Dr. Sarah Hallberg: Cardiovascular Disease and a LCHF Diet

This video is part of "Question and Answer Fridays"where Dr. Sarah answers questions she receives on her Facebook page.

Graham

We support Professor Tim Noakes

All About Mushrooms : A Great Vegetable

Mushrooms, they are always in my kitchen ... and are often included with our daily breakfast of say ham and eggs with mushrooms! Low Carb Pork Sausages (the ones made with 97% pork), scrambled eggs and mushrooms ... even in Frittata's mushrooms can be a great addition.
Of course we are quite fortunate to be able to choose from a wide variety, and I recently read this article about Mushrooms. It is from 'Waitrose', a very nice supermarket! I do not shop there every week, but visit occasionally and always come away with some great whole fresh food. Please read on and find out a little more about this vegetable.

"There are two main categories of mushrooms - the familiar cultivated types such as button, chestnut and flat and the more exotic looking wild varieties such as ceps and chanterelles.

Brown cap mushrooms:
See Chestnut mushrooms, below.

Button:
The most common type of mushroom, these are readily available. They have creamy white caps with pink gills which darken to beige as they grow. Available all year.
Uses: Whole in salads, casseroles and pasta bakes or sliced in sauces, pies and soups.
To store: Place in a paper bag in the salad drawer of the fridge to keep for a few days.
To prepare: Cultivated mushrooms are usually very clean: just wipe with a kitchen towel or rinse briefly and dry before use. Do not peel. Leave the mushrooms whole or slice as necessary.
To cook: Button mushrooms do not require much cooking - fry for 4-5 minutes or add to dishes 5-10 minutes before the end of cooking time.

Ceps:
Known as cèpes in France and porcini in Italy, these creamy yellow mushrooms have a good flavour and a velvet-like texture. They are quite meaty and have a spongy underside, rather than gills. Available all year.
Uses: Add cooked ceps to omelettes, pasta or add to stir-fries and mixed mushroom dishes.
To store: Place in a paper bag in the salad drawer of the fridge to keep for a few days.
To prepare: Scrape the spongy underside away before cooking (it goes soggy) and wipe clean with kitchen paper.
To cook: Fry in butter over a high heat or grill, brushed with olive oil for 5-10 minutes, sprinkled with chopped fresh parsley and garlic.

Chanterelle:
These creamy-yellow mushrooms are a distinctive frilly trumpet shape with a slightly rubbery texture. They have a firm flesh with a subtle, fruity flavour. Available all year.
Uses: Serve with scrambled eggs for a tasty breakfast, add to creamy pasta sauces or simply serve on toast.
To store: Place in a paper bag in the salad drawer of the fridge to keep for a few days.
To prepare: They can be a bit tricky to clean - dirt gets stuck under the gills, so they need to be rinsed thoroughly under running water and then gently dried with kitchen paper.
To cook: Sauté in a little butter to release the juices, then turn the heat up to concentrate the flavour.

Chestnut:
These have a strong taste and a meaty texture, they have a similar appearance to a button mushroom but are a darker colour. The mushrooms should be open, but not too flat, exposing the pink to dark brown gills on the underside. Available all year.
Uses: They are perfect eaten raw or lightly cooked.
To store: Place in a paper bag in the salad drawer of the refrigerator to keep for a few days.
To prepare: Cultivated mushrooms are usually very clean: just wipe with a kitchen towel or rinse briefly and dry before use. Do not peel. Leave the mushrooms whole or slice as necessary.

Crimini:
These are a similar shape to button mushrooms and are from the same family. However they have light tan to rich brown caps and a firm texture. They have a stronger, earthier flavour than button mushrooms.
Uses: Use with or instead of button mushrooms. They are particularly good in meat and game dishes.
To store: Keep in the fridge, in a paper bag for up to 5 days.
To prepare: Wipe with a kitchen towel or rinse briefly and dry before use. Do not peel. Leave the mushrooms whole or slice as necessary.

Enoki:
Named after the enoki tree that it grows on, the wild variety has a tiny yellow-orange cap with a long, slender stem, the more common cultivated variety are a creamy colour. They have a sweet, fruity flavour with a slight crunch and are native to Japan where they are widely used. Available all year.
Uses: They are used in Japanese cookery to add flavour to soups, stews and salads.
To store: Place in a paper bag in the salad drawer of the fridge to keep for a few days.
To prepare: Wipe the mushrooms clean with kitchen paper, trim the roots at the base and separate the stems before serving.

Exotic medley:
A ready-mixed 200g pack of exotic organic mushrooms which contains oyster, shiitake and horse mushrooms. Available all year.
Uses: Add cooked exotic mushrooms to omelettes, pasta sauces or serve simply with brown bread and butter.
To store: Keep in the fridge in the pack and consume by the best before date.
To prepare: Rinse briefly under cold running water and dry before use. Do not peel. Chop roughly before cooking.
To cook: Fry in butter over a high heat or grill, brushed with olive oil for 5-10 minutes, sprinkled with chopped fresh parsley and garlic.

Gigante:
These large mushrooms are matured for longer to achieve a deliciously meaty flavour. They are grown on Dutch farms using a straw-based compost and are exclusive to Waitrose. Available all year.
Uses: Slice and serve as a side dish or add to casseroles or stir-fries. Gigante mushrooms are also ideal for stuffing and baking for a main course or starter.
To store: Place in a paper bag in the salad drawer of the fridge to keep for 2-3 days.
To prepare: Rinse briefly under cold running water and dry before use. Do not peel. Leave the mushrooms whole or slice as necessary. If baking and stuffing remove the stalk before stuffing.
To cook: Grill or fry sliced gigantes in a little butter for 5-10 minutes. To bake, top with butter and place in an ovenproof dish with 4 tbsp cold water, cook in a preheated oven at 190(C, gas mark 5 for 45 minutes or until tender.

Oyster:
So called because of their fan-like shape. They grow naturally in woods, in clusters of overlapping tiers, but the cultivated varieties are grown on composted wheat straw. They have a subtle flavour and a chewy texture. Oyster mushrooms are commonly grey but yellow and pink ones are also available. However these lose their colour once cooked. Available all year.
Uses: Add to pasta recipes, risotto or stir-fry with other types of mushroom.
To store: Place in a paper bag in the salad drawer of the fridge to keep for a few days.
To prepare: Wipe the mushrooms with a kitchen towel and trim the end of the stems. Cook them whole or cut or tear into length-ways strips.
To cook: Fry in vegetable oil, grill or bake beside joints in a roasting tin.

Porcini:
Porcinci are wild mushrooms native to the Alpine regions of Italy and France (where they are known as ceps). They have a distinctive aroma and rich flavour. Fresh porcini are only available in late summer and autumn so the dried variety is more commonly used. Only a small amount of dried porcini, around 25-50g, is needed to add an intense flavour to a variety of savoury dishes. Waitrose sell dried porcini mushrooms in the Waitrose Cooks' Ingredients range. Cultivated or mixed wild fresh mushrooms can be used instead of porcini.
Uses: Soaked dried porcini can be added to a variety of savoury dishes in the same way as fresh mushrooms. They are particularly good in pasta dishes, risotto, soups, stews and omelettes. Porcini go particularly well with garlic or fresh herbs such as flat leaf parsley or thyme. The soaking water can be included in risottos, stews and soups.
To store: Keep dried porcini in a cool, dry place and consume by the best before date. Once soaked in water use within 2 hours.
To prepare: Pour 175ml boiling water onto 25g porcini mushrooms and soak for about 15 minutes. Drain the mushrooms, reserving the soaking water, and chop or leave whole as desired.

Portabella:
These are large mushrooms with a meaty texture and a wonderful aroma, they can be up to 10cm in diameter. Available all year.
Uses: Sauté whole flat mushrooms in a little butter and garlic or remove the stalk and stuff and bake.
To store: Place in a paper bag in the salad drawer of the fridge to keep for a few days.
To prepare: Wipe with a kitchen towel or rinse briefly and dry before use. Do not peel. Leave the mushrooms whole or slice as necessary.

Portabellini:
Medium-sized brown mushrooms (about 7cm in diameter) that have a firm texture and a nutty flavour. Waitrose sell prepacked portabellini mushrooms in 250g packs.
Uses: Portabellini mushrooms can be sliced and eaten raw in salads or lightly cooked and included in soups, pasta dishes, casseroles or sauces. They can also be stuffed and baked.
To store: Place in a paper bag in the salad drawer of the refrigerator and use by the best before date.To prepare: Rinse thoroughly under cold running water and dry before use. Do not peel. Leave the mushrooms whole or slice as necessary. If baking and stuffing remove the stalk before stuffing.
To cook: Grill or fry sliced portabellinis in a little butter for 5-6 minutes. To bake, top with butter or a savoury stuffing and place in an ovenproof dish with 4 tbsp cold water, cook in a preheated oven at 190C, gas mark 5 for 45 minutes or until tender.

Shiitake:
Pronounced 'sheetarky', these mushrooms originated in Japan and Korea and are available fresh or dried. Fresh mushrooms have firm caps and light brown meaty flesh with a pleasant and distinct flavour that lingers on the tongue. They should be plump with curled-under edges. Available all year.
Uses: Add to sauces and stocks, wrap in foil with fish, white meat or vegetables, or chop and use in stuffings for poultry, fish or meat.
To store: Place in a paper bag in the salad drawer of the fridge to keep for a few days.
To prepare: There is no need to wash, just wipe with a kitchen towel. Remove the tough stems and slice or leave the mushroom cap whole.
To cook: Fry in butter or oil; or brush with oil and cook under the grill.

Dried:
Many of the more exotic varieties of mushroom are available dried. When reconstituted they have a concentrated flavour.

Dried cep:
Wild mushrooms with a nutty flavour, these are especially popular in Italy where they are known as porcini.
Uses: To add to rice and pasta dishes.
To store: Keep in a dry, dark cupboard for up to 1 year.
To prepare: To rehydrate, soak in warm water for 20 minutes, stirring occasionally. Then drain using a sieve, reserve the soaking liquor for use in recipes too.

Dried shiitake:
These have a strong, almost meaty flavour. They are used widely in Oriental cuisine and are also known as Chinese black mushrooms.
Uses: Shiitake mushrooms add flavour and interest to stir-fries, sauces and soups.
To store: Keep in a dry, dark cupboard for up to 1 year.
To prepare: To rehydrate, soak in warm water for 20 minutes, stirring occasionally. Then drain using a sieve, reserve the soaking liquor for use in recipes too.

Dried mixed:
A delicious combination of cep, chanterelle and fairy ring mushrooms which can be used in a range of recipes.
Uses: In a wide variety of dishes including risottos, pasta dishes, soups and stir-fries.
To store: Keep in a dry, dark cupboard for up to 1 year.
To prepare: To rehydrate, soak in warm water for 20 minutes, stirring occasionally. Then drain using a sieve, reserve the soaking liquor for use in recipes too"

See original article here

More about the nutritional value of mushrooms here

I hope that where you live you may have a shop, supermarket or produce store where you too can have access to these lovely vegetables ... you may even grow your own!

How about trying this very easy mushroom dish 

Portobello mushrooms with pate and cheddar cheese

See recipe here

All the best Jan

The British Dietetic Association and other health hazards.

I apologise for the length of this post, but believe background information is required. It is my opinion, and that of many others, the BDA is a health hazard for UK diabetics. Please indulge me and read this post. Thank you.  

I was diagnosed a type two diabetic in March 2008. My HbA1c was 12 and blood glucose meter showing 26, extremely high and highly dangerous blood glucose numbers. I was prescribed Metformin and given a guide to diabetes control by my appointed diabetes nurse. The guide was sponsored by Takeda the largest insulin manufacturer in Japan. My nurse informed me I must cut out all sugar, as did the guide. The mainstay of my new diet was to be starchy carbohydrates. Rice, bread, pasta, couscous, potatoes etc. according to the Takeda guide. At that time, I did not know what a carbohydrate was, I did not know, that when digested they would have the same effect on my blood glucose as sugar. I tried the diet for a few weeks, my blood glucose numbers improved, but never got better than 12 mmol, an improvement, but still highly dangerous numbers. I was acutely aware of the very serious complications of highly elevated BG numbers. Two weeks after my diagnosis, I buried my Father. He died riddled with diabetic complications. He had followed the NHS advice including diet to the letter.

I decided to research type two diabetes, I was very eager to avoid the grim complications if at all possible. It seemed logical to me, if I could get my blood glucose numbers to non diabetic, I could avoid blindness, kidney failure and amputations. A few weeks later, I received one of the greatest pieces of luck of my entire life. I met via a forum a man called Fergus Craig. Fergus has been a type one diabetic since his teenage days, for many years his diabetes control was very poor. Running high BG numbers and well over weight, in short, a disaster waiting to happen, and it very near did. Driving one day he suffered a serious hypo (dangerously low blood sugar) he passed out and crashed his car into a lamppost. Mercifully no one else was involved and Fergus suffered no serious injuries.

After years of denial and poor diabetes control, Fergus realised he had been very lucky and changes had to be made. He went looking for sound information, and discovered the work of Dr. Richard Bernstein, considered by many, including Fergus and myself, as the world's leading expert on blood glucose control for diabetics. Fergus adopted the Bernstein diet of 30 carbs per day spread over three meals. Within a short time he lost over 40 lbs in weight and for the first time in his diabetic life, was maintaining non diabetic HbA1c numbers. He took up marathon running and competing in 100 mile plus cycle races. In short a completely changed man. He has held non diabetic BG numbers for the last ten years or more, and his insulin use reduced to a third of previous requirements.

As for my story, I adopted the Bernstein approach, 30 grams of carbohydrate per day. I dumped the breakfast cereals, toast and orange juice. Eggs, bacon, mushrooms, cherry tomatoes became my start to the day. Fish with a salad my lunch, and meat and three veg my dinner. Within seven days my fasting BG numbers ranged from four to six. Three months after my diagnosis it was time for a check up with my Doctor and more blood work. Results, 50 lb weight loss, HbA1c 5.5 and vastly improved lipid panel. My Doctor was amazed in the changes, I told him how I had achieved the transformation. I then heard the words so many like me have heard “well if it works for you stay with it”

If it works for me, it will work for almost all diabetics. I was so outraged regarding the lamentable treatment, and dietary advice dolled out to diabetics, I set up a website to demonstrate the massive benefits of the low carb lifestyle lowcarbdiabetic.co.uk and posted many posts on a forum encouraging diabetics to follow my way of diabetes control. At that stage it should have been plain sailing for me, and other diabetics on the forum, to stay safe and take control of their diabetes. How wrong I was, heavy duty negative comments came in almost immediately, from a high profile BDA dietitian, Chris Cashin using a pseudo name. Cashin hounded low carbers around the clock, we could be setting ourselves up for scurvy, osteoporosis, bowel disorders and worse, with our low carb lifestyle. That was my first communication with a BDA dietitian, it would not be my last.

I should state at this stage, I have been helped by excellent dietitians, some have become friends, none from the BDA. It is my opinion the BDA is a major health hazard for diabetics. They appear to have no sound policy for the safe control of diabetes, and their dietary recommendations are lamentable. I have informed BDA dietitians of my views on numerous occasions. Unsurprisingly, my words fell on deaf ears. On twitter they blocked me, straight questions never received a straight answer. They were the dietary experts, how dare this mere blogger, this upstart, have the temerity to question their supreme knowledge. Meanwhile the BDA and other dietary organisations have done absolutely nothing to stem the epidemics of obesity and the often linked type two diabetes. In fact the situation gets worse by the day.

That being said, the BDA has become world class in passing the buck. Nothing to do with us they bellow at every opportunity, blame the others. Well, who are the others you may be thinking. Regarding the BDA dietary information for diabetics, it's all down to Diabetes UK according to high profile BDA dietitian Catherine Collins. The dangerous and misleading information on the BDA website regarding "ideal HbA1c" is the fault of NICE, according to another high profile BDA dietitian Paul McArdle. Another very high profile BDA member Dr. Duane Mellor appears to be distancing himself from the mainstay of the BDA for many years, the awful Eat Well plate.

So, there you have it. I suspect the BDA will stay cosy in their smug little world, while pleading, almost begging, with their motto "Trust A Dietitian" Hiding behind other organisations, who incidentally, are getting nowhere fast in the fight against diabetes, as the NHS audited diabetes statistics prove year after year. High profile dietitians will continue to hang out on places like twitter, rubbishing highly qualified and respected Scientists and medical professionals, who are proving to be the salvation of countless diabetics and people wishing to lose weight. It does not require much thought to understand the stance of the BDA, they have been very wrong for decades. In the real world they are becoming increasingly irrelevant. The mainstay of their message to diabetics "reduce saturated fats and increase starchy carbs" has failed totally.

Over seven years ago I stated on my website "Be very careful when being advised by a dietitian. If you are being told to base your diet on starchy high carbohydrate foods and drop the fat, drop the dietitian, if you want to stay complication free and keep medication to a minimum" That advice still stands, and increasingly, all around the world, enlightened and informed medical professionals are in agreement. I welcome the opportunity to debate the issues outlined in this post with BDA dietitians. I doubt that will happen. They will continue to block me on places like twitter, for them it will be business as usual. It will be business as usual for the NHS, the amputations will continue, the wheel chairs and white sticks will be issued. And £billions spent, much so unnecessary, because so many so called health care organisations, are clearly not fit for purpose.

Eddie

From the BDA website today. Link to information here.

The "ideal HbA1c" is not ideal by a long way. Long term these numbers will lead to serious complications for many and are above the levels organ damage starts.

"People with diabetes should eat a healthy diet the same as somebody without diabetes" This information is so wrong it borders on the criminal in my opinion. It is one of the major factors why the annual NHS audited statistics prove on an average year, 93% of type one diabetics and over 50% of type two diabetics never obtain safe HbA1c number.

Note the high number of highly refined carbohydrates and junk including a can of cola. Following this Eat Well plate of food, it is highly unlikely a diabetic will ever maintain safe and stable blood glucose numbers.

Some recent screen shots from twitter.

Eggs : So Simple and Nutritious

Some days all you want is something simple and nutritious to start your day. 

This soft boiled egg was perfect.

More details about why eggs are so healthy can be read here

All the best Jan

Adele - Million Years Ago

Another song from Adele's record breaking best selling album 25

Graham

Bryan Adams - You Belong To Me

Graham

Beth Hart & Joe Bonamassa - Live - I'd Rather Go Blind

Maybe a bit too close to home, this song title on a diabetes blog, but these two blow what's left of my brains out. Trust me, live music does not get better than this. Eddie

Peter Gabriel - The power of the heart.

Saturday night is music night on this blog. This song is for Jan my Wife. Oh that I had what it takes to have written it for her. Eddie

What will you choose?

Eddie

Recipe For The Best Childhood Ever

Looking back at my childhood, I was truly spoilt ! I was so spoilt, and I don't mean showered with toys, toys and more toys, I was spoilt ... and indeed my cup was running over with Nature, Sunshine, and Imagination ... I also had so much love and laughter, and I will be forever grateful.

Not all children are so fortunate and with this in mind 'The Wildlife Trusts' have been running a campaign called 'Every Child Wild'. The image above and immediately below are from their site, please go over and have a look.  

Speaking personally our younger family members are also fortunate,
each and every one of them loves the outdoors and isn't it good to see them enjoy it too.

best friends - deep in conversation

brother and sister enjoying a cycle ride

the terminator impersonator ! I'll be back !

fun at the farm


love you dad

As it's the weekend, if you know any 'young people' why not have some time out with them and help them enjoy this great 'recipe' on our doorstep ... Nature, Sunshine, Imagination and plenty of love and laughter. Even if it may be raining why not dress appropriately and have some weekend fun!

Now if you are looking for a good food recipe let me point you this way please > 

Pork Casserole Rustic Style

recipe can be found here

Wishing all readers a Happy Weekend

All the best Jan

Low-fat lie one big diet cover-up: Dr Joe Kosterich

You might expect that major recommendations about health and diet (like the low fat diet) would be rigorously tested and assessed before being promoted to the public. 

Sadly you would be wrong.

Hard on the heels of the 'bacon and red meat causes cancer scare' news, scientists in the UK have found that cooking with vegetable oils like sunflower oil releases toxic chemicals called aldehydes, which increase the risk of cancer, heart disease and dementia.

The healthiest oil to cook with was coconut oil; butter was second and olive oil third. 

How can this be, when we have been told saturated fats are bad?

An absolutely damning review published in the British Medical Journal found that the introduction of low fat dietary recommendations had absolutely NO basis.

Let me repeat this. There was never any scientific basis to recommend a low fat diet.

To quote the researchers: "Dietary recommendations were introduced ... in the absence of supporting evidence from randomised control trials." 

The best they could muster were studies on 2647 males, where one group had lower cholesterol. But, and it is a big but, there was no difference in rates of heart disease or mortality between the lower and higher cholesterol groups.

A 1970s study, which became very influential, showed a reduction in cholesterol levels in one group of men eating a low fat diet compared to a group eating a "normal" 1970s diet. Yet the low fat group had a higher death rate.

Even though the total numbers were small, the study was the basis to promote the low fat diet as a way to lower cholesterol and reduce heart disease.

To quote Milton Friedman: "One of the great mistakes is to judge policies and programs by their intentions rather than their results."

It has not been a great time for supporters of the 'fat is bad' mantra. Last year Time magazine ran a cover story titled: 'Eat butter - Scientists labeled fat the enemy. Why they were wrong.'

This was prescient. Earlier this year, the powerful US Dietary Guidelines Advisory Committee announced that cholesterol was no longer a "nutrient of concern". It has also removed any upper restriction on how much fat is part of a healthy diet.

Guidelines on diet are released every five years based on a review of the scientific literature. It states: "Reducing total fat (replacing total fat with overall carbohydrates) does not lower CVD [cardiovascular disease] risk…Dietary advice should put the emphasis on optimising types of dietary fat and not reducing total fat." 

In other words, low fat foods where fats are replaced by sugars are out!

Studies have consistently showed no correlation between fats in the diet and any form of disease. The only type of diet consistently shown to have a positive impact is the Mediterranean diet.

The Journal of the American Medical Association noted: "Based on years of inaccurate messages about total fat, a 2014 Gallup poll shows that a majority of US residents are still actively trying to avoid fat while eating far too many refined carbohydrates."

The quote above is easily applicable to Australian residents too. New Australian guidelines were released earlier this year but they still clung to the 'fat is bad' story. 

Yet the JAMA author has a different view: "It is time for the US Department of Agriculture and Department of Health and Human Services to develop the proper signage, public health messages, and other educational efforts to help people understand that limiting total fat does not produce any meaningful health benefits and that increasing healthful fats, including more than 35 per cent of calories, has documented health benefits."

It doesn't have to be Paleo
Celebrity chef Pete Evans has attracted much criticism from the nutritional establishments for pretty much doing this.

While the full Paleo diet, which he supports, may be extreme, a diet higher in protein and fats and lower in carbohydrates, especially grains and refined carbohydrates, leaves most people healthier, feeling better and with more energy. 

Generally this type of diet leads to weight loss. In simplest terms, this is because the body releases less insulin on a low carb diet. Insulin promotes fat storage and inhibits fat burning. Plus we reach insulin resistance if we flog the insulin system too hard for too long. This is the precursor to type two diabetes, shown in a 10-year study in 150 countries, to be due to refined carbohydrate consumption and NOT obesity.

You might wonder why there has been little coverage of all this significant health and nutritional information. Well, reputations and dollars are at stake, that's why. 

Dietary advice from "authorities" is in my view permanently tarnished. Rather than ask authorities, we should ask our grandparents what they ate when they were young.

It was real, not manufactured food, and until recently had been growing somewhere or moving around. It was eaten the day it was cooked. It went off if not eaten in a few days. It did not come in boxes with a use-by-date and labels with health claims. 

In the totality of human history, the low fat diet will be seen as perhaps the worst fad diet. 

http://www.brisbanetimes.com.au/

Graham

Pork Loin in a Lemon and Dijon creamy sauce, with pickled red onion

Hasn't the week gone by quickly ... Friday already. For many Friday is often a fish dish but why not consider this pork loin recipe idea. It is quick and easy and the mix of lemon and Dijon mustard in a creamy sauce does make it delicious.

Ingredients
Serves 4
1 red onion
2 tbsp red wine vinegar
1 tbsp caster sugar
1 (British) free-range pork loin (about 400g)
1-2 tbsp olive oil
½ lemon
½ tbsp Dijon mustard
2½ tbsp crème fraîche
Handful fresh parsley

To Accompany (suggestions)
Cauliflower Rice
Steamed seasonal greens

Method
1.Finely slice the onion, then mix with the vinegar and sugar in a glass or ceramic bowl.
2. Cut the pork loin into 2cm thick slices. Heat the oil in a large frying pan over a medium-high heat, then fry the pork slices for 5 minutes, turning, or until they take on some colour.
3. Squeeze the lemon juice over the pork, then add the mustard and crème fraîche. Cook over a medium heat for 2-3 minutes, taste and season.
4. Serve the pork straightaway with the pickled onion and a good scattering of chopped parsley, with a side of seasonal greens if you like.

Living the LCHF lifestyle I may also make some cauliflower rice to accompany this. You, dear reader, may prefer something different ... 

Recipe adapted from this idea

I hope you enjoy this recipe suggestion. We try and bring a wide variety, but not all recipes will suit all. Any food allergies, or underlying health issues 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

Glucose levels tied to bone turnover in diabetics

NEW YORK (Reuters Health) - Blood glucose changes may alter bone turnover and have detrimental effects on bone health in diabetics, according to Danish researchers.

As Dr. Jakob Starup-Linde told Reuters Health by email, "Our findings suggest that the bone turnover is dependent on plasma glucose levels in patients with diabetes. Thus, glycemic variability may cause the diabetic bone disease with high fracture rates in spite of normal to increased bone mineral density."

In a November 7 online paper in Bone, Dr. Starup-Linde of Aarhus University Hospital and colleagues note that fracture risk is increased in diabetics. This is 7-fold increased risk in type 1 diabetes (T1D) and 1.4-fold increased risk in patients with type 2 diabetes (T2D).

Oral ingestion of glucose causes an acute decrease in bone turnover markers, and thus glucose levels may affect bone turnover in diabetes. To investigate further, the team examined blood samples from 98 T1D patients and 96 T2D patients. These had been taken in non-fasting conditions in the morning.

There were lower bone turnover markers in patients with T2D than T1D. In particular this was true of P-Procollagen type 1 amino terminal propeptide (P1NP), p-osteocalcin (OC), and s-Receptor Activator of Nuclear factor Kappa beta Ligand (RANKL).

In addition, s-osteoprotegerin (OPG) was higher in T2D but P-C-terminal cross-linked telopeptide of type-I collagen (CTX), p-fibroblast growth factor-23 (FGF-23), p-sclerostin, and p-undercarboxylated osteocalcin (ucOC) were similar in both groups.

Increasing non-fasting glucose levels were inversely related to p-CTX, p-P1NP, p-OC, and p-ucOC and directly related to s-OPG. This was the case in simple linear and multiple linear regressions adjusted for factors influencing bone turnover markers including hemoglobin A1c (HbA1c).

"We found," the investigators continue, "that the p-glucose levels were correlated negatively with bone turnover markers and positively with s-OPG in patients with T1D whereas p-glucose levels were only positively correlated with s-OPG in patients with T2D."

"Bone turnover in patients with diabetes," they add, "may fluctuate in the same manner as p-glucose and disrupt the remodeling process, which may decrease bone quality, if removal of old bone is interrupted and the remodeling not complete."

"The practical implications of the study," the researchers conclude, "are that glucose fluctuations need to be taken into account and not just average glucose levels when measuring bone turnover markers in patients with diabetes."

Commenting on the findings by email, Dr. Fernando Rivadeneira of University Medical Center Rotterdam, the Netherlands, told Reuters Health, "This well-conducted study provides additional evidence supporting the contention (we and others have made previously) that the skeletal complications consisting of higher fracture risk despite relatively higher (bone mineral density) observed in patients with type 2 diabetes mellitus, are related to the inhibition of the physiological remodeling (resorption and formation) process needed for bone repair."

Dr. Rivadeneira, who is an associate professor of musculoskeletal genomics, added, "Their study also shows that this deleterious process is not just about high glucose levels; the study also pinpoints clear differences across biochemical markers between patients with type 1 and type 2 diabetes. Noteworthy are those differences in markers like vitamin D and those from the OPG-RANK-RANKL pathway, which (pending further scrutiny) should be considered for the differential treatment and prevention of skeletal complications, depending on the type of diabetes of the patient."

The European Union Framework Programme 7 and the Familien Hede Nielsens Fund partially supported this research. The authors reported no disclosures.

http://www.annalsoflongtermcare.com/

Graham

Did you say Babooshka or Shakshouka !

... Babooshka, you may recall was a hit in the 1980's for singer Kate Bush. 

Now, Shakshouka or Shakshuka is believed to have originated from Tunisia ( Tunisian Arabic : شكشوكة‎ ). It is a dish of poached eggs in a rich, spiced sauce and can make the ultimate centre-of-the-table breakfast! 

... perhaps you could enjoy this dish whilst listening to Kate Bush - just a thought!

Now, if you'd like to make this Shakshouka here is what you need:

INGREDIENTS 

Serves Up To Four
1-2 tsp coconut oil
1 red pepper, chopped
1 medium aubergine (eggplant), chopped
1 tomato, chopped
1 tin of canned tomatoes (400g)
1 garlic clove, crushed
1 tbsp tomato paste
1 tsp harissa sauce (optional)
1 tsp ground cumin
1 tsp paprika
Sea salt and black pepper
1/4 cup water
1 cup kale or spinach, shredded
4 eggs
Optional: Serve with a spoonful of yogurt and sprinkle of fresh herbs (basil or cilantro)

WHAT TO DO
1. Preheat oven to 350°F (180°C)
2. Heat the oil in a medium frying pan, and cook the pepper and aubergine (eggplant) for 5-10 minutes over medium heat, tossing well, until softened.
3. Add tomatoes, tomato paste, harissa, cumin, paprika, sea salt and pepper and water and simmer for 10 to 15 minutes until sauce becomes thick. Add in your shredded kale or spinach last minute and stir through.
4. Pour sauce into a baking dish (or leave in your frypan if it is oven proof).
5. Make four hollows in the top, crack eggs into the holes, place into the oven and bake for 10-15 minutes or until your eggs are cooked to your liking.
6. Optional: Serve with a spoonful (dollop) of yogurt and sprinkle of fresh herbs (basil or cilantro) 

Recipe idea from here

... of course you could always call this dish 'Baked Eggs' - but it hasn't got the exotic ring to it has it !

Hope you enjoy it.

All the best Jan

Coke’s Chief Scientist, Who Orchestrated Obesity Research, Is Leaving

Coca-Cola’s top scientist is stepping down after revelations that the beverage giant initiated a strategy of funding scientific research that played down the role of Coke products in the spread of obesity.

Rhona S. Applebaum, Coke’s chief science and health officer, helped orchestrate the establishment of a nonprofit group known as the Global Energy Balance Network. The group’s members were university scientists who encouraged the public to focus on exercise and worry less about how calories from food and beverages contribute to obesity.

Coca-Cola spent $1.5 million last year to support the group, including a $1 million grant to the University of Colorado medical school, where the nonprofit group’s president, James O. Hill, a prominent obesity researcher, is a professor.

Coke’s financial ties to the group were first reported in an article in The New York Times in August, which prompted criticism that the soft drink giant was trying to influence scientific research on sugary drinks.

The university returned the money to Coca-Cola this month after public health experts raised concerns.

Dr. Applebaum, a food scientist with a Ph.D. in microbiology, had been Coke’s chief scientific and regulatory officer since 2004. In that role she helped lead the company’s efforts to work with scientists as a way to counter criticism about sugary drinks.

At one food industry conference in 2012, Dr. Applebaum gave a talk outlining Coca-Cola’s strategy of “cultivating relationships” with top scientists as a way to “balance the debate” about soft drinks.

A spokeswoman for Coca-Cola said on Tuesday that Dr. Applebaum, 61, had made the decision to retire in October and that her retirement “has been accepted and the transition is underway.” The company declined a request for an interview with Dr. Applebaum.

Coca-Cola has said that while it offered financial support for the Global Energy Balance Network, the company had no influence on the group or the scientific research it produced. But reports show that Dr. Applebaum and other executives at Coke helped pick the group’s leaders, create its mission statement and design its website, findings first reported this week by The Associated Press.

The A.P. also published a series of emails between Dr. Hill of the University of Colorado and Coke executives that revealed the initial strategy of the Global Energy Balance Network. Before the G.E.B.N. was created, Dr. Hill proposed publishing research that would help the company fend off criticism about its products by shifting the blame for obesity to physical inactivity.

“Here is my concept,” Dr. Hill wrote to Coca-Cola executives about the study he was proposing, according to the emails. “I think it could provide a strong rationale for why a company selling sugar water should focus on promoting physical activity. This would be a very large and expensive study, but could be a game changer. We need this study to be done.”

In other emails obtained by The A.P., Dr. Hill told executives at Coca-Cola that he wanted to work on the company’s behalf to improve its public reputation. At the time, Coca-Cola and other beverage companies were engaged in a public relations battle, with soda sales declining and cities around the country proposing taxes on sugary drinks, which have been linked to obesity, diabetes and heart disease.

Dr. Hill wrote to executives at the company that it was “not fair” that Coca-Cola was being singled out as “the No. 1 villain in the obesity world.” Dr. Hill added: “I want to help your company avoid the image of being a problem in people’s lives and back to being a company that brings important and fun things to them.”

The emails also show that Muhtar Kent, Coke’s chief executive, wanted to enlist Dr. Hill to help shape media coverage about soft drinks. In an email on Oct. 18, Mr. Kent asked Dr. Applebaum and other top officials at Coke how he might persuade the CBS News host Charlie Rose to invite Dr. Hill on his show. “CBS This Morning” had just broadcast a segment about the amount of exercise required to burn off the calories in a serving of Coca-Cola. Dr. Applebaum replied to Mr. Kent’s email that day with Dr. Hill’s credentials. Dr. Hill did not appear on the show.

On Tuesday, a spokeswoman for Coca-Cola said that Mr. Kent had sent the email because he had been concerned that the news segment “was inaccurate.”

In a statement, Mr. Kent said, “It has become clear to us that there was not a sufficient level of transparency with regard to the company’s involvement with the Global Energy Balance Network. Clearly, we have more work to do to reflect the values of this great company in all that we do.”

Dr. Hill declined a request for comment. But in an interview in August, he insisted that Coca-Cola did not speak for him or his organization. “They’re not running the show,” he said. “We’re running the show.”

In a statement on Tuesday, the University of Colorado School of Medicine suggested it did not see any problems with Dr. Hill’s relationship with Coca-Cola.

“The school of medicine does not prohibit faculty members from communicating with governmental, for-profit or nonprofit entities that provide funding for initiatives intended to improve individual and public health,” the university said. “The school does expect such efforts to be hypothesis-driven and designed to answer questions and not to advance a specific point of view.”

Michael F. Jacobson, the executive director of the Center for Science in the Public Interest, a consumer advocacy group, said it was concerning to see “how a major corporation is using a professor to propagate their views.”

Marion Nestle, a professor of nutrition, food studies and public health at New York University and the author of “Soda Politics,” said that when food and beverage companies pay for research, they do so to aid marketing efforts and to “silence critics.”

Dr. Nestle added, “The Global Energy Balance Network has been a public relations disaster for Coca-Cola.”

http://well.blogs.nytimes.com/

Graham

Herby stuffed field mushrooms

Don't you just love mushrooms! Well I certainly do, and of course there are so many different varieties available. Having just recently bought some closed cup white mushrooms, I used some with breakfast earlier. But I also bought some larger ones in order that something quite similar to the mushroom you see pictured above will be on my dinner plate later ... and of course one for Eddie too!

I saw this stuffed mushrooms recipe of Ghillie's in a recent magazine article and I thought it a great one to share. It is a super vegetarian starter but also makes a creamy side dish perfect with steak or lamb.

Ingredients:
Serves 6

(6.5g carb per serving)
6 large flat mushrooms
1 large knob of butter
400 g young-leaf spinach
150 g light Boursin with herbs (or vegetarian alternative)
1 tbsp ready-made natural or homemade breadcrumbs *
30 g walnuts, chopped (optional) **
1 tbsp olive oil

Method:

1. Preheat the oven to 200°C, fan 180°C, gas 6. Remove the mushroom stalks and chop them, then put the mushroom caps on a small baking tray. In a large pan, melt the butter and fry the chopped mushroom stalks for 2 minutes.
2. Add the spinach, then cover and cook, shaking the pan, until wilted. Spoon into a colander and squeeze out any excess juice. Transfer the spinach and mushroom stalks to a bowl and mix with the Boursin, a pinch of salt and a good grinding of black pepper.
3. Spoon the mixture into the mushroom caps and sprinkle over the breadcrumbs, mixed with the walnuts*, (if using). Drizzle with oil and bake in the oven for 15-20 minutes.

Kitchen secret: these make a great accompaniment to a main course, but also make an ideal vegetarian starter, allowing one or two per serving.

* Now some may prefer not to use breadcrumbs - so why not add a little additional cheese instead, just grate some cheddar, or other cheese of your choice!

** I would certainly add the walnuts, but of course this may not suit all, especially those with nut allergies, so please adapt the recipe as necessary.

Happy Eating !

All the best Jan

AMA Wants Ban on DTC Advertising

Putting the brakes on golf cart Rx promotion?

ATLANTA — Direct-to-consumer (DTC) advertising should be banned in order to reduce the demand for expensive, unnecessary drug treatments, the American Medical Association’s (AMA) House of Delegates voted on Tuesday.

“Today’s vote in support of an advertising ban reflects concerns among physicians about the negative impact of commercially-driven promotions, and the role that marketing costs play in fueling escalating drug prices,” AMA board chair-elect Patrice A. Harris, MD, MA, said in a statement issued after the vote at the association’s interim meeting here. “Direct-to-consumer advertising also inflates demand for new and more expensive drugs, even when these drugs may not be appropriate.”

The policy also advocates for a campaign to urge prescription drug affordability — including demanding more competition in the drug industry — and for urging more transparency in drug costs; it also calls for convening a physician task force on the issue.

“Physicians strive to provide the best possible care to their patients, but increases in drug prices can impact the ability of physicians to offer their patients the best drug treatments,” said Harris. “Patient care can be compromised and delayed when prescription drugs are unaffordable and subject to coverage limitations by the patient’s health plan. In a worst-case scenario, patients forego necessary treatments when drugs are too expensive.”

Banning DTC advertising would be a really good idea, said Sunny Linnebur, PharmD, associate professor of clinical pharmacy at the University of Colorado Skaggs School of Pharmacy, in Aurora. “I can see the potential risks that occur when patients watch commercials and immediately think they need to be on that medication,” she said in a phone interview.

“Number one, it puts pressure on providers — doctors, nurse practitioners, and physician assistants — to prescribe those medications. Number two, patients are not always in the best place to make decisions about which medications they should and should not take, and commercials are targeting patients and can make them think that medicine is for them, when it’s not safe for them.”

In addition, such ads can increase providers’ workloads because “we [may] have to discuss medications that were never going to be on the table to begin with,” said Linnebur.

David Holdford, PhD, professor of pharmacotherapy and outcomes science at Virginia Commonwealth University, in Richmond, said that although too much money is being spent on marketing and too little on drug research and development, it’s doubtful that banning DTC ads will serve to either increase spending on drug research or bring down the price of drugs.

“DTC spending is approximately $3 billion per year — 11% of all promotional spending,” he said in an email, citing a report by the Pew Charitable Trusts. “Direct-to-provider [advertising] is the other 89%.”

“MDs are still in control of the prescription pad,” Holdford said. “They do not have to prescribe for heavily promoted DTC drugs, but they do. In fact, studies consistently show that physicians are not cost-effective in their prescribing behaviors.”

The AMA has grappled with the DTC issue before. In April, the association wrote to the Centers for Medicare and Medicaid Services complaining about the misuse of Medicare’s annual wellness visit by commercial firms that promote whole-body scans as a means of disease prevention.

“We note that some consumer groups have asked the Federal Trade Commission to investigate the direct-to-consumer marketing of some of these commercial entities on the grounds that their advertisements contain false or misleading representations or material omissions,” wrote the AMA along with several other physician organizations. “This raises serious concerns for us about potential program integrity threats that these entities may pose to Medicare.”


The FDA also has been studying the issue for some time. In 2003, the agency presented results from surveys of patients and physicians, which found that of 500 doctors surveyed, 60% said that when they discussed a medication with a patient who had seen an ad for it, the ad had no beneficial affect on the discussion. And fewer than 20% said their patients understood how to get more information about a drug as a result of seeing an ad for it.

In other meeting news, the House of Delegates also passed resolutions in support of:

• Revising quality standards and Meaningful Use requirements to make the program more streamlined and less burdensome.

• Passing federal, bipartisan legislation to speed up paramedic training for returning veterans who received emergency medical training while in the military.

• Developing model state legislation to increase use of prescription drug monitoring programs (PDMPs). “The AMA strongly supports ensuring patient privacy protections, interstate interoperability of PDMPs as well as improving the functionality and workflow of these tools to help physicians make informed prescribing decisions,” the association said in a statement.

• Lifting a Congressional ban on coverage of in vitro fertilization treatment by the Department of Veterans Affairs. Current law prohibits the department from covering this service, even though it is covered for active-duty military.

In addition, the delegates called on the federal government to analyze the consolidation of the health insurance industry over the last 5 to 10 years before approving any further mergers.

http://www.medpagetoday.com/

Thankfully in the UK  advertising drugs is not allowed 

Graham 

Steak with Creamy Mushroom Sauce

If you are looking for a tasty steak dish ... then this may be for you! We like to include beef in our menu plans, sometimes as a good Roast Beef dish, sometimes as a casserole, sometimes as a 'plain' steak with salad ... and sometimes with a nice creamy mushroom sauce!

Ingredients:
Serves 4
1/4 cup (2 ozs) butter
10 ounces cremini or button mushrooms, sliced
1/2 tsp salt
1/4 tsp pepper
2 cloves garlic, minced
1/2 tsp dried thyme
1/3 cup heavy (double) whipping cream
4 small New York strip steaks (sirloin) about 6 ounces each
Salt and pepper to taste

Preparation:
In a large saute pan over medium heat, melt butter until hot and frothy. Add mushrooms, sprinkle with salt and pepper and sauté until mushrooms are brown and tender, 5 to 10 minutes.

Add garlic and thyme and cook until fragrant, about 1 minute. Stir in cream, reduce heat to low and simmer until thickened, another 5 minutes or so.

Meanwhile, preheat grill to medium. Season steaks on both sides with salt and pepper. Grill to desired 'done-ness', about 5 to 7 minutes per side for medium rare.

Remove steak and let rest 5 minutes. Spoon mushroom sauce over steaks and serve.

This recipe idea from Carolyn

When looking at any recipes, if you may need to change US vs Metric vs Imperial do use this link here 

Cheers and good health 

All the best Jan

Malnutrition causing thousands of hospital admissions

More than 2,000 cases of patients with malnutrition were recorded by 43 hospital trusts in a single year.

There were 193 "episodes" of malnutrition in 12 months at Salford Royal NHS Foundation Trust alone, according to new figures.

Freedom of Information (FOI) figures show a rise of 259 between the 43 trusts compared with three years ago.

A food bank charity said it feared families were struggling to afford to feed themselves.

The government said that malnutrition was "unacceptable".

Meanwhile, there are warnings that parents are going without food so their children do not go hungry.

'Thousands' at risk

The figures were revealed as Tameside Hospital, also in Greater Manchester, became the first NHS hospital in the UK to set up a permanent food bank on site.

Medical staff reported a significant increase in the number of malnourished patients turning up for treatment and care.

Trisha Jarman from Tameside East food bank said: "There are a lot of people out there that are malnourished.

"It's not just people coming into hospital, it's across the board. People are struggling to feed themselves and their families, particularly at this time of the year."

NHS bosses in Salford have warned that thousands of people in the city, which is included in a pilot scheme aimed at tackling the problem, may be struggling.

Kirstine Farrer, head of innovation and research at Salford Clinical Commissioning Group (CCG), said: "A report by the BAPEN (British Association for Parenteral and Enteral Nutrition) in 2013 suggested that of Salford's population of 35,000 aged 65 years or older, 14 per cent - or almost 5,000 people - may be at risk of malnutrition."

She said health services were working with the community to raise awareness and prevent people going hungry.

'Missing meals'

The figures were revealed following an FOI request by Birmingham City University student Eiryo Saeki to NHS foundation trusts, of which 43 responded.

Hospitals were asked to provide numbers of patients who had been in hospital with symptoms of malnutrition such as Kwashiorkor, a swelling under the skin often found in countries where there is famine or a limited food supply.

Salford Royal NHS Foundation Trust said its figures related to "episodes" of malnutrition, and could include patients being counted more than once if they were transferred between consultants.

The figures also showed that Birmingham Children's Hospital reported 31 instances of malnutrition last year, almost double the number for 2013.

Thousands treated for malnutrition

NHS Foundation Trusts that saw the most cases



Charity The Trussell Trust said between 31 March and 1 April 2015 food banks in Greater Manchester fed 16,083 people, of whom 6,206 were children.

Chairman Chris Mould said: "Our food banks see tens of thousands of people who have been going hungry, missing meals and cutting back on the quality of the food they buy.

"We meet families across the UK who are struggling to put enough food on the table, and at the extreme end of that you get people who are malnourished.

"We often see parents who are going without food so that they can feed their children, and these parents often struggle to afford enough nutritious food for their children too."

He said the Trust did not believe anyone should have to go hungry in the UK, and was working with the public, charities and politicians to "find solutions to the underlying causes of food poverty".

'Shocking'

The figures do not break down the ages of the patients but the charity Age UK is concerned about malnutrition in older people.

Caroline Abrahams, charity director at Age UK said: "In a civilised society people should not be suffering from malnutrition - these figures are shocking.

"Malnutrition in older people, both in the community and in hospitals, is often left undetected.

"Health professionals and those in social care need to get better at spotting the signs and then making sure that a suitable care plan is put in place to ensure those at risk of malnutrition do not slip through the gaps between services and get consistent treatment and support.

"Eating and drinking well is critical when it comes to staying healthy and independent, yet this can become more difficult as we get older.

"It is also important that older people, along with their friends, family and health care professionals, challenge assumptions around malnutrition and don't ignore the problem.

"For example, people shouldn't assume that losing weight is automatically part of ageing."

'Damage done'

In Tameside, the hospital's chief executive, Karen James, said staff had noticed patients are "often coming through malnourished" and when talking to patients "we find out that they are suffering and there is a need".

She said people were making choices about whether to pay a bill or feed the family.

Three food collection points have been set up at the hospital, with donations delivered to a central warehouse.

Natalie Welsh, a nutrition specialist nurse at Tameside, said: "It's really important that these people are highlighted in our community because quite often by the time they come through our doors and need to be admitted, the damage is already done.

"It can take us a long time to get them to recover from illness and disability because of the malnutrition they have suffered."

A Department of Health spokesperson said: "Malnutrition is unacceptable. Though the rising figures we have seen may well be in part due to better diagnosis and detection, even more action is required.

"That is why we have ensured that everyone over the age of 40 can have a free NHS health check to spot the warning signs of poor nutrition, and have provided £500k funding to Age UK to reduce malnutrition among older people."

http://www.bbc.co.uk/

Graham