Do Slower-digesting Carbohydrates Make Us Feel More Full?

One of the most common pieces of advice in the health-nutrition world is that we should focus our carbohydrate intake on slowly-digesting carbohydrates, because they make us feel more full than rapidly-digesting carbohydrates.  Rapidly-digesting carbohydrates, such as potatoes, stand accused of causing us to overeat, resulting in obesity, diabetes, and many other chronic ailments.  Is this true?
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Cross-country comparison of quality control in EA

No quality control or assurance instruments implemented in Germany.

Wanted to see what was happening elsewhere.

What are the international trends in EIA and SEA.

4 key words 4 country case studies.

INTEGRATION:

PERSONNEL:

TRANSPARENCY:

EFFECTIVENESS:

Concluding Questions:

Social determinants of risk perception

Risk perceptions can be biased

Literature review

5 models

Mitigation measures are distorted

Integrated ESHIA often use a risk assessment that categorises impacts in terms of likelihood, severity and significance.

Expert group consensus or judgement is used to determine these aspects.

But is this biased by risk perception.

Can see risk perception as unstable and can move from being amplified to attenuated easy.

Climate change is not seen as a risk but fracking is though experts might say that this should be the other way round.

Information deficit: is IA focused on this when feelings is more important.

Psychometric model

Voluntary vs involuntary

Risk benefit calculation

Economic rationality

Affective vs Analytic thinking

Cognitive biases

Cultural world view

Status anxiety

"White male effects"

Implications are that there are 'merchants of doubt' and 'merchants of fear'.

Expert's risk perception can bias impact assessment.

Need to understand this.

EA consultants significance for level of performance

Swedish consultants think that health should better included in EA.

They have a broad understanding but they don't utilise this in their EAs.

The level of approval is a key criteria used by consultants to judge how much assessment to undertake. The level of performance ie what is undertaken, good enough practice.

Consultants are in strong position to guide performance.

They think practice should be improved but make choices that restrict their role. Maintain a good enough level of performance.

Barriers

Consultants think that reaching beyond the approval level is not their job.

Facilitators

They recognise the value of a broad approach to health.

Consultants need to take a more leading role in pushing boundaries of best practice.

We're all experts: engagement in HIAS

I'm Positive health: assets not just problems.

Used Egan wheel as health determinants framework.

Chatham House rules, confidentiality and anonymity of feedback, we are not representing government or department.

Results 

Broader 

Residents views were acknowledge and felt acknowledged

Evaluation

Pre and post workshops

Interviews

Focus on consensus based on theoretical framework (personal, social and institutional/governance factors)

Analysis using Atlas.ti

The findings for the engagement was:

The process: quality workshop, trusted facilitators.

Barriers

Distrust of national actors

different mindsets

different interests

There was perceived consensus but actually there were disagreements.

Stakeholder engagement reached.

Commitment to a vision

BUT

How 'real' is the consensus?

Did that matter?

Have space to agree to disagree

Health in EA: HIA in EA of oil drilling

Hermosa, Los Angeles

Community had full control of whether to allow drilling or not because there was an oil ban or no local drilling which was being voted on again.

HIA commissioned by local government.

Understand projects impacts in environment and heath.

Numerous public meetings and small workshops and engaged communities along the process and used variety of methods eg open house

Challenges

Different consultancies

HIAs dependent on assessments in EIR and timing of getting information difficult.

HIAS needed to focus on impacts of project with required mitigation.

More communication the better.

Digital media are increasingly used by all stakeholders.

Being available for communicating through media.

Vote was 80% to keep the ban in place.

Barriers

Interdisciplinary working and getting information in a timely way.

Recommendations 

Integrate HIA team with EIR team early

Community environmental health risk indicator for outdoor pollutants and health determinants

Array of problems and opportunities but limited funds.

Air pollution is the important environmental factor.

CHERIO looks at time lost each year due to ill health, disability and early death due to environmental exposure.

Cumulative health impact ie % total disease burden. Range of different levels across The Netherlands.

Scenario of a cut in traffic generates increases and decreases i.e. a shift in disease burden which if not spatially analysed shows no change in disease burden.

Can analyse by socio-economic or other characteristics.

Can help prioritisation, comparison of alternatives, monitoring/benchmarking.

Facilitator

Environmental Act

Barrier

Data availability at a local scale

Recommendations

Use this as part of assessment.