Saturated fats no longer the true enemy, experts say

Saturated fats are not the enemy. But processed foods are, according to a new policy statement from the Heart and Stroke Foundation of Canada.

On Thursday, the foundation released a new policy statement that questions conventional wisdom about the dangers of saturated fats on the heart.

Saturated fat is found naturally in red meat, dairy products and certain oils, such as palm oil. For years, a debate has raged over whether saturated fat contributes to poor heart health. Many nutrition and dietary experts, including the American Heart Association, warn that saturated fats can raise the risk of cardiovascular disease and urge people to limit consumption of dairy, red meat and fried, processed food.

But recently, more evidence has emerged that calls that relationship into question. Although more work needs to be done to fully understand how saturated fats affect long-term health, the Heart and Stroke Foundation said it no longer makes sense to single it out. Instead, Canadians need to focus on eating fresh fruits and vegetables, whole grains, meat and other products that have not been processed, said Manuel Arango, director of health policy at the Heart and Stroke Foundation. There is no question that fried and processed foods contribute to poor long-term health, he said.

The organization is also urging Canadians to stop fixating on one particular aspect of food – such as fat, sodium, calories, sugar – and instead focus on eating unprocessed, whole foods. Also steer clear of products advertised as low fat because, chances are, they are loaded with other things you don’t want, such as calories, sodium or other additives, according to the association.

“That low fat claim could potentially be quite misleading,” Arango said.

Russell de Souza, a nutrition epidemiologist at McMaster University in Hamilton, recently completed a study that found saturated fat is not linked to stroke, type 2 diabetes, heart disease or death.

The study, published last month in the British Medical Journal, did find a clear relationship between trans fats, which are often found in processed or fried foods, and heart health problems.

In the past, de Souza said, studies found that people who ate lower levels of saturated fats tended to have better heart health.

But if you examined their food choices, those people chose to eat more plant-based foods that are high in antioxidants and important nutrients, which could have contributed to their heart health.

The research has never clearly shown that saturated fats are the cause of heart health problems. Now, the tide appears to be turning.

“Maybe butter is not as bad as we thought it was before,” Arango said.

“At the end of the day, our bottom line is we need this balanced diet and you don’t have to worry as much about intake of saturated fat.”

That doesn’t mean loading up on butter and steak is a good idea. Rather, the Heart and Stroke Foundation is advocating for moderation and choosing whole foods instead of processed ones.

http://www.theglobeandmail.com/

Graham

Pumpkin Spice Muffins : Low Carb

Pumpkin spice muffins, just right for this time of year, don't you think! This is a very nice recipe suggestion from Elviira at 'Low Carb So Simple'... and like her, I am sure you will find these low carb 'pumpkin spice muffins' are soft, moist and incredibly yummy!

Ingredients:
12 medium size muffins
(net carbs 2.2g)
1 1/2 cup = 360 ml almond flour
1 tablespoon (organic) pumpkin pie spice
2/3 cup = 160 ml erythritol crystals
2/3 cup = 160 ml (organic) pumpkin
4 extra large (organic) eggs

Elviira gives some very useful hints and tips on how to cook these delicious low carb muffins, which you will find here

You may not have come across Pumpkin pie spice, it is an American spice mix commonly used as an ingredient in pumpkin pie, similar to the British and Commonwealth mixed spice. It is generally a blend of powdered cinnamon, nutmeg, ginger, cloves, and sometimes allspice. It can also be used as a seasoning in general cooking.

To make your own - here is Betty Crocker's easy recipe for Pumpkin Spice

To start, you’ll need all of three minutes and the following ingredients:

3 tablespoons ground cinnamon, 2 teaspoons ground ginger, 2 teaspoons ground nutmeg,

1 ½ teaspoons ground allspice and 1 ½ teaspoons ground cloves.

Mix the spices together in a small bowl ... doesn't it smell lovely

Store the mixture in a clean small jar or spice container.

... and just because we are talking about pumpkins

I couldn't resist putting this photo up

grandson with a lovely pumpkin, photo taken in 2014 ...

it will soon be time for the 2016 pumpkin!

All the best Jan

HOW LONG DID YOUR ANCESTORS LIVE WHILE EATING BACON, LARD & WHOLE MILK?

My Great - Grandma was a tough ol' chick

She ate real, traditional food and could cook up fried chicken from scratch. When I say “from scratch,” I literally mean “from scratch.” As in, she would kill a chicken, dress it, coat it with flourand fry that baby up in a big ol’ frying pan of lard.

She was an amazing woman, my great-grandma. That woman wasn’t afraid of anything. She’d sleep out in the dark woods with hungry bears if you dared her to. She was that tough.

Naturally, when I started to research traditional, nourishing foods, I thought of my great-grandmother. I knew SHE would have supported my lifestyle, and probably could have taught me some amazing traditional cooking skills. But…Did Grandma really know best ?

One of the most common questions when talking about the wisdom of traditional diets is…..“Didn’t people way back then drop dead at 40? They ate a lot of meat and fat. They must have had a shorter life expectancy, right?”

Wrong!
he truth is, life expectancy is NOT a recorded number of the age people died, but rather anaverage of all deaths, with a very high number of infant deaths. High infant mortality rates before 1900 skewed the numbers. The high infant mortality rate before the 1900s was due to unclean conditions and poor medical care. Subsequently, life expectancy numbers before the year 1900 gets easily knocked down to a low life number.

Because infant mortality rates decreased as medical technology increased, the average life expectancy for men in 1907 was 45.6 years. In 1957, it was 66.4. In 2007 it reached 75.5. The increase in life expectancy numbers is due mostly to a decreasing infant mortality rate, which decreased from 9.99% in 1907 to 2.63% in 1957, and then all the way down to 0.68% in 2007.

THE TRUTH IS THE HUMAN LIFESPAN HAS BEEN CONSISTENT FOR MORE THAN 2,000 YEARS!

"The inclusion of infant mortality rates in calculating life expectancy creates the mistaken impression that earlier generations died at a young age; Americans were not dying en masse at the age of 46 in 1907. The fact is that the maximum human lifespan — a concept often confused with “life expectancy” — has remained more or less the same for thousands of years. The idea that our ancestors routinely died young (say, at age 40), has no basis in scientific fact. When Socrates died at the age of 70 around 399 B.C., he did not die of old age but instead by execution. It is ironic that ancient Greeks lived into their 70s and older, while more than 2,000 years later modern Americans aren’t living much longer.”

– Benjamin Radford, Bad Science Column

JUST FOR CURIOSITY, I DECIDED TO RESEARCH MY OWN ANCESTRAL LINE AS WELL AS MY HUSBAND’S ANCESTRAL LINE TO FIND OUT HOW LONG OUR VERY OWN ANCESTORS LIVED.

My husband’s great-great-great-great grandfather Augustas Oliver Artemas Stowell, was born June 4th, 1783 and died August 23, 1860 at age 77.

My husband’s great-great-great-great grandmother Mary Stephens Holmes, was born Sept. 15th, 1797 and died Nov. 20th, 1885 at age 88.

My great-great-great-great grandfather James Monroe Lindsey, was born December 30th, 1829 and died January 9, 1912 at age 83.

My great-great-great-great grandmother Mary Sarah Ann Little, was born July 2nd, 1832 and died March 5th, 1910 at age 78.

Crazy, right? Turns out Grandma and Grandpa knew how to live a long, healthy life with traditional food!

Read more here: http://www.weedemandreap.com/

Graham

Walnut-coated salmon with a goat’s cheese and cauliflower mash

Walnuts are a delicious and crunchy topping for salmon, while the combination of earthy cauliflower and creamy goat's cheese makes an amazing mash, why not try it and see!

Ingredients:
Serves 4
100g walnuts, finely chopped
2 tbsp honey
1 tsp cider vinegar
1 tsp za'atar
4 x 130g skinless salmon fillets
1 large head of cauliflower, cut into florets
100g soft goat's cheese
320g tenderstem broccoli

Method:
1. Preheat the oven to 200°C/gas mark 6. Mix together the walnuts, honey, vinegar and za’atar. Place the salmon fillets on a baking tray lined with greaseproof paper. Top each fillet with the walnut mixture, pressing down so it coats the skin. Bake in the oven for 12-15 minutes, until golden and crispy on top and the fish is opaque.
2. Meanwhile, boil the cauliflower florets for 10-12 minutes until soft. Drain and return to the pan. Cook over a gentle heat for a couple of minutes to dry it out. Add the goat's cheese and mash with a potato masher, then season with black pepper.
3. Meanwhile, steam the tenderstem broccoli for 8-10 minutes. Serve with the salmon and mash.

Each serving provides
15.3g carbohydrate 6.9g fibre 39.0g protein 41.4g fat

Original recipe idea from here

Did you know za'atar, pictured above, is a blend of herbs, sesame and salt. As a prepared condiment it is generally made with ground dried thyme, oregano, marjoram, or some combination thereof, mixed with toasted sesame seeds, and salt, although other spices such as sumac might also be added. You can read more details here 

We bring a variety of articles and recipe ideas to this blog, and not all may be suitable for you. If you may have any food allergies, or underlying health issues these must always be taken into account. If you are a diabetic and not sure how certain foods may affect your blood sugars, test is best, i.e. use your meter. 

All the best Jan

Food Scientists using x-rays to figure out fats

Newswise — University of Guelph researchers studying the intimate structure of edible fats are getting help from the United States Department of Energy (DOE).

The researchers hope to replace unhealthful trans and saturated fats with better non-saturated versions – all without compromising texture. That swap could have great implications for the food industry, says Maria Fernanda Peyronel-Svaikauskas, a research associate working with food scientist Prof. Alejandro Marangoni.

To conduct their studies, Peyronel-Svaikauskas and the other U of G researchers use the DOE’s Advanced Photon Source (APS) at Argonne National Laboratory in Lemont, Illinois.

X-rays generated at that facility enable scientists to study and characterize the structure of edible fats at meso and micro levels (hundreds of nanometres to a few micrometres in size).

Edible fats are made of triglycerides that clump to form crystalline nanoplatelets (CNPs), which in turn form larger masses of particles.

The researchers use the APS to study those larger structures inside and out. Unlike using conventional microscopy, using X-rays means researchers need not condition or manipulate samples for in-situ measurement.

Peyronel-Svaikauskas says trans and saturated fats are important because they provide structure for semi-solid edible fats such as shortening or butter-like spreads. But “as soon as the healthier unsaturated fats are used to replace the trans and saturated ones, the solid structure is lost,” she says.

“The key problem is the food industry trying to do this with much trial and error. We are trying to help them with our research by removing the trial and error.”

Researchers have looked at fats using other sophisticated imaging techniques for decades.

The Guelph team uses new technology at the APS called ultra-small angle X-ray scattering for the first such structural analysis of fats and oils. The researchers model CNPs in computer simulations to guide experiments and predict outcomes.

Researchers need to propose experiments and book APS time through the DOE. Peyronel-Svaikauskas says they need to be ready to go to Illinois and squeeze a lot of work into eight-hour shifts, all in a high-security facility.

“You feel like you don’t want to touch anything, and every step you take, there is someone telling you what or what not to do. You’re always concerned that you’re going to press the wrong button or that the alarm will sound. It’s tense.”

Radiation is a concern when working with X-rays, but she says researchers can accomplish a lot using the high-flux, high-energy X-ray beams at the APS.

“You’re looking at X-ray scattering at really tiny angles. The smaller the angle, the larger the feature you look at in your sample. That’s important if you want to understand how the meso to micro structure gets formed.”

They found characteristic patterns normally missed by conventional wide- or small-angle scattering. Their computer models and predictions helped them understand what was happening to fat structures.

Food scientists may use this information to decide whether they have the desired product for a particular purpose, such as a spreading or a fat to make cookies or to get the best chocolate.

“When you think about the amount of applications for fat, it’s tremendous,” says Peyronel-Svaikauskas. “It’s hard to say that what you see in one system can be translated to another system because you are talking about different molecules, and each one has to be processed according to the functionality you want at the end.”

By understanding the structure of unhealthful fats, she hopes to advise industry when substituting an unsaturated fat for a saturated one.

The U of G researchers also plan to look at the effects of enzymes on their samples.

http://www.newswise.com/

Looks like another frankenfood could be in the pipeline !

Graham

Harvest Festival and Food-banks

photo credit

'We plough the fields, and scatter the good seed on the land;

But it is fed and watered by God's almighty hand:

He sends the snow in winter, the warmth to swell the grain,

The breezes and the sunshine, and soft refreshing rain.

Chorus All good gifts around us

Are sent from heaven above,

Then thank the Lord, O thank the Lord

For all His love.'

above lyrics as published in 1861 in A Garland of Songs

The months of September and October are wonderful harvest months with vegetables such as Aubergine (egg-plant), Cabbage and Celeriac ... each of which is a low carbers favourite ... to fruits like apples, plums and raspberries, with raspberries definitely on many a low carbers dish. I used to enjoy both my local church and school harvest festivals and of course these still continue each year, many of which include the hymn above, but reading a magazine article recently - sadly I thought the words rang true. No matter if you live in the UK, the USA, Canada, - and beyond - see if you agree.

" The rise of food-banks has given Britain's harvest festival tradition a new momentum - but has left little room for fresh produce as part of the celebrations.

In the past, September was a time when churches and school halls were filled with an abundance of seasonal fresh fruit, vegetables and bread, much of it destined for those in need.

That began to change as tinned and dried foods became more prominent, and a strict 'no-perishables' policy is now common among harvest festival organisers, whose goods are increasingly bound for foodbanks and charities.

'In my youth, you'd have harvest festival on Sunday, and on Monday you'd pack everything that came in and take it out round the community,' says Reverend Gillian Houghton, a minister at Guisley Methodist Church in Leeds. But that isn't the case these days - churches have less direct contact with people in need, so now we ask for non-perishables, which we send to a food-bank and a local homelessness project.'

Use of food banks have risen to record levels, with The Trussell Trust - which operates a network of more than 400, with collection points in Waitrose stores - providing over one million three day emergency supplies last year. There is usually a large spike in donations around harvest time, particularly from Churches, Schools and other organisations.

'During previous years we've been incredibly humbled by the level of support people across the UK have given food-banks at Harvest time,' says the trusts network director, Adrian Curtis. 'This is the busiest time of year for us, when the colder weather means people can face having to choose between turning on the heating or putting food on the table.'

In 2010, a YouGov survey found more than 80% of people in the UK no longer celebrate harvest festival and, of those who do, more than half mark the occasion by donating dried or tinned goods.

Despite a campaign to bring fresh produce back to the heart of the celebrations, those at the sharp end says it's just not what is needed anymore.

'We can't take any fresh food because we can't store it,' says Vivian Salter, a director at Braintree Area Foodbank in Essex. 'Our rules on storage are exactly the same as they are for a supermarket.'

'Sometimes churches will have an auction of fresh produce, and give us the proceeds of that, but mostly they encourage people to bring tins and packets.'

Despite talk of dwindling interest, churches, charities and farmers insist harvest traditions are alive and well in Britain.

'Festival services remain very popular, especially among families and children,' says a Church of England spokesman. 'As the Church seeks to tackle issues about the environment, climate change and sustainability, its themes of of thanksgiving for creation, care for the countryside have struck a fresh chord with a new generation.'

But the modern harvest festival hasn't entirely severed its links with the agricultural past.

'I've been involved with Ely Cathedral's festival for many years, where we have fresh fruit and veg - and even livestock - at the service,' says Brian Finnerty of the National Farmer's Union of East Anglia.

Other Churches in the region have started running farmers' markets during festival weekends, he says, while a new recipe book Great British Food From Great British Farms *, will be given out during this year's celebrations. 'It's really a good opportunity to reinforce the links between food and farming,' adds Finnerty. "

The above words taken from Waitrose Weekend Magazine    

photo credit

*Please note the recipes in this on-line book may not be suitable for you. If you may have any food allergies, or underlying health issues these must always be taken into account. If you are a diabetic and not sure how certain foods may affect your blood sugars, test is best, i.e. use your meter.

If you may be looking for a lovely Aubergine (egg-plant) recipe,

this one is lovely, and makes a very nice snack.

Mini Aubergine / Eggplant Pizzas

 find the recipe here

All the best Jan

Gluten Free vs Grain Free

Libby at Ditch the Carbs wrote this article a little while ago, but the words may be of interest to many readers: "So we’ve all heard about going gluten free. Is it necessary? Is it the latest fad diet? Is it for everyone? What about healthy whole grains? And what is so wrong with gluten anyway, surely we’ve been eating bread for thousands of years right?"

She produced the above chart - but she also wrote much more about this - you can read it here

All the best Jan

Beetroot and orange soup with mustard seeds

Whether you choose to serve your soup in soup bowls, or a mug like these ones pictured above, this bright earthy soup (from Sainsbury's magazine) comes with a touch of orange sunshine! It can also make a great starter if you should be entertaining ...

Ingredients:
Serves 8
1 bunch of raw beetroot (about 700g), trimmed, bigger ones halved
1 tbsp olive oil, plus extra to serve
50 g butter
1 large onion, roughly chopped
2 cloves garlic, roughly chopped
2 tbsp red wine vinegar
600 ml vegetable stock
finely grated zest of ½ orange
1 tbsp mustard seeds

Method:
1. Preheat the oven to 200°C, fan 180°C, gas 6. Put the beetroot in a roasting tin, drizzle with the oil and roast for 1 hour or until tender.
2. Remove from the oven and allow to cool slightly. Wearing rubber gloves, rub the beetroot to remove the skin, then discard it. Roughly chop the beetroot and set aside.
3. Melt the butter in a pan, add the onion and garlic and cook for 5 minutes until soft and beginning to colour. Add the vinegar; simmer for 3 minutes. Add the stock and beetroot and bring to the boil. Simmer for 5 minutes.

4. Meanwhile, toast the zest and mustard seeds in a dry frying pan for 2-3 minutes. Transfer to a plate.
5. Remove the soup from the heat and season. Blitz in a blender until smooth. Ladle the soup into mini mugs or bowls and top with the zest and mustard seeds. Drizzle with a little olive oil.

Tip - get ahead:

Make the soup up to 2 days ahead; chill. It can also be frozen.

Nutritional Details:
Each serving provides
4.4g carbohydrate 1.5g fibre 1.1g protein 8.4g Fat

Recipe idea from here

More about beetroot ... a favourite in 1970's British salads (served cooked and pickled in vinegar), beetroot is a root vegetable with dark, purple skin and pink/purple flesh. It has also enjoyed something of a deserved comeback in recent years, its earthy, rich and sweet flavour and vibrant colour lends itself to a variety of both sweet and savoury dishes.

Beetroot is a close relative of spinach and chard and has an earthy flavour and a good nutritional content - it's also reckoned to be a good detoxifier.

Choose the best:
Raw beetroot should have their stalks (fresh, not wilting) and roots (nice and firm) intact.

Prepare it:
To cook whole, wash but don't peel, then cut the stalks to 2.5cm and leave the root at the bottom; if either are trimmed too much, the beetroot's colour will bleed. Then, bake in a low oven, either wrapped in foil or in a little water in a lidded casserole dish. It should be ready in 2-3 hours. For boiling, prepare it in the same way, then simmer for around an hour.

Store it:
Fresh, they'll keep for several weeks in a cool, dark place.

Cook it:
Roast, chop and dress with walnut oil and chives. Bake in olive oil and cumin seeds, then dot with feta and bake again. Boil the beetroots for a few minutes, drain and serve with olive oil or butter. Juice raw beetroot, and mix half and half with carrot juice for a vitamin-rich drink.

Above picture and beetroot information taken from here

We bring a variety of articles and recipe ideas to this blog, and not all may be suitable for you. If you may have any food allergies, or underlying health issues these must always be taken into account. If you are a diabetic and not sure how certain foods may affect your blood sugars, test is best, i.e. use your meter.

All the best Jan

Test to see if you’ll get statins side-effects – available 2020

Eight million people take statins in the UK, which help lower cholesterol and reduce the risk of heart attack, but many suffer side effects. A major study of more than 100,000 people who’d been prescribed statins from 2000 to 2008 found that 17 percent of patients reported side effects such as muscle pain, nausea, and liver and nervous system problems, tiredness or shortness of breath.

Two-thirds of those who reported side effects stopped taking the drugs, and, the study found, half of those prescribed statins quit taking them at least temporarily, while 20 per cent quit for more than a year. However, the British Heart Foundation points out the vast majority of people who take them will not have a problem.

Now a team at Dundee University are developing a simple saliva and blood test that looks for particular compounds that predict whether someone will suffer adverse reactions when they take these pills. The scientists are hoping a commercially available test could become a reality by 2020.

http://www.hippocraticpost.com/

Graham

When you are a blogger ...

... you can choose what you like to post and blog about !

It may be a lovely LCHF recipe idea, this one is tasty
Provençal Chicken

Ingredients:
Serves Four

4.0g carbohydrate per serving

1 tbsp oil

100 g lean smoked bacon medallions, roughly chopped

1 red onion, cut into wedges

1 courgette, halved and cut into chunks

1 aubergine (eggplant), cut into small pieces

4 tomatoes, cut into large wedges

3 cloves garlic, finely chopped

1 red chilli, chopped

500 g carton passata

half a chicken stock cube, crumbled

460 g chicken thigh fillets

14g of fresh flat leaf parsley, washed and roughly chopped

2 tsp mixed herbs

The cooking instructions are here

it could be a picture of some lovely Autumn Berries, I thought these were nice

or how about some (old) photo's of our five grand-children that made me smile

it could even be a 'Winnie The Pooh' giphy, that our grand-daughters like

... be careful when you're trying to race after the falling Autumn leaves!

or it could be I just want to wish you all a happy and enjoyable day

When you are a blogger ...
you can wish all your friends, and readers, a good day and a good week ahead

and thank them for taking time to read the low carb diabetic blog

All the best Jan

Serious drug side effects are massively underreported in medical papers

An astonishing 64 per cent of drug or medical device side effects are left out of the published reports that clinicians so frequently base decisions on. This is the finding of a recent paper published in the journal PLOS Medicine by a team of UK researchers.

The paper looked at 28 studies dealing with the discrepancies present in hundreds of published trial results, versus their unpublished counterparts. Unpublished data was found in places such as pharmaceutical reports and clinical trial registries. This includes ClinicalTrials.gov in the US, one of the first of its kind set up to bring greater transparency to the industry.

The authors found that harmful side effects would have been missed between 43 per cent and 100 per cent of the time if only the published findings were consulted, and 64 per cent on average.

“There is strong evidence that much of the information on adverse events remains unpublished and that the number and range of adverse events is higher in unpublished than in published versions of the same study,” the authors wrote.

It is incredibly difficult to accurately assess the depth of the problem. But the authors believe it is, nevertheless, vast in scope.

“Most people in the healthcare sector like to demonstrate improvements in peoples’ lives - people only read about treatments that make them better,” co-author Yoon K Loke, professor of Medicine and Pharmacology at the University of East Anglia, told WIRED.

“The main purpose of a paper is that there is good news and that something works. Most people consider side effects to be bad news so they present the minimum possible. The journals want to publish something that is exciting and interesting. I wouldn’t say it is anyone’s fault in particular. People like to think they have the new cure for cancer. I blame the culture.”

The 28 studies the team looked at each approached the problem differently, so various specific issues were highlighted in each. One study, in particular, found that although there were fewer unpublished data sources than published among the trials studied, the total number of serious side effects was higher in the unpublished set. For example, instances of “suicide ideations, attempts, or injury, homicidal ideations, and psychiatric symptoms” all higher in the unpublished set. The side effects being dealt with in these broad studies are clearly not all trivial.

The authors are now calling for full and transparent reporting of trial results so that medical professionals can base their decisions on the wider picture.

This is far from an unknown problem. Loke says we are so frequently getting only “a small, incomplete picture” of what actually happened in a trial. In many instances the authors behind the 28 studies had to submit Freedom of Information requests to get a fuller picture.

John Ioannidis, professor in disease prevention at Stanford Medicine and academic editor on the PLOS Medicine study, believes most editors and journals are in fact not actually aware of the extent of the problem. “Reporting of harms has always been suboptimal, even worse than reporting of effectiveness outcomes that has also had substantial deficiencies,” he told WIRED. “Many journals are starting to take more seriously the need for making detailed protocols and raw data routinely available. This will hopefully help remedy some of this bias or at a minimum it will help probe its depth. But there will still remain a lot of unpublished data and their non-availability may keep distorting the literature.”

He adds that although there is some academic guidance provided to authors reporting on harmful side effects, “most journals don’t follow this guidance routinely”. “This leaves a lot of subjectivity on what/how to report among the typically large and difficult to organise amount of information that may be collected - either by plan or haphazardly - on side effects during a trial.

There have been higher profile instances of side effects being omitted from published papers that demonstrate just how grave the problem can be.

A 2014 Newsweek story highlighted how a "significant amount of negative data" from trials of the drug Tamiflu were withheld from the public. Around 70 deaths were attributed to the drug, many of them suicides - but this potential side effect was not known to the US Centre for Disease Control and Prevention or the doctors administering it.

Headway is being made to remedy the problem, but progress is slow. On September 14 the United Nations released a report from The High-Level Panel on Access to Medicines, which urged governments to “require that the unidentified data on all completed and discontinued clinical trials be made publicly available in an easily searchable public register”.

This was already being called for as far back as 2008, when the International Committee of Medical Journal Editors decided only to publish trials that had been publicly registered before they began.

"Registering trials means logging details of the trial in a publicly accessible online database so researchers can see that the trial has happened and its protocol," Sile Lane, director of campaigns and policy at independent charity Sense About Science, told WIRED.

"Anyone can look at the register entry to see what the trialists planned to do and then look at the published report to see if they have reported back honestly and completely. This helps us hold the trialists to account." ICMJE is also considering requiring every trial to submit and publish raw data.

GlaxoSmithKline has promised to make clinical study reports from all of its trials since 2000 public, while Bristol-Myers Squib andJohnson & Johnson have both agreed to make raw trial data open to researchers. However in general, says Lane, "big industry umbrella groups have not made this a priority and are not pushing to find remedies".

"History is only moving in one direction, and that's towards transparency...Some companies and some academics do this now. There's really no excuse for anyone running a trial not to do this."

http://www.wired.co.uk/

Graham

Baked Mini Bell Peppers

"Wow – so delicious! Small bell peppers with a creamy and spicy cheese will be a success at the dinner table. Great as a low-carb side dish or as a snack.

Ingredients
4 servings ( 5 carbs per serving )

½ lb (225 g) mini bell peppers, about 8-10
½ lb (225 g) cream cheese
1 oz. (30 g) chorizo, in thin slices
½ – 1 tablespoon mild chipotle paste
2 tablespoons olive oil
1 tablespoon fresh thyme or cilantro
1 cup (240 ml) grated (shredded) cheese"

For cooking instructions, see Diet Doctor site, here

Mini Bell Peppers:
These small, thumb size peppers measure about three inches tall and have a crisp texture. Mini Sweet peppers are thinner-skinned than larger peppers and their texture withstands grilling and cooking.
Seasons/Availability
Mini Sweet bell peppers are available year-round.
Current Facts
Mini Sweet peppers are grown specifically for their size, flavor and appearance. They are available in a trio of red, yellow and orange colors.
Applications
Mini Sweet peppers are great eaten fresh, out-of-hand or added to any number of dishes. Stuff peppers with cheese or ground meats; add raw peppers to salads or pasta dishes for added texture. Roasted Mini Sweet peppers make a nice addition to soups or stews. If refrigerated, the peppers will keep for up to two weeks, left at room temperature they will lose their crunchy texture within hours. Freeze roasted or grilled peppers for future use.

Details about mini bell peppers taken from here

All the best Jan

Travis - Idlewild ft. Josephine Oniyama

New from Travis enjoy
Graham

Lauren Shera - Once I Was A Bird

Saturday night time to chill out
Graham

Emeli Sandé - Clown

OK last one from me tonight, the stunning looking and very talented Emeli Sandé. Eddie 

FÁBRY - EMILIÓ - SZAKCSI LAKATOS BÉLA - BABOS GYULA - JÓNÁS ÁKOS - Gelem Gelem

Another track from the Man and friends. It's so easy to make great music when you have this sort of talent. Eddie

Szakcsi Lakatos Béla Sachi Peace For Pastorius

Saturday night again and music night on this blog. I added this album to my collection back in 1988. It is the work of Szakcsi Lakatos Béla born Budapest in 1943. He worked with and admired the work of bass legend Jaco Pastorius. Many people regard Jaco as one of the worlds true musical innovators. Like so many gifted musicians, Jaco went into self destruct mode, alcohol, drugs and mental illness. He was killed in a fight with a night club bouncer, and died aged 35. This piece of sublime music is a tribute to his memory. Eddie

The USA is going to the dogs! and it's official.

"When the U.S. sneezes, the rest of the world catches a cold" Who has not heard that quote. You don't need the brains of Einstein to understand what that quote means, when the US economy is going down, the rest of the world is in trouble. In many ways the UK is a much scaled down version of the US. How we got to be at fifth place is way beyond me. Our once envy of the world National Health Service is rapidly declining. Poverty is on the increase, over one million people depend on free food charities. Adults are living at home into their thirties because even a modest flat/apartment is totally unaffordable, and in real terms earnings have been going backwards for years.

As I said earlier "When the U.S. sneezes, the rest of the world catches a cold" The question I am asking myself, is how bad is it going to get? and we still have the prospect of either Clinton or Trump as the next US President.  

As Bloomberg reports, Iceland and Sweden share the top slot with Singapore as world leaders when it comes to health goals set by the United Nations, according to a report published in the Lancet. Using the UN’s sustainable development goals as guideposts, which measure the obvious (poverty, clean water, education) and less obvious (societal inequality, industry innovation), more than 1,870 researchers in 124 countries compiled data on 33 different indicators of progress toward the UN goals related to health.

The massive study emerged from a decadelong collaboration focused on the worldwide distribution of disease.

About a year and a half ago, the researchers involved decided their data might help measure progress on what may be the single most ambitious undertaking humans have ever committed themselves to: survival. In doing so, they came up with some disturbing findings, including that the country with the biggest economy (not to mention, if we’re talking about health, multibillion-dollar health-food and fitness industries) ranks No. 28 overall, between Japan and Estonia.

A reader comments.

"The U.S. is Number 1 in plenty of categories. It's Number 1 in prescription drug ingestion.  The U.S. makes up only 6% of the world's population, but its citizens ingest 80% of the worlds prescription drugs.  The U.S. is also Number 1 in incarcerations.  Again, with only 6% of the world's population, the U.S. has 25% of the world's imprisoned.  And, although I can't prove it statistically, having gone to Walmart, I think it's safe to post that the U.S. is Number 1 in having the greatest percentage of the world's scooter people.  That's why when Walmart remodelled its stores, it made the isles wider.  See you at the Golden Corral, fellow Americans." 

More on this article here.

If the stats quoted for US pharma drugs use, is anywhere near accurate, the mind boggles. 

The full Lancet report can be read here. 

Have a cheerful weekend folks. 

Eddie

Thyme and Roast Beef, with a Mustard Crust

image of thyme from wikipedia

Usually a favourite for Sunday dinners when it’s sprinkled on to roast meat or veg, you’ll find trusty thyme in most herb racks. But there’s so much more to this aromatic shrub. Here’s everything you need to know about thyme recipes.

What is thyme?

A modest-looking shrub with long thin sprigs of sprouting leaves. The sprigs and leaves can be used fresh, ground or dried. Just a teaspoon adds a pungent earthy flavour – but it’s not too overpowering, so it’s great for layering with other seasoning. Thyme is an aromatic herb, which means it’s used as much for its fragrant scent as its taste.

Where is thyme from?

Part of the mint family, thyme grows in Southern Europe and the Mediterranean. The ancient Greeks loved it for its fragrant aroma and used it as incense.

How do I use thyme?

If it’s fresh thyme, you can use just the leaves, whole sprigs or chop it up. Dried thyme can be used during cooking so the flavour has time to infuse – think pasta sauces, soups and even baking – or sprinkled on top of dishes to give an instant flavour boost. Generally, 1 tsp dried thyme is equal to 1 tbsp (3 tsp) snipped fresh thyme.

What can I make with thyme?

It’s great for meat marinades and cracking in veggie traybakes. Feeling more adventurous? Use it to liven up grilled fish, homemade pizza, creamy risottos or even cocktails. Plus, it pairs amazingly with lemon and goes great with other Mediterranean herbs like oregano, parsley and rosemary.

How long does thyme keep for?

Fresh thyme lasts for up to a couple of weeks in the fridge, while the dried stuff lasts for two to three years when stored in a cool, dark cupboard. Make sure you keep the lid tightly closed when you’re not using it.

Words above taken from here

If you are looking for something tasty for a great family Sunday meal, you've found it! This lovely recipe has a crisp mustard crust, and uses thyme, which just adds to the flavour. These ingredients serves four with leftovers, which are just perfect for use with some lovely swede rosti the next day!

Ingredients:

1 large British beef roasting joint (approx 1.5kg)
1 tbsp plain flour
2 large red onions, cut into wedges
16 shallots, peeled
2 bulbs of garlic, cloves separated but unpeeled
15 g fresh thyme
200 g Chantenay carrots, trimmed
A little (sunflower) oil

Method:
1. Take the joint out of the fridge 30 minutes before cooking to bring it up to room temperature. Preheat the oven to 230ºC, fan 210ºC, gas 8.
2. Weigh the beef to calculate the exact cooking time – for medium, cook for 15 minutes per 450g plus an extra 20 minutes; for well-done, cook for 20 minutes per 450g plus an extra 20 minutes.
3. Put the beef in a large roasting tin. Sift the flour and mustard together in a bowl, then use a tea-strainer or sieve to dust it over the fatty side of the joint. Season with freshly ground black pepper.
4. Roast the joint for 20 minutes, then reduce the oven temperature to 200ºC, fan 180ºC, gas 6 and cook for the remaining calculated cooking time. Baste the joint every 30 minutes with the pan juices.
5. An hour before the end of cooking time, put the onions, shallots and garlic in the roasting tin around the meat. Scatter over the sprigs of thyme, reserving a few sprigs for garnish. Toss the vegetables in the pan juices to coat; drizzle them with a little (sunflower) oil if necessary.
6. When the beef is cooked to your liking, transfer it and the roasted vegetables to a serving platter and cover loosely with foil. Let the meat rest for 20 minutes. Carve and serve with the roasted onion, garlic and shallots, plus veggies and trimmings of your choice. Garnish with the reserved thyme.

Original recipe idea here

We bring a variety of articles and recipe ideas to this blog, and not all may be suitable for you. If you may have any food allergies, or underlying health issues these must always be taken into account. If you are a diabetic and not sure how certain foods may affect your blood sugars, test is best, i.e. use your meter.

All the best Jan

Is Use of Diabetes Meds in Pregnancy Linked to ADHD?

MUNICH — Risk of attention-deficit/hyperactivity disorder (ADHD) may be increased in children of mothers who used medication for gestational diabetes or type 2 diabetes for more than 2 months during pregnancy, new research shows.

"Our data show that children exposed to their mothers' gestational diabetes or type 2 diabetes that required antidiabetic medication during pregnancy were found to be at greater risk of ADHD than children" who were not exposed to antidiabetic medications, reported Anny Xiang, PhD, Kaiser Permanente Southern California (KPSC), Pasadena, at the recent European Association for the Study of Diabetes (EASD) 2016 Annual Meeting.

"The magnitude of association seems to increase with increasing duration of…use," she added. "In children whose mothers took antidiabetic medication for over 60 days, after multivariate adjustment, we found a 23% increased incidence of ADHD (hazard ratio [HR], 1.23; P = .06)."

Comoderator of the session, Alexandra Kautzky-Willer, MD, professor of gender medicine at the Medical University of Vienna, Austria, commented on the findings, bearing in mind that 85% of the pregnant women in the study were on insulin treatment.

"These results are interesting, but we cannot say that insulin has a negative effect on offspring. It would be good to know about the hyperglycemic states of patients, which were not actually discussed but might be related to the outcomes."

Dr Kautzky-Willer emphasized that it was an important study due to the lack of work in this field currently and because insulin treatment is very common in pregnant women with type 2 diabetes. However, she stressed, "We cannot conclude that medication is dangerous at the moment."

Fellow moderator Adam Tabak, MD, PhD, from University College, London, United Kingdom, agreed. These are "interesting hypothesis-generating data, but I wouldn't rush to any conclusions at this stage. We need more phenotypically defined details of the population and to catch the unmeasured confounders," he stated.

Knowledge Gap: Gestational Diabetes, Type 2 Diabetes, and ADHD

Maternal type 2 diabetes and gestational diabetes are associated with increased risks of perinatal morbidities as well as obesity and metabolic disorders in the child, but the relationship between gestational diabetes and neurobehavioral disorders is not well studied, noted Dr Xiang.

This large, retrospective, population-based study aimed to assess the association of maternal type 2 diabetes or gestational diabetes with the risk of ADHD in the offspring, she added.

Information was extracted from electronic medical records on singleton pregnancies from 1995 to 2009 held by KPSC where delivery occurred between 18 and 44 gestational weeks.

Children with a diagnosis of autism were excluded, as were mothers with type 1 diabetes or polycystic ovarian syndrome, to focus specifically on type 2 diabetes and gestational diabetes, explained Dr Xiang.

Participant children were followed until the date of diagnosis of ADHD, last date of KPSC membership, death, or until December 31, 2014.

Children exposed to type 2 diabetes or gestational diabetes were stratified according to maternal age and ethnicity, and they were matched with children not exposed to maternal diabetes.

Of those children eligible for inclusion, 20,481 were exposed to gestational diabetes, 3407 were exposed to type 2 diabetes, and 110,905 were not exposed to diabetes.

Duration of Antidiabetic Medication Use Associated With ADHD

Outcomes were the development of ADHD and the age at diagnosis, with adjustments made for maternal age at delivery, household income, education, mother's history of ADHD, and gender, as well as potential confounders including preeclampsia/eclampsia, gestational weeks at delivery, birth weight, and birth defects.

The incidence of ADHD was similar in all groups: 4.1% in those not exposed to maternal diabetes, 3.9% in children of mothers with type 2 diabetes, and 3.8% in those exposed to gestational diabetes.

But Dr Xiang went on to explain that in children whose mothers were treated with antidiabetic medication (n = 7479), there was a small but significant increased risk of ADHD (HR, 1.20, adjusted to 1.16; P = .03), compared with children from mothers with diabetes [gestational or type 2 diabetes] who did not take any medication at all during pregnancy.

Among women with type 2 diabetes, 47% used medication during pregnancy, while 29% of those with gestational diabetes received pharmacologic treatment.

Results were then further stratified by duration of antidiabetic medication use into 1 to 29 days, 30 to 59 days, and 60 days or more, and a duration-dependent relationship with ADHD incidence was identified.

"The trend was significant both with and without adjustment for covariates, with a 23% increased incidence of ADHD in children whose mothers took antidiabetic medication for over 60 days."

The associations of ADHD with antidiabetic medication use for less than 60 days did not reach significance.

Dr Xiang acknowledged, however, that the study has limitations and stressed that more research is needed.

"We wonder if the increased duration [of use] might be a surrogate for the severity of diabetes during pregnancy and that this might be the surrogate for the increasing risk of ADHD," she observed, noting that this might be an avenue for future work.

And moderator Dr Tabak stressed that the limitations of the study should be taken seriously. "Some unmeasured confounders could be behind these findings…because these women could be socioeconomically very different."

Drs Xiang, Kautzky-Willer, and Tabak have declared no relevant financial relationships.

http://www.medscape.com/

Graham

Brussels Sprout and Cheddar Cheese Soup : Perfect For Autumn Days

If you should have spent time raking up any fallen Autumn leaves, or perhaps just been out enjoying a walk in some Autumn sunshine - then you may probably welcome a lovely bowl of this warming soup. 

This recipe suggestion is by Emma Franklin who is Assistant Food Editor at Sainsbury's magazine. Emma prefers to choose cheeseboard over the dessert trolley and perhaps her love for cheese shows in this recipe idea. I think the mature cheddar cheese goes so well with the Brussels sprouts and with cooler Autumn Days ahead why not keep this recipe in mind ...

Ingredients:
Serves Four
a splash of olive oil, plus extra for drizzling
2 medium onions, chopped
300 g cooked Brussels sprouts*
2 garlic cloves, crushed
650 ml vegetable stock
4 tbsp single cream
100 g mature cheddar, grated, plus extra to serve

Method:

1. Heat the oil in a medium pan and fry the onions over a medium heat until soft, 8-10 minutes. Meanwhile, roughly chop half the cooked sprouts and cut the rest into halves or quarters, depending on size.
2. Add the garlic to the pan and stir-fry for 1 minute, then add the chopped sprouts and stock, cover with a lid and bring to the boil. Take the pan off the heat and leave to cool slightly.
3. Purée the soup. Stir the cream, remaining sprouts, cheese and some seasoning into the pan and simmer for 2-3 minutes or until the cheese has melted. Serve with a drizzle of olive oil and a scattering of extra cheese.

*Please note the Brussels Sprouts should be cooked first, approx 8-10 minutes, or until tender, in boiling salted water.

Each serving provides:
7.9g carbohydrate 5.7g fibre 4.2g protein 5.0g fat

Enjoy your Autumn Days ...

All the best Jan

The Low Carb Diabetic Blog !

Why The Low Carb Diabetic Blog ?

Well the blog has been going for some years now, and we have recently welcomed many new readers from all around the world.

From both emails and comments received some have asked about the blog when and why was it first introduced etc:

Our original profile states:

"We are a small band of diabetics all low carbers. Posting links to diabetes related articles and low carb food advice. In our spare time we like to lampoon the spreaders of fear and misinformation. Welcome to the crazy world of diabetes."

Our Interests: "Challenging the outdated dogma that believes diabetics should base their diet on blood glucose raising carbohydrates, and demolishing the myths that says saturated fat causes chronic disease."

Our Favourite books include "Dr.Richard Bernstein The Diabetes Solution, Gary Taubes The Diet Delusion, Dr. Malcolm Kendrick The Cholestrol Con. "

In more recent times the blog has taken on a more magazine type feel with a widening of articles, news, views, recipes, some personal stories, and our ever popular Saturday Night Is Music Night Spot.

The team's main concern is still with diabetes and the better control of it by following a LCHF lifestyle, but more and more people, who are not diabetic, have been discovering this lifestyle and seeing for themselves the improvement in health and well-being it can give.

None of the low carb team are medical professionals. The articles you read are personal views but often link to both medical and scientific studies.

I am the only one of the team who is not a diabetic, but being married to Eddie a Type 2 diabetic, and seeing how this LCHF lifestyle can and does help so many, it just made sense to live the lifestyle myself and join the small team.

We look forward to posting up many more articles, and many thanks for taking time to read.

You may also be interested to read this "Introduction to low-carb for beginners", you can find it here

All the best Jan

Ricotta and almond courgette ravioli with a crushed-tomato salsa

Yes, a clever way with raw courgette/zucchini, wrapped around ricotta with a punchy relish! This is gluten-free and very low-carb. Yellow courgettes are ideal if you want your ravioli to resemble the real thing, but green ones work perfectly well. It is important to make the courgette strips as thin as possible so they stay in shape when folded. You can use ground almonds in the filling if you prefer, but it is worth going to the effort of blitzing toasted flaked almonds for the extra flavour they bring.

Serves Four
INGREDIENTS
2 large courgettes/zucchini
25ml extra-virgin olive oil
100g toasted flaked almonds
250g ricotta
50g vegetarian hard cheese, finely grated
small handful of fresh basil leaves, finely sliced
75g wild rocket

For the salsa
3 tbsp extra-virgin olive oil
1 tsp red-wine vinegar
1 shallot, peeled
1 garlic clove, peeled
300g vine-ripened cherry tomatoes, quartered
large handful of fresh basil leaves, finely sliced

METHOD
Slice the courgettes/zucchini into thin ribbons using a mandolin or peeler. You need 40, each at least 12½cm long.

Toss the ribbons in a bowl with the oil until evenly coated, and set aside to soften.

For the salsa, put the oil and vinegar in a medium-sized bowl. Finely chop the shallot and garlic, add them to the bowl and whisk everything together. Season, then toss through the tomatoes.

Using a potato masher, roughly mash them up a little so the juices come out, making a sauce but leaving lots of texture. Finally, stir in the basil. Set aside.

Blitz 75g of the flaked almonds in a mini-blender to create fine crumbs. Tip into a medium-sized bowl and add the ricotta, hard cheese and basil. Stir well and season.

Lay two pieces of courgette/zucchini criss-crossed on a clean board. Spoon a tablespoon of ricotta mixture in the centre.

Wrap the two ends of the bottom piece of courgette/zucchini over the filling, followed by the two ends of the top piece, to enclose. Turn the parcel seam-side down.

Repeat to make 20 parcels, arranging five on each serving plate as you go. These can be made up to two days ahead. If making in advance, place them on a large tray lined with non-stick baking paper.

When ready to serve, spoon the salsa over the ravioli. Pile some rocket leaves on top, scatter with the remaining almonds and finish with a twist of pepper.

Above photo credit - Cristian Barnett.

Original recipe idea/words by Sharon Hearne-Smith here

Read more about courgettes here

All the best Jan

Ben Goldacre: Bad pharma and the canary in the coalmine for problems in modern medicine

Ben Goldacre is on the phone from London and he’s getting exercised about statins. “Statins are the canary in the cage for problems in modern medicine,” he says.

They are also the subjects of his next book – yet to be completed – and were addressed at some length in his last one,Bad Pharma (2012).

His continued focus is not surprising. For a host of reasons, research into statins and the prescribing patterns that research catalyses pretty much epitomise his concerns about medical academia.

They are concerns that, since he qualified as a medical doctor in 2000 after studies in Oxford, Milan and Los Angeles, have seen him move from GP, to author, to researcher, to, now, medical activist.

Goldacre, UK-born to Australian parents, fronts two long-term campaigns designed to bring about root and branch reform of the ways clinical trials are conducted and reported.

The first, AllTrials, has been running since 2013. It seeks to ensure that every trial is both registered with an appropriate authority and then published, regardless of result. At present, perhaps as much as 50% of trial write-ups never see the light of day.

The second campaign, CompareTrials (CT), kicked off late last year and aims to enforce procedural transparency in trials. At issue is the matter of switched priorities: trials that start by researching one outcome, but then change to another before the exercise is concluded.

Earlier this year, the CT team checked every trial published between October 2015 and January 2016 in five major publications, including the British Medical Journal and the Annals of Internal Medicine.

The results reported were compared to the outcomes specified when the trials were initially registered, or the founding protocols published. Out of 67, only nine did what they set out to do. In the rest, 354 stated outcomes were not completed, and 357 new ones were added.

Goldacre happily admits that CT is a “preposterously nerdy venture”. That said, however, it doesn’t diminish its importance.

“There’s a real problem in the way that clinical trials report their results. You can measure the outcome of your trial in hundreds of different ways,” he said.

He poses the hypothetical example a drug aimed at improving cardiovascular health. How baseline and improved health are assessed are matters of great complexity. Blood tests can measure perhaps 20 applicable lines of evidence, each set against potentially hundreds of cut-off points. Symptom questionnaires can be measured against a plethora of ratings scales. Hospital admissions can be recorded by treatment, code, doctors’ notes or length of stay. Patients can be monitored over days, weeks, years, decades.

“So you potentially have thousands and thousands of ways of measuring something like cardiovascular health,” he says, “And because there are so many ways of measuring it, that means the results are really vulnerable to cherry-picking.

“That’s why traditionally we ask people at the beginning of a clinical trial to specify exactly what they are going to measure as the success criteria, and exactly how they are going to measure it.”

Tradition, obligation, and principle, however, are not unbreakable bonds (as any subscriber to Retraction Watch can testify). Much of Goldacre’s Bad Pharma comprises a detailed and depressing catalogue of the many ways in which researchers – sometimes at the behest of the pharmaceutical companies sponsoring the work – recalibrate their initial intentions and generally fiddle with the data.

Sometimes this is merely a matter of spin – such as expressing a benefit as a relative rather than absolute risk reduction – but sometimes it is much more organic.

Outcome priorities are changed; negative results are omitted; trials are foreshortened or extended to better massage the data. In the book, Goldacre terms these tactics “a quiet and diffuse scandal”.

Perhaps this would not matter quite so much if it weren’t for the fact that published trial results feed into pharmaceutical marketing and doctor prescribing choices.

In Bad Pharma, Goldacre relates a trial featuring a new painkiller, celecoxib, that was tested against two other pills to assess side-effect gastrointestinal complications. The published study showed clearly that over a six-month period the new drug was way better than the old ones, leading many GPs to preference it in prescribing.

But it eventually came to light that the original intention of the trial was to test the three pills for a 12-month period – over which celecoxib performed no better than its rivals.

At the other end of scale, in the late 1990s pharmaceutical company GSK investigated anecdotal reports of deaths associated with its asthma inhaler drug Salmeterol. It set up a large clinical trial, with participants monitored intensively for 28 weeks.

It then asked participating doctors to keep an eye out for adverse events for another six months – but did not actively search for cases.

Not surprisingly, the period of intensive monitoring revealed a higher number of negative outcomes (measured against a placebo) than the follow-up period when no one was looking too hard. Changing its initial trial protocol, GSK reported the figure for the two periods combined, thus reducing the apparent severity of the problem.

Which brings us back to statins, the most commonly prescribed medication in the developed world, and Goldacre’s canaries.

In Bad Pharma, he points out that the two most popular prescribed statins, atorvastatin and simvastatin, both work well, but no one has ever tested them against each other to determine which one works better. This is an important point, because if one works only slightly better than the other it’s still a result that could convert into the prevention of thousands of strokes and heart attacks every year.

In the absence of this data, prescribing, Goldacre points out, is effectively a random act. But attempts to formally constitute that randomness as a countrywide trial in England met with a farcical level of bureaucratic complication. That makes statins “one of the most fascinating problems in medicine right now”.

“Over 100 million people take a statin every morning and yet there are huge gaps, firstly in our knowledge about which is best, and gaps in our knowledge about side effects,” he says.

“But also, we have failed, so badly, to communicate the modest benefits of these treatments to the public that there is huge widespread panic and anxiety among not just patients but also doctors, in many cases, about what the benefits of these treatments are.

“If we can’t get this stuff right for [statins] the single most commonly prescribed class of drug in the whole of the developed world – a tablet that is taken every day by 100 million people – then that’s a real window into our failures to do appropriate clinical trials throughout the whole of medicine.”

It’s a subject to which he will no doubt return, not only in his forthcoming book, but also in his upcoming speaking tour of Australian capital cities, kicking off in Brisbane on 22 September.

https://cosmosmagazine.com/

Graham