From a comment received on the fun and games thread.

"You're flogging a dead horse on the cereal thread on ETYM Eddie."

“Escape from Caloriegate” Why Low Calorie Diets Fail, and What to "Count" Instead of Calories

“Escape from Caloriegate” podcast – Episode #1 Show Notes

Podcast: Play in new window | Download

Welcome!

In the inaugural episode of “Escape from Caloriegate,” I assault one of the most deeply entrenched ideas in health/nutrition: the doctrine of “calories in calories out.” This episode and the next few that follow it will consist of me rambling into the microphone solo, in an attempt to get you to think in radical new ways about stodgy old problems that are keeping you and the rest of society stuck in 2nd gear.
After the show ramps up, I’m going to be bringing on people who actually know what they’re talking about :] — including some of the most brilliant minds in diet, health, science and beyond. It’s gonna be crazy, in a good way.
So let’s roll.
Here’s what’s cooking in Episode #1:
• The radical premise of “Escape from Caloriegate”
• The Calories In Calories Out (CICO) mindset is the root of all evil
• Why obesity is a problem of “overstoring” not “overeating”
• If Gary Taubes is the Christopher Columbus of this idea, consider me one of the “John Smiths”
• I’m not a doctor, not going to treat anybody
• My motley resume: degree in physics from Yale, failed screenwriter, obsessed with counterintuitive ideas
• Diverse creative speculation is the thread that binds my work
• I’m a low carb fan, but show is not “rah rah” low carb
• We need better questions, not more people who claim to know the answers
• If we screwed up on calories for 60+ years, what does this teach us about science, about our capacity to learn anything about nature?
• Are there “Caloriegate” like mistakes in other fields? (I believe so)
• “It’s Overstoring Not Overstoring” (IONO): the antidote to CICO
• Is IONO just the “carbs insulin hypothesis” warmed over? (no)
• Diet wars focus on calories vs. carbs, but this is a false choice
• “Obesity is most simply defined as the state in which the amount of triglycerides stored in adipose tissue is abnormally increased”
• CICO says “excess energy” causes this excess storage
• Carbs-Insulin says “bad carbs -> insulin problems” causes excess storage
• Both models make mistake of incorporating cause into definition of problem
• Why not say “obesity IS the overstoring of fat” and go from there?
• Repeat after me: “it’s IONO not CICO”
• How do you determine when a counterintuitive idea is legitimate or not?
• Two ways to go wrong – a) quackery; b) cynicism
• 4×4 matrix looks at degree of perspective and degree of critical thinking
• no perspective, no critical thinking = go with the herd
• perspective w/o critical thinking = homeopathy and crazy beliefs in crystals
• critical thinking w/o perspective = default too abruptly back to conventional wisdom
• critical thinking WITH perspective = brilliant insights, like Theory of Relativity
• how do we find this “Awakened Critical Thinking”?
• does eating turmeric prevent cancer?
• Science is a blunt tool – can’t really answer questions like that without hard work
• Karl Popper’s definition of science: “Every genuine test of a theory is an attempt to falsify it”
• Almost no one (including most so-called “scientists”) abides by this rule
• Gary Taubes on coenzyme Q10 – healthy for you or not? His surprising answer!
• To get scientific answers (per Popper’s definition of science) to all our diet questions would take 400,000 years and cost $6,000,000,000,000,000.00.
• There’s a gap between what science tells us and what we want to know
• Gurus are all too happy to fill that gap with their opinions
• How do we escape from “Caloriegate”?

http://www.caloriegate.com/calories-in-calories-out/escape-from-caloriegate-podcast-episode-1-show-notes

Graham

Commonly used painkiller 'should be banned over heart risk'

A painkiller used by at least a million people in Britain a year should be banned because it raises the risk of heart attack and stroke by almost half, say British academics.

Safer alternatives exist to diclofenac, say researchers at the Barts and the London School of Medicine and Dentistry, who want it banned worldwide.

Diclofenac, like ibuprofen, is a non-steroidal anti-inflammatory drug or ‘NSAID’. It is often prescribed after surgery and to combat arthritic pain, when ibuprofen is not strong enough.

It can also be purchased over the counter at a pharmacy without a prescription, for example in the branded form of Voltarol Pain-eze tablets.

But two years ago the Barts researchers found that it was linked with a 40 per cent increased risk of heart attack and stroke.

That analysis crystallised the fears of many doctors, who have raised concerns about the drug for years.

More here.

The Greatest Man on Earth

Statin drug users live three months longer !

Other than aspirin’s statins are probably the most used drug. Some medics want children on them, other lunatics have said put them in the drinking water supply. Statins are a $30 billion world wide industry and we hate them. The benefits are minimal if any, and the side effects are many. So, if you are one of the rare people that benefit from statins, what can you expect to gain ? Well it turns out you may live three months longer. Not much of a benefit, when you consider the many disabling and life threatening side effects that are regularly reported. From Dr.John Briffa’s blog.

"Mathematical and statistical models are unlikely to accurately predict the true outcomes of a treatment, but they’re probably better than guessing. And it turns out that when all the individuals were thrown into the mix statins, on average, allowed individuals to live without cardiovascular disease for an additional 7 months. When it comes to the all-important life expectancy question, this was increased by an average of just 3 months. I did some maths and calculated that this represents an increase in lifespan of about 0.3 per cent.

These last words utterly sum up, I think, how it is in the real world: when individuals are informed about the true facts about the likely benefits, hardly without exception they take a pass. And that’s before we even get to talk about the potential side effects such as fatigue, muscle pain and memory loss."

Dr. Briffa's article here.

Full study here.

Eddie

"Fire in the Blood": Millions Die in Africa After Big Pharma Blocks Imports of Generic AIDS Drugs !

http://www.democracynow.org/2013/1/23/fire_in_the_blood_millions_die 

Graham

Ants can tell !

China trade now bigger than US

China is now the largest trading nation in the world in terms of imports and exports, after overtaking the US last year.

China has leapfrogged the US to become the world’s biggest trading nation, bringing an end to the US’s post-war dominance of global commerce.

The total value of US exports and imports in 2012 was $3.82 trillion (£2.4 trillion), the US Commerce Department has revealed. China’s customs administration has already announced that the country’s total trade last year was worth $3.87 trillion.

“It is remarkable that an economy that is only a fraction of the size of the US economy has a larger trading volume,” Nicholas Lardy, a senior fellow at the Peterson Institute for International Economics in Washington, told Bloomberg. “The surpassing of the US is not because of a substantially undervalued currency that has led to an export boom,” Mr Lardy said, pointing out that Chinese imports have grown at a faster rate than exports since 2007.

Not only has China managed to post a larger total trading figure, but the breakdown of imports compared with exports also makes for favourable reading in Beijing. China had a full-year trade surplus of $231.1bn with the US posting a total 2012 trade deficit of $727.9bn.

More here.

Fun and games.

The UK diabetes forum scene is in a semi-hibernating and pretty boring mode at the moment. Diabetes.co.uk is like watching grass grow since the lowcarb bad boys got banned, and set up the ‘eat to your meter’ rest home, for the easily upset and cakes and commiseration brigade. The standout entertainer at DCUK these days is A.M.Brennan, a medical student I am told. AMB makes old Sid look like a diplomat when it comes to rudeness and wearing the obnoxious crown. AMB should fit very nicely into the NHS when trained. A residency at the Stafford Hospital would be an obvious place for his talents. The Bonkers Brothers are pretty quiet these days as are the Slippery Sisters, Phoenix and Cherub, Jopar seems to have called it a day altogether. So, the forum of flog lumbers on with over 50,000 members, most have never posted, and can you blame them, why interrupt a good snooze to post on the dullest diabetes forum in the UK, other than Kenny’s place.

One thing you can’t accuse diabetes abc of doing is spreading poor information, because there is no information. In fact there has not been a post since January the 23rd. Say what you like about Ken, and most people do, he was great value for money on the entertainment front. Ken took dietary lunacy and bad forum  moderation, to a height even Felix Baumgartner fears to go, but xyzzy at eat to your meter is giving Ken a run for his money. It’s Kenny’s style all over again. You know how it works. You take on a mod, swiftly more mods come to his assistance, followed by a bunch of forum serfs. Before you can say ‘get them cereals down ya’ you are into the world of Déjà vu, and wondering, maybe it’s not as cold outside as you think, and time to head out to a river with some Pike lures and a decent rod and reel.


Eat To Your Meter, I had high hopes for that place, although on reflection, you have to wonder about the sanity of an outfit that wanted me as a part owner and board member. Did they think I would roll over and join the bonkers portion control and low GI diet aficionados ? These days I am reading a lot about short bread and digestive biscuits and Donna kebabs, jeez, bring on the horse meat a far healthier option, and certainly lowcarb. I thought ETYM would be a trail blazer, cutting edge, nil/minimal meds and a beacon against junk food and big pharma corruption, not a chance. It’s play it safe, middle of the road, and a carbon copy of DCUK at its worst. The last thing the UK needed was another mutual appreciation society for some of the mods and their toadying sycophants.

There are some good and knowledgeable people posting, but their patience and interest is waning, they have better things do than watch paint dry, let’s face it, you get thanked over there for posting this  ‘I was falling asleep after lunch again today’ Yes dear, I’m falling asleep reading the bloody posts. The larf of the week has to be when the biscuit munching Donna Kebab asked “I'm sorry if this is off topic, but i'm really wondering what an average week of meals looks like for Eddie. Does he eat vegetables or only meat?” Took me back to the ‘Does he take sugar’ era, anyone remember that ? Where is Borofergie when they need him, loafing about on some tropical beach I hear, what a slacker. Talking of arch slackers where is Carbo these days ?

His last post on his cesspit blog was on Wednesday, December 19, 2012, even the comments have stopped coming in. Has his one, overworked anonymous multi poster done the off ? Who knows, but what about Carbo himself ? The rumours are rife, from he succumbed to chronic dysentery brought about by a massive Orlistat overdose, to a bad back. One thing’s for sure, he has got very lazy in the posting department. There was a time when you could set your watch with his posts against our blog team, but not any more. We played our part in his exit visa from a mods job at DCUK. We had a hand in the failure of his diabetes for death forum, surely we have not seen the last of him and his wondrous blog. Make an effort lad, get off that commode and start pulling your weight !

Eddie

It’s not all fun and games !

We get a lot of fun out of writing this blog, if it was hard work and all doom and gloom, we would have called it a day awhile ago, but there is a serious side to what we do. The serious side is our website which I set up over four years ago. In those days as a newly diagnosed type two diabetic, my knowledge of weight and blood glucose control was minimal. I wanted a site for people like me, newly diagnosed, worried, and in receipt of confusing information. As an ex engineer I have always liked simple, simple usually works and keeps on working. Anyone can design something with far more working parts and flashing lights, but in engineering, less is often far more, when reliability and costs are involved, any fool can make something far more complicated than it needs to be. Controlling type two diabetes can be very easy, if you keep things simple. Some emails received over the last few weeks.

Our website here.

Eddie

E Mail 1

"Hi all

Just to say an enormous thank you for the best website I've read with regard to diabetic advise and information. 

I have read many recently in my newly diagnosed T2 confused, terified state.  The information has the clarity I needed and I now feel I have a direction to go!"

E Mail 2

Hi!

I have just recently been diagnosed with type 2 diabetes and was overwhelmed with everything, not knowing where to turn. Your website was a  Godsend! There is so much conflicting information out there - doctors, diabetic organisations, internet! I literally felt like I was running around in circles. I am a 45 year old mum of two. I was diagnosed with pre-diabetes about two years ago but was not given much information about where to go from there .... and as a consequence I have ended up with full blown diabetes. I was shocked into action about 10 days ago when my blood glucose reading was 21! I went to the doctor who did a HbA1C test which was 9. I am now taking ... grudgingly .... Metformin 500 mg a day and immediately significantly cut my carb intake (I haven't had bread, pasta, potatoes, rice, etc). I have got my fasting blood glucose level down from 12 on the first day I started testing to 8.4 this morning. My after meal blood glucose readings have been between 6.5 to 7.7. Other than thanking you immensely for your website and information I would like to ask about the amount and intensity of exercise I should be doing? 

Once again thank you soooooo much for your website! Great job!

E Mail 3

Hello, and may I wish you a Happy new year. I just happened upon your site 
and have had a thoroughly good time reading the various entries. 


I was diagnosed with Borderline Type 2 diabetes in May this year and 
have been able to bring my HbA1c "scores" down consistently since then 
by diet alone. I am totally wheelchair dependent & cannot walk or stand 
to do any "vigorous" exercise in my wheelchair because of a spinal 
condition therefore I haven't been able to add any form of blood 
glucose lowering exercise to my approach to managing it - thus it has 
been through carb. management alone. 


I too received the NHS Guidelines re food and their recommendations re 
carbohydrate intake ! Being housebound I am able to spend a lot of time 
on Googling so I set about finding out as much as I could about Type 2 
diabetes for myself and was astonished at the amount of positive and 
practical information regarding the HbA1c results of people with Type 2 
diabetes who had significantly reduced their daily primary carbohydrate 
intake ! I bought myself a glucose meter and systematically tested 
myself to SEE the immediate results of what I ate ! It was amazing that 
just by pricking my finger I could actually SEE exactly what effect 
upon my blood glucose specific amounts of carbohydrates had ! I kept a 
chart for each meal and snack and found the most amazing and easy App 
and book(s) that specifically shows the amount of carbohydrates in a 
wide (and widening) range of UK foods. It shows you actual photographs 
of foods & drinks on plates/in bowls/glasses etc in measured portion 
sizes with the calorie and carbohydrate content immediately (no 
calculation per 100g etc) seen ! 


Armed with the book and the App on my iPhone and my glucose meter I 
have significantly reduced my carbohydrate intake, lost nearly 2 stone 
and have also seen a consistent improvement in my cholesterol and 
thyroid function "scores" - the Doctor was intrigued and asked exactly 
what I was doing. I showed her the book and App and she borrowed the 
book. Now the surgery has issued every doctor and practice nurse with a 
copy of the book and every newly diagnosed diabetic is shown the book 
and App and is given the website address if they have access to a 
computer. They also recommend the book/app to patients seeking advice 
re general or specific weight loss. 


I have just embarked upon a new wave of research to reinstate my 
diabetic diligence (after Being A Bit "Norty" over Christmas & new Year 
food-wise !) which was how I happened upon your really supportive and 
informative site which I have now Bookmarked. I just wanted to thank 
you for all the work you have obviously put into the site and to pass 
on the link to the App and the books I found that so easily helped me 
to monitor my carb intake and through consistently doing that lower my 
HbA1c score as others newly diagnosed might find it helpful in managing 
their carb. intake. 

Happy New Year

For Eddie and Graham and all the readers, Health and Happiness

Julie (and John)

Stafford scandal: Let’s face the truth about our uncaring, selfish and cruel NHS

It is officially calculated that, between 2005 and 2009, up to 1,200 patients at Stafford Hospital died needlessly. Let us imagine that a comparable disaster occurred in any other institution or enterprise in this country. Suppose that hundreds of customers of the cold food counter at Sainsbury’s or Tesco died of food poisoning. Suppose that, at an army barracks, large comprehensive, steelworks, bank, hotel, university campus or holiday theme park, people died, and went on dying for years, at rates that hugely exceeded anything that could be attributed to the normal course of nature.

What would happen? In all cases – though more quickly in the private sector than in the public – the relevant management would be sacked. Indeed, the very idea of unnecessary deaths taking years to notice is almost inconceivable. Criminal charges would be brought. In many cases, the offending institution would close down.

But this is the National Health Service, and so we approach it with superstitious reverence, as if the fact that Stafford Hospital performed so many human sacrifices is so awe-inspiring that little can be done about it. For all its rhetoric of condemnation, this week’s report of the Mid Staffs inquiry by Robert Francis QC argues, in effect, that those in charge should stay in charge.

More here.

Young at heart.

Songwriters: JOHNNY RICHARDS, CAROLYN LEIGH

One of my Wife's favorite songs, always makes her cry.


Eddie

Swede a great lowcarb food !

Americans know it as "rutabaga". The Scottish call it "neeps" and serve it with haggis. The swede, a fairly recent root vegetable, is thought to have originated around the 17th century in Bohemia. In 1620 a Swiss botanist described the root vegetable, believed to be a hybrid of the cabbage and the turnip. By 1664 it was growing in England. A good source of vit.C, fibre, folate and potassium. Low in calories.

 
Wash then peel thoroughly to remove the thick outer skin. Swede can be prepared and served in any of the methods used for potatoes. Swede can be added to soups, stews and casseroles. Use mashed swede instead of mashed potato it has a slightly sweet taste. Swede can also be made into fritters and pancakes. Collins Gem states 2.3 grams of carb per 100 grams. Who needs BG raising spuds ?

Eddie

'Light' sodas may hike diabetes risk: study (Update)

Artificially sweetened sodas have been linked to a higher risk of Type 2 diabetes for women than sodas sweetened with ordinary sugar, a French study unveiled on Thursday found.

"Contrary to conventional thinking, the risk of diabetes is higher with 'light' beverages compared with 'regular' sweetened drinks," the National Institute of Health and Medical Research (Inserm) said. The evidence comes from a wide-scale, long-term study, it said in a press release. More than 66,000 French women volunteers were quizzed about their dietary habits and their health was then monitored over 14 years from 1993 to 2007. The women were middle-aged or older when they joined the study—born between 1925 and 1950. 

Sugar-sweetened sodas have previously been linked to an increased risk of diabetes, but less is known about their artificially sweetened counterparts—often promoted as a healthier substitute. Researchers led by Inserm's Francoise Clavel-Chapelon and Guy Fagherazzi dug into the data mine to look at the prevalence of diabetes among women who drank either type of soda, and those who drank only unsweetened fruit juice. Compared with juice-drinkers, women who drank both types of soda had a higher incidence of diabetes.

More here.

Findus beef lasagne was up to 100 per cent horse meat !

"Shoppers who bought the lasagne meals, which are produced by French food supplier Comigel on behalf of Findus, have now been warned not to eat them.

Retail giant Tesco and discount chain Aldi withdrew a range of ready meals produced by Comigel over fears they contained contaminated meat.

The FSA said there is no evidence to suggest the horse meat found is a food safety risk.

But the agency confirmed tests have been ordered on the lasagne for the veterinary drug phenylbutazone. Animals treated with "bute" are not allowed to enter the food chain."

Findus has a hard earned good reputation for good food at a reasonable price. If a company like Findus does not know what is in it’s processed foods and ready meals the situation is pretty grim. All the more reason to base your meals on fresh vegetables, add some good proteins and quality fats. The less man has been involved the better. Don’t base your food on a failed science experiment or greed by big international food outfits, buy fresh and local wherever possible.

Eddie

More here.

More About Drug Industry Lawlessness !

During a December panel discussion at the Washington, D.C.-based Food and Drug Law Institute, a nonprofit organization providing an ongoing forum for discussing legal issues involving the Food and Drug Administration (FDA) and the drug industry, the growing epidemic of criminal and civil legal violations by the pharmaceutical industry was a hot topic.

Eric Blumberg, deputy chief counsel for litigation at the FDA, pulled no punches. Commenting on the growing, billions-per-year monetary fraud settlements by the drug industry, he stated: “Money is clearly not doing the job; qui tam (whistleblower) complaints are still falling across my desk like snowflakes! We need to employ a ‘bigger hammer,’ to send people to jail.

The seemingly never-ending, record-breaking succession of billion-dollar fines against this industry argues instead, in my view, that industry does see these penalties as merely “the cost of doing business.” This is yet another reason for the quite out-of-control prices of prescription drugs. 

More here.

Reducing saturated fat in favour of ‘vegetable’ oils increases risk of heart attack !

Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis

Abstract

Objective To evaluate the effectiveness of replacing dietary saturated fat with omega 6 linoleic acid, for the secondary prevention of coronary heart disease and death.

Design Evaluation of recovered data from the Sydney Diet Heart Study, a single blinded, parallel group, randomized controlled trial conducted in 1966-73; and an updated meta-analysis including these previously missing data.

Setting Ambulatory, coronary care clinic in Sydney, Australia.

Participants 458 men aged 30-59 years with a recent coronary event.

Interventions Replacement of dietary saturated fats (from animal fats, common margarines, and shortenings) with omega 6 linoleic acid (from safflower oil and safflower oil polyunsaturated margarine). Controls received no specific dietary instruction or study foods. All non-dietary aspects were designed to be equivalent in both groups.

Outcome measures All cause mortality (primary outcome), cardiovascular mortality, and mortality from coronary heart disease (secondary outcomes). We used an intention to treat, survival analysis approach to compare mortality outcomes by group.

Results The intervention group (n=221) had higher rates of death than controls (n=237) (all cause 17.6% v 11.8%, hazard ratio 1.62 (95% confidence interval 1.00 to 2.64), P=0.05; cardiovascular disease 17.2% v 11.0%, 1.70 (1.03 to 2.80), P=0.04; coronary heart disease 16.3% v 10.1%, 1.74 (1.04 to 2.92), P=0.04). Inclusion of these recovered data in an updated meta-analysis of linoleic acid intervention trials showed non-significant trends toward increased risks of death from coronary heart disease (hazard ratio 1.33 (0.99 to 1.79); P=0.06) and cardiovascular disease (1.27 (0.98 to 1.65); P=0.07).

Conclusions Advice to substitute polyunsaturated fats for saturated fats is a key component of worldwide dietary guidelines for coronary heart disease risk reduction. However, clinical benefits of the most abundant polyunsaturated fatty acid, omega 6 linoleic acid, have not been established. In this cohort, substituting dietary linoleic acid in place of saturated fats increased the rates of death from all causes, coronary heart disease, and cardiovascular disease. An updated meta-analysis of linoleic acid intervention trials showed no evidence of cardiovascular benefit. These findings could have important implications for worldwide dietary advice to substitute omega 6 linoleic acid, or polyunsaturated fats in general, for saturated fats.

Trial registration Clinical trials NCT01621087.

Full text http://www.bmj.com/content/346/bmj.e8707

Graham

Chris Masterjohn — Oxidative Stress & Carbohydrate Intolerance: An Ancestral Perspective

Chris Masterjohn — Oxidative Stress & Carbohydrate Intolerance: An Ancestral Perspective from Ancestral Health Society on Vimeo.

EU lead on clinical trials comes out in favour of transparency. Hurrah!

There is a new EU Clinical Trials Regulation currently passing through parliament in Brussels. It is currently in draft form, and riddled with holes: essentially it allows companies and researchers to withhold trial results, and play fast and loose with analyses. These problems are best documented in the BMJ by one of the co-founders of Cochrane:

Withheld clinical trial results are the biggest untold scandal of the 21st century. It is modern medicine’s equivalent of bloodletting, and future generations will look back in amazement to think that we were ever so stupid as to tolerate it.

More here.

Taking insulin for type 2 diabetes could expose patients to greater risk of health complications !

Patients with type 2 diabetes treated with insulin could be exposed to a greater risk of health complications including heart attack, stroke, cancer and eye complications a new study has found.

Examining the UK Clinical Practice Research Datalink (CPRD) - data that characterises about 10% of the UK population - a team of researchers from Cardiff University's School of Medicine looked at the risk of death for patients taking insulin compared with other treatments designed to lower blood glucose levels in people with type 2 diabetes.

The team's epidemiological study found people have greater risk of individual complications associated with diabetes such as heart attack, stroke, eye complications and renal disease when compared with patients treated with alternative glucose-lowering treatments.

"Insulin treatment remains the most longstanding blood-glucose-lowering therapies for people with type 2 diabetes, with its use growing markedly in recent years," according to Professor Craig Currie from Cardiff University's School of Medicine, who led the study.

"However, with new diabetes therapies and treatments emerging there has been a new spotlight on treatments to ensure what the best and safest form of diabetes treatment is.

"By reviewing data from CPRD between 1999 and 2011 we've confirmed there are increased health risks for patients with type 2 diabetes who take insulin to manage their condition," he adds.

The study adds to previous findings which identified potential health risks of insulin in this specific group of people.

Initial concerns were first raised regarding the use of insulin in type 2 diabetes from a population-based study in Canada, which reported a three-fold increase in mortality.

A similar study of people in UK primary care with type 2 diabetes treated with insulin also reported a 50% risk of increased mortality compared with another common treatment regimen.

Professor Currie adds: "Patients currently being treated with insulin should not, under any circumstances, stop taking their medications, and it is important to emphasise that this report related to only type 2 diabetes which typically starts in older people who are overweight.

"Each patient's individual circumstances are different and treatment decisions are managed by their clinician with all of their medical history fully considered.

"The vast majority of people who take insulin will experience no adverse effects and it remains a reliable and common form of treatment worldwide but this study shows that we need to investigate this matter urgently and the drug regulatory authorities should take interest in this issue.

"Anyone who is concerned should speak to their GP first before taking any action on managing their condition."

###
Notes:

Mortality and Other Important Diabetes-Related Outcomes With Insulin vs Other Antihyperglycemic Therapies in Type 2 Diabetes was published in The Journal of Clinical Endocrinology and Metabolism.

The full paper is available at: http://jcem.endojournals.org/content/early/recent

http://www.eurekalert.org/pub_releases/2013-02/cu-tif020413.php

Unfortunately the full paper is only available for subscribers.
Graham

The truth about carbohydrates: An interview with researcher Jean-Pierre Flatt, Ph.D.

Jean-Pierre Flatt, Ph.D. is a leading researcher in field of energy metabolism and body weight regulation. His group was one of the first to discover than despite being a common belief, carbohydrates are not easily converted to fat in humans. In 1995 he received the McCollum Award from the American Society of Clinical Nutrition for his work on weight maintenance.

Part of the interview.

Hobbs: Are carbohydrates important in weight control?

Flatt: Yes. Carbohydrates determine the amount of fat that is burned. The more carbohydrates you eat, the less fat you burn. The less carbohydrates you eat, the more fat you burn.

Hobbs: How much fat is burned on a low-carbohydrate diet?

Flatt: A person can burn 150 to 250 grams of fat per day if carbohydrate intake is restricted to 50 grams or less. That is roughly one-third to one-half a pound of fat per day.

More on this very interesting interview here.

Eddie

If you can’t score a goal, move the goal posts !

Regular readers here know we never tire of publishing the NHS annual audits regarding diabetes in the UK. Year in and year out the abysmal lack of progress is presented. Of course the situation regarding numbers of confirmed diabetics goes forever up, the epidemic of type two diabetes continues unabated. The stats on HbA1c which give an illustration of how well controlled a diabetic is, are woeful in the extreme. So, what do you do if you want to give the impression you are making some headway, what do you do if you can‘t score a goal ? Improve treatment and reduce the grim numbers, not in the UK. In the UK they move the goal posts.

Results for England. The National Diabetes Audit 2010-2011
Percentage of registered Type 1patients in England
HbA1c >= 6.5% (48 mmol/mol) = 92.6%
HbA1c >   7.5% (58 mmol/mol) = 71.3%
HbA1c > 10.0% (86 mmol/mol) = 18.1%

Percentage of registered Type 2 patients in England
HbA1c >= 6.5% (48 mmol/mol = 72.5%
HbA1c > 7.5% (58 mmol/mol) = 32.6%
HbA1c >10.0% (86 mmol/mol) = 6.8%

These results are very similar to those obtained in previous NHS audits over the past 5 - 6 years.

"An NHS prescribing advisory body has called for a change in diabetes guidance to include a minimum HbA1c target level, reflecting the weight of trial data suggesting lowering blood sugar below a certain level may harm patients.

In the light of mounting evidence that driving levels down to below the 7.5% recommended in the QOF increases the risk of cardiovascular events.

The latest MeReC Extra includes an analysis of the UK primary care trial published in The Lancet in February, and follows an editorial in the BMJ which also questioned the clinical value of an HbA1c value of less than 7.0%.

The Lancet paper, a retrospective study using data from the UK General Practice Research Database, identified that a median HbA1c level of about 7.5% was associated with the lowest risk of all-cause mortality and macrovascular disease events.

But it also showed there was a U-shaped association between increased all-cause mortality above and below an HbA1c of 7.5%. Changes above or below an HbA1c of 7.5% was associated with a greater risk, regardless of whether treatment was intensified with oral hypoglycaemic agents or insulin injections.

Compared with the reference group who had a median HbA1c of 7.5%, all-cause mortality in the 6.4% HbA1c decile was 52% higher and 79% higher in the 10.6% HbA1c decile.

The May MeRec Extra suggested GPs ‘may wish to consider the implication of the study in their discussion with patients about risks and benefits of intensifying drug treatment and setting of individual HbA1c targets.'

It concluded: ‘If this ‘U-shaped' relationship between HbA1c levels and mortality in patients with type 2 diabetes receiving combination blood glucose lowering treatment is confirmed, this would add weight to the view that diabetes guidelines might need revision to include a minimum HbA1c value.'

The NPC review said that this evidence, in addition to similar findings from the ACCORD, ADVANCE and Veterans Affairs diabetes trials, which also failed to find a consistent significant benefit of intensive glycaemic control on cardiovascular outcomes and mortality, ‘added weight' to the possibility of a minimum HbA1c target."

As you can see the deeply flawed ACCORD trial is being trotted out again.

Eddie

More here.

More crap on the way no one needs the vibrating fork!

After the story on hundreds of new diabetes drugs in the pipe line, another piece of junk is coming soon, the vibrating fork. The forks are due to go on sale in the US this summer for $99 (£60) and in the UK later in the year. Evidently if you eat too fast the fork starts to vibrate. Should prove to be as useless as the forum of flogs diet plates. What if you are eating soup ? Seriously, can anyone think of a more useless gadget ? How about a food plate with a big hole in the middle, if you load it up with too much food, most of the food stays on your work top or falls on the floor, should be a winner at only £35. It’s a mad house and getting worse !

See the wonder fork here.

Eddie

More type two diabetes death meds on the way !

It may surprise some to know there are over 200 new diabetes medications in the pipeline. It looks like big pharma realise diabetes is the new Klondike gold rush. With evidence building fast against the $30 billion a year statin con, a new mega earner is needed to keep the trough filled. Whether these new diabetes drugs work probably does not matter, if they kill people, not a problem. As long as the profits exceed the fines and compensation payouts to the victims and their families, all fair in love and war. Patients are considered collateral damage. As Stalin once said, “The death of one man is a tragedy. The death of millions is a statistic”

FDA approves three new drugs for type two diabetes. 

"All three drugs contain a new active ingredient, alogliptin, either alone or in combination with other, previously approved medications. The newly approved drugs include Nesina (alogliptin), Kazano (alogliptin plus metformin) and Oseni (alogliptin plus pioglitazone), the FDA said in a news release.

The FDA urges that the new medications be used in combination with a healthy diet and exercise to help bring diabetes under control. All of the drugs underwent study either as stand-alone products or used alongside standard diabetes medications such as sulfonyureas or insulin. In the case of Nesina, the drug showed safety and effectiveness across 14 clinical trials, involving more than 8,500 patients, according to the FDA. The most common side effects included stuffy or runny nose, headache, and upper respiratory tract infections.

The agency is also requesting that a "boxed warning" be included on Kazano's labeling, highlighting the potential risk of lactic acidosis (lactic acid buildup in the blood), which can occur in products containing metformin. Oseni was studied in four clinical trials involving more than 1,500 patients, the FDA noted. Side effects were similar to those seen with Nesina, as well as back pain. Oseni's labeling will also carry a boxed warning, this time cautioning users about the risk for heart failure that accompanies drugs containing pioglitazone."

So, we have three new drugs that come with lot’s of health warnings and side effects from upper respiratory tract infections to back pain. Labelling will also carry a boxed warning, this time cautioning users about the risk for heart failure that accompanies drugs containing pioglitazone. The lowering of HbA1c will be minimal and entirely negated by a donut, well that’s progress for you.

Please note these vegetables do not cause dangerous side effects and do not carry black box warnings for cancer or heart attack.

Eddie

Three new diabetes drugs link here.
Two hundred and twenty one new diabetes drugs link here.