Nutrition By Numbers
By Sarah-Jane CollinsMarch 6, 2012
No one was convinced blood sugar levels made a difference to people who weren’t diabetic. Jennie Brand-Miller proved it — while raising two children and struggling with a hearing problem.
Jennie Brand-Miller will turn 60 this year, but the slight, softly spoken professor shows no signs of slowing down. Her corner office in the 1970s concrete box that houses biosciences at the University of Sydney is packed with literature on the Glycemic Index, examples of foods that the university's commercial testing facilities have certified as low-GI, and a collection of particularly sweet and delicate tea cups.
As well as single tea cups in brilliant colours and distinctive styles, there is a full set in a luminous green with what looks like hand-painted floral patterns - six small cups and saucers, and a lovely, slender pot. "I still use them all," Brand-Miller says. "They were my mother's."
Herself a mother of two, Brand-Miller began her career at the University of Sydney in the late 1970s, fresh from completing a PhD at the University of New South Wales on lactose intolerance in indigenous children. She has been at Sydney University for 34 years, and she credits an accident with providing her with her life's research.
"We really pioneered… the Glycemic Index of food. We didn't invent it, the concept was produced first in 1981 by some Canadian researchers, but what we did was really help prove that this concept was useful, clinically useful… and had relevance to the average person on the street," Brand-Miller says.
The Glycemic Index has completely changed the way doctors and nutritionists think about food, with implications for anyone wanting to control or regulate their diet. Until the early 1980s, popular wisdom dictated that sugars created sharp bursts in blood sugar levels, spiking and then bottoming out soon after. Starches such as bread and potatoes were thought to provide long-lasting fuel for the body, with a slow and even release of energy. But we now know foods that may otherwise seem very healthy can produce short, sharp spikes in blood sugar - with a swift crash.
Eating foods with that kind of profile can make you tired, make you eat more, and make you eat more often. This causes problems for people with diabetes, yes, but health problems attributed to a high-GI diet can affect plenty of people without diabetes as well. Three decades ago, this was not a concept that was well understood or even well known in the field of nutrition research. But the work of a young researcher at the University of Sydney moved the Glycemic Index into the public forefront and changed the way we all think of the humble potato.
"That first paper, the 1981 [Canadian] paper, was actually put on my desk by accident - it was meant for someone else and I read it. I thought it was fascinating. It had tested the GI of the first 50 foods and it showed things like potatoes produced higher blood glucose per gram than a Mars bar, or sugary food or ice cream - and that shocked everybody," she says.
Thinking the Canadians might be on to something that could have wide-ranging implications for nutrition and diet, Brand-Miller began testing foods herself.
"The dogma in the medical textbooks at the time was that starchy foods like bread and potatoes were digested and absorbed slowly and sugary foods were digested quickly… The whole basis of diabetic diets was based on this assumption that starchy foods were good for you and sugary foods should be strictly avoided, which made life miserable for a lot of people," she says.
"So we started to test foods here, and we still do it on a commercial basis for the food industry. We've got a metabolic kitchen which right now has about 20 students in it, and they test whatever food is under contract right now… and we produce the Glycemic Index."
At about the same time Brand-Miller was beginning work on the Glycemic Index, she was also struggling to overcome hearing problems that had begun in her childhood.
"They call it sensorineural hearing loss of congenital origin, probably a less common genetic form of loss based on limited genetic testing.... It was probably there at birth but undetected," Brand-Miller says.
As a teenager attending SCEGGS Darlinghurst - a prominent inner-Sydney Anglican girls school - Brand-Miller began to notice a problem. By the time she took up her first post as a nutrition lecturer at Sydney, she was unable to hear well enough to do the work without hearing aids.
"I went gradually deaf. As a teenager I recognised that I didn't hear as well as my peers and I was actually prescribed a hearing aid at 15, but I didn't wear it… My hearing continued to deteriorate and it comes to a point where a hearing aid is not very helpful," she says.
Over the next 20 years she continued to work, lecturing, teaching and researching with increasing difficulty. In 1998 she decided it was time to do something more drastic to allow her to continue to work effectively.
"When I was 46 I had my first Cochlear implant operation and I often describe it as like jump leads to a flat battery on a car - it just restarted everything.
"I could hear on the telephone, I could hear around meeting tables, where I was having extreme difficulties. I even had trouble one-to-one in a quiet room at that stage. So it meant that I was confident enough to give papers at conferences in front of thousands of people. It was still quite difficult, but it was what I needed," she says.
Still, one Cochlear implant was not enough to comprehensively restore Brand-Miller's hearing, and about three years ago she had a second Cochlear implant. She boasts that now she can hear better than some of her friends.
"You need two good ears. It's just like people don't wear a monocle anymore -they have glasses, so that you can see well out of both eyes, just like you have two ears.
"So now I can hear really well in noise, sometimes even better than my peers… some of my friends are beginning to have age-related hearing loss, and I can see in conditions like restaurants, where it's really noisy, that I'm hearing better than them."
Her experience has made Brand-Miller a strong advocate for Cochlear implants. In the next 10 years of her career, she says, Brand-Miller intends to work hard to ensure people understand the difference that an implant - or two - can make.
"It was just chalk and cheese… You need to be able to communicate as a scientist. You need to be able to hear and answer questions. Before I had my Cochlear implant I was asking students in my lectures to pass their questions up on a piece of paper - so it was all possible, but it was tough. And I think it's really hard on your self-esteem when you can't hear properly because people can think, 'Oh, well, she must be stupid,' or something," Brand-Miller says.
Cochlear implants are the brainchild of Australian scientist Graeme Clark, who in 2004 won the Prime Minister's science prize for his efforts helping people to hear again. Brand-Miller credits him with her continued career.
"If it wasn't for Graeme Clark I wouldn't be talking to you now… Human language is so important for being human," she says.
Fiona Atkinson, who also works on the Glycemic Index, says Brand-Miller always found ways to manage her hearing issues.
"She's always been very open about [her hearing]. When she was lecturing to students she would often say at the start of the lecture, back in the early days before she had both [Cochlear implants], if you have a question, can you raise your hand. [Because] she couldn't necessarily identify in a big lecture theatre where a question was coming from in the room," Atkinson says, adding:
"But she learnt to overcome."
That experience stood her in good stead to take on the sceptics who didn't believe the Glycemic Index could be widely helpful.
Atkinson says that in the beginning there was a lot of scepticism about the value of the GI research, but Brand-Miller simply pushed through it.
"Early on on with her career, there was a lot of critics or sceptics, saying, 'Oh, you're saying that GI is going to be beneficial for a wide range of problems, perhaps you're stretching it a bit.' But actually she's persisted and done studies with [people with] diabetes, heart disease, athletes," Atkinson says.
And the research now shows Brand-Miller was right.
"We're now seeing the benefits of low GI in preventing macular degeneration eye problems - so she's really had quite a wide-reaching impact because she's been tenacious and persisted with this concept of GI …. It's had a massive impact on the management and treatment of diabetes in particular, but also on a range of other health problems or diseases."
Talking to Brand-Miller, there is a sense that her hearing problems were not the biggest obstacle she has had to overcome in her career. She has two children, born at a time when women still were expected to choose between their family and their job.
When asked what it was like to juggle a heavy research and teaching load with young children, Brand-Miller is frank about how hard it was.
"I want to be totally honest. I think I worked very hard, probably too hard in retrospect. I had a very high work ethic and yet I wanted to have children, and when I had my first child the University of Sydney had a policy that either you came back full-time, or not at all," she says.
"I remember putting my son in childcare when he was 16 weeks old and I remember coming back to the office and crying. It was pretty hard.
"It wasn't until I had my second child, a little girl, by that time you could choose part-time if you wished…. which made life a lot easier. But I still suffered over the usual things, torn between work, career and family," Brand-Miller says.
She doesn't regret the struggle, and says her family is proud of the work she does.
"I would not have chosen just to be a mum. I have this incredible sense of fulfillment and achievement because I've done this work."
One thing Brand-Miller believes is that although things have changed since the birth of her eldest child, women are still struggling to juggle work and family, and she says scientific work is particularly difficult.
"I think it's still difficult because a lot of the responsibilities of the household still rest in the hands of the women, and I think you have to have a partner who is equally invested in you and the children and the whole family unit. I think if you've got that you can succeed very well," she says.
"There's not a lot of women here in this school. The women who have come and gone, I think, have found it quite a difficult school, but I take my hat off to the University of Sydney, I think they're really trying hard to make it easier for women."
She says these days there is more support for returning mothers, including fellowships and flexible work hours that allow them to get on top of their research responsibilities and continue to teach when possible.
That kind of work flexibility is vital, Brand-Miller believes, to ensure the best scientists are at work, making new discoveries and charting new territory.
"I think it's really foolish to ignore the intellectual input of women, because if you ignore women and don't give them the same opportunities as men you're missing out on 50 percent of the game," she says.
Brand-Miller sees herself as a mentor to younger scientists. Atkinson says Brand-Miller takes that responsibility very seriously. "Jennie almost adopted me," Atkinson says.
"She took me under her wing… I did a research project with her looking at diets, one of which was a low-GI diet and looking at blood glucose and insulin responses, and she offered me a job," Atkinson says.
"I could have gone and worked in a hospital or worked out in private practice, but she really inspires you think big picture - and by doing research you can potentially help quite a lot of people on a larger scale. She's very good at mentoring young students to foster their research careers or looking at that as a possibility."
For Brand-Miller there is always more work to be done. The university is building a $385 million obesity, diabetes and cardiovascular research centre, The Charles Perkins Centre, where the GI research group will be located.
Brand-Miller, the author or co-author of more than 20 diet and nutrition books and papers, says she wants to continue for at least another decade to work to help people understand their food choices and how those affect their health.
Some of her current research involves studying the impact of the mother's diet on a baby in the womb, and how that might affect the child's risk of childhood obesity. She also is working on blood sugar control for adults with Type 1 diabetes, and analysing the gene involved in starch digestion.
"I want to be part of the next 10 years of research and discovery, and I love my teaching role as well. I like being in contact with the students and young people. I like being in a position to mentor and inspire them and show them what they are good at and help them overcome their weaknesses - it's really a privileged position to be in," she says.
Brand-Miller was a 2006 finalist for Australian of the Year, and in June 2011 she was made a Member in the General Division of the Order of Australia for "service to education in the field of human nutrition as a researcher and academic, and as a supporter of people with a hearing impairment".
"My research seems to have made a difference to the average punter. I like the fact that it just doesn't end in a scientific journal. What we have done is translate our research into practical advice."