Another must watch if you believe big pharma is interested in your health. We are just numbers on a balance sheet and our lives and health mean nothing to them. When are these criminals going to jail for killing people ? Eddie
I have worked and lived in London most of my life. I have worked and lived amongst people of every colour and race, every religion, and nationality. I learned a long time ago they were all the same as me. They wanted to be left in peace, they wanted to be treated with respect. They wanted a chance to earn a decent living and give their kids a better life than themselves. I have never had any problems with anyone, I treat people with respect and they have treated me with respect. We have to live and let live. I love being around different people, I love the buzz and the energy. Look around certain forums especially diabetes forums and you will see all sorts of grief and argument, usually over diet. As if diabetics do not have enough to put up with, they turn on each other, morning, noon and night. How pathetic is that, instead of taking on big pharma and junk food outfits, they rip into their own kind. I can partially understand why, so many are addicted to the junk that made them ill in the first place. Diabetics have lost the ability to process sugars and starchy carbohydrates in a normal way. But so many will fight to the death to defend junk that has very little nutritional value, and in many cases requires dubious drugs to cover the blood glucose rise, and in many cases lead to their downfall. To survive, prosper and progress, we have to adapt and work with all people, whatever their race, colour or creed, when are diabetics going to wake up. Eddie
Well my friends the weekend is rapidly approaching. If you are bored rigid by the likes of Strictly Come Dancing and the usual dross on the box, may I suggest you check into the latest comedy hotspot that is diabetes.co.uk. Don't worry if you are not a diabetic they cater for all. So much of the information posted will have you howling with laughter, trust me it's a mad house. The long term lowcarb anti clique are in attendance, comedy favourites such as Phoenix, Nobhead and the Cherub, together with a comparatively new bunch of jokers, Brett, Mongoose and up and coming real star attraction Douglas. Trust me folks, I reckon Douglas is going to go a long way on the forum, it takes very special talent to make the incomparable Sid Bonkers look sane. Having said that, Sid is posting some great stuff these days, has he seen the light ? or is he playing a waiting game, and will be launching a counter attack into the world of lunacy soon, time will tell. Do you know, sometimes I think watching the antics at the fun forum was almost worth becoming a diabetic for, jeez it's given me some laughs over the years. But as I said, don't worry if you are not a diabetic, it's side splitting stuff all the way. BTW look out for AMBreadvan a legend in his own lunchtime and not to be missed. Have a great weekend Eddie
Hi folks this came in today as a comment. Allegedly from Dr Paul Jones - University of Carmarthen. As regulars will know we have received numerous negative comments under the name of Dr Paul Jones. I do not know whether these are from Dr Paul Jones or even if the man actually exists, but one thing is sure, the sender is completely un-hinged. BTW I have removed the name of the person being ridiculed, because they are not a member of our team and do not comment on this blog, and as such cannot reply to the Doctor/spoofer/ Multiple Miggs. "Hello -------------
I'm not a fan of yours as you know --------------
But...As they can make Penicillin from mouldy bread, they should be able to make something of you.
There is much room for improvement in the medical care of women with diabetes before they conceive and during pregnancy, new research indicates. This neglect gives rise to poor outcomes, with a significantly higher rate of stillbirth and infant death than is seen in the general population, one of the studies illustrates.
Although the new research was conducted separately in 2 countries with different healthcare systems — Israel and the United Kingdom — both studies reveal that there is a big gap between what is recommended and what is happening in practice for such women. Furthermore, the British study documented no improvement in outcomes for diabetes patients having babies over the 12 years studied, from 1996 to 2008.
"Diabetic women and their physicians need to be better prepared for pregnancy," lead author of the Israeli study, Shlomit Riskin-Mashiah, MD, from the University of Haifa in Israel, told Medscape Medical News. "Diabetes needs their attention all of the time, and especially at the beginning of pregnancy and during gestation."
She stressed that many of the outcomes they examined during preconception and pregnancy — such as whether women got eye exams and had good glycemic control — "should be just usual diabetes care." Although monitoring during this period does not appear to be worse than it is at other times in a diabetic woman's life, "it should be much better — there needs to be greater awareness of the importance of periconception care in diabetes," she urged.
The authors of the British study, led by Peter W.G. Tennant, MSc, from Newcastle University, agree. "In the North of England, fewer than half of women with pre-existing diabetes attend preconception care, with the proportion declining over time. To achieve any reduction in the relative risk of stillbirth and infant death in women with pre-existing diabetes, the barriers to uptake of preconception care and adequate preparation for pregnancy must be urgently understood and addressed," they implore.
The study by Dr. Riskin-Mashiah and colleagues was published online November 12 in Diabetes Care. The study be Tennant and colleagues was published online in Diabetologia.
Diabetes Increases Risk for Pregnancy Complications
Both studies explain that pre-existing diabetes increases the risk for pregnancy complications to the mother, fetus, and newborn infant.
The British study set out to specifically document the rate of adverse pregnancy outcomes in women with diabetes in a contemporary setting.
Tennant and colleagues surveyed 1206 women with type 1 diabetes and 342 women with type 2 diabetes who gave birth to single babies.
They found the risk for stillbirth (at 3%) was nearly 6 times greater in women with pre-existing diabetes than in those without the condition (relative risk [RR], 4.56; P < .0001); the risk for infant death (at 0.7%) was nearly twice as high (RR, 1.86; P = .046). There was no difference in the risk for fetal and infant death between women with type 1 and type 2 diabetes,
Blood glucose concentration around the start of pregnancy was the most important predictor of fetal and infant death, with the odds increasing by 33% and 42%, respectively, for each 1 percentage point increase in HbA1c.
The researchers did demonstrate, however, a J-shaped association, with the lowest risk in those with periconception HbA1c around 6.6%
"We would therefore recommend good, but not overly strict, control [of HbA1c] before and throughout pregnancy," Tennant told Medscape Medical News.
However, even in women with optimal periconception HbA1c, the risk for fetal death was still more than twice as high as in women with diabetes, suggesting other risk factors have an effect.
Prepregnancy consumption of folic acid was associated with half the risk for fetal or infant death, however. Women with pre-existing diabetes are advised to take high doses (5 mg/day) of folic acid. Although this was originally intended to reduce the risk of having a baby with a neural tube defect, Tennant said the findings suggest there are additional benefits of folic acid in this patient group.
Poor Care Persists for Pregnant Diabetics
Startlingly, in the British study, there was no reduction in the excess risk for fetal and infant death in women with diabetes over the 12-year study period.
This is despite guidance from organizations such as the American Diabetes Association recommending daily folate supplementation from preconception; good metabolic control — preferably with HbA1c below 6% to 7% with appropriate insulin therapy; dietary consultation; assessment for systemic complications, including diabetic nephropathy, retinopathy, and thyroid disease; and review of treatment to rule out, preconceptually, the use of potentially hazardous medications.
LONDON, UK (GlobalData), 28 November 2013 - The total number of diabetic retinopathy prevalent cases in the seven major markets (7MM) the US, France, Germany, Italy, Spain, UK and Japan is expected to increase from 4.89 million in 2012 to 7.17 million by 2022, at an Annual Growth Rate (AGR) of 4.68%, forecasts research and consulting firm GlobalData.
The companys latest report* states that out of the 7MM, Japan and the US had the largest shares of diagnosed prevalent cases of diabetic retinopathy in 2012, with 2.99 million and 2.21 million cases, respectively. This trend will continue by 2022, when Japan will lead the 7MM with 3.55 million people affected by the condition.
Jessica Davies, GlobalDatas Epidemiologist, says: Diabetic retinopathy is the principal cause of vision impairment in working-age adults throughout the world, and affects a third of diagnosed diabetics. High blood glucose levels in people with poorly-managed diabetes damage the small blood vessels in the retina, and therefore affect the vision.
The major risk factors of the disease include the duration of diabetes, hyperglycemia, hypertension and dyslipidemia. Additionally, nearly all patients with type 1 diabetes, and an estimated 60% of patients with type 2 diabetes, are affected by diabetic retinopathy within 20 years of developing diabetes.
Davies says: While the prevalence of diabetes is expected to increase, the incidence and prevalence of diabetic retinopathy should not be expected to grow at the same rate, due to effective management of blood glucose levels, blood pressure and serum lipid levels.
GlobalData emphasizes the importance of access to the screening and treatment of diabetic retinopathy in order to reduce the burden of diabetes-related vision loss.
Effective prevention requires knowledge of the magnitude of the problem. Therefore, more prospective population-based studies, along with analysis of the factors mediating the causal pathway of diabetic retinopathy, are vital to comprehending the disease, the epidemiologist concludes.
Type 2 diabetes is more hazardous and lethal than type 1 diabetes
OBJECTIVE To evaluate long-term clinical outcomes and survival in young-onset type 2 diabetes (T2DM) compared with type 1 diabetes (T1DM) with a similar age of onset.
RESEARCH DESIGN AND METHODS Records from the Royal Prince Alfred Hospital Diabetes Clinical Database, established in 1986, were matched with the Australian National Death Index to establish mortality outcomes for all subjects until June 2011. Clinical and mortality outcomes in 354 patients with T2DM, age of onset between 15 and 30 years (T2DM15–30), were compared with T1DM in several ways but primarily with 470 patients with T1DM with a similar age of onset (T1DM15–30) to minimize the confounding effect of age on outcome.
RESULTS For a median observation period of 21.4 (interquartile range 14–30.7) and 23.4 (15.7–32.4) years for the T2DM and T1DM cohorts, respectively, 71 of 824 patients (8.6%) died. A significant mortality excess was noted in T2DM15–30 (11 vs. 6.8%, P = 0.03), with an increased hazard for death (hazard ratio 2.0 [95% CI 1.2–3.2], P = 0.003). Death for T2DM15–30 occurred after a significantly shorter disease duration (26.9 [18.1–36.0] vs. 36.5 [24.4–45.4] years, P = 0.01) and at a relatively young age. There were more cardiovascular deaths in T2DM15–30 (50 vs. 30%, P < 0.05). Despite equivalent glycemic control and shorter disease duration, the prevalence of albuminuria and less favorable cardiovascular risk factors were greater in the T2DM15–30 cohort, even soon after diabetes onset. Neuropathy scores and macrovascular complications were also increased in T2DM15–30 (P < 0.0001).
CONCLUSIONS Young-onset T2DM is the more lethal phenotype of diabetes and is associated with a greater mortality, more diabetes complications, and unfavorable cardiovascular disease risk factors when compared with T1DM.
I thought of the post title and the famous Christmas song Winter Wonderland came to mind. Apparently it was first published in 1934. The composer was Felix Bernard (1897-1944) and the lyricist was Richard B. Smith (1901-1935). I think the most popular versions of this classic Christmas song, Winter Wonderland, were recorded by the Andrews Sisters and Perry Como. Of course you may know of, and prefer, other popular singers.
I think that the lyrics of Winter Wonderland have definitely contributed to the magical vision of snow that we conjure up at Christmas. That and the tradition of building snowmen and therefore turning fantasy into reality by creating a real Winter Wonderland. Magic or what? Just see it from a child's eyes.
So, with your best singing voices please ….here is the first verse:
Sleigh bells ring, are you listening, In the lane, snow is glistening A beautiful sight, We’re happy tonight. Walking in a winter wonderland
I thought it apt to share this post with fellow blogger Suzanne, she can be found at spunkysuzi.blogspot.co.uk. I have un-ashamedly used her wonderful snow and ice pictures. I just think they capture walking in a winter wonderland so well.
Whether our walks are enjoyed in colder conditions or warmer climates, perhaps we should all make the effort to enjoy some fresh air. That’s what I did this afternoon, before I went out I also enjoyed some great low carb food, a crust-less quiche with Chorizo and red onion, you can find the recipe here
Crust-less quiche with Chorizo and red onion.
Now tomorrow why don't you put on your walking shoes.
"Perhaps I should just stick to the 1.5 section...... but what about discussions, other medications, diet?"
The best idea the woman ever had in my opinion. This is a woman that thinks Hope Warshaw and a diet of 50% carbs per day should be the way to go for type two diabetics. The Phoenix aka the slippery one has spent years rubbishing low carb while she sits back with all the tools, Insulin, a pump, test strips, top medical advice etc. All the time undermining people who in many cases can't even get their hands on some test strips. Elsewhere she is known as OnePointFive, well known US blogger the Wooo has certainly got Phoenix sussed. TheWooo
@OnePointFive As your moniker states, you are a 1.5 diabetic. YOU are nothing like a type 2 diabetic and cannot relate to their concerns. You are much more in common with a type 1 metabolically healthy subject. Just as you don't seem to understand why type 2s need to restrict carbs and can't just inject insulin like you or a type 1 or a MODY diabetic, you are also not likely to succumb to the complications because exogenous insulin will manage your condition entirely, assuming you are compliant with blood sugar checks and insulin coverate and monitoring/observing how your blood glucose responds to variables.
This is not the case for a type 2 diabetic who is intrinsically DISEASED in the liver, and in the very core of their cells. Whereas your c-peptide is barely detectable, theirs will be extremely HIGH. They are rarely insulin deficient, and often hyperinsulinemic in the early phases. The problem with type 2 diabetes is that the cells are like that of a corpse - they are half dead - they simply fail to generate energy normally. No matter what this person does, they will succumb to illnesses UNLESS THEY STOP TRYING TO USE GLUCOSE FOR ENERGY. THe best therapy for the type 2 is getting off glucose ASAP, using non-insulin dependent sources of nutrition like fats, and maximizing glucose tolerance as much as possible via micronutrients, weight training/moderate exercise, good sleep patterns and so on.
Here's a little chart to illustrate the differences in insulin secretion and resistance between 1, 1.5, and 2. As you can see, 1.5 is pretty much type 1 that occurs in old age, with some insulin resistance but not significant.
The fact you laugh at type 2 diabetics on low carb diets, would be like someone with situational laughing at a manic depressive for taking lithium. Situational depression may resolve without life long medication, but bipolar disorder will NOT. Sure, both of these people have a condition considered by doctors to be described as "depression" but the etiology and treatment of the condition is radically different. The various categories of diabetes are just like this. You have no idea what type 2 diabetics experience and what treatment they benefit from, because the news flash is for you: it isn't the same as type 1, type 1.5, or mody diabetes.
The exchange diet is a method of eating that provide diabetic with a set of guidelines necessary to eat healthy. A dietician will help prepare and educate you on the exchange diet – the food groups and what substitutions you can make.
On the exchange diet all foods are divided into six food groups:
* Breads and other Starches * Fruit * Vegetables * Dairy Foods * Meat and Meat Substitutes * Fats
Your dietician will provide you with the number of servings you should have from each group daily and at individual meal or snack times. Within each of the categories there are many food options. Each food has a specific serving size that equals one serving, in cases such as fruits and vegetables you probably will not have to measure your foods but for meats and other groups a food scale and measuring cup is recommended.
The exchange part of the diet refers to being able to swap a food in one food group for another in the same group as long as you adhere to the serving suggestion. For instance ½ cup of cooked pasta can be exchanged for 2 rice cakes in one meal. The list your dietician gives you will be pretty complete but there are bound to be items not listed. In that case, you can call your dietician for advice or keep a list of items that you need to know the proper serving size for.
At the beginning the exchange diet may seem like a lot of work, but as time goes on and you become accustomed to the serving sizes of your favorite foods it will become less so. Proper eating habits are crucial to managing diabetes and the exchange diet is a way to eat a healthy balanced diet full of variety.
Prior statin treatment and high admission cholesterol have been associated with favorable outcome after ischemic stroke (IS), a paradox not completely explained. The aim of this study was to investigate the effect of admission cholesterol levels and the impact of statin treatment on short- and long-term survival after IS.
Consecutive patients admitted in 2006 and 2010 were included in the study. Total cholesterol of 4.6 mmol/L or more was defined as high. Logistic regression analysis was performed to assess predictors of 1-month mortality, and Cox proportional hazard regression analysis was applied to investigate predictors of long-term mortality.
Of 190 patients included in the final analysis, 21 (11%) died within 1 month and 61 (32%) died during 7 years of observation. Low cholesterol was associated with older age, lower blood pressure (BP), presence of angina, and higher risk of death. Three-month, 1-year, and 5-year survival rates were 100%, 98%, and 84%, respectively, in high cholesterol patients, compared with 92%, 87%, and 57% in low cholesterol group (P = .0001 with the log-rank test). Mortality risk was increased for patients with low cholesterol (hazard ratio: 1.97; 95% confidence interval [CI]: 1.05-3.69), after adjustment for age and admission National Institutes of Health Stroke Scale score. After further adjustment for angina and admission BP, the effect of cholesterol on mortality risk was still obvious, yet attenuated (hazard ratio: 1.87; 95% CI: .94-3.32).
High admission cholesterol may be associated with increased long-term survival after IS. Future studies on the temporal profile of cholesterol levels and stroke outcome would be of interest.
Excuse me should I be wrong, but, I believe most who read this blog have a comfortable home. I am sure there could be improvements we’d like to make, improve the heating system, change the colour scheme, perhaps buy a new sofa, hang a different picture on the wall, have different accessories. We could probably make quite a long list should we set our minds to it. Is this more of a woman’s prerogative or a mans? Well I know many men who take a great pride and interest in their home as much as the woman of the house, so I guess it comes down to what works in your household and what your particular circumstances are.
As I said, I do think those that read this blog are blessed with a roof over their head and food to eat on the table. The discussion, argument and controversy about the type of food we choose to eat is well documented, but as astute readers know, and of course, all our readers are astute, the blog isn’t called The Low Carb Diabetic for nothing.
Case in point, what did you eat for dinner tonight? Was it salmon with steamed broccoli and celeriac dauphinoise or perhaps chicken with some stir fry mixed vegetables. I would guess most readers who do follow the low carb high fat lifestyle certainly didn’t have rice on their dinner plate ? Cauliflower rice yes, white rice no.
I saw an article today about the five most expensive houses available to buy in London. Fabulous houses yes, crazy prices definitely. The world has always been about those who have money and those that don’t … nothing is going to change that.
I just hope that those who live in these houses are happy in their home and that they do spare a thought to those who aren’t as fortunate as them. I don’t mean the likes of you and me that are sitting reading or typing on blogs or forums. I mean those both here in the UK and further a field who do not have a roof over their head, they may not know where or when their next meal is coming from. They may be homeless through many reasons. Perhaps they lost their job or they may be homeless because they have been caught up in the wars of this world. They may be homeless because of the terrible disaster that nature created in the Philippines’s. Food to them isn’t whether it’s low carb, high carb they just want to be able to eat.
So with Christmas coming perhaps it is time to pause and think of others. If you haven’t already donated to a good cause or helped someone not as fortunate as you why not do it NOW. If you cannot afford to donate money then perhaps you could give your time, many charities would be pleased of your help. If you know of someone who may be on their own at Christmas invite them round, cook the dinner for them. Make a difference to someone.
Home is where the heart is and sometimes we just need to open the door, and let other people know we do care.
How is your new week going? Is it going to be one that seems to be a head-long rush or will you be able to relax and take your time over things. For most I suspect it could be somewhere in the middle. Well my week started with a family visit and lunch out ...... nice.
I chose a tasty light lunch because I knew that dinner was going to be Chicken and mixed vegetable stir fry.
Well sometimes you just want a quick, easy and tasty low carb meal, and this meal is just that.
Have a look at the recipe and method below and see what you think.
Ingredients: Serves two. 2 Large chicken breasts cut into pieces. 350 grams of vegetable stir fry, ( I used Sainsbury's brand ) 6 tablespoons olive oil, 4 tablespoons soy sauce, Salt and pepper to taste Method: Clean, cut and place chicken in a small frying pan, I use a small 8" non stick omelet pan - add some olive oil or butter and fry on a low heat until starting to brown. Place 350 grams of the vegetable stir fry into a large frying pan or wok. While the chicken is cooking heat the vegetables in some butter or olive oil at a low heat. When everything is piping hot, tip the chicken into the vegetables and stir, add lots of soy sauce and serve. It's quick, easy and tasty and less than 10 carbs. I check the chicken is cooked through by cutting a few pieces in half.
My old man was a very hard worker, he became an engineer after a spell in the Royal Marines during the WW2. One of his many sayings that is repeatable on a public blog was"I'd rather be worked to death than bored to death" I agree with him. When work is really interesting and stretchers your mind constantly, the hours fly past. I remember working 12 hours plus on many occasions and almost begrudged stopping to eat or have to sleep, such was the interest and challenge.
Over my working life so much has changed, so many jobs are mind blowing, boring, the pay is awful and the hours long. A good example is reading about Chinese factories, where nets up being put up around the buildings, to catch workers who have thrown themselves off the roof. I can understand this, a twelve hour shift in a despised job would be torture to me, but that is how millions have to live. The problem is here in the UK. So often I say to Graham "we were so lucky, we had the best of what this country ever had to offer a man, who was prepared to work hard and use his brain" those days are gone and I do not believe they will ever return. I hate what this country and most of the world has become, a rat race to the bottom. Most of my working life I had bargaining chips, I had skills companies paid good money to acquire. When looking for a new job, for me there were various factors in my decision. First the job had to pay more money, second the work had to be interesting, and as a bonus they had to have technologies that were leading edge. Now, we are a nation of shopkeepers and warehouseman of foreign made goods.
So much has gone, so many workers on zero hour contracts, with money so low they have to be subsidised by the tax payer in the form of tax credits. Instead of the customer is always right, the customer is there to be lied to and ripped off. Everything is cheaply made junk, made to last a year or so, then discarded for the latest piece of techno-crap. Very often made in some third world crap hole by virtual slaves and slave labour children, this is the future, and it ain't none too bright. Check out this BBC story today and tell me I am wrong.
A BBC investigation into a UK-based Amazon warehouse has found conditions that a stress expert said could cause "mental and physical illness".
Professor Michael Marmot was shown secret filming of night shifts involving up to 11 miles of walking - where an undercover worker was expected to collect orders every 33 seconds.
It comes as the company employs 15,000 extra staff to cater for Christmas.
Amazon said the safety of its workers was its "number one priority."
Undercover reporter Adam Littler, 23, got an agency job at Amazon's Swansea warehouse. He took a hidden camera inside for BBC Panorama to record what happened on his shifts.
He was employed as a "picker", collecting orders from 800,000 square foot of storage.
A handset told him what to collect and put on his trolley. It allotted him a set number of seconds to find each product and counted down. If he made a mistake the scanner beeped.
"We are machines, we are robots, we plug our scanner in, we're holding it, but we might as well be plugging it into ourselves", he said.
"LONDON, UK (GlobalData), 22 November 2013 - The total prevalent cases of diabetic neuropathy in the seven major markets (7MM) the US, France, Germany, Italy, Spain, UK and Japan is expected to increase steadily from 13.84 million in 2012 to 19.78 million by 2022, forecasts research and consulting firm GlobalData.
The companys latest report* states that out of the 7MM, the US will have the highest number of prevalent diabetic neuropathy cases during the forecast period, with a share of approximately 45%. Currently, the condition affects an estimated 50% of patients with diabetes worldwide and is one of the leading causes of morbidity, often causing foot ulcerations or the need for amputation.
Alyssa B. Klein, GlobalDatas Senior Epidemiologist, says: Some of the risk factors of diabetic neuropathy include poor glycemic control, age, duration of diabetes and obesity. However, diabetic neuropathy is considered to be part of the natural progression of diabetes as a microvascular complication of the disease.
GlobalData identifies an urgent need for a better understanding of diabetic neuropathy due to the rapidly increasing diabetic population in the 7MM. Therefore, a more effective strategy to reduce the number of microvascular diabetic complications, as well as other sequelae, may lie in identifying the undiagnosed diabetic population.
Klein continues: An estimated 50% of diabetics are unaware that they even have the disease. When they are finally diagnosed, they are already affected by many of the microvascular complications.
Screening programs focusing on identifying diabetics at a stage when the condition is more manageable could be the most effective strategy for preventing these complications, which are the result of long-term, unregulated blood glucose levels, the epidemiologist concludes."
This outfit sends me lots of stuff, some of interest to diabetics.
But a leading neurologist, Dr David Perlmutter, has said we should avoid grains altogether, as they are contributing to some serious conditions and illnesses such asdementia, depression and chronic headaches.
For those of us who have made the switch to healthier grains such as wholemeal, this will come as disconcerting news.
"Lifestyle factors are profoundly influential in determining risk for Alzheimer's, and yet, perhaps because they cannot be monetised, no one is bringing this information to public awareness," he wrote in a piece on Mind Body Green, The Surprising Ways Grains Are Destroying Your Brain.
It's his belief that the risk of Alzheimer's disease can be reduced by changing yourdiet. On his website, he says: "During an appearance on the Dr. Oz show two ago, I was asked to highlight what I would consider to be the three items we should all be working into our diets more frequently to help support better brain health. Not knowing how popular it would later become, I outlined my “Anti-Alzheimer’s Trio,” three foods high in “brain-healthy” fat including grass-fed beef, coconut oil and avocados.
"These items are all low in carbs and high in fat, helping to reduce some of that brain-bullying inflammation the root cause of so many ailments. Specifically, coconut oil is known as a rich source of beta-HBA, is one of our brain’s 'superfuels'."
Dr Perlmutter's belief that grains are not good for the body echoes what other nutritionists have been saying, which is that our body's evolutionary clock is set 10,000 years ago, when we didn't have grains in our diet.
Nutritionist and IBS expert Petronella Ravenshear says: "We’ve changed our diet in the last 10,000 years but our bodies haven't caught up yet. We didn't have things like grains and milk, and now it has become a part of our daily diet. After the second world war people were looking for cheap food sources and cereal and milk became one of them. People came into schools and said you need calcium for strong bones - well, we used to have strong bones without drinking milk because there was no such thing 10,000 years ago.
"We are the only animals that have special foods for breakfast – I say eat what you fancy. If you want eggs, smoked salmon, or a piece of chicken, have it - it doesn’t have to be cereal based – it is not good for us. Gluten is Latin for glue because it has such a sticky characteristic – milk protein is also sticky."
Here are his action points to help preserve your brain health and function:
• Reduce your carbohydrate consumption immediately. Shoot for a total of no more than 80 grams of carbs in your daily diet. This means favoring vegetables that grow above ground like kale, broccoli, spinach, and cauliflower as opposed to those that store carbohydrate in the form of starch like potatoes and beets. It means limiting fruit consumption and being especially vigilant with things like fruit juice. A single 12 ounce glass of orange juice contains a full 36 grams of sugar. That's about 9 teaspoons -- the same as a can of soda.
• Eat more fat. Increase your consumption of healthful fats like extra virgin olive oil, avocado, grass-fed beef, wild fish, coconut oil, nuts and seeds. At the same time, keep in mind that modified fats like hydrogenated or trans fats are the worst choices for brain health. Cooking oils like corn oil and soy oil that have been processed to stay on the grocery store shelf for months or even years have no place in a brain healthy program.
• Get at least 20 minutes of aerobic exercise each day. Aerobic exercise actually activates the DNA that turns on the growth of the hippocampus, giving you a second chance at not only preserving, but actually enhancing memory function.
• Add a nutritional supplement providing approximately 1,000 mg of the omega-3 DHA to your daily supplements. Like aerobics, DHA also activates the gene pathway that enhances growth of new brain cells where you need them most -- in the memory center.
Everyday in clinic, we tell our patients to choose foods low in saturated fat. Because these foods raise plasma cholesterol, the thinking goes, they cause heart disease. Today, every major medical organization – from theAmerican Heart Association to the Harvard School of Public Health to the USDA [1-3] – recommends a diet low in saturated fat to prevent and treat heart disease. The fat-cholesterol-heart disease connection is so thoroughly integrated into both medicine and popular culture that it’s become dogma. But since the initial data on saturated fat and cholesterol were published, our understanding of heart disease and cholesterol has significantly improved. We’ve moved from looking at total cholesterol to measuring LDL, HDL, and triglycerides. And as we better understand the pathophysiology of vascular disease, we may start to move away from cholesterol and directly measure lipoproteins instead. But even as our risk factor assessment has evolved, the diets we recommend to our patients have not. Are we due for a more nuanced approach to evidence-based dietary recommendations? Let’s take a look at the evidence.
The Early Observational Research
The first hypothesis that saturated fat might cause heart disease was developed more than a half century ago from data on the eating patterns of various nations. Back in the 1950s, researchers noted the epidemiologic relationship between heart disease and saturated fat consumption.[5,6,7] These associations were reinforced by data from the Framingham Heart Study which showed an association between hyperlipidemia and heart disease. Critics at the time noted flaws in the original epidemiologic research, pointing out that additional available data would eliminate the saturated fat-heart disease association. And while the Framingham study did find that cardiovascular disease was five times more likely for men with cholesterol over 260 than under 200, there was no difference between these groups in the type or quantity of fat consumed. The investigators also noted that cholesterol has “no predictive value” for women. And data on plasma cholesterol doesn’t necessarily tell us much about the effect on heart disease. A 1969 report from the National Heart, Lung, and Blood Institute stated, “It is not known whether dietary manipulation has any effect whatsoever on coronary heart disease.”
Metabolic Ward Data
Dietary research is notoriously hard to carry out. Researchers often rely on food frequency questionnaires to determine what participants in the study ate. Trusting their data requires placing faith in the ability of patients to recall exactly how frequently they eat various types of food. Many researchers believe these questionnaires to be a totally unreliable method of quantifying what people actually eat. Investigations on institutionalized patients provide a way around this data collection conundrum. The Finnish Mental Hospital Trial and the Los Angeles Veterans Adminstration Study are the two most well known papers in this area. The Finnish trial was a crossover study looking at patients in two psychiatric hospitals in Helsinki; one hospital served its patients full fat milk and butter while the other served unsaturated vegetable oils and filled milk (milk that has been filtered and had its fat replaced by emulsified vegetable oil). At the end of 6 years, the hospitals switched diets. The Finnish study found a 50% relative risk reduction in cardiovascular mortality (although no change in total mortality) in male patients fed the low saturated fat diet. Critics of the Finnish study have noted that the study was poorly controlled: almost half of the participants either entered or left the study over its 12 year duration and sugar consumption varied by more than 50% over the course of the trial. The Los Angeles VA study found an 18% relative risk reduction in cardiovascular deaths by replacing animal fat with vegetable oil, but no difference in overall mortality.
Newer research and confounding observations
More recent investigations have only served to complicate this issue further. After a 2008 expert meeting, the Food and Agricultural Organization of the WHO concluded that “Insufficient evidence relating to effect on the risk of heart disease in replacing saturated fat with carbohydrates” and “Probable evidence that replacing saturated fats with refined carbohydrates may increase risk of heart disease and favor metabolic syndrome development.” The Women’s Health Initiative found that a reduction in saturated fat did not significantly reduce the risk of heart disease or stroke. The A to Z weight loss study published in JAMA found better blood pressure and lipid profiles in patients following the Atkins diet compared to those reducing their saturated fat intake. A 2010 meta-analysis of prospective cohort studies looking at saturated fat and heart disease concluded, “There is no significant evidence for concluding that dietary saturated fat is associated with an increase in CVD.”
While many of the studies investigating the effect of diet on health look at proxies for cardiovascular disease like cholesterol levels and blood pressure instead of measuring hard outcomes like cardiac events and mortality, others confound the effect of dietary changes by measuring the effects of multiple simultaneous interventions. The most famous example of this is Dr. Dean Ornish, who has demonstrated an incredible impact on cardiovascular disease through his research on comprehensive lifestyle changes. Dr. Ornish attributes the effect to his ultra low fat diet, but his is still a hypothesis waiting to be rigorously tested.
Reconciling Discordant Observations: The Vital Importance of Replacement Nutrients
Caveats abound in the research on diet and heart disease and we must take caution before drawing conclusions about healthy eating. When counseling our patients, it is vital to remember that decreasing saturated fat changes two variables in the food consumption equation: the removal of saturated fat and the addition of something else to replace it. Indeed, the replacement that our patients choose is likely to be the factor that determines whether a reduction in saturated fat consumption is helpful or harmful.
A look at some other populations provides useful context. When the Tokelau people, Pacific Islanders who consume more than half of their calories from saturated fat, migrate to New Zealand, their saturated fat consumption goes down by half. But their rates of heart attack go up. The Masai, an African tribe, are another excellent example. When they are young, they eat a diet almost exclusively composed of blood, milk, and meat, at least one third of calories from saturated fat. As they get older, the Masai that continue this diet are remarkably free of atherosclerosis, even after age 60. But those Masai that reduce their consumption of these substances high in saturated fat and replace them with flour, sugar, and shortening begin to develop atherosclerosis.
Telling patients to reduce saturated fat consumption without giving them instructions on what to replace it with is a gamble. While the evidence suggests that replacing saturated fat with unsaturated fat reduces the risk of cardiovascular disease, it appears that replacing saturated fat with carbohydrates tends to worsen insulin sensitivity and lead to development of metabolic syndrome.[23,24,25].
A 2011 Cochrane Review found that replacing saturated fat with unsaturated fat can reduce relative risk of cardiovascular events by 14%, which equates to a 1% absolute risk reduction over two years. This is a modest, albeit significant benefit for a major lifestyle change. So we should be open with patients about the magnitude of risk reduction from adopting our proposed dietary recommendations. And we should also be careful about how we frame the changes, being honest about the risk they face by substituting carbohydrates for saturated fat.
This absolute risk reduction is one of the most important take home points when thinking about evidence based dietary recommendations. Smoking cessation and blood pressure control are likely to be lifestyle interventions with a greater magnitude of benefit than saturated fat reduction. We should allocate time in our clinical practices to discuss lifestyle modification, but we should also be mindful of the absolute benefits that we hope to attain.
Dr. Gregory Katz is a 2nd year resident at NYU School of Medicine
Peer reviewed by Robert Donnino, MD, Cardiology Section Editor, Clinical Correlations
Check out the young Woman in the photograph, I am sure she is a very wonderful person and the apple of her parents and friends eye. Obviously very young, but for me looks a picture of health. I expect as in the UK a SA Dietitian is University educated, so clearly the Woman is far from illiterate. So, what's the problem.
Check this out from Catherine's website.
“We also wish to draw attention to the fact that “carb-free”, “low-carb”, “high-protein” and other such diets have shown no long-term benefit over conventionally balanced healthy eating plans. Healthcare professionals and patients should be aware of the scientific merits (or lack thereof) related to nutrition recommendations from various sources. Most importantly, they should receive their guidance from practitioners trained in diabetes rather than from the media.”
"In this day and age, where you can tweet, pin, drop, Facebook and who knows what else – it is even more important to second guess what you read. There are many gurus and quack’s out there whose interests are somewhat questionable. So, don’t just blindly follow what they are telling you to do. Rather, take a step back and investigate first. Your health is worth that.
So, how do you know if what these quacks/guru’s are “feeding” you is… true or not? You go to the scientific research which is available… Don’t understand it? Your best bet is then to seek out an expert opinion. Someone who is trained in the applicable field. In terms of nutrition, dietitians are the food experts. Visit Association of Dietetics South Africa (ADSA) -www.adsa.org.za to find your nearest dietitian."
"So, how do you know if what these quacks/guru’s are “feeding” you is… true or not? You go to the scientific research which is available…"
"quacks/guru’s" does she mean people like me ! BTW did you notice on Graham's post the Dietitian was making comments re high fat and high protein as is Catherine. We have never recommended high fat and high protein, so often these people twist what we say and have found to be successful.
We recommend low carb, high quality fat, medium protein, a big difference, not that a high protein diet is a problem for a non diabetic individual with good kidney function. The tragedy in all this is a very well intentioned bright young lady has been fed a complete crock of dietary garbage, at least as far as diabetics are concerned. She will send thousands to a painful and early grave, unless she sees the light.
Eddie, your friendly neighbourhood quack and guru, who can shred any argument re. the best way to control type two diabetes, put forward by any healthcare professional, who does not believe that a low carb diet and exercise, and nil/minimal meds is the best way to control type two diabetes.