidemiology at the Samuel Lunenfeld Institute in Toronto.

"Adopting a diet lower in fat and higher in vegetables, fruit and whole grains, and doing regular exercise are believed to reduce the risk of colorectal cancer."

The fact that more people are being tested for colorectal cancer has also made a difference because, detected early, the disease can be treated. Diagnostic procedures mean that polyps or lesions can be removed before the cancer has a chance to spread.

"For colorectal cancer, the difference between an early and late diagnosis can mean the difference between life and death," said Barb Whiley, director of cancer-control policy at the CCS.

She said that while it is good news that mortality and incidence rates are falling, the decline could be greater if Canadians ate better, and that treatment could improve if people were less squeamish about talking to their physicians about colorectal cancer.

"The early symptoms include changes in bowel habits, bloating, abdominal pain and, later, rectal bleeding, and unfortunately, these are things many people are not comfortable talking about," Dr. Whiley said.

She said that while statistics tell us that a person's individual risk of getting colorectal cancer is falling, the actual number of Canadians with the disease is on the rise because the population is aging. That, in turn, means more pressure on the health-care system.

Approximately 370 people are diagnosed with cancer every day in Canada, and about 180 die. About 47 of the diagnoses and 18 of the deaths every day are from colorectal cancer.

Colorectal cancer ranks as the second most frequent cause of cancer deaths among Canadians. Only lung cancer is more deadly.

The CCS recommends that people over 50 talk to their physicians about screening tests, and that those with family histories of the disease (about 20 per cent of cases) be tested earlier.

But there is growing evidence that population-based screening for colorectal cancer could reduce the mortality rate by a further 30 to 50 per cent.

Two groups of experts are currently examining the question, and are expected to make a recommendation soon on whether widespread screening should be conducted for colorectal cancer the way it is for breast cancer.

"It's a very timely question and we are anxiously awaiting the reports," Dr. Whiley said.

Screening is usually a two-step process. A stool sample is submitted annually for fecal occult blood screening. The test, which can be done at home and submitted to a lab, can detect hidden or "occult" blood in a stool that could be evidence of a polyp or tumour.

Those who have a positive test then undergo a barium enema, in which the colon is coated with barium, which allows polyps to be detected with an X-ray, or a full colonoscopy, in which a flexible scope is inserted into the colon, allowing a full visual inspection.

Critics say population-based screening is costly and inefficient. A Canada-wide screening program would cost about $100-million.

It is estimated that 134,100 Canadians will be diagnosed with some form of cancer in 2001, and 65,300 will die of cancer. Only heart disease kills more. (Related Web site: http://www.cancer.ca/stats)

Statistical highlights An estimated 134,100 new cases of cancer and 65,300 deaths from cancer will occur in Canada this year.

Cancer costs the Canadian economy about $14.5-billion annually.

The most frequently diagnosed cancers will continue to be breast cancer and prostate cancer.

19,500 women will be diagnosed as having breast cancer and about 5,500 will die from the disease.

17,800 men will be diagnosed as having prostate cancer and about 4,300 will die.

Lung cancer remains the leading cause of cancer death for both men and women. One-third of cancer deaths in men and one-quarter in women are because of lung cancer.

Lung-cancer incidence and mortality rates among women are half as high as rates among men. However, they are four times as high as rates in 1971.

Cancer is the leading cause of premature death in Canada, being responsible for almost one-third of all potential years of life lost.

It is estimated that the number of new cancer cases will increase by 70 per cent by the year 2015.

The vast majority of cancer diagnoses and deaths occur in people over 50.

Cancer mortality rates for men have been declining slowly since 1988. For women, cancer mortality rates have been declining steadily since the early 1970s -- with the exception of lung cancer.

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Professor finds the best way to eat pasta (National Post, April 16, 2001)
Michael Higgins, with files from The Daily Telegraph

A university professor has discovered the secret of eating spaghetti gracefully without splashing yourself and other diners: Use a spoon.

Professor Colin Humphreys, who conducted laboratory experiments during his lunch breaks, said the spoon can be used to collect the pasta, shield the sauce from splashing, and also be the tool that conveys the spaghetti to the mouth.

Mr. Humphreys, a professor of material science at the University of Cambridge in England, claims the safest way to eat spaghetti is to first use a vertically held fork to collect a few strands.

Then rotate the spaghetti against the concave surface of the spoon while the spoon is parallel to the plate. Finally, when the spaghetti roll is suitable, remove the fork and eat the pasta off the spoon.

He made his discovery after carrying out experiments in his departmental tearoom and laboratories to calculate the "kinetic energy, centrifugal force and co-efficient of friction" for different kinds of pasta.

The scientist and his team, which specializes in semiconductors and electron microscopy, were commissioned by Tesco, a British supermarket chain, to research the tidiest and most efficient way of eating pasta.

They also studied pasta sauce patterns on white tablecloths to establish the average distribution of escaped sauce and immediately reached their first conclusion: A pasta sauce's viscosity influences the distribution of splatter.

Thick Italian cheese sauces and cream-based sauces have higher levels of viscosity than lighter tomato-based sauces, which means they stick firmly to the pasta and are less likely to spray the surroundings.

Mario Phan, manager of Ciao Bella restaurant in downtown Vancouver, disagrees with the learned professor.

"The fork should be at an angle of 90 degrees when it is put in the mouth," he said. "I never use a spoon to eat it. I wouldn't enjoy it."

As to the question of splashing he added: "If you are wearing white, use the spoon and a fork. But if you are just using a fork, then be prepared to get splashed."

Jenny Marino, chef of Jenny's restaurant in Calgary and originally from southern Italy, also disagrees with Mr. Humphreys, saying the fork should be used to eat the spaghetti.

But she did agree on the amount of spaghetti to put on the fork.

"You only put two, or three or four pieces of spaghetti on the fork." She also warned: "You are going to get dirty if you don't know what you are doing."

Philip Oliver, manager of Bellini's Ristorante, in Toronto, was firm: "It should be eaten off the fork, which is how most Italians eat it." However, Mr. Oliver already knew what Mr. Humphreys had found out by detailed research.

"If you have a liquidy, tomato sauce and eat it with a spoon then it does retain some of the sauce but if the sauce is thicker than it stays on the spaghetti and is easier to eat on the fork."

Mr. Humphreys said a common mistake was to hold the spoon vertical, which failed to use its dish-like qualities to shield diners when the last bit of pasta was being rotated.

The laboratory experiments proved that the risk of sauce splatter is highest as the last 4.3 inches of spaghetti are rolled on to the fork: A final flick of the wrist can accelerate the speed of the spaghetti tip to almost three metres per second, producing enough centrifugal force to make the sauce fly 1.3 metres.

THREE TECHNIQUES:

1. THE TIDY ROLL
Twirl a few strands slowly, holding the fork vertically and using the spoon as a splatter shield.

2. THE TRADITIONAL
Purists frown on using a spoon and insist a few strands should be slowly rolled with the fork held horizontally.

3. THE SPIN AND SPLATTER
Maximum splatter occurs when you twirl quickly with the fork held horizontally against the spoon. A deft flick of the wrist as the final few centimetres of spaghetti are taken up can propel sauce as far as 1.3 metres.

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Regular Physical Activity Reduces Cancer Risk (Cancer Care Ontario, February 2001)

Evidence linking regular physical activity with a reduced risk of colon and breast cancer is strong enough to warrant making physical activity an integral part of cancer prevention strategies, according to a report published in the journal Chronic Diseases In Canada. “We now have the consensus of scientific experts that physical activity should be a key component of cancer prevention,” said Dr. Loraine Marrett, one of the report’s authors and a senior epidemiologist at Cancer Care Ontario.

The report, prepared for Cancer Care Ontario’s Division of Preventive Oncology, is based on an evaluation of existing scientific evidence as well as the recommendations of an expert panel.

Dr. Christine Friedenreich, a research scientist at the Alberta Cancer Board and a recognized expert on the links between physical activity and cancer, evaluated existing scientific evidence using criteria developed by the World Cancer Research Fund/American Institute for Cancer Research on nutrition and cancer prevention.

The evaluation assessed the frequency, intensity and duration of physical activity associated with cancer risk reduction as well as physical activity intervention research.

Evidence was ranked in the following categories:

convincing - evidence that is conclusive;
probable - evidence that is strong enough to conclude that a causal relation is likely;
possible - evidence that demonstrates that a causal relation may exist; and
insufficient - evidence that suggests a relationship but is not of a sufficient quantity

The expert panel, made up of 11 Canadian, American and European scientists with expertise in the areas of epidemiology, physical education and health, exercise science and behavioural science, reviewed Dr. Friedenreich’s evaluation and concluded that existing scientific evidence is convincing for the role of physical activity in preventing colon cancer; probable for breast cancer; possible for prostate cancer and insufficient for other types of cancer.

The expert panel recommended that:

physical activity be promoted in public health messages and primary prevention interventions for cancer. Specifically, it is recommended that people get 30-45 minutes of moderate to vigorous activity on most days of the week;

in future research, physical activity be comprehensively assessed, including measurements of the multiple dimensions and types of physical activity; biologic mechanisms; and behavioural and population factors;

Cancer Care Ontario incorporate physical activity messages in its primary prevention programming around nutrition and healthy body weight. Cancer Care Ontario's Prevention Unit is currently developing provincial cancer prevention strategies focused on diet, healthy body weight, and physical activity. Strategies will be developed in partnership with the Canadian Cancer Society and other voluntary agencies, public health units, community health centres and other partners. The programs will provide practical guidelines for people who want to reduce their risk of cancer through diet and exercise.

“This review contributes to our understanding of the causes of cancer,” said Mr. John Garcia, Director of Cancer Care Ontario’s Prevention Unit. “The evidence presented in the report clearly points to the need for greater investment in primary prevention including strategies to increase physical activity and the consumption of fruits and vegetables, maintain health body weight and reduce tobacco use.”

Increased physical activity also can help prevent other chronic diseases and supports Cancer Care Ontario’s collaborative work with other organizations to reduce the incidence of heart disease, stroke, diabetes, cancer and other chronic diseases.

Cancer is one of Ontario’s most important health problems. More than 50,000 Ontarians are diagnosed with cancer each year and more than 25,000 people die from the disease. Cancer prevention is one of the best opportunities to reduce cancer deaths because the majority of cancer is preventable.

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USDA Diet Analysis Supports Grain-Based Foods (World-Grain.com, January 2001)
Washington, D.C., U.S.

A resounding vote of confidence was delivered to the grain-based foods industry in a U.S. government research analysis that raises serious questions about the effectiveness of high-protein diets.

The disclosures, and additional information strongly affirming the value of high-carbohydrate diets, were part of a U.S. Department of Agriculture white paper examining existing scientific literature on weight reduction.

Reacting to the report, Judi Adams, president of the U.S. Wheat Foods Council, said the group agreed with USDA's findings that a "moderate-fat, high-carbohydrate regimen" was the key to weight control. She added that the nutrition community needed to proactively combat the multibillion-dollar fad-diet industry that played off consumers' desire to lose weight.

"Good health and weight management come from following an exercise program and a well-balanced eating plan, which includes the consumption of grains," Adams said. "Grains play a key role in delivering essential nutrients and represent the base of the USDA's Food Guide Pyramid."

The Wheat Foods Council is a nonprofit organization formed in 1972 to help increase public awareness of grains, complex carbohydrates and fiber as essential components of a healthful diet. The Council is supported voluntarily by wheat producers, millers, bakers and related industries.

Other leaders in the grain-based foods industry also were elated with the USDA report. Paul C. Abenante, president of the American Bakers Association, said the findings confirmed the industry's position on the healthiness of its products.

"It finally takes a scientific, nutrition-based shot at the Atkins and like high-protein diets and pigeonholes them to what they are, a fad approach to nutrition," Abenante said.

At the heart of the USDA findings was the simple observation that "diets that reduce caloric intake result in weight loss." Noting that obesity remains a significant problem in the United States, the summary said, "It is important to note that weight loss is not the same as weight maintenance."

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More Than a Grain of Truth (National Institute of Nutrition, No. 2, 1999)

Deep down, you probably know that grains are “good for you.” But if you’re like most Canadians, you don’t give them much thought. You could be missing out on some great opportunities!

No doubt you’re aware of the virtues of the carbohydrate and fibre in grain products. The unsung hero is starch, particularly “resistant starch,” so-called because it resists digestion until reaching the colon.

Grain products also provide important amounts of protein, B vitamins and minerals. In fact, with meat intake declining, enriched grain products are becoming a greater source of iron. As a bonus for women, many grain products are now also fortified with the B vitamin folic acid, recommended before and during early pregnancy to reduce the risk of certain birth defects.

The Great Regulators

With their action on blood sugar, intestinal function, blood cholesterol and appetite, grain products can be thought of as the “great regulators.”

Blood sugar — Some foods cause only a small rise in blood sugar after eating them. These generally include minimally refined whole grain products, and pasta with its slowly digestible starch. Eating such foods may improve blood sugar control and reduce the body’s need for insulin, a plus for people with diabetes as well as those at risk of developing the disease.

Intestinal function — Some grain products help to prevent constipation and may reduce the risk of colon cancer. The types with mainly insoluble fibre (e.g. wheat bran, rye, corn bran) tend to pass through the colon undigested, with a bulking effect that aids bowel regularity. The types with soluble fibre (e.g. oats, barley) and resistant starch serve as food for bacteria in the colon, producing protective substances as well as aiding bowel regularity.

Blood cholesterol —Foods high in soluble fibre, such as oats and barley, can lower blood cholesterol levels, particularly in people with high levels. Lower levels may help reduce the risk of heart disease.

Appetite — People who eat high carbohydrate, high fibre diets (which likely include many grain products) tend to eat fewer calories and have lower body weights. Such diets provide more bulk so it’s possible to feel full for a longer time on fewer calories.

The Best Grain Choices

Canadians still eat about the same amount of grain products as 30 years ago — but not always up to the 5 to 12 daily servings advised by Canada’s food guide. We’ve made some changes in our choices, though, which are worth sticking with:

Focus on breakfast cereals that are high in fibre and made with whole grains such as whole wheat, oats or barley. Try them as a snack.

Experiment with the many varieties of pasta and rice available on the market, especially whole grain types.

Make whole grain bread your number one choice. Bread is not fattening — just be careful what you spread on top.

Look for lower fat choices when selecting baked goods. But watch the portion size — calories still count.

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Report on the Role of Grains in Canadian Diet Sends a Wake Up Call (NIN, Ottawa, July 1999)

Grain products get an “A+” for their healthful qualities in a report released by the National Institute of Nutrition (NIN), Canada’s premier source of objective, credible nutrition information. However, the report confirms that many Canadians need to boost their intake to merit a passing grade.

“Canadians are missing out on some great opportunities to enjoy food while enhancing their health,” affirms the primary author of the report, Alison Stephen, Ph.D., a professor in the College of Pharmacy and Nutrition at the University of Saskatchewan. “The good news is that grain products are something Canadians should eat more of, not less.”

The NIN report reviews the latest research on the role of grains and grain products in health and disease, and compares Canadians’ current eating habits with nutrition recommendations for optimal health.

What’s so Great about Grains?

Aside from their well-known carbohydrate and fibre content, enriched grain products like bread, pasta, rice and breakfast cereals are important sources of protein, B vitamins and minerals. In fact, with meat intake declining, enriched grain products are becoming a more significant source of iron for Canadians.

As a bonus for women, many grain products are now also fortified with the B vitamin folic acid, which is especially important during the child-bearing years to reduce the risk of certain birth defects such as spina bifida.

“But the unsung hero in grain foods is starch, particularly ‘slowly digestible’ and ‘resistant’ starch,” explains Stephen. Many of the healthful qualities of grain products are due to their different kinds of starch.

The Great Regulators

Grain products can be thought of as the “great regulators”, having positive effects on the control of blood sugar, intestinal function, blood cholesterol and appetite.

- Some foods cause only a small rise in blood sugar after eating them. These generally include minimally refined whole grain products, and pasta with its slowly digestible starch. Contrary to the myth that high carbohydrate diets increase insulin resistance, eating such foods may actually improve blood sugar control and reduce the body’s need for insulin. This is a plus for people with diabetes as well as people who are at risk of developing the disease.

- Some grain products help to prevent constipation and may reduce the risk of colon cancer. The types with mainly insoluble fibre (e.g. wheat bran, rye, corn bran) pass through the colon largely undigested, with a bulking effect that aids bowel regularity. The types with soluble fibre (e.g. oats, barley) and resistant starch (which resists digestion until reaching the colon) serve as food for bacteria in the colon, producing substances that may protect against colon cancer, as well as aiding bowel regularity.

- Foods high in soluble fibre, such as oats and barley, can lower blood cholesterol levels, particularly in people with high levels. A high blood cholesterol level is a risk factor for heart disease.

- Despite the fattening image of grain products, people who eat high carbohydrate, high fibre diets actually tend to eat fewer calories and have lower body weights. Such diets provide more bulk, so it’s possible to feel full for a longer time on fewer calories.

Getting the Most out of Grains

“Canadians still eat about the same amount of grain products as 30 years ago — but not always up to the 5 to 12 daily servings advised by Canada’s food guide,” says Stephen.

NIN advises Canadians to:

- Focus on higher fibre and whole grain breakfast cereals made from whole wheat, oats or barley.

- Experiment with the many varieties of rice, such as brown or basmati, and different types of pasta, including whole wheat options.

- Choose whole grain or multi-grain specialty bread most often.

- Enjoy smaller portions of baked goods and treats such as croissants or donuts, and choose lower fat options such as bagels more often.

The report, “The Role of Grains in the Canadian Diet”, was commissioned by NIN and reviewed by members of NIN’s Scientific Advisory Committee as well as other key Canadian experts.

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