Dr. Keith Runyan: Why I Chose a Ketogenic Diet For Diabetes Management

Often people use the term “diet” to mean something that is temporary for a specific purpose, usually weight loss. For me, it is a permanent way of eating now. I am a retired physician living with Type 1 diabetes since 1998. I started to exercise regularly in 2007 to help ward off complications, particularly cardiovascular disease. I was unaware at the time that aerobic exercise alone would have little impact on the development of cardiovascular disease. It wasn’t until 2011 when I contemplated doing an ironman distance triathlon, that I discovered diet is the most important determinate in the development of most chronic diseases, including cardiovascular disease. My research led me to begin a very low carbohydrate, ketogenic diet in February 2012.

Why I Chose a Low Carb Ketogenic Diet for Diabetes Management

Carbohydrate is the macronutrient that raises blood glucose the most, so keeping consumption low is my primary goal. Of next importance is using whole foods that naturally have the necessary micronutrients and enough complete proteins to support my exercise. I had to add fat to my meals to replace calories from the omitted carbohydrates. My protein intake did not change after starting a ketogenic low carb high fat diet. This way of eating has resulted in a significant improvement in my blood glucose control and a 1.2% reduction in HbA1c. Most importantly, the diet supplies my body with the energy, substrates, and nutrients to enable daily resistance and aerobic/endurance exercise, with minimal need for sports nutrition (sugar), or development of hypoglycemia. I completed The Great Floridian Triathlon in October 2012 without any sugar, food, or hypoglycemia thanks to my low carbohydrate ketogenic lifestyle.

Nutritional Ketosis

My diet keeps me in a state of nutritional ketosis*, the natural result of a low carbohydrate diet that instructs the fat cells to release fat and the liver to convert some of that fat into ketones. Ketones, including acetoacetate and beta-hydroxybutyrate, are small energy molecules clipped from long fatty acids to replace a portion of the glucose requirements of many key organs, particularly the brain. The body over time becomes metabolically flexible, and able to utilize glucose, fat, and ketones, instead of just glucose and fat. This is especially important for those with diabetes who may experience hypoglycemia since ketones can supply the brain with fuel when blood glucose is temporarily low. The low carbohydrate ketogenic diet has also been found to be anti-inflammatory and improves cardiovascular risk factors in persons with metabolic syndrome.

To stay in continuous nutritional ketosis I keep my total carbohydrate content at about 50 grams/day, but others may require as little as 20 grams/day. By monitoring urine ketones, blood ketones, and/or breath ketones, I have confirmed nearly continuous nutritional ketosis. My dietary protein intake is about 1.4 grams/kg body weight/day, so for my 5’8″ height and 166 lb. weight, that’s about 105 grams of protein/day. My dietary fat intake is fairly high as a percentage of calorie intake (about 75%), but the quantity of dietary fat (about 209 grams/day) is just enough to feel energetic and maintain a lean body composition.

Hunger has never been a problem for me, but has become even less noticeable since starting my diet. I eat breakfast at 8 a.m. and dinner at 6 p.m.. I started skipping lunch (thus eating two meals a day) in 2001 to avoid taking insulin with lunch, and thereby decrease the likelihood of hypoglycemia while at work. Eating at regular times is not absolutely necessary when type 1 is treated with insulin analogs, but I prefer a regular schedule because insulin sensitivity changes throughout the day particularly after exercise and this affects the mealtime insulin doses needed. Persons with diabetes often ask me how difficult it is to maintain such a rigid diet. It’s really not all that difficult. Here’s what I eat.

What I Cook And Eat

• Beef, grass-fed, including skeletal muscle (65% lean), heart, liver, and kidney
• Fish, mainly wild Alaskan salmon
• Pork sausage and bacon (both uncured)
• Lamb occasionally
• Chicken & Turkey occasionally
• Eggs (chicken)
• Non-starchy vegetables (about 5% carbohydrate content by weight): Cabbage (Red, Green, Napa), Kale, Collard Greens, Spinach, Bell Peppers, Carrots, Leeks, Onions, Mushrooms, Brussels sprouts, Home-made Sauerkraut from Red Cabbage, Bok-Choy, Broccoli, Cauliflower, Yellow Squash, Zucchini, Cucumber, Lettuce (Iceberg & Romaine), Turnip Root, others I’m not recalling.
• Fruit – Avocado, Tomatoes, Olives, Strawberries, Blueberries, Blackberries, lemon juice on fish and salads
• Nuts & Seeds – Pepitas, Macadamia, Brazil, Pecan, Walnut, Pistachio, Cashew
• Fat – Butter, Coconut & Olive Oils often, Cheese rarely (all these added fats are admittedly processed)
• Note: I developed an intolerance to milk prior to my diagnosis of T1D. I did try heavy whipping cream after starting my KLCHF diet, but am also intolerant of it.

Read more:  http://asweetlife.org/

Graham

29th February 2016 : Leap Day : Leap Year

Leap Day, on February 29, has been a day of traditions, folklore and superstitions ever since Leap Years were first introduced by Julius Caesar over 2000 years ago.

Women Propose to Their Men:
According to an old Irish legend, or possibly history, St Brigid struck a deal with St Patrick to allow women to propose to men – and not just the other way around – every four years.

This is believed to have been introduced to balance the traditional roles of men and women in a similar way to how leap day balances the calendar.

Gloves Hide Naked Ring Finger:
In some places, leap day has been known as “Bachelors’ Day” for the same reason. A man was expected to pay a penalty, such as a gown or money, if he refused a marriage proposal from a woman on Leap Day.

In many European countries, especially in the upper classes of society, tradition dictates that any man who refuses a woman's proposal on February 29 has to buy her 12 pairs of gloves. The intention is that the woman can wear the gloves to hide the embarrassment of not having an engagement ring. During the middle ages there were laws governing this tradition.

Leap Day Babies World Record:
People born on February 29 are all invited to join The Honor society of Leap Year Day Babies.

According to the Guinness Book of Records, the only verified example of a family producing three consecutive generations born on February 29 is that of the Keogh family. Peter Anthony was born in Ireland on a Leap Day in 1940, while his son, Peter Eric, was born in the UK on February 29, 1964. Peter Eric's daughter, Bethany Wealth, was also a Leap Day baby, born in the UK on February 29, 1996.

The Henriksen family from Andenes, Norway currently holds the official record for the most number of children born in one family on leap day. Karin Henriksen gave birth to three children on February 29; her daughter Heidi in 1960 and her sons Olav and Leif-Martin in 1964 and 1968.

When do Leap Day Babies Celebrate Their Birthdays:
Leap day on February 29 occurs (nearly) every four years, but leap day babies, or leaplings, still get to celebrate their birthdays in common years. Some celebrate on February 28, some prefer March 1. However, many countries have laws defining which date a person born on February 29 comes of age in legal terms. For instance in New Zealand, the official birthday falls on February 28 in common years; in other countries like the United Kingdom, leap year babies have to wait until March 1.

Unlucky in Love:

In Scotland, it used to be considered unlucky for someone to be born on leap day, just as Friday 13th is considered an unlucky day by many. Greeks consider it unlucky for couples to marry during a leap year, and especially on Leap Day.

St Oswald’s Day:
Leap day is also St Oswald’s Day, named after the Archbishop of York who died on February 29, 992. His memorial is celebrated on February 29 during leap years and on February 28 during common years.

See words above, and more, from articles here and here

Looking for a great LCHF leap day meal - how about this

Beef Bourguignon ... so low carb

using beautiful diced braising steak

Raspberry Chocolate Sundae : Low Carb Heaven

using raspberries, blackberries, chocolate cream and coconut

Enjoy your day ...
Enjoy your life, love and health ...
Look after yourself, and loved ones, the best way you know how ...

All the best Jan

High levels of intense exercise may be unhealthy for the heart

More Research Needed Into the Effect of Intense Exercise on Heart Structure and Function, According to Sports Cardiologist Writing in the Canadian Journal of Cardiology.

There is growing evidence that high levels of intense exercise may be cardiotoxic and promote permanent structural changes in the heart, which can, in some individuals, predispose them to experience arrhythmias (abnormal heart rhythm). A review published in the Canadian Journal of Cardiology explores current controversies and makes the case for investing in large prospective research studies into the effect of intense exercise on heart structure and function.

There are unquestionable benefits to "getting off the couch." However, there is already fairly compelling evidence supporting the association between long-term sports practice and increased prevalence of atrial fibrillation, and the fact that this relates to chronic altered atrial substrate. Without challenging the undeniable evidence supporting low and moderate intensity exercise, this review by sports cardiologist André La Gerche, MD, PhD, provides a balanced discussion of the available data for and against the concept that intense exercise, particularly endurance exercise, may cause adverse cardiac changes in some athletes.

"Much of the discussion regarding the relative risks and benefits of long-term endurance sports training is hijacked by definitive media-grabbing statements, which has fueled an environment in which one may be criticized for even questioning the benefits of exercise," explains Dr. La Gerche, who is Head of Sports Cardiology at the Baker IDI Heart and Diabetes Institute, Melbourne, Australia. "This paper discusses the often questionable, incomplete, and controversial science behind the emerging concern that high levels of intense exercise may be associated with some adverse health effects."

As Dr. La Gerche points out, all available therapies, pharmacological or otherwise, have a dose-response relationship whereby benefits diminish at high doses and the risk of adverse events increases. An open mind would consider that this may even be possible for exercise.

A commonly held view is that adverse clinical events in athletes are explained by exercise acting as a trigger in individuals who are susceptible because of an underlying abnormality. Dr. La Gerche excludes inherited conditions from this discussion, focusing instead on whether exercise may affect a change in the heart that may serve as a cause of arrhythmias in its own right. He reviews the following emerging controversies:

More here:  http://www.medicalnewstoday.com/

Relax ... It's Sunday

Take Some Beautiful Flowers

Cook a wonderful Roast

Pour a glass of wine

Enjoy some berries served with cream

All these can help to make a nice Sunday

Enjoy yours ...

All the best Jan

Holly Johnson - Ascension

New from Holly Johnson

Graham

Enya - Echoes In Rain

Still going strong after all these years a song from Enya's latest album

Graham

Whatever you have planned ...

and take time for a cuppa

and slice of low carb Coffee and Walnut Sponge Cake

Ingredients:

100 grams of ground almonds

100 grams of walnuts

1 teaspoon baking powder

2 large eggs

1 tablespoon of melted butter

2 tablespoons of double (heavy) cream

1 tablespoon of instant coffee

100 grams of clotted cream

Method:

1. Mix all dry ingredients in a bowl.

2. Melt the butter, I used a Pyrex jug, add the eggs, cream.

3. Place 1 tablespoon of instant coffee in a cup and pour some boiling water over the coffee, keep water to a minimum, just enough to melt the coffee. Then add the dry ingredients and mix.

4. Microwave in a 700 watt for 5 minutes in a 6" x 3" micro-wave safe glass dish.

5. Allow to cool and cut in half. Spread on clotted cream and add walnut halves.

Serves 6 , around five carbs per portion.

Please note this cake is very low in carbs, but quite high in calories, so have a small slice !

All the best Jan

Even small improvements in blood glucose levels can result in huge benefits

Sanofi, Diabetes UK and JDRF today announce the publication of IMPACT 2 in the journal Diabetic Medicine.

This new study shows that, if sustained, even modest improvement in blood glucose levels can provide significantly improved outcomes for the 3.5 million people diagnosed with diabetes in the UK. As a result, if applied to the whole diabetes population, almost a million serious medical complications, such as blindness, amputation and kidney failure could be avoided over 25 years, improving the lives of people with diabetes.Better management of blood glucose levels over the same period could equate to a cost avoidance of £5.5 billion for the NHS.

IMPACT 2 is a study based on data and population modelling. It is the outcome of a collaboration between Diabetes UK, JDRF and Sanofi, and the analysis was completed by IMS and the York Health Economics Consortium. It quantifies the patient and financial benefit over 25 years of earlier intervention for better controlling blood glucose. The findings highlight results that could have a significant impact for people with diabetes and NHS budgets:

• For people with Type 2 diabetes the figure of potentially preventable complications is 870,000 equating to a cost avoidance of £4.5 billion over 25 years for the NHS.

Chris Askew, Diabetes UK Chief Executive commented, “IMPACT 2 demonstrates that even small improvements in blood glucose levels can result in huge benefits for people with diabetes with the potential to stop 23,000 people suffering severe kidney failure, almost 160,000 leg ulcers and amputations and over 50,000 people suffering severe loss of vision. This should be a priority for all those involved in providing care for people with diabetes.” He continued, “Preventing Type 2 diabetes through public health initiatives is of course the best way of reducing spend long-term, however much greater efforts are needed to ensure all people with diabetes get the support and care they need for a good quality of life and better health outcomes.”

Karen Addington, Chief Executive of JDRF in the UK, agreed, adding, “People with Type 1 diabetes are routinely still receiving poorer care and are less likely to be meeting NICE recommended blood glucose targets, when compared to people with Type 2 diabetes. The IMPACT 2 results show the benefit to people living with Type 1 diabetes and the NHS in providing appropriate care, support and education to help people manage their condition.”

Blood glucose management in the UK

The report is published against a backdrop of blood glucose management in the UK being amongst the worst in Europe and around two thirds of all people with diabetes in England not achieving the treatment targets recommended by National Institute for Health and Care Excellence (NICE).  In addition, despite well-documented benefits of reducing complications through timely control of blood glucose, levels are too high before additional interventions are provided. On average, people in the UK with Type 2 diabetes have the highest blood glucose levels (HbA1c 9.8 per cent) when compared to nine other developed countries, at the point of insulin initiation.

“The scale of the findings have important implications for clinical practice in the NHS. In a cost constrained healthcare system, interventions, medical or otherwise, will always be required to justify any improvement in patient outcome against cost. For the first time clinicians have clear evidence of the reduction in spending that could be conferred by reducing serious diabetes related complications through better blood glucose control,” says Professor Steve Bain, Professor in Medicine (Diabetes), University of Swansea.

NHS spend on diabetes is on the increase 

NHS spend on diabetes is already considerable and on the increase. IMPACT 1 showed that diabetes costs the NHS £10 billion each year – around £1 million an hour – which is about 10 per cent of the entire NHS budget.  Nearly 80 per cent of these costs are attributable to treating avoidable complications, which could potentially be reduced through better management of diabetes, including improved blood glucose control. Diabetes is now the leading preventable cause of sight loss in people of working age in the UK and 135 amputations are carried out every week as a result of poor management of the condition.

“Diabetes is a major healthcare problem with a large and increasing number of people in the UK suffering from avoidable microvascular complications such as kidney disease and foot amputations because their blood glucose levels are too high. IMPACT 2 quantifies the reduction in the number of complications, and the potential cost avoidance if modest improvements to patients’ blood glucose levels were made. There is the potential to generate real improvements in outcomes for patients with diabetes by making even small but sustained improvements in their blood glucose levels,” explains Dr Mike Baxter, Consultant Advisor to Sanofi Diabetes and lead author of the study.

https://www.diabetes.org.uk/

With average HbA1c levels of 9.8% it going to take more than a small improvement to get to a safe place, LC is the answer but that's a diet DUK do not approve of  which is good news for Sanofi profits 

Graham

Lamb cutlets with cannellini beans and parmesan dressing

In the Northern Hemisphere Spring is getting nearer and nearer! Spring starts on Sunday 20th March and ends on Monday 20th June. Here in the UK the past few days have not been too bad and many have been out and about enjoying some blue skies and sunshine... So with Spring in the air, well in our thoughts, I thought why not enjoy some 'greenery' with our meal and enjoy this delightful dish. 

The greenery is provided by using wild rocket which is sometimes known as Arugula. Now we all know that salad greens are healthy, and that most are very low in calories. However, did you know that not all give you a good dose of nutrients... well Arugula/ Rocket is one leafy green vegetable that stands out as a rich source of many vitamins and minerals. 

Consider the difference between iceberg lettuce and arugula/rocket:

Arugula contains about eight times the calcium,
fives times the vitamin A, vitamin C and vitamin K,
four times the iron as the same amount of iceberg lettuce.
The choice is easy... start with arugula/rocket for a healthier salad! 

Here is what you need:
Serves Four
(16.9g carbs per serving)

1 tsp Dijon mustard
1 garlic clove, chopped
2 anchovies, very finely chopped
150 ml olive oil, plus extra for brushing
juice and zest of 1 lemon
4 tbsp grated parmesan
70 g wild rocket
12 lamb cutlets (approx 550g)
2 x 410g tins cannellini beans, drained and rinsed
1 tbsp white or red wine vinegar

Here is what you do:
1. For the dressing, whizz the mustard, garlic, anchovies, 100ml of the olive oil and the lemon juice in a food processor or blender. Pour into a bowl, then stir in the lemon zest, grated Parmesan and half of the rocket, chopped.
2. Preheat a griddle/grill pan (or barbecue). Brush the lamb cutlets with oil and season. Griddle/grill (or barbecue) the cutlets over a high heat for 2-3 minutes on each side until brown and crisp.
3. Put the cannellini beans in a pan with the remaining olive oil and the vinegar; season well. Heat gently for a few minutes to warm through, then stir in the rest of the rocket. Serve the lamb on a bed of beans and rocket with the dressing drizzled over.

Thanks to Sainsbury's for the original idea here

I hope you may try out this dish soon.

Now is the table ready ...

... where did I put those place mats

Thanks for reading

All the best Jan

Dr. Aseem Reveals That Too Much Medicine Is Killing Us

Graham

Dr Richard Bernstein, Books and Shackelton's Endurance !

Many of us enjoy a good read, to sit down with a book and relax. I wonder what your favourite top ten books would be? If you are a Diabetic then I think most would agree the number one must have book is 'Diabetes Solution' by Dr. Richard Bernstein, 'a legendary figure in the diabetic community, an engineer who developed a revolutionary new method of treating his own diabetes in the 1970s -- and then entered medical school at age forty-five so he could help other diabetics'.

We are so fortunate to be able to choose from a wealth and variety of books. When choosing we now even consider, do we want a hardback, paperback ... or the electronic style...

We can immerse ourselves in a good read, learn from a good read ... escape from the pressures of the world ... sit down with a cup of tea, or glass of wine and 'chill out' for a while.

Now, just for a moment, imagine you are an explorer and just about to set out to the Antartic 100 years ago like Sir Ernest Shackleton ...I wonder what reading books you may take with you? Let me share a few words ...

"What books were taken to the Antarctic 100 years ago?

When Sir Ernest Shackleton set off for Antarctica on his ship Endurance, he made sure he had plenty of reading material. But details of precisely what books he took have remained hidden in this photograph - until now.

The image from the ill-fated South Pole expedition - taken in early March 1915 by Australian photographer Frank Hurley - has been digitised by the Royal Geographical Society in London.

It is now known that the explorer carried with him dictionaries, encyclopedias and books chronicling other dangerous polar expeditions.

He took established works by Dostoyevsky and Shelley - but also, explains Alasdair MacLeod from the RGS, "newly published fiction by popular authors of the time".

"The cabin wall on the left also shows a framed print of Rudyard Kipling's poem 'If', which Shackleton carried with him on to the ice floe when the ship sank."

In January 1915, Endurance and her crew became trapped in ice in the Weddell Sea. Shackleton and his men would remain there for 10 months - until the ship sank. They then spent the best part of another year on the ice, before all 28 of them were rescued.

Use this link to see the full list of books identified by experts at the RGS - and you can also see more stark images of Shackleton's struggle for survival."

... now if I was going any where cold a good soup may be just what I'd want, how about this one, a tasty and warming Roast Red Pepper & Tomato Soup stacked with vitamins & minerals.

... now where did I put that soup spoon?

Thanks for reading

All the best Jan

Atorvastatin Use Associated With Acute Pancreatitis: A Case-Control Study in Taiwan.

Abstract 

Few data are present in the literature on the relationship between atorvastatin use and acute pancreatitis. 

The aim of this study was to explore this issue in Taiwan.Using representative claims data established from the Taiwan National Health Insurance Program, this case-control study consisted of 5810 cases aged 20 to 84 years with a first-time diagnosis of acute pancreatitis during the period 1998 to 2011and 5733 randomly selected controls without acute pancreatitis.

Both cases and controls were matched by sex, age, comorbidities, and index year of diagnosing acute pancreatitis. Subjects who at least received 1 prescription for other statins or nonstatin lipid-lowering drugs were excluded from the study. If subjects never had 1 prescription for atorvastatin, they were defined as never use of atorvastatin.

Current use of atorvastatin was defined as subjects whose last remaining 1 tablet of atorvastatin was noted ≤7 days before the date of diagnosing acute pancreatitis. Late use of atorvastatin was defined as subjects whose last remaining 1 tablet of atorvastatin was noted >7 days before the date of diagnosing acute pancreatitis

The odds ratio with 95% confidence interval of acute pancreatitis associated with atorvastatin use was calculated by using the logistic regression analysis.The logistic regression analysis revealed that the odds ratio of acute pancreatitis was 1.67 for subjects with current use of atorvastatin (95% confidence interval 1.18, 2.38), when compared with subjects with never use of atorvastatin. The odds ratio decreased to 1.15 for those with late use of atorvastatin (95% confidence interval 0.87, 1.52), but without statistical significance.

Current use of atorvastatin is associated with the diagnosis of acute pancreatitis. Clinically, clinicians should consider the possibility of atorvastatin-associated acute pancreatitis when patients present with a diagnosis of acute pancreatitis without a definite etiology but are taking atorvastatin.

http://www.ncbi.nlm.nih.gov/

Graham

Courgettes / Zucchini ... they are on my shopping list!

Courgettes / Zucchini are becoming ever more popular and with good reason, they have a deliciously sweet, nutty taste. They’re often used to bulk out sauces and dishes like a bolognaise or lasagne, but why not also enjoy courgettes in their own right.

Many of us enjoy growing our own Courgettes, but if left too long in the soil, they will grow huge and bloated with water. While these green monsters might look magnificent, the best tasting courgettes are the shorter, slim ones.

If you’re already living the LCHF lifestyle, you will know that courgettes are low in carbs, just 2g. carb per 100g, and they are probably high up on your must buy shopping (or growing) list. They may not pack the nutritional punch of other green vegetables (broccoli, kale etc.) but they do contain significant levels of potassium to control blood pressure and vitamin C to boost your immune system.

The courgette’s thin dark skin is high in soluble fibre, which slows digestion and stabilises blood sugar levels – potentially getting rid of those pesky mid-afternoon sweet cravings. Soluble fibre can also prevent constipation and help with those horrible IBS symptoms so many of us endure.

You can buy courgettes from most big supermarkets as well as small farmers markets (when in season). Many prefer to buy locally sourced courgettes as supermarkets can of course ship vegetables thousands of miles despite them being in season a few minutes down the road, but how and where you buy is always a personal choice.

Now – how to prepare courgettes? Try not to cook courgettes with too much water as they can go quite soggy. The best way to cook them is to get a good crunch. Slice them in thin chip shapes, place them on foil and drizzle with extra virgin olive oil and a sprinkling of salt, spices and herbs, then place under the grill until golden. You can eat these as a snack, or with a salad. Alternatively, you can roast courgettes up with a selection of other vegetables to enjoy with classic meat and buttery mashed swede. Or you can make Greek style fritters on the BBQ with lots of chopped dill.

Courgettes keep well in the fridge, but don’t leave them too long or they’ll develop a slightly bitter taste.

More information here, with a lovely Courgette / Zucchini Fries recipe here.
Some text taken from this resource here

Simple sauteed zucchini-courgettes with Gruyere cheese recipe here

Sunny Breakfast - Eggs with Courgettes and Tomatoes

a winning way to start the day!

How about putting courgettes (zucchini) on your shopping list

All the best Jan

Why do we think we know what we know? A metaknowledge analysis of the salt controversy

Abstract 

Background: Although several public health organizations have recommended population-wide reduction in salt intake, the evidence on the population benefits remains unclear. We conducted a metaknowledge analysis of the literature on salt intake and health outcomes.

Methods: We identified reports—primary studies, systematic reviews, guidelines and comments, letters or reviews—addressing the effect of sodium intake on cerebro- cardiovascular disease or mortality. We classified reports as supportive or contradictory of the hypothesis that salt reduction leads to population benefits, and constructed a network of citations connecting these reports. We tested for citation bias using an exponential random graph model. We also assessed the inclusion of primary studies in systematic reviews on the topic.

Results: We identified 269 reports (25% primary studies, 5% systematic reviews, 4% guidelines and 66% comments, letters, or reviews) from between 1978 and 2014. Of these, 54% were supportive of the hypothesis, 33% were contradictory and 13% were inconclusive. Reports were 1.51 [95% confidence interval (CI) 1.38 to 1.65] times more likely to cite reports that drew a similar conclusion, than to cite reports drawing a different conclusion. In all, 48 primary studies were selected for inclusion across 10 systematic reviews. If any given primary study was selected by a review, the probability that a further review would also have selected it was 27.0% (95% CI 20.3% to 33.7%).

Conclusions: We documented a strong polarization of scientific reports on the link between sodium intake and health outcomes, and a pattern of uncertainty in systematic reviews about what should count as evidence.

Full Text:  http://ije.oxfordjournals.org/

Graham

Turkeys voting for Christmas.

Hidden corporate donors poured $11M into fight to stop GMO labels in Wash.

A food-industry group tried to shield identities of major corporations that spent $11 million to defeat a 2013 food-labeling initiative in what Attorney General Bob Ferguson argues is among the worst cases of concealment in state history.

Newly unsealed documents shed further light on a food-industry trade group’s efforts to shield the identity of corporate donors who poured $11 million into a campaign to defeat a 2013 food-labeling initiative in Washington.

In a filing ahead of a key Friday court hearing, state Attorney General Bob Ferguson accused the Grocery Manufacturers Association of an “egregious” plot to evade campaign-disclosure laws that ranks “among the worst in state history.”

“It was a detailed scheme over many months to purposely, in their words, shield their donors from public scrutiny, and that’s not OK,” Ferguson said in an interview.

GMA rejected the accusations, saying it never intended to break state law. In court briefs and a statement, the group criticized Ferguson’s lawsuit as “based on a one-sided misportrayal of the facts” and called the state’s disclosure law “hopelessly vague.”

The case goes back to 2013’s Initiative 522, which sought to require labeling of genetically modified foods in Washington. The measure was defeated, with a record$22 million spent on the “no” campaign.

GMA was the largest donor, spending more than $11 million. Late in the campaign, Ferguson sued the D.C.-based trade association, saying it had violated state disclosure law by soliciting big money from companies to defeat labeling measures including I-522, while failing to disclose the corporations funding the effort.

The association’s donations were reported only as coming from the GMA, not the individual corporations who had kicked into the fund, including PepsiCo, Nestle and General Mills.

Internal GMA documents show the trade group wanted to insulate its individual members from public blowback for opposing food-labeling initiatives.To do that, the group created a special fund, called the Defense of Brand Strategic Account.

At a January 2013 board meeting discussing the effort, GMA officials said the fund would “shield individual companies from public disclosure and possible criticism,” according to minutes cited in a state court motion unsealed this week.

A month later, the board authorized creation of the fund, with leaders touting one of its advantages as “the ability to identify only GMA as the contributor,” documents show.

That April, GMA distributed talking points to its members suggesting they answer “No” if asked whether they were funding the “No on I-522” campaign.

After the lawsuit filing, GMA agreed to disclose its donors, but Ferguson’s lawsuit argues the damage was done, since the group had succeeded for most of the campaign season in hiding them.

The suit also accuses GMA of failing to properly register as a political committee and of failing to file 58 campaign-finance reports on time.

Ferguson, a Democrat up for re-election this fall, said his office seeks a major penalty sufficient to send a message to other campaigns that avoiding disclosure in the state won’t be tolerated.

In a summary-judgment motion, Senior Assistant Attorney General Linda Dalton argued the penalty should be at least $14 million — equal to the amount GMA pumped into its anti-labeling internal account without proper disclosure.

Ferguson said that could be tripled if a judge agrees GMA intentionally flouted the law.

In a statement, GMA pushed back, saying its internal documents reveal no lawbreaking, but simply the association’s First Amendment right to act “as a single spokesperson for the common interest of its members.”

It said the court “can now focus on Washington State’s hopelessly vague disclosure law and how the State’s administration of this law improperly burdens the constitutionally protected right of trade associations to engage in political debate in Washington State.”

In a court brief, GMA lawyers added that the group even followed advice from Ferguson’s office on some of its disclosures and said the Attorney General’s Office has not held other organizations, including union and trial-lawyer groups, to the same standards.

A hearing is set for Friday in Thurston County Superior Court, where a judge will consider ruling on motions for summary judgment by the state or the GMA. The court also could decide to send the case to trial later this year.

http://www.seattletimes.com/

Graham

Spiced squash, butter bean and purple sprouting broccoli stew

Now this could make a nice change for your mid-week meal plans ... it's a veggie dish topped with some lovely feta cheese. It's from the Hemsley sisters, Jasmine and Melissa and has also featured in Sainsbury's magazine.

Ingredients:

Serves 6 - amend to suit
1 tbsp ground cumin
1 tbsp ground coriander
1½ tsp smoked paprika
½ tsp crushed chilies
1 tbsp ghee (or butter)
2 large onions, diced

2 tsp fresh thyme or oregano leaves, or 1 tsp dried thyme or oregano
4 garlic cloves, finely chopped
zest and juice of 1 lemon
1 small butternut squash (around 800g), peeled and chopped into 3cm cubes
1 litre homemade chicken stock or good-quality vegetable stock
600g purple sprouting broccoli
3 x 400g tins butter beans, drained
1 large handful of coriander
1 large handful of flat-leaf parsley
100g organic feta cheese, to 
crumble over
extra-virgin olive oil, to serve

Method:

1. Toast the cumin, coriander, paprika and half the crushed chilies in a large dry casserole briefly, stirring, until fragrant.
2. Add the ghee or butter and the onions for 5 minutes until soft, not brown. Add the thyme, garlic and lemon zest for 1 minute more.

3. Add the squash to the pan along with the stock; bring to the boil, then simmer gently for about 10 minutes until the squash is almost tender, add the drained butter beans and season with salt and pepper. Simmer 
for a further 5 minutes.
4. Add the purple sprouting broccoli, cover and simmer for about 10 minutes until tender, then add the lemon juice and half of the coriander and parsley. Spoon into bowls and top each serving with the remaining parsley and coriander, some crumbled feta cheese and a drizzle of extra-virgin olive oil; sprinkle with the remaining crushed chilies.

You can read more about purple sprouting broccoli here - also if you like King prawns cooked in butter, garlic and a mixed herbs seasoning. Accompanied by swede boiled and mashed with lots of butter, and some purple sprouting broccoli, there is a recipe idea to see.

We try and bring a variety of 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.

Enjoy your day

All the best Jan

Gloria Hunniford on how she CURED herself of pre-diabetes

The TV presenter was told she was pre-diabetic during an annual blood test and knew she had to take action

Gloria Hunniford, 75, co-hosts the new BBC1 show Food: Truth or Scare.

Here she tells how food has affected her health and how she aims to help you

There’s dieting for vanity and there’s dieting for sanity. And the latter has helped me beat off the threat of diabetes.

It was during an annual blood test in 2013 that my doctor said I was pre-diabetic and told me to take my life in my hands.

That meant cutting out croissants, chocolate and biscuits – for, like my late sister Lena who struggled with diabetes, I had a sweet tooth.

I’d dieted before but going on a medical diet gives you determination. I cut out all the sugar I could.

Inside six weeks, my GP ran another test and said, for my age, I had achieved the best reading.

This was the start of a journey in which I have learned more about food , its benefits and its pitfalls.

It’s clear to me now that sugar, not fat, is public enemy number one. And low fat just means it’s been replaced by too much sugar.

A few months after bringing my sugar levels down, I cut my finger carving lamb. I suffered a terrible reaction, close to blood poisoning.

The doctor treating me said if I was pre-diabetic, I ought to quit carbs too because they turn into sugar in the body.

So I gave up bread, pasta and potatoes. It wasn’t the end of the world. Now I’ll have egg or sausage for breakfast, but no bread.

It’s soup or salad with fish for lunch and in the evening I’ll replace potatoes with cauliflower, which has the same sort of crunch.

Instead of sugary snacks I’ll have a chunk of cheese, nuts or a glass of milk.

After cutting out sugar and carbs, I’d dropped two stone to 8st 7lb – a little too thin, so I’m now back up at 9st 1lb.

My story underpins the whole TV series and our link between food and health.

To help make the right diet choices, it’s necessary to cut through confusing and sometimes downright frightening headlines.

Advice changes all the time too.

When my husband Stephen, 74, had a heart attack 12 years ago, I told him he wasn’t allowed more than three eggs a week because of his high cholesterol.

But during filming I found eggs have no impact on it. In fact, they are a superfood with as many nutrients as fillet steak.

When it comes to vitamins I’m a self-confessed junkie. I’ve been taking supplements since I was 17.

We spoke to some experts who suggested pills weren’t necessary if you follow a good diet – but who does that when we’re all so busy?

I want to live as long as I can for my family, including my late daughter Caron’s kids. Vitamins are my insurance policy.

I learned so much while doing this show. For example, cooking with olive oil can be bad for you beyond a certain temperature.

And don’t chop carrots until they’re cooked to retain their goodness.

Armed with the correct information, you can make the right decisions.

http://www.mirror.co.uk/

Graham

Lemons : So Handy When Cooking

Oval in shape, with a pronounced bulge on one end, lemons are one of the most versatile fruits around, and contain a high level of Vitamin C.

Although the juicy yellow flesh is a little too sour to eat on its own, its citrus fragrance and tartness means it's wonderful combined with all manner of ingredients and dishes, from the sweet to the savoury. The bright yellow skin can be used as well, when zested. A kitchen essential.

Availability:
All year round but at their best from January until March.

Choose the best:
Look for unblemished, firm lemons that feel heavy for their size and have no tinges of green (which indicates that they're under-ripe). Avoid very pale lemons, as they are older, and will contain less juice.

The best lemons for juicing or using for wedges are those with a smooth, thin skin. The best for zesting are those with a thicker, knobbly skin, which tend to be on the large size.

If you intend to use the zest, buy unwaxed lemons (shops should state this clearly). If you can't find them, scrub the lemons thoroughly before zesting.

Prepare it:
To extract the maximum amount of juice, make sure the lemons are at room temperature, and firmly roll them back and forth under your palm a couple of times - that helps to break down some of the flesh's fibres.

Alternatively, microwave lemons for around 30 seconds, depending on the size of the lemon - warming them up helps them give up more juice.

Store it:
In a perforated bag in the fridge (for a couple of weeks); in a fruit bowl (for around a week). Once cut, wrap in clingfilm and keep in the fridge for up to four days.

Cook it:
Serve fresh wedges or slices with fish or add to the pan when roasting veg or meat. Add the zest to salads, baking or sauces. Use the juice to make salad dressings, lemonade, de-glaze a pan or add a couple of drops to water to make acidulated water. Use the flesh and peel in marmalades and preserves. Halve and use to stuff a chicken before roasting.

Alternatives:
Try lime.

Above details from here

A lemon wedge goes great with low carb Crepes / Pancakes

see recipe here

Or how about a low carb lemon sponge cake

see recipe here

All the best Jan

Amy Winehouse - You Know I'm No Good

Gone but never forgotten the late great Amy Winehouse

Graham

"Blue Moon Revisited".wmv - Cowboy Junkies -

Sit back and relax with an old classic
Graham

Candice Parise & Valery Rodriguez - Show Must Go On

I'm not a great fan of covers, especially covers of the great Freddie Mercury's and Queens music, but this is a damn fine effort in my opinion. Eddie 

The Who - Won't Get Fooled Again

Saturday night again and that's music night on this blog. Dedicated to all the people who were given abysmal dietary advice. One thing for sure, we won't get fooled again. Eddie

Dietitians modern day luddites.

The Luddites were 19th-century English textile workers (or self-employed weavers who feared the end of their trade) who protested against newly developed labour-economising technologies, primarily between 1811 and 1816. The stocking frames,spinning frames and power looms introduced during the Industrial Revolution threatened to replace them with less-skilled, low-wage labourers, leaving them without work. The Luddite movement culminated in a region-wide rebellion in Northwest England that required a massive deployment of military force to suppress. Wiki

A comment posted on our blog post Why The World Needs More People Like Prof Tim Noakes.

"What a wonderful and heartfelt letter, which echoes the innermost thoughts and feelings of so many around the world. 

Professor Noakes is much more than an inspiration. Having witnessed so much controversy in the field of dietetics, I was devastated to learn that Professor Noakes, an emeritus Professor of the highest level, had been reported by the president of the Association for Dietetics in South Africa. At first I felt stunned, then sickened and sadness.

The field of nutritional science cannot be monopolised worldwide by one organisation. In my experience, anyone who is not dietetic trained should not dare breath, let alone think about nutrition. Even branded by slogans such as 'only being able to trust one organisation to know about nutrition'. The entire world is becoming increasingly fed up with this egotistical standpoint. The case concerning Professor Noakes has angered many professionals worldwide, but it has brought us together, made us stronger, united and exposed the truth. Just watching the Professor Noakes and Marthie Leach televised debate was extremely uncomfortable viewing but extremely revealing.

We have taught high carbohydrate, low fat for decades. Where has it brought Us? I have taught high carbohydrate, low fat for many years. We are only trained to believe and promote what those leading the training believe. Most do not take a step further and question the underlying principles of what they have been taught. And when you believe and are constantly reminded that you are the only experts in your field, why would you think to question anything?

It is only those that have reached a higher level of thinking, that are open thinking, extremely humble, respectful of others knowledge and experiences, and those who truly - and I mean truly care, that can stand up and admit we got it wrong. That is what will shape the future. Emily's letter has really captured the thoughts and feelings of so many.

Professor Noakes is an inspiration to us all."

My first thought was to call this post 'why are so many dietitians so insecure' I can give you many examples for thinking this way. None will forget the blitzkrieg mounted against Dr. Rangan Chattarjee by the British Dietetic Association, after the BBC program Doctor in the house. Or the negative comments made on social media by high profile BDA members against Dr. Aseem Malhotra. In South Africa, A1 rated science Professor Tim Noakes, has been facing a hearing more reminiscent of the Spanish Inquisition, than a fair open enquiry. We must not forget the Dr. Annika Dahlquist story, or Jennifer Elliott, an Australian dietitian, who has been de-registered by her professional body: the Dietitians Association of Australia (DAA) for putting her patients health above the interests of the corrupt DAA.

Now, if dietitians and their associations were beacons of success, or paragons of honesty and openness, I could understand their concerns about others giving contrary advice, to their well worn scripts. But they are not, not by a very long way. Far too many dietetic organisations and their members, have achieved nothing in the fight against the epidemics of obesity and it's often linked type two diabetes. It is a fact many dietetic organisations and their members, have received money from junk food companies.

The low fat high carbohydrate diet recommendations, will soon be going the way of the Dodo, as will many dietitians, who cling on to failed, outdated pseudo science. If dietitians want to be respected as true professionals, they should start acting like professionals, and work with all healthcare professionals, for the good of their patients. They must free themselves from unhealthy food companies, who have infiltrated so many dietetic associations and bought the approval of countless dietitians worldwide. 

Fortunately the world of dietetics is not a lost cause, indeed the opposite applies. The list of Scientists, Doctors and Dietitians grows longer by the day, who have raised themselves above the parapet, of greed and the corruption of junk food. They realise the last forty years of low fat and high carbohydrate recommendations have failed totally. These enlightened professionals are recommending a whole fresh food diet, it is ludicrous for anyone to argue against a real food lifestyle. The longer the established dietetic organisations try to turn back the tide, the more irrelevant they will become.

Last words to Sylvan Weinberg, former president of the American College of Cardiology.

"The low-fat diet heart hypothesis has been controversial for nearly 100 years. The low-fat, high-carbohydrate diet, promulgated vigorously by the National Cholesterol Education Programme, National Institutes of Health and American Heart Association since the Lipid Research Clinics-Primary Prevention Program in 1984, and earlier by the US Department of Agriculture food pyramid, may well have played an unintended role in the current epidemics of obesity, lipid abnormalities, type 2 diabetes and metabolic syndromes.

This diet can no longer be defended by appeal to the authority of prestigious medical organisations or by rejecting clinical experience and a growing medical literature suggesting that the much-maligned low-carbohydrate, high-protein diet may have a salutary effect on the epidemics in question"

Eddie

References 

Dr. Sylvan L Weinberg http://www.ncbi.nlm.nih.gov/pubmed/14998608

BDA https://www.bda.uk.com/news/view?id=89&x%5B0%5D=news%2Flist

Professor Tim Noakes http://www.biznews.com/low-carb-healthy-fat-science/2015/12/15/tim-noakes-hearing-why-it-really-isnt-about-twitter/

Dr. Annika Dahlquist http://drmalcolmkendrick.org/2013/10/20/sweden-gets-is-right/

Jennifer Elliott http://www.zoeharcombe.com/2015/10/jennifer-elliott-vs-dietitians-association-of-australia/