Worldwide Dietary Therapies for Adults With Epilepsy and Other Disorders

Abstract

During the 3rd International Symposium on Dietary Therapies held in Chicago, Illinois, there was a first-ever, half-day session devoted to the management of adults with epilepsy and other disorders with dietary treatments. Speakers from 3 different continents shared their successes, challenges, and future directions in their management of these patients. Diets used to treat adults included the classic ketogenic diet, the modified Atkins diet, and a low glycemic index treatment. The utility of dietary therapies was demonstrated not only in patients with epilepsy but also patients with propriospinal myoclonus, astrocytoma, type 2 diabetes, obesity, hyperlipidemia, and metabolic disorder. The session provided evidence that dietary therapies are safe and effective in adults.

http://jcn.sagepub.com/content/early/2013/05/13/0883073813488671.abstract

Sorry can't access the full article.

Graham

Sulphonylureas 'linked with CV mortality increase' !

GPs should consider alternatives to sulphonylureas in patients with Type 2 diabetes as their use is linked to an increase in cardiovascular disease, claim researchers.
 

The study
The US meta-analysis of 33 randomised and observational studies included 1,325,446 patients with diabetes a mean age ranging from 52 to 76 years. Cardiovascular composite endpoints such as a major cardiovascular event, cardiovascular death or stroke were compared for patients with diabetes taking sulphonylureas, compared with other diabetes treatments, such as metformin and thiazolidinediones. Ratios were adjusted for potential confounders including baseline cardiovascular risk, concomitant medications and diabetes severity.
The results
A significant association between sulphonylurea use and cardiovascular mortality was seen, with a relative risk 1.27 compared with other diabetes treatments. Sulphonylurea use was also significantly associated with a 10% increased risk of the cardiovascular composite endpoint, compared with other diabetes treatments.  Sulphonylureas were associated with a 16% increased risk of the cardiovascular composite endpoint when compared with metformin. Statistical pooling found no statistically significant associations between sulphonylureas use and stroke, compared with other diabetes treatments.
What this means for GPs
The researchers concluded that their results ‘warrant consideration in clinical practice, when other treatment options may be available’

Link to Pulse article 22nd. of May here.

Diabetes medication’s risks, policy and market performance monitored !

Sales of a popular diabetes-treatment medication declined in the first three months of 2013 in comparison to the same period in 2012. In an overlapping development, the U.S. Food and Drug Administration has been evaluating medical scientific findings “that suggest an increased risk” of pancreatic ailments in patients who use this drug and others in its class.

Merck on May 1 reported a 9 percent first-quarter decline in the worldwide sales of its “top pharmaceutical products, as well as total sales of animal health and consumer care products” to a still hefty $10.7 billion. Additionally discouraging was the 4 percent dip to $884 million in the sales of one of its top-selling drugs, the diabetes medication Januvia (sitagliptin); Merck reported U.S. Januvia sales alone fell 5 percent.

In the U.S., while Merck deals with a product sales slide driven by what it has dubbed “customer inventory levels,” the pharmaceutical corporation must defend itself from Januvia lawsuits fueled by claims of unreasonable risks of pancreatic disorders that came to fruition.

The FDA announced Sept. 25, 2009, that it would revise “the prescribing information for Januvia (sitagliptin) and Janumet (sitagliptin/metformin) to include information on reported cases of acute pancreatitis in patients using these products.” Dozens of adverse event reports submitted to the administration between October 2006 and February 2009 tipped regulators that something might have been amiss. Reported complications included “acute pancreatitis, including two cases of hemorrhagic or necrotizing pancreatitis in patients using sitagliptin.”

The agency dusted off its regulatory microscope again for these drugs in March, announcing that it was “evaluating unpublished new findings by a group of academic researchers that suggest an increased risk of pancreatitis and pre-cancerous cellular changes called pancreatic duct metaplasia in patients with type 2 diabetes treated with a class of drugs called incretin mimetics,” a group that includes sitagliptin.

We have the usual confluence of market, public policy and legal rights perspectives centered on one therapy.

Merck investors are counting on an improved performance of what Merck Chief Executive Officer Kenneth Frazier called “key growth products” such as Januvia, which is demonstrably a franchise player in the diabetes-treatment game.

Meanwhile, the FDA is counting on medical science to pin down once and for all the breadth and gravity of the risks of serious pancreatic disorders that many suffering Januvia patients claim they unnecessarily and unreasonably have borne.

Ultimately, the patient afflicted with apparent Januvia side effects can count on a justice system to adjudicate his or her right to compensation.

http://houston.legalexaminer.com/fda-and-prescription-drugs/diabetes-medications-risks-policy-and-market-performance-monitored.aspx?googleid=308676

Graham

Dr Paul Jones - University of Carmarthen the real deal or a bullshitting spoofer ?

Over the weekend we received three comments from someone claiming to be Dr Paul Jones. If the poster was the genuine article he came over as a numbskull. If the person was a spoofer taking Dr. Jones name in vein thought he/she would impress, they failed. They came across as a lying spoofer, certainly no more than that. One thing is for sure, the poster was no fan of Barry Groves. Therefore by definition was no fan of the low carb high fat diet/lifestyle Barry promoted. Look on any diabetes forum or blog and low carb antis can be easily found, most medical professionals do not endorse low carb high fat. Is this a problem ? Could us lowcarbers have it all wrong ? Could our lifestyle be a one way ticket to a grizzly end ?

If we are wrong and the naysayers have it right, it’s worth looking at what the naysayers say. We should base our diet on starchy carbs with every meal. This has lead to 93% of UK type one diabetics never getting to a safe HbA1c number, so that has failed totally, but does provide vast sums of money to big pharma. It has also lead to the epidemics of obesity and all that goes with it. The voices of doom tell us saturated fat will lead to heart attacks and stroke. This is arguably the greatest lie ever hoisted on the world, and has been proved false time and time again, but does provide massive amounts of money to junk food companies.  Low fat high sugar foods are much more profitable than short shelf life fresh foods. Next comes the great cholesterol con, worth around $30 billion a year to big pharma. Almost every day we are hearing of more side effects these drugs cause, we also see data that proves total cholesterol numbers have no correlation when comparing CVD risk. Just as many people with so called safe cholesterol numbers have heart attacks. So, whether Dr. Jones is genuine or a lying impersonator matters not a jot, if they do not see the proven benefits of low carb high fat

There is one 100% fool proof way of demolishing the low carb high fat antis every time, just ask this question.

How do I hold non diabetic blood glucose numbers, a safe weight, and all my other blood work numbers in the safe or normal range, other than low carb ? I asked Dr. Jones or the spoofer this question on Sunday night, I am still waiting for an answer, I reckon I will be waiting a long time for some useful information. As we have seen so many times, the antis and naysayers tell us what they believe does not work, but never a scrap of information as to what does work. One thing we can say for certain whether Dr Paul Jones - University of Carmarthen is the real deal or a bullshitting spoofer, he/she knows nothing about the safe way to control diabetes, and if he is genuine, it clearly demonstrates the extremely poor quality of some University lecturers.

Eddie

A low-carbohydrate diet may prevent end-stage renal failure in type 2 diabetes.

An obese patient with type 2 diabetes whose diet was changed from the recommended high-carbohydrate, low-fat type to a low-carbohydrate diet showed a significant reduction in bodyweight, improved glycemic control and a reversal of a six year long decline of renal function. The reversal of the renal function was likely caused by both improved glycemic control and elimination of the patient's obesity.

Insulin treatment in type 2 diabetes patients usually leads to weight increase which may cause further injury to the kidney. Although other unknown metabolic mechanisms cannot be excluded, it is likely that the obesity caused by the combination of high-carbohydrate diet and insulin in this case contributed to the patient's deteriorating kidney function. In such patients, where control of bodyweight and hyperglycemia is vital, a trial with a low-carbohydrate diet may be appropriate to avoid the risk of adding obesity-associated renal failure to already failing kidneys.

  

Conclusion

The present case report shows that a low-carbohydrate, high-fat diet improves glycemic control, reduces body weight and may prevent the development of end-stage renal failure in an overweight patient with type-2 diabetes. Furthermore, it raises the concern that the obesity caused by the combination of a high-carbohydrate diet and insulin may have contributed to the patient's failing kidney function.

More here.

Eddie

Australians to join multi-million dollar diabetes drug (Actos) class action lawsuit !

Diabetes: More than 1.7 million prescriptions for the drug have been filled in Australia over the past four years.

Australian victims of a popular diabetes drug that has been linked to bladder cancer will join a US class action suing the makers of the drug.

Tens of thousands of Australians are thought to have taken the diabetes drug Actos, which has been linked to a 40 per cent increased risk of bladder cancer.

Law firm Maurice Blackburn said it would join a class action against Takeda and Eli Lilly, the co-manufacturers and distributors of the drug.

Maurice Blackburn Principal Damian Scattini said the companies had behaved “terribly”.

Advertisement

“They knew before they even released the drug that it had a tendency to induce tumours in rats but they proceeded irrespective of that,” he said.

International studies have found the main ingredient of Actos, pioglitazone, causes an increased risk of bladder cancer after patients have been taking it for between one and two years.

He said the legal case about the drug, held in California, had resulted in the jury awarding $6.5 million dollars in compensation to victims, before the judge overturned the decision on technical grounds.

“Initial signs look very good for this case,” he said. “The science is terrible for the defendant and what they did is terrible”.

The law firm is initially joining the action on behalf of one patient, Brisbane man Peter Marshall, but has since been contacted by other patients.

More than 1.7 million prescriptions for the drug have been filled in Australia over the past four years, Medicare figures show.

Australia's drug regulator in 2011 issued a warning about pioglitazone, stating: “use of ... pioglitazone, for more than a year may be associated with an increased risk of bladder cancer”. At that time it said it was undertaking a comprehensive review of the data and would provide more information to consumers when this was completed.

The warning caused prescriptions to drop from nearly 437,000 in 2011 to just over 378,800 in 2012.

Mr Scattini said consumers in France and Germany were no longer exposed to the drug as it had been taken off the market, and in America a black-box warning said long-term use was linked to bladder cancer.

But in Australia and New Zealand the drug was still available and in-packet warnings were weaker.

“I don't know why Australians are not entitled to the same protection as other first world countries,” he said

Actos is not the first diabetes drug to be linked to serious health problems.

The manufacturer of the diabetes drug Avandia, GlaxoSmithKline, has paid out more than $460 million to settle thousands of personal-injury lawsuits after it was accused of not revealing links between Avandia and heart attacks.

A spokeswoman for the TGA said it had published information on its website and in the consumer product information for Actos explaining the link with bladder cancer.

This information said “pioglitazone should not be used in patients with bladder cancer or a history of bladder cancer [and] the risk of bladder cancer should be considered in the care of all patients treated,” she said.

She added that the risks and benefits of using any drug should be discussed by patients with their doctor.

Read more: http://www.smh.com.au/national/australians-to-join-multimillion-dollar-diabetes-drug-class-action-lawsuit-20130520-2jvs1.html#ixzz2TrjVL9yi

Graham

Our youngest talking about video games.

Our youngest kid is a gaming nut. Studying history at uni with a view to teach history or maybe a journalist, he can talk for hours on many subjects without notes. His forte is music. One of the best guitar players I have ever heard. Eddie

Franziska Spritzler, RD, CDE - A Dietitian on our side !

It takes courage to go against the established dogma for what consists of the so called healthy diet. Increasingly, more Doctors and Healthcare Professionals are sticking their heads above the parapet, they refuse to be conned by big pharma and junk food companies. They are more interested in the health of their patients and clients than the pay cheque or job security. They are boat rockers, and deserve our support. Such a Woman is Franziska Spritzler, RD, CDE. We need more people like Franziska, please visit her site, let her know she is appreciated, it’s people like Franziska who will bring about the much needed change.

Eddie

Franziska Spritzler RD CDE

Franziska's site is here

Jimmy Moore has the last laugh !

When you are famous, and Jimmy Moore is arguably the most high profile lowcarb blogger in the world, it’s not always a bed of roses. When things are going well everyone wants to be your friend, when things are going wrong, and you are open and admit you are failing, the weasels and vultures soon come out of the woodwork. Jimmy could have kept his weight problems to himself, he did not have to go the whole hog and be totally open and honest. One of his biggest critics Evelyn Kokur at her grim blog the carbsane asylum, has stalked and hounded Jimmy for a long time. Well Jimmy has sure had the last laugh now. While she has taken down her photographs clearly showing a very over weight person, and her only photograph on display, is an out of focus, closely cropped head shot, Jimmy has been on the weight loss case big time. While Evelyn has been talking the talk, Jimmy has been walking the walk. Jimmy is looking a million dollars, get over to his blog and see how he achieved his great success. 

Jimmy's blog here.

Eddie

Dietary Saturated Fat Has Undeserved Bad Reputation, Says Review

"The influence of dietary fats on serum cholesterol has been overstated," concludes a review in an American Society for Nutrition publication that, in its words, "calls for a rational reevaluation of existing dietary recommendations that focus on minimizing dietary SFAs [saturated fatty acids], for which mechanisms for adverse health effects are lacking" [1].

Indeed, argues the author, Dr Glen D Lawrence (Long Island University, Brooklyn, NY), it is likely other factors, such as oxidized polyunsaturated fatty acids (PUFAs) or preservatives in processed meats, that are also present in high-SFA foods that lead to adverse health effects typically associated with high SFA intake.

"The meager effect that saturated fats have on serum cholesterol levels when modest but adequate amounts of polyunsaturated oils are included in the diet, and the lack of any clear evidence that saturated fats are promoting any of the conditions that can be attributed to PUFA, makes one wonder how saturated fats got such a bad reputation in the health literature," Lawrence writes in the review published May 1, 2013 in the journal Advances in Nutrition.

The article's case is built on interpretations of research from the biochemistry, epidemiologic, and clinical literature but which, nonetheless, does not reference a tremendous body of research supporting alternative views. Still, Lawrence describes:

• The role of lipid peroxidation in promoting atherogenesis, arguing that its effects are more pronounced on PUFA than on SFAs or monosaturated fatty acids.
• An arguably protective effect of omega-3 PUFAs against proinflammatory effects of omega-6 and other PUFAs.
• Evidence that potentially carcinogenic preservatives in processed meats as well as high-heat cooking methods have influenced perceptions that red meat per se has adverse health effects.
• How "the preparation and cooking methods used for foods that are traditionally classified as saturated fat foods may be producing substances from PUFAs and carbohydrates in those foods that are promoting disease."
• Studies suggesting positive health effects from dairy fat and tropical oils, both high in SFAs and therefore discredited as unhealthy.
• The hazards of diets with increased carbohydrates as a result of being lower in fat, in low-fat diets followed to improve health, especially cardiovascular health.

"The adverse health effects that have been associated with saturated fats in the past are most likely due to factors other than SFAs," the article concludes. "Consequently, the dietary recommendations to restrict saturated fats in the diet should be revised to reflect differences in handling before consumption . . . It is time to reevaluate the dietary recommendations that focus on lowering serum cholesterol and to use a more holistic approach to dietary policy."

Lawrence had no disclosures.  http://www.medscape.com/  Free registration required 

Graham

Omega-3 supplements 'do not prevent CVD'

There is no evidence that taking omega-3 fatty acid supplements is useful for preventing cardiovascular disease, conclude primary care researchers.
  

The study

Previous studies have shown an association between omega-3 supplementation and reduced cardiovascular mortality and morbidity after a heart attack and in patients with heart failure. This Italian placebo-controlled study looked at the introduction of omega-3 fatty acid supplementation by GPs in 12,505 men and women with multiple cardiovascular risk factors or atherosclerotic vascular disease, but no history of myocardial infarction. The primary end point was the cumulative rate of death, nonfatal myocardial infarction and nonfatal stroke. One year into the study the event rate was ‘lower than anticipated’ and the primary end point was revised as time to death from cardiovascular causes or hospital admission for cardiovascular causes
.
The findings
After five years, the primary end point occurred in 1,478 patients (11.8%), of whom 733 had received n-3 fatty acid supplements and 745 had received placebo (11.7% and 11.9% of the total sub-groups respectively), a non-significant difference. Overall, hospital admissions for cardiovascular causes were mainly in patients >65 years, and only 7.7% of patients admitted to hospital for cardiovascular causes died from them during the study.

What this means for GPs
The researchers noted that their results ‘provide no evidence of the usefulness of n-3 fatty acids for preventing cardiovascular death or disease’ in the patients analysed, despite efforts in the study to ‘to optimize medical therapies and control cardiovascular risk factors’.

Link to information here

Caro Emerald - Liquid Lunch !

Didn't have a liquid lunch but just back from an enjoyable liquid supper!
Graham

Lady pass the aspirin, something’s gotta work

I know I did it to myself but man oh man it hurts

That second lost Martini, the one that went down real smooth

Set me on the bender with nothing left to lose

Somewhere over the Rainbow - Israel "IZ" Kamakawiwoʻole over 81 million views can't be wrong !

Sittin' On The Dock Of The Bay | Playing For Change

Saturday night is music night !

Eric Clapton, Buddy Guy, BB King, Jimmie Vaughan (Rock me baby) 

Barry Groves was right the NHS is wrong !

Checking around it would appear the comment posted on this blog last night was a spoof. The only way we will ever know the truth is if Dr Paul Jones - University of Carmarthen contacts us, as Carole said ‘search University of Carmarthen, nothing comes up’ What the comment demonstrates very clearly, is the lengths lowcarb antis will go to to besmirch a very popular and respected man. Even the grave does not offer refuge from the dullards and carbohydrate addicted. Regulars at the forum diabetes.co.uk will remember the most avid critics of Barry Groves and low carb high fat, namely Sid Bonkers, Jopar, Phoenix, Cugila, Ally5555, Noblehead et al. Known as the clique.

Barry Groves promoted a lowcarb high fat diet, as a healthier option to the standard dietary advice from the NHS, ADA, BDA and DUK etc. especially for the control of obesity and its often linked type two diabetes. The $64000 question has to be was Barry wrong ? As many know, whatever success lowcarbers post up on forums and blogs, whether diabetic or not, is usually dismissed by the medical profession as anecdotal (subjective unreliable untrustworthy sketchy) the medical profession like to deal in facts. So, let’s look at some facts.

The most comprehensive and audited data concerning diabetes facts in the UK are from the published NHS audits (see link 1 below) the audits prove 93.1% of type one diabetics miss the HbA1c 6.5 target. The same pitiful results can be seen if you check out the previous five years of NHS audits. The numbers for type two diabetics are also a disgrace. We can take as fact the NHS and other outfits advising diabetics are failing catastrophically, where else would a failure rate of 93% be accepted ? Don’t forget the professionals work with facts. Well, the professionals tell us a reduction in saturated fats will improve our risk factors for CVD, do the facts back this claim up ? No ! see link 2

A meta-analysis published in the American Journal of Clinical Nutrition, pooled together data from 21 unique studies that included almost 350,000 people, about 11,000 of whom developed cardiovascular disease (CVD), tracked for an average of 14 years, and concluded that there is no relationship between the intake of saturated fat and the incidence of heart disease or stroke.

Conclusions: A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD.

So, who are we to believe ? The medics with their massive failure in getting so many diabetics to a safe place, their dietary advice that borders on criminal, the dietary advice pushed out year after year, as the twin epidemics of obesity and type two diabetes goes forever upward. The saturated fat advice is completely wrong. What impact have dieticians had on obesity or outcomes for diabetics ? Nothing positive that I can see, just check out diabetes forums and blogs. The same forum and blog posters reporting success are almost always on a low carb high fat diet, exactly what Barry promoted for years. But of course that’s all anecdotal, the medics deal in fact, the NHS facts shame them. How galling it must be for them, to see an average Joe on a forum or blog, showing so many over weight people or diabetics, the way to safe weight loss and diabetic salvation.

Last word today on this subject to Dr. Malcolm Kendrick, a Medical Professional who does know what he is talking about with the courage to go against the lunacy that prevails in the NHS.

“The reality is that over the years, and around the world we have killed literally millions of diabetics by advising them to eat a high-carb diet and avoid fats. Only now is it being recognised that previous advice was and remains useless, dangerous and scientifically illiterate”

Eddie

Link 1

Link 2

Dr Paul Jones - University of Carmarthen comments on Barry Groves on this blog !

This post came in as a comment on the Barry Groves RIP thread last night. I will be commenting later but in the meantime I am interested in your comments and opinions. Eddie


Although a death is a saddening experience and my sympathies are with his family.

One must remember Mr Groves armed with a dodgy doctorate dispersed equally dodgy dietary and life style tips.

Such as the gem as implying smoking fine as there is some sort of conspiracy by the medical professional to deprive the public of smoking. Quoting the mental rants of Dr. Kitty Little who claimed diesel fumes where to blame for the increases in lung cancer amongst the like of lorry drivers. Not there smoking habits or Barry Groves style breakfasts in road side cafés.

By his own admission he suffered from bowel cancer and underwent surgery and conventional treatment for, only later to slag off.

He certainty did not live half a century in robust health as some have suggested.

He books and website in my opinion are full of advice that should be taken with a pinch of salt or in Barrys case a tablespoon of the stuff.

Regards

Dr Paul Jones - University of Carmarthen

Type 2 diabetes rise in under-40s, says Cardiff research "Essentially we are a nation of lazy porkers,"

People under 40 are being warned to watch their weight as researchers find a sharp rise in the number with type 2 diabetes.

Cardiff University found the incidence trebled in the UK population between 1991 and 2010, but rose nearly ten-fold among under-40s.

They now account for 12% of all newly diagnosed cases, up from 5%.

"Essentially we are a nation of lazy porkers," research leader Prof Craig Currie told BBC Radio Five live.

"As a consequence at a very young age we are getting a disease that later will lead to a number of severe complications potentially.

"You have got to have lived on Mars if you don't realise that being fat is going to cause you a few problems."

The team from the university's school of medicine said it was the most worrying element of a rise in the incidence of type 2 diabetes in the UK population as a whole.

In 1991, there were 169 cases per 100,000 people, rising to 515 in 2010.

Among under-40s, the incidence rose from 15 to 138 cases per 100,000 people.

Experts say type 2 diabetes can bring greater health issues in later life as people have longer to develop associated problems, such as blindness, kidney failure and amputations.

Prof Currie said people would lose a significant number of years off their life due to poor health and, as a result, they would "cost a fortune" to the NHS.

"This will undoubtedly place an increasing burden on healthcare resources and result in poorer quality of life, he said.

"If you are a porker when you are young and you get diabetes you are storing up bother."

Prof Currie said the research shows an increase in the prevalence of type 2 diabetes in children and adolescents.

He said the findings supported theories of obesity, diet and family history being key factors.

Type 2 diabetes occurs when the body does not produce enough insulin to function properly, or the body's cells do not react to insulin.

It is far more common than type 1 diabetes, which occurs when the body does not produce any insulin. In the UK, about 90% of all adults with diabetes have type 2.

The study tracked patients newly diagnosed with type 2 diabetes between 1991 and 2010. Patients were then grouped into five-year intervals by year of diagnosis and age at diagnosis to examine trends over time.

In November Conservative Bracknell MP Dr Phillip Lee, a practising GP, told the Institute for Economic Affairs that those with medical conditions caused by their lifestyle may have to make a contribution to their healthcare costs in the future.

On Friday, he reiterated the message on BBC Radio Five live, saying: "It is not an easy message for people to hear but basically our lifestyles are causing these conditions to increase.

"If you've got the money to pay for the food, you've got the money to pay for the drugs."

Dai Williams, national director of Diabetes UK Cymru, said the type 2 disease used to be common among elderly people but today's "obesity crisis" had led to it affecting those of a younger age.

"At the moment diabetes is costing the NHS in Wales over half a billion pounds a year - that's an astronomically large amount of money really," he told BBC Radio Wales.

He urged more action to educate people about the health problems associated with the obesity "epidemic" and the dangers of a poor diet.

The study was published in the journal of Diabetes Obesity and Metabolism.

Its editor Prof Richard Donnelly said: "This is an important study which highlights the continued rise of type 2 diabetes as a major public health challenge for the UK."

http://www.bbc.co.uk/news/uk-wales-22543559

Edit to add this comment from Bracknell MP Dr Phillip Lee

I want people to be free to choose any lifestyle they wish at the same time as understanding the future healthcare cost ramifications of their choices.  I want to give more to the truly deserving because we have spent less on those who were perfectly able to provide for themselves.  Consequently, moving the responsibility for drug costs away from the State to the individual would allow the individual to attach such a sense of responsibility.

http://www.phillip-lee.com/article-local/lifestyle-choices-challenge-nhs/

Graham 

FBI launch world wide manhunt for missing ETYM board member Borofergie.

Considered by many as one of the worlds staunchest lowcarbers, Borofergie has been missing from the Eat To Your Meter forum since the end of January. FBI veteran Frank J Bullet the third, is heading the case, and has not ruled out foul play. Dismissing rumours that fergie was banged up at Guantanamo Bay, he nevertheless looked a worried man at yesterdays press briefing. Bullet’s main lead of enquiry focuses on the belief fergie is in Patagonia at the Roger ‘Keto Warrior’ Jenkins MBE training camp for lowcarb cyber terrorism. The hunt continues.

Have you seen this man ?

The Sun

Phoenix and Noblehead inform a newbie about lowcarb !

How many carbs is lowcarb ? A newbie posts a new thread and asks the question.

“I was diagnosed in Feb 2013 and since then have lost nearly 3 stone and exercise every day for at least 60 minutes although many on this forum recommend a self test monitor I have resisted the temptation until I get my next HbA1c result which is due to be taken in the next week or so.

I do have a couple of questions which I would be grateful if someone could help with.

Firstly, how low is low carb by using the myfitness pal I have been consuming roughly between 80 to at the highest 140g per day. These carbs are generally veg bit of fruit banana (once a week), berries ( but no potato) nothing white i.e white bread, pasta, rice, cake etc. I do have ryvita and atkins bars for a chocolate fix or oat cakes. My diet is mostly chicken, salmon salad meat, cheese and eggs with gluten free chocolate rice cakes (brilliant). Is this low enough to deal with blood glucose issues ?”

Noblehead says

“Depends where you look for a definition of low carb, some say under 50g and others say anything under 130g a day.” Not a million miles out but most type two diabetics with good control use around 50 or less carbs per day.

Phoenix says.

“This is a definition of low carb from a group of lowcarb proponents including Drs Bernstein, Dahlqvist, Feinman, Volek and others.

We suggest the following definitions:

The ADA designates low carbohydrate diets as less than 130 g/d or 26% of a nominal 2000 kcal diet and we consider this a reasonable cut off for the definition of a low-carbohydrate diet. Carbohydrate consumption before the epidemic of obesity averaged 43%, and we suggest 26% to 45% as the range for moderate-carbohydrate diets. The intake of less than 30 g/d, as noted above should be referred to as a very low carbohydrate ketogenic diet (VLCKD).”

Would Bernstein recommend a non insulin type two diabetic eats 26% to 45% by calories of carb ? Not in a million years and I can’t see Dahlqvist, Feinman, Volek going in that direction either !

Phoenix continues.

"Diabetes UK defines anything less than 45% low carb

For the purpose of this position statement, the term “low-carbohydrate” is used as a collective term to describe any amount of carbohydrate restriction which is less than the dietary reference value of 45% of total energy.

(so for the 2000 cal diet anything less than 225 g carb.)
Other groups give different definitions so for example in the Swedish guidelines 30-40% of calories ( ie at 2000 calories a day , 150- 200g) is designated a moderate low carb diet and below 30% an extremely low carb diet.

From individuals you will get lots of different answers."

“From individuals you will get lots of different answers.” Too right you would. Check out the forum, or anywhere else, and see what well controlled type two diabetics are using in the way of carbs, and it will be around 30-50 grams of carb per day. There are a few exceptions, but the figures Phoenix is quoting are ludicrous for most non insulin using diabetics. I checked the profile for the member, no meds info. But the member stated “although many on this forum recommend a self test monitor I have resisted the temptation until I get my next HbA1c” so my money is on this person is not using insulin.

The carb loving pump user never gives up, but she should know by now, neither does our team.

Eddie

Link to thread here

Thought for the day.

"On a plane once, a very overweight kid sat next to me and his overweight, ill-looking parents were across the aisle. I was in the aisle seat and during the five-hour flight they kept passing sugary snacks to him directly under my nose. I kept my thoughts to myself until we were disembarking. I pulled an Atkins book out of my carry-on bag and gave it to the parents. I have no idea if it had any effect but I felt it was the least I could do."

Doctor Jay Wortman  check out Jay's blog here.


Eddie

Studies Support Population-Based Efforts to Lower Excessive Dietary Sodium Intakes, But Raise Questions About Potential Harm From Too Little Salt Intake

WASHINGTON -- Recent studies that examine links between sodium consumption and health outcomes support recommendations to lower sodium intake from the very high levels some Americans consume now, but evidence from these studies does not support reduction in sodium intake to below 2,300 mg per day, says a new report from the Institute of Medicine.

Despite efforts over the past several decades to reduce dietary intake of sodium, a main component of table salt, the average American adult still consumes 3,400 mg or more of sodium a day – equivalent to about 1 ½ teaspoons of salt. The current Dietary Guidelines for Americans urge most people ages 14 to 50 to limit their sodium intake to 2,300 mg daily. People ages 51 or older, African Americans, and people with hypertension, diabetes, or chronic kidney disease – groups that together make up more than 50 percent of the U.S. population – are advised to follow an even stricter limit of 1,500 mg per day. These recommendations are based largely on a body of research that links higher sodium intakes to certain “surrogate markers” such as high blood pressure, an established risk factor for heart disease. 

The expert committee that wrote the new report reviewed recent studies that in contrast examined how sodium consumption affects direct health outcomes like heart disease and death. “These new studies support previous findings that reducing sodium from very high intake levels to moderate levels improves health,” said committee chair Brian Strom, George S. Pepper Professor of Public Health and Preventive Medicine at the University of Pennsylvania Perelman School of Medicine. “But they also suggest that lowering sodium intake too much may actually increase a person’s risk of some health problems.”

While cautioning that the quantity of evidence was less-than-optimal and that the studies were qualitatively limited by the methods used to measure sodium intake, the small number of patients with health outcomes of interest in some of the studies, and other methodological constraints, the committee concluded that:

·         evidence supports a positive relationship between higher levels of sodium intake and risk of heart disease, which is consistent with previous research based on sodium’s effects on blood pressure;

·         studies on health outcomes are inconsistent in quality and insufficient in quantity to conclude that lowering sodium intake levels below 2,300 mg/day either increases or decreases the risk of heart disease, stroke, or all-cause mortality in the general U.S. population;

·         evidence indicates that low sodium intake may lead to risk of adverse health effects among those with mid- to late-stage heart failure who are receiving aggressive treatment for their disease;

·         there is limited evidence addressing the association between low sodium intake and health outcomes in population subgroups (i.e., those with diabetes, kidney disease, heart disease, hypertension or borderline hypertension; those 51 years of age and older; and African Americans). While studies on health outcomes provide some evidence for adverse health effects of low sodium intake (in ranges approximating 1,500 to 2,300 mg daily) among those with diabetes, kidney disease, or heart disease, the evidence on both the benefit and harm is not strong enough to indicate that these subgroups should be treated differently from the general U.S. population. Thus, the evidence on direct health outcomes does not support recommendations to lower sodium intake within these subgroups to or even below 1,500 mg daily; and

·         further research is needed to shed more light on associations between lower levels of sodium (in the 1,500 to 2,300 mg/day range) and health outcomes, both in the general population and the subgroups.

The report does not establish a “healthy” intake range, both because the committee was not tasked with doing so and because variability in the methodologies used among the studies would have precluded it. 

The recent studies suggest that dietary sodium intake may affect heart disease risk through pathways in addition to blood pressure.  “These studies make clear that looking at sodium’s effects on blood pressure is not enough to determine dietary sodium’s ultimate impact on health,” said Strom. “Changes in diet are more complex than simply changing a single mineral. More research is needed to understand these pathways.”

The report was sponsored by the Centers for Disease Control and Prevention. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public.  The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.  A committee roster follows.

http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=18311

Graham

People can't keep to lowcarb and other myths !

I have been low carbing with Eddie for five years now and I haven't withered away, gone down with any terrible disease. In fact my health is good, my energy levels good and do you know what? I would and do recommend a low carb lifestyle to everyone I meet.Over the years I have heard more times than I care to remember people say "I can't possibly stick to low carb it's not healthy, it's dangerous, it's boring." Well it isn't, yes that is my opinion but also the opinion of many others out there. Check out comments on this blog, other blogs and forums. The good news about Low Carb, High Fat is growing daily and YOU can be part of it. It's my turn to cook tonight so I am cheating YES shock, horror I'm doing a Delia well sort of. We've had this before courtesy of Waitrose it tastes great and and the low carb content will not be taking Eddie's BG numbers into the danger zone. Oh and BTW each complete meal is around ten carbs per person, less than one slice of tastless white bread.

Waitrose £10 meal deal

The starter poached salmon mousse x 2. Poached salmon 55% full fat soft cheese 20% mayonnaise 10% butter, water, tomato puree. Carbs. 0.5g per mousse.

Mediterranean Roasting Vegetables 400gram.  Red onion 29% Courgette 20% Red pepper 19% Yellow Pepper 18% Cherry Tomatoes 11% Olive Oil, garlic puree, basil. Carbohydrate 6.4 grams per half pack.

Chicken Fillets with caesar melt 380gram. Chicken 68% Cherry Tomatoes 12% Parmigiano Reggiano Cheese 4% Pork Belly 4% Wheat Flour, Single Cream, Whole Milk, Water, Butter, Sunflower Oil, Salt, Parsley, Black Pepper, Cornflour, Garlic Puree, Potato Starch, Yeast. Carbohydrates per half pack 4 .8 grams

Total Carbohydrates per person per complete meal 11.7 grams

All the best Jan 

P.S. It's a great bottle of wine and is included in the price.

P.P.S. I have just checked my till receipt, and full price of this meal would have cost £16-46 if the items had been bought individually. At our local gastro pub we wouldn't have got any change out of £40-00!

What are your thoughts on insulin pumps?

 Dr. Richard K. Bernstein

"I spent a month in a major insulin pump center and saw several things. Many of the female patients seemed to have wings on their sides where the pump tubing was inserted and they got lipohypertrophy from localized injections, but that was the least of it. None of them actually had remotely normal blood sugars. 

Of the new patients who visit me using pumps, there was only one whom I was able to get near normal blood sugars. It was because he was still in his honeymoon period of diabetes. After a year on the pump, his blood sugar started getting unpredictable. Why? I believe it is because of the scar tissue that forms where you have a foreign body inserted for days at a time. We find that if we take people off of pumps and have them inject insulin, they cannot inject into old pump sites because they won't get predictable absorption of the insulin. They have to find new places to inject the insulin.

I assume that the reason I have never seen other pump users controlled, is because of the scar tissue that forms as a result of the pump's tubing. For some people it may take several years for the scaring to occur, but I would say that after seven years everyone who uses a pump gets scar tissue at the infusion sites."

More on this story here. 

Middle-Aged Americans Committing Suicide at Unprecedented Rate !

Newly released statistics from the US Centers for Disease Control and Prevention (CDC) show that more Americans now commit suicide than die in traffic accidents.^{1, 2, 3}
Between 1999 and 2010, the suicide rate among American adults ages 35-64 rose by more than 28 percent, to just under 18 deaths per 100,000.

The sharpest rise in suicides is seen among the middle-aged, suggesting there may be a link to the downturn in our economy, which to some degree has affected most Americans over the past decade. During the 1932 Great Depression, as many as 22 people per 100,000 committed suicide.

The suicide rate for men in their 50’s has risen by 50 percent, to nearly 30 suicides per 100,000.
The suicide rate for middle-aged women is just over eight deaths per 100,000. While not nearly as high as that for men, suicide rates still increased with age among women, with the largest increase seen among women between the ages of 60-64. In this age group, suicide rates rose by nearly 60 percent in the last decade.

Sadly, the knee-jerk conventional treatment for depression and suicidal tendencies is almost exclusively prescription antidepressants. Every year, more than 253 million prescriptions for antidepressants are filled in the United States, making them the second most prescribed drug class in the United States (second only to cholesterol-lowering drugs).⁴

But how effective are antidepressants in alleviating the symptoms of depression?
Studies have repeatedly demonstrated that antidepressants are often no more effective than a placebo, and in some case less effective. A study published in the January 2010 issue of JAMA concluded there is little evidence that SSRIs (a popular group of antidepressants that includes Prozac, Paxil, and Zoloft) have any benefit to people with mild to moderate depression.⁵ The researchers stated:

Full story here.