13 June 2013 - Dr. ANTIGONE KOURIS - ADJUNCT ASSOCIATE PROFESSOR


Dr. ANTIGONE KOURIS

- Adjunct Associate Professor -
BSc (Biochem) (Melb), Honours Nutrition (Deakin), Grad Dip Diet (Deakin), PhD (Monash), Dip Botanic Med (Newcastle)

G'day guys,
Today I welcome another very talented Australian guest, a woman with great credentials and a person I would like to spend hours chatting to for personal health reasons - Doctor Antigone Kouris, Adjunct Associate Professor, Clinical Dietition and Nutritionist. 

Antigone Kouris-Blazos  is an Adjunct Associate Professor in the Department of Dietetics and Human Nutrition at La Trobe University, past managing editor of Asia Pacific Journal of Clinical Nutrition and www.healthyeatingclub.com, is an Accredited Practising Dietitian with over 25 years experience, has co-authored 5 university text books and 3 of her own books including a cook book released this year and has over 40 published papers, mostly on the Mediterranean diet and longevity. 

Welcome, Dr Kouris ...

  WHY DID YOU STUDY NUTRITION? 

As a young girl I became very interested in nutrition after I had a severe allergic reaction to strawberries. From that point on I wanted to understand the mechanisms behind the body’s biochemical reaction to food.

I also wanted to understand the importance of food and its components (vitamins, minerals, phytochemicals)  in bodily functions and health maintenance.  This curiosity resulted in the study of Biochemistry at Melbourne University for 3 years, of which I loved. I topped my year and was asked by the Head of Biochemistry to stay on and do my honours in Biochemistry, but I had other plans.

I wanted to learn more about nutritional biochemistry and its application in real life. So I decided that Dietetics was the way to go, because I preferred talking to people rather than doing laboratory work. 


CAN YOU SUMMARISE YOUR PROFESSIONAL JOURNEY?

I have over 25 years experience in nutrition as an academic, researcher, teacher,  clinical dietitian and as an author/writer.

My PhD was the first to show that following a Mediterranean diet in old age reduces the risk of death. About 300 elderly Greeks living in Australia and Greece were studied.  I also had the privilege to be involved in an international study called "Food Habits in Later Life" which included 800 people from Sweden, Japan, Greece and  Australia (Greeks and Anglocelts). I was also sent to the Kimberleys in Western Australia to study the health and diet of elderly Aboriginal Australians.   

Teaching involved lecturing to medical students at Monash University and dietetic students at La Trobe University.  It also extended to supervising 6 PhD students. 

My writing skills were utilised as a co-author of 5 university text books,       
author of 3 of my own books, for my  40 research papers and as the  managing editor of the Asia  Pacific Journal of Clinical Nutrition for 4 years
and a website www.healthyeatingclub.com for 10 years (both owned by Professor Mark Wahlqvist).



After researching the food habits and herbal remedies used by elderly Greeks for my PhD in 1992, and being fortunate to work in an Integrative Medical clinic for 5 years (belonging to a leader in the field Dr Vicki Kotsirilos), I developed an interest in herbal medicine and completed a Diploma in Botanic Medicine in 2010. 

Recently my patients challenged me to develop a healthy gourmet biscuit - so now I also have experience in developing and marketing my own food product! 
 

I am currently an Adjunct Associate Professor in Dietetics at La Trobe University and run a busy private practice in Melbourne.

 HOW DID YOU GET INVOLVED IN RESEARCH?

As a young girl I had a very inquisitive mind and wanted to understand the why and the how, especially when it came to the human body, and I often found myself “hypothesising”.

I had applied to do Dietetics at Deakin University after I completed my Bachelor of Science at Melbourne University.  I did not get in because there were limited spots for the Dietetics course for external students despite having straight As and Bs.

I was then “forced” to do an Honours year by research on the diabetic diet as a more  secure pathway into Dietetics. My project was supervised by Professor Mark  Wahlqvist, the Head of Dietetics at Deakin University.   This was a fortuitous turn of  events because this man was to change my career path forever! 


HOW DID YOU END UP AT MONASH UNIVERSITY? 

My first job was in the cardiac unit at a Melbourne Hospital.  I had been working for about 1 year and was getting a little bored with the repetitive nature of the dietary advice I was giving to patients who did not seem that keen to make changes.  I felt I was not properly utilising my inquisitive ‘research’ mind and my in depth knowledge in biochemistry and nutrition. 

My career path took a sharp turn for the better when I was offered a job as a research dietitian and in parallel to do a PhD in the Department of Medicine at Monash University by my honours supervisor Professor Mark Wahlqvist. 


HOW DID YOU PICK YOUR PHD TOPIC?

Professor Wahlqvist was interested in finding out whether diet improves longevity in old age and why Greek migrants to Australia were living longer than the Australian born and Greeks in Greece.

From a very young age I was fascinated by the Greek diet and was keen to investigate its health attributes with formal research. So this was a perfect opportunity. I felt honoured and very fortunate that this world renowned Professor was keen to be my PhD supervisor and mentor.

This study also required that I live in a Greek village near Athens for a  few months to interview elderly Greeks. I collaborated with Athens University and the Athens School of Public Health to complete this part of my PhD in 1989. 




I was very fortunate to work with the esteemed and highly respected Professor Dimitri Trichopoulos and his wife Professor Antonia Trichopoulou and Professor Evangelos Polychronopoulos.











 WHAT EXACTLY WAS YOUR RESEARCH ABOUT?

I was appointed the study coordinator of an international mortality follow-up study known as "Food Habits in Later Life". Between 1988 and 1991 data were collected on diet, health and lifestyle on 800 people aged 70 and over from countries experiencing longevity: Sweden, Greece,  Australia  (Greek and Anglo-Celtic Australians) and Japan. 

Participants were followed up for 5-7 years to determine survival status and the impact that diet has on longevity. 

WHAT DID YOUR RESEARCH DISCOVER?  

My PhD was the first to show in 1995 that a mediterranean dietary pattern improves overall survival in both Greek and non-Greek elderly resulting in a landmark paper in the British Medical Journal in 1995, British Journal of Nutrition 1999, the American Journal of Clinical Nutrition in 1995 and Age and Ageing in 1996.  Our findings captured the attention of the media and we were splashed all over the newspapers in Australia and abroad.

My research team was also the first to develop a validated Mediterranean diet score which is now used by many other researchers around the world working in this area.  

Subjects who had a more 'mediterranean style' eating pattern i.e high intakes of plant foods (cereals, legumes, vegetables, fruits and nuts), high intake of olive oil, low intakes of animal foods (meat, milk and dairy products) and moderate fish and alcohol consumption had a reduced risk of death by more than 40%. 

Interestingly the subjects who followed a more Mediterranean style diet had less skin wrinkling.  Also,  Greek elderly who followed a more traditional meal pattern by having their main meal for lunch and a smaller meal for dinner were slimmer and had lower fasting blood sugars.


          
 DID YOU FIND OUT WHY 1ST GREEK AUSTRALIANS LIVED LONGER? 

Elderly Greeks in Australia had the lowest risk of death even though they had the highest rates of obesity and other CVD risk factors (this phenomenon was described as a “Morbidity Mortality Paradox”), followed by the slimmer and more athletic elderly Swedes, Japanese and Anglo-Australians - the elderly Greeks in Greece had the highest risk of death. 

The elderly Greeks in Australia appeared to be “getting away” with these CVD risk factors because of their adherance to a more traditional plant based mediterranean diet, especially their high intake of legumes, into old age. 

 IS DIET IMPORTANT FOR LONGEVITY?

The statistical analyses containing ten potential predictors of survival (mediterranean diet score, memory score, general health score, activities of daily living (ADL) score, exercise score, social activity score, social networks scores, wellbeing, smoking, gender)  revealed that diet was more important  than most of the variables for survival, except for smoking, being male and having a poor memory. 


          DID YOUR RESEARCH IDENTIFY ANY SPECIFIC FOOD AS BEING PARTICULARLY PROTECTIVE?

When the Mediterranean diet score was analysed in greater detail by my PhD student (Dr Irene Darmadi) to determine which food group conferred the greatest impact on longevity in comparison to the other food groups it was found that a regular intake of legumes was the most important food group for longevity. 



WHAT WOULD BE THE MAIN MESSAGES COMING OUT OF YOUR RESEARCH? 

Our research has 2 important messages: 1) eating a Mediterranean food pattern, especially  legume based vegetarian meals (about 2 a week), may improve your longevity; 2) it may be possible to reduce the severity of your CVD risk factors (obesity, high cholesterol, diabetes, high blood pressure)  if you eat a mediterreanean style diet. 

WHY DID YOU WRITE YOUR BOOKS? 

My books were written out of necessity. I was often asked by patients in my private practice “which is the best food source of this vitamin?” and “does my medication interact with my vitamin  supplement ” or “how do you eat a Mediterranean diet ”. 

The answers to these questions can be found in thick text books or scattered across the internet on various websites, but they were not available in one location in an easy to read summarised format which was affordable by the average person and by students. 

         
     

My Mediterranean recipe book was inspired by my research on elderly Greeks, but also by my Greek mother and mother-in-law, who are both wonderful cooks. I was keen to share these precious, easy and tasty recipes with my patients and the world to help them live longer healthier lives.      
         
          WHY DID YOU DEVELOP SPECIAL DIETARY COOKIES CALLED “SKINNYBIKTM”?  

As with my books, my patients were my inspiration. Patients were constantly asking me if there was a healthy but tasty cookie they could have with their cup of tea or coffee and complained they could not find any cookie that was remotely healthy in cafes.  Many of these patients suffered from diabetes, high cholesterol, hypertension or bowel problems.

I could not recommend any of the cookies currently available because they were usually too high in sugar, refined starch, salt and saturated fat and too low in fibre.

I know some of my dietitian colleagues are probably saying that we should not eat biscuits at all and that we need to break the habit of eating between meals. Yes, in an ideal world with no temptations!  I believe that in order to stay healthy we need to have healthier options available to us, including biscuits. 
We have a huge coffee culture in Australia so there is a real need to provide a healthier biscuit option for people who are trying to be careful and for people with certain ailments.   


WAS IT DIFFICULT TO DEVELOP SKINNYBIKTM COOKIES?

It has probably been the hardest thing I have ever done because of the skills needed in business and marketing!  As far as I know, I am the first dietitian in Australia to develop a food product and take it to market.  It took 2 years (in my spare time) to develop SkinnybikTM because adjusting the recipe to make it superior nutritionally would often result in a cookie that was hard, dry, tasteless or costly.  My dietetic and food science skills and love of cooking and eating certainly came in very handy. 

DID YOU GET ANY HELP TO DEVELOP SKINNYBIKTM COOKIES?

My husband and biscuit lover Chris Blazos (Director of SkinnybikTM) has been instrumental.  He is a mechanical engineer with experience in food manufacturing and packaging.  He guided me on the texture of the dough and factory equipment as well as the packaging.  He also has exceptional biscuit taste buds. He would comment that the cookies tasted great but were too dry (due to their high fibre content). So I juggled the ingredients until I got his final approval!  

I also got over 200 patients to taste test at my clinic before I finalised the recipe.  When one of my patients said “are you sure these are healthy – they don’t taste healthy” I knew I was ready to launch. 

SO WHAT IS SO GOOD ABOUT SKINNYBIKTM COOKIES?

The taste, the wholesome ingredients and the excellent nutrient profile! 
 

They are soft baked and delicious despite being reduced in almost everything, except fibre, protein and good fats.

There are no other cookies in the market which tick so many good nutrition boxes.

Usually when a food product claims to be “reduced in sugar” it is high in fat or vice versa.  Furthermore, gluten free products are often high in fat and sugar. Not so for Skinnybik cookies!



HOW DO SKINNYBIKTM COOKIES COMPARE TO OTHER BISCUITS?

Compared to other sweet biscuits (like oatmeal or choc chip),  SkinnybikTM cookies are lower in sugar by 50%, lower in carbs by 40%, they have about 300% more fibre,  30% less fat, 80% less saturated fat, 0% trans fat, 70% more protein and about 70% less salt. They are also reduced in calories by 20-25% with only about 55 calories per 15g cookie.  They are also a source of magnesium and do not contain artificial colours or preservatives.  
This favourable nutrient profile means they are acceptable even as a breakfast food with a milky coffee or tea.
 

DO YOU HAVE DIFFERENT FLAVOURS IN THE SKINNYBIKTM RANGE?

SKINNYBIKTM cookies currently come in 2 flavours:
 

1. Spelt, date and butterscotch – fructose friendly , 50% less sugar, 10% fibre, 0% trans fats (contain wholemeal spelt flour, oat bran, rice bran, almonds, canola oil, egg). The spelt cookie is low in various sugars (lactose/fructose) and fructans (also known as FODMAPs) so is suitable for people following the low FODMAP diet for bowel problems.
 

2. Millet, Mocha and dark chocolate chip – gluten free, 50% less sugar, 7% fibre, 0% trans fats  (contain millet meal, brown rice flour, lupin flour, dark chocolate, cocoa, canola oil, egg)
 

The millet cookie is gluten free so is suitable for people with celiac disease or for patients avoiding wheat.


DO YOU HAVE ANY TIPS FOR US UNHEALTHY PEOPLE?

Eat everything in moderation and try to have a couple of vegetarian legume based meals a week .  The Herald Sun recently interviewed me with other nutrition experts regarding the best weight loss diets... and yes ....there is also evidence that the Mediterranean diet is good for weight loss!

My research

My books and publications

My cookie


Clancy's comment: Many years ago I asked my gastroenterologist why he became a gastroenterologist. He laughed, because no one had ever asked him that question before. He is now retired but still deals with the likes of me. However, his answer was interesting, 'I was concerned about what people were eating.' Interesting, eh? And, fortunately we have professionals like Doctor Antigone Kouris who make it their life's passion to look after us. 

Thank you, Doctor Kouris. Appreciate your tireless dedication.

I'm ...