Vitamin D Deficiency: A Global Concern !

If you live north of the line connecting San Francisco to Philadelphia and Athens to Beijing, odds are that you don’t get enough vitamin D. The same holds true if you don’t get outside for at least a 15-minute daily walk in the sun. African-Americans and others with dark skin, as well as older individuals, tend to have much lower levels of vitamin D, as do people who are overweight or obese.

Worldwide, an estimated 1 billion people have inadequate levels of vitamin D in their blood, and deficiencies can be found in all ethnicities and age groups. (1-3)  Indeed, in industrialized countries, doctors are even seeing the resurgence of rickets, the bone-weakening disease that had been largely eradicated through vitamin D fortification. (4-6)

Why are these widespread vitamin D deficiencies of such great concern? Because research conducted over the past decade suggests that vitamin D plays a much broader disease-fighting role than once thought.

Being “D-ficient” may increase the risk of a host of chronic diseases, such as osteoporosis, heart disease,some cancers, and multiple sclerosis, as well as infectious diseases, such as tuberculosis and even theseasonal flu.

Currently, there’s scientific debate about how much vitamin D people need each day. The Institute of Medicine, in a long-awaited report released on November 30, 2010 recommends tripling the daily vitamin D intake for children and adults in the U.S. and Canada, to 600 IU per day. (7) The report also recognized the safety of vitamin D by increasing the upper limit from 2,000 to 4,000 IU per day, and acknowledged that even at 4,000 IU per day, there was no good evidence of harm. The new guidelines, however, are overly conservative about the recommended intake, and they do not give enough weight to some of the latest science on vitamin D and health. For bone health and chronic disease prevention, many people are likely to need more vitamin D than even these new government guidelines recommend.

Read more about why the IOM’s new vitamin D and calcium guidelines are too low in vitamin D and too high in calcium for bone health.

http://www.hsph.harvard.edu/nutritionsource/vitamin-d/

Graham

New evidence for a direct sugar-to-diabetes link !

Sugar consumption and diabetes risk may be more closely linked than anyone realized.

For years, research has supported a roundabout path from excess sugar intake to type 2 diabetes. Eat too much of anything, including sugar, and the resulting weight gain raises your diabetes risk, the theory goes. There’s lots of evidence to support this pattern, but also a big hitch: A small but noteworthy proportion of people with type 2 diabetes aren’t overweight or obese. And up to 40 percent of normal-weight people show signs of the metabolic syndrome, a constellation of metabolic disturbances that predisposes people to diabetes.

From our press release on the study:

Not only was sugar availability correlated to diabetes risk, but the longer a population was exposed to excess sugar, the higher its diabetes rate after controlling for obesity and other factors. In addition, diabetes rates dropped over time when sugar availability dropped, independent of changes to consumption of other calories and physical activity or obesity rates.

 The findings do not prove that sugar causes diabetes, Basu emphasized, but do provide real-world support for the body of previous laboratory and experimental trials that suggest sugar affects the liver and pancreas in ways that other types of foods or obesity do not. “We really put the data through a wringer in order to test it out,” Basu said.

“As far as I know, this is the first paper that has had data on the relationship of sugar consumption to diabetes,” said Marion Nestle, PhD, a professor of nutrition, food studies and public health at New York University who was not involved in the study. “This has been a source of controversy forever. It’s been very, very difficult to separate sugar from the calories it provides. This work is carefully done, it’s interesting and it deserves attention.”

More here.

Edit to add link to full study:

The Relationship of Sugar to Population-Level Diabetes Prevalence: An Econometric Analysis of Repeated Cross-Sectional Data

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0057873

Graham

Receptionists 'dragon' reputation is unfair, study finds.

GP receptionists’ reputation as grumpy and unhelpful is unfair because they have such a difficult job in prioritising patients with minimal time, information and training, a study has found.

Researchers from the University of Manchester and University of Liverpool found that receptionists typically feel a responsibility to protect the most vulnerable patients, but find this challenging because of a shortage of appointment slots and some patients ‘trying to play the system’.

The study, Slaying the dragon myth: an ethnographic study of receptionists in UK general practice, published in the British Journal of General Practice, analysed more than 200 hours of interactions between 45 GP receptionists and patients, and conducted interviews with receptionists.

It concluded: ‘The historical perception of the receptionist as a “dragon behind the desk” has been getting in the way of understanding the role of receptionists and thus improving patient care; to slay it entirely will require a concerted approach to understanding and supporting receptionists so that they can better facilitate patient access to health professionals and other sources of help.’

Lead researcher Jonathan Hammond, a research assistant at the University of Manchester, said: ‘It might be the case that what are portrayed as individual failings on the part of receptionists are actually due to systemic problems within GP practices.’

Source Pulse

If you are into gaming check this guy out !

This guy is my youngest child, 20 years of age. If you are wondering why he has a different surname, it’s because I won him in a Xmas cracker around 18 years ago. His Father died of cancer a few months after he was born, and he is one of the lights of my life. I have been his legal guardian since he was a kid, but thought he should carry his Fathers name. Studying history at University and at the moment wants to be a history teacher or a journalist, who knows what the future may bring.

A stella musician (guitar) he was teaching music at 15 years of age, and you can see, he can talk the hind legs off a donkey (I wonder where he gets that from ?) Eddie

Great lowcarb grub on a tight budget.

I am often amazed, when I read a comment on a forum or blog, that states lowcarb is hard to keep to. How anyone can get fed up with lobsters, scallops, fillet steak and foie gras is beyond me. OK I jest, for most, that sort of food is a rare treat. Seriously folks, the grub below must be one of the great lowcarb bargains around in the UK at the moment. Real grub and far cheaper than take away fast food junk.

From ASDA Chicken and Mushroom Casserole pack £4.00. This pack weighs 1kg. Chicken drum sticks and thighs 74% Smoked Bacon 9% Pork Belly 8.7 the rest made up of chopped red onion and mushrooms. Pack states serves four, but between two it’s a real blow out and here’s the best part, it taste great and  only 1.7 grams of carb per 100 grams. It’s gonna be a regular with us, try it, I don’t think you will be disappointed.

Sorry about the pic, down loaded from ASDA site (and people moan about my pics) them's the breaks eh.

Eddie

59 percent of the tuna Americans consume is not tuna !

Just when you thought eating fish was iffy enough due to Fukushima radiation, the gulf oil spill, mercury and other toxins found in fish, one of the largest seafood fraud investigations in the world to date has found that 59 percent of the tuna Americans consume is not really tuna. Worse still, most of the fake tuna was found to actually be a fish known for causing gastrointestinal problems.

The non-profit ocean protection group Oceana collected more than 1,200 samples from 674 retail outlets in 21 states from 2010 to 2012 to determine if they were honestly labeled. DNA testing found that one-third of the 1,215 seafood samples were mislabeled, according to U.S. Food and Drug Administration (FDA) guidelines.

The fish Oceana found to be most often mislabeled was red snapper, where 87 percent of the samples collected were actually one of several other varieties of fish - such as perch and tilapia. Perhaps the most disturbing finding was that 84 percent of the fake fish substituted for second place tuna was escolar - a fish which can cause explosive, oily, and orange diarrhea.

Escolar, often mistakenly labeled in raw form as a variety of tuna called "butterfish," is a type of snake mackerel that is unable to metabolize the wax esters called gemplyotoxin which are naturally found in its diet. The esters are called gempylotoxin, and are very similar to castor oil or mineral oil and the esters are what gives escolar an oily texture similar to tuna. As a result of the esters, eating full portions of escolar can cause severe gastrointestinal problems.

More here

New Meta-Analysis Demonstrates the Benefits of a Low-Carb Diet, like the Atkins Diet, in the Management of Type 2 Diabetes !

DENVER, Feb. 26, 2013 /PRNewswire/ -- A recently published meta-analysis in the American Journal of Clinical Nutrition reviewed 20 randomized control trials on the effect of various diets on glycemic control, lipids and weight loss in individuals with type 2 diabetes. The results found that a low-carb diet, like the Atkins Diet™, showed greater improvements in glycemic control biomarkers for type 2 diabetics and should be considered in the overall strategy of diabetes management. 

"We are very encouraged by the findings of the meta-analysis in that it demonstrates the beneficial effects of a low-carb diet among type 2 diabetics. This is critical, considering that the World Health Organization estimates that approximately 347 million people worldwide have diabetes with the majority of those having type 2 diabetes," said Colette Heimowitz, vice president of education and nutrition at Atkins Nutritionals, Inc.  "This steady stream of new research validates the efficacy and safety of low-carb diets, and it continues to support the belief that the Atkins Diet is a valid option for people who are looking to address their type 2 diabetes."

Source for this article and more here

The American Journal of Nutrition paper here

Drug firm Roche pledges greater access to trials data.

The pharmaceutical company Roche has announced that it will make more of the data from its clinical trials available to researchers.

But the announcement has been dismissed as "pathetic" by campaigners arguing for greater transparency from the pharmaceutical industry - an issue I wrote about last month.

It's estimated that half of all clinical trials have never been published and positive trial results are twice as likely to be published as negative findings. The AllTrials campaign wants the pharmaceutical industry to publish all data, and is supported by the Wellcome Trust, the BMJ and NICE.

The doctor and columnist Ben Goldacre, who has spearheaded the campaign for data transparency said GSK had "led the field" by signing up to AllTrials and it was "bizarre to see that Roche expect to be praised today for continuing to withhold data." He predicted that the era of drug companies and researchers "routinely withholding important information about clinical trials is coming to an end."

More here.

What if wild animals ate fast food ?

Jonathan Eisen at TEDMED: Not all microbes are pathogens.

As Jonathan Eisen of the University of California of Davis points out, the health of our microbiome is vital to protecting us from disease.

Interesting video with Jonathon Eisen a Type one diabetic:





Graham

Pancreatitis Doubles for Those Taking New Class of Diabetes Drugs, Scientists Say !

People who take the newest class of diabetes drugs to control blood sugar are twice as likely as those on other forms of sugar-control medication to be hospitalized with pancreatitis, Johns Hopkins researchers report.

In an article published online inJAMA Internal Medicine, the scientists say the new drugs -- glucagon-like peptide-1-based therapies (GLP-1) -- are associated with an increased risk of hospitalization for acute pancreatitis. The agents sitagliptin and exenatide -- generic names for the drugs sold under the brand names Januvia and Byetta -- appear to contribute to the formation of lesions in the pancreas and the proliferation of ducts in the organ, resulting in wellsprings of inflammation.

"These agents are used by millions of Americans with diabetes. These new diabetes drugs are very effective in lowering blood glucose. However, important safety findings may not have been fully explored and some side effects such as acute pancreatitis don't appear until widespread use after approval," says study leader Sonal Singh, M.D., M.P.H., an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine.

Full story here.

Many mainstream nutritionists are guilty of spreading dietary myths !

• Many mainstream nutritionists are guilty of spreading dietary myths and misconceptions that lead to poor health outcomes. Here, I review 10 of the most widespread lies that have been refuted by science
• The National Academies’ Institute of Medicine recommends adults to get 45–65 percent of their calories from carbohydrates, 20–35 percent from fat, and 10–35 percent from protein. This is an inverse ideal fat to carb ratio that is virtually guaranteed to lead you astray and result in a heightened risk of chronic disease.
• Most people likely benefit from 50-70 percent of calories as healthful fats in their diet for optimal health, whereas you need very few carbohydrates to maintain good health. Although that may seem like a lot, fat is much denser and consumes a much smaller portion of your meal plate
• The low-fat myth may have done more harm to the health of millions than any other dietary recommendation as the resulting low-fat craze led to increased consumption of trans-fats, which we now know increases your risk of obesity, diabetes and heart disease—the very health problems wrongfully attributed to saturated fats
• Most people use artificial sweeteners to lose weight and/or because they’re diabetic and need to avoid sugar. Ironically, nearly all the studies that have carefully analyzed artificial sweeteners show that those who use artificial sweeteners actually gain more weight than those who consume caloric sweeteners. Studies have also revealed that artificial sweeteners can be worse than sugar for diabetics
• Fructose, soy, eggs, whole grains, milk, lunch meats, and genetically engineered foods are also victims of widespread misconceptions that threaten your health unless you get it “right”
• From Dr. Mercola Full story here.

The AliB and Gut Flora story.

Last year we published a post called ‘Maybe AliB was right all along’ we have posted it again below. Graham, John and myself, started to read AliB’s posts on the forum DCUK some years ago. Ali believed gut flora played a very big part in many diseases, including type two diabetes. Ali was not the average run of the mill forum poster, she had some theories and ideas that were controversial, she could think outside of the box.. Our team did not agree with some of her posts, but she was always polite, she went to great trouble to explain her ideas, never losing her temper or rude to anyone. For me she was a very interesting person, and brought real debate to the forum. To the grey matter impaired and those of little imagination, she was a crack pot and talking nonsense.

As reported below she was railroaded off at DCUK, the same was repeated at the ETYM forum. Ali doesn’t give up easy, but how much grief can you take from the dullards before you walk. The post below is self explanatory, two readers of this blog commented on the post yesterday, they had remembered Ali. I think their memories were jogged when another post went up regarding gut flora and cholesterol. I’m beginning to think Ali was way ahead of the game, and it is sad that she no longer posts. With all this in mind, I have started this thread, and will bump it up each time, another item comes into the news regarding gut flora, and it’s effects on our health.  It’s the least I can do for Ali, after all, I invited her to join ETYM, I did send her an apology when she left, I had hoped her unique talents would be appreciated on the new forum, I was wrong.

Maybe AliB was right all along ! First posted 27th. September 2012

View the post and comments here

Type 2 diabetes breakthrough: Imbalance in gut bacteria likely cause.

But breakthrough research just published in the journal Nature strongly indicates another, bottom line cause has been discovered - an imbalance of "good" versus "bad" bacteria in the intestinal tract appears to trigger type 2 diabetes.

The research team pointed out the 1.5 kilograms of bacteria that each of us carries around in our intestines have a huge impact on our well-being. If the equilibrium of what is known as this "microflora" in the gut is disrupted, health can suffer. For their study, the scientists zeroed in on the intestinal bacteria of 345 people from China. The 171 research subjects who had type 2 diabetes were found to have "a more hostile bacterial environment in their intestines" than those not suffering from the disease. The study suggests this kind of out-of-balance gut flora could increase resistance to different medicines as well as likely be the trigger for type 2 diabetes. The scientists identified specific biological indicators in the gut flora that could eventually be used to identify those at risk of type 2 diabetes as well as to diagnose the disease

.

More on this article here.

Gut Bacteria Linked to Cholesterol Metabolism.

Researchers at the Sahlgrenska Academy, University of Gothenburg, Sweden, show that cholesterol metabolism is regulated by bacteria in the small intestine. These findings may be important for the development of new drugs for cardiovascular disease.

The influence of gut bacteria on human health and disease is a rapidly expanding research area. Fredrick Bäckhed's research group is a leader in this field and is investigating how gut bacteria are linked to lifestyle diseases such as obesity, diabetes and cardiovascular disease.

'If future research can identify the specific bacteria that affect FXR signaling in the gut, this could lead to new ways to treat diabetes and cardiovascular disease', says Fredrik Bäckhed, professor at the Sahlgrenska Academy, University of Gothenburg, who led the study.

More here.

Eddie

Forum Moderators their part in my downfall !

Over the last five years I have known more than a few forum moderators. They have varied in their knowledge and ability greatly. From highly experienced long term diabetics with great skill and knowledge, to complete buffoons. From fair minded people with a sense of humour, to Stalinist dictators. From honest people working unpaid and giving up their free time, to power drunk foul mouthed dishonest liars. Forum moderating can be a thankless task, and unfortunately, good moderators are a very rare commodity.

Good forum mods are very much like a good football referee. They can make quick judgement calls, and don’t ruin the run of the play, for minor or petty rule infringements. They allow the game to flow, sure for serious infringements to the rules or laws of the game, they know they must blow the whistle. A good referee knows he cannot interpret the rules to suit his personal agenda, nor can he act in a dishonest or corrupt way. The good referee knows the game and the players are what the crowd has come to see, and he is only there to ensure fair play. Unfortunately many forum mods are very poor referees.

So many forum mods feel they own the pitch, that they are the players, and the referee. Matters are made worse when they make up the rules to suit their own agenda. It goes from bad to worse, when the moderator is bent and resorts to dishonesty and blatantly lies. This we have seen on so many occasions. The red card is waived and players leave the field, the game is ruined by poor or dishonest refereeing. The game ends, and we wonder what could have been. What could the team have achieved if the match had continued?

The complete lunacy of the situation comes to light, when the referees  agree with the red carded player, and openly tell the people, yes I play the same game, but please keep it quiet, we don’t want to upset the reserve players. So what do we end up with ? A mediocre team that few want to watch, the attendance numbers go down, players leave the team, and the team ends up relegated or disbanded. As the great Jimmy Greaves once said “Football it’s a funny old game”. Maybe, but the world of diabetes is not funny, but it sure is crazy.

Oh well, onwards and upwards.

Eddie

Hope Warshaw State of the Nutrient: Carbohydrate:

Dear Colleague,

I read. I listen...diabetes blogs, magazine articles, professional group list servs, websites, Facebook posts, tweets on Twitter, and much more. Each day, I get more concerned about the laser-like focus and singular attention in the diabetes universe on the portrayal of carbohydrates as the omnipotent nutrient. With the support of research and current management guidelines, it's time for me to review the State of the Nutrient: Carbohydratehere.

I must conclude, the state of this important macronutrient is in crisis. Glycemic ControlMyopia, as I call it, has taken root. It's unhealthy and unhelpful.

But first, a definition of Glycemic Control Myopia. It includes limiting (and advocating for) total carbohydrate consumption below 40-45% of calories (or significantly lower) and placing laser-like focus for people with diabetes (PWD) on carbohydrate intake and glycemic control. Sure, it's understandable that when PWD learn that the carbohydrate from foods is what contributes most to the rise in post-prandial glucose levels, they think severe carbohydrate restriction is goal number one. And if they search on "diabetes diet" on the Internet, they'll find plenty of information to perpetuate this notion which is unsupported by research.

Understandable, but it's our role as practitioners, when given the opportunity (which is not nearly frequently enough), to provide accurate evidence-based information about carbohydrates. The reality is that if a PWD, type 1 or 2, has sufficient insulin available at the time of carbohydrate consumption, either from endogenous or exogenous insulin, they should be quite able to control their post-prandial glucose levels. Bottom line: post-prandial glycemic control requires a balance of digestible carbohydrate intake and insulin availability. And yes, today we know that additional hormones are involved in glycemic control – glucagon, amylin, incretins and more.

To my four concerns about Glycemic Control Myopia...

Concern #1: Carbohydrate Restriction Can Add Up to Unhealthy Eating

As I recapped in my January 2013 NutriZine Wylie-Rosett et al. in their research editorial, discussed how our focus on carbohydrates and carbohydrate counting is promoting unhealthy eating among youth with type 1 diabetes (T1D).^1,2 I'll add here the findings of Mehta, et al's small study from Joslin Diabetes Center, Boston, MA in youth with T1D and parents participating in focus groups.³ Results show that parents and youth qualified their perceptions of "healthful eating" by focusing on a food's glycemic effect. As such, foods resulting in larger or more erratic postprandial glycemic excursions were considered less healthful. The study found that for both youth and parents, an emphasis on carbohydrate quantity over quality may distort beliefs and behaviors regarding "healthful eating."

Reality is that Americans have been eating about 45-50% of calories as carbohydrate for years4 (albeit with an increase in total calories and less nutrient dense forms of carbohydrate over the last few decades).⁴People with diabetes have been shown to eat about 44 to 46%.⁵ Regarding our sources of carbohydrates as Americans, we need to direct our focus on quality, not quantity. We eat excess added sugars (~22 tsp/day)⁶ and insufficient amounts of nutrient-dense sources of carbohydrates – fruits, vegetables, whole grains, legumes and low fat dairy foods – critical foods in a healthy eating pattern (more about this below). So, rather than trying to get PWD to focus on the quantity of carbohydrates they eat, shouldn't we encourage them to focus on quality? Research by Sacks et al., showed that over the long haul people in the POUNDS LOST weight loss study gravitated back to a macronutrient balance in which the carbohydrates accounted for 43 to 53% of calories.⁷ Yes, within the range that most people with diabetes and Americans eat.

Research also shows that the greatest predictor of glycemic control is the reduction of total energy (calorie) intake, not the reduction of total carbohydrate consumption (or other significant changes in macronutrient distribution).⁵ And since Americans consume a large portion of their non-nutrient dense excess calories from added sugars, doesn't it make sense to put our focus on decreasing consumption of these to achieve total energy reduction and increasing consumption of nutrient dense sources of carbohydrates?

As educators/providers, we need to reign in this low carbohydrate zealotry and offer, well yes, some basic nutrition education and knowledge and guidance about just what is healthy eating such as:

• Our calories are provided in foods and beverages which contain varying amounts of carbohydrate protein and fat (as I teach – packages of nutrients). Foods aren't "carbs", they contain carbohydrate.
• An explanation of macronutrient balance. If one eats less carbohydrate, then they may (over the course of time) eat more protein and fat. And these sources of protein and fat may, based on common American food choices and preferences, provide more saturated fats. And what we know about saturated fat is that it causes insulin resistance, which is a central feature in prediabetes and T2D.⁵  The Dietary Reference Intake and Dietary Guideline recommendation for carbohydrate is 45- 65% of calories.^4,8 According to the 2010 Dietary Guidelines for Americans⁴, it's difficult, especially at lower calorie levels (<1500 calories), to eat sufficient amounts of  many of the shortfall nutrients when eating at the low end (~45%) of this range of carbohydrates: dietary fiber, potassium, calcium, magnesium (and other minerals) and vitamin A,C,D (and other vitamins);. The Dietary Guidelines 2010, go on to state related to achieving weight loss, "Diets that are less than 45 percent carbohydrate or more than 35 percent protein are difficult to adhere to, are not more effective than other calorie-controlled diets for weight loss and weight maintenance, and may pose health risk, and are therefore not recommended for weight loss or maintenance."⁴

And isn't another important factor in our work giving the PWD we counsel advice they can follow day in, day out, not just for a couple of weeks? Yes, they will have diabetes the rest of their life.  

Concern #2: Carbohydrate Restriction Doesn't Assure Glycemic Control

Yes, sounds counterintuitive. However research DOES NOT show that restricting carbohydrate necessarily improves glycemic control. Consider Delahanty, et al.'s review of the dietary data from 532 of the intensively-treated DCCT participants. Participants who consumed a mean carbohydrate intake of 56% of calories had a significantly lower A1C, 7.08%, compared to an A1C of 7.47%, for participants whose mean carbohydrate intake was 37% of calories.⁹ People who ate less carbohydrate ate more total fat and saturated fat.

Concern #3: Carbohydrate Restriction Aids and Abets Medication Avoidance

The focus here is on T2D, particularly those PWD with fewer years of diabetes duration. There seems to be an overarching notion that BG lowering medications should be avoided (despite having to eat unhealthfully, very low carbohydrates, to maintain glycemic control) for as long as possible and that having to take one or more medication is paramount to failure or defeat. This notion catapults me back to my early years in diabetes when we only had two categories of BG lowering medications – sulfonylureas (1st generation) and insulin (mainly NPH and regular), and not the much wider variety of medications available today.

We've come a long way baby, as the saying goes, with BG lowering medications. In addition, we now know that prediabetes/T2D is progressive and at diagnosis of T2D people have already lost 50 – 80% of their beta cell mass and/or cells. Relevant to this population the 2012 ADA/EASD Management of Hyperglycemia in Type 2 Diabetes position statement, encourages starting an insulin sensitizer (most commonly metformin) in most people with T2D unless they are highly motivated to engage in lifestyle change for 3-6 months to determine success with glycemic control before initiating medication.¹⁰

Yes, I've been accused of being a drug salesman. I can assure you I'm not! I'm a diabetes educator who believes that being honest with clients about our current understanding of T2D disease progression, healthy eating (a la U.S. Dietary Guidelines) and the critical importance of glucose, lipid and blood pressure control over time to prevent/delay diabetes complications. We owe it PWD with T2 to let them know about the many new categories of BG lowering medications, how these are being use, and how they can help them stay healthy over time when initiated EARLY in their course of T2D. 

And when it comes to people with T1D or their caregivers, it's important for us to make the point that no research to date shows that taking less insulin by limiting carbohydrate intake appears to have any long term health or glycemic control benefits. To achieve glycemic control the goal with insulin in T1D is to adjust prandial doses of rapid-acting insulin to match desired carbohydrate intake.¹¹

Concern #4: Carbohydrate Restriction Potentiates Disease Tunnel Vision and Stands in the Way of Healthy Eating

By no means do PWD only have the disease diabetes. We know they, like all people, are at risk for other chronic diseases. In fact, all PWD are at greater risk for CVD. Research is accumulating to show that, due to the common thread of insulin resistance, people with T2D and prediabetes may be more prone to develop certain cancers, like breast (in post menopausal women)¹², pancreas, colon and others. There's mounting evidence that the optimal eating plan for chronic disease prevention is one that is plant-based. That doesn't necessarily mean going vegetarian, but it does mean minimizing meats/protein-based foods (especially red and processed meats) and saturated fats and eating mainly carbohydrate-based, nutrient dense foods. That's certainly not low carbohydrate!

Educators need to widen the mindset of PWD and discuss how a healthy eating pattern with sufficient amounts of quality sources of carbohydrates can assist with control of diabetes as well as prevention/delay of other chronic diseases PWD are at greater risk for. To learn more I encourage you to sit back and watch our brand new lecture Diabetes and Cancer: What's the Connection?  by Karen Collins, MS, RD, CDN, Nutrition Advisor, American Institute for Cancer Research. PRESENTdiabetes.com lectures come with FREE CE through the Academy of Nutrition and Dietetics Commission on Dietetic Registration (CDR) for nutrition professionals. Also all lectures on PRESENTDiabetes.com are approved for CE through the Mt. Sinai School of Medicine in New York and the CDR. 

Yes, hopefully I've gotten your wheels turning and churning. I'm anxious to get your read of the research and your thoughts from your clinical practice and beyond. Please join me on eTalk to chat about the State of the Nutrient: Carbohydrate?

http://www.presentdiabetes.com/ezines/#ezine402

 There you have it eat plenty of carbs and take your medications or you could end up like me suffering from  Glycemic Control Myopia.

Graham

Edit to add this comment from Hope Warshaw re Richard Bernstein MD:

"Let's make sure we let science drive our clinical advice vs. diet books like South Beach or self-proclaimed physicians like Richard Bernstein, MD who has never published a research study (that I know of) testing and documenting his low-carb hypotheses re: glycemic control."

http://www.presentdiabetes.com/etalk/index.php?topicid=4362#-1

The Extraordinary Science of Addictive Junk Food.

On the evening of April 8, 1999, a long line of Town Cars and taxis pulled up to the Minneapolis headquarters of Pillsbury and discharged 11 men who controlled America’s largest food companies. Nestlé was in attendance, as were Kraft and Nabisco, General Mills and Procter & Gamble, Coca-Cola and Mars. Rivals any other day, the C.E.O.’s and company presidents had come together for a rare, private meeting. On the agenda was one item: the emerging obesity epidemic and how to deal with it. While the atmosphere was cordial, the men assembled were hardly friends. Their stature was defined by their skill in fighting one another for what they called “stomach share” — the amount of digestive space that any one company’s brand can grab from the competition.

The public and the food companies have known for decades now — or at the very least since this meeting — that sugary, salty, fatty foods are not good for us in the quantities that we consume them. So why are the diabetes and obesity and hypertension numbers still spiraling out of control? It’s not just a matter of poor willpower on the part of the consumer and a give-the-people-what-they-want attitude on the part of the food manufacturers. What I found, over four years of research and reporting, was a conscious effort — taking place in labs and marketing meetings and grocery-store aisles — to get people hooked on foods that are convenient and inexpensive. I talked to more than 300 people in or formerly employed by the processed-food industry, from scientists to marketers to C.E.O.’s. Some were willing whistle-blowers, while others spoke reluctantly when presented with some of the thousands of pages of secret memos that I obtained from inside the food industry’s operations. What follows is a series of small case studies of a handful of characters whose work then, and perspective now, sheds light on how the foods are created and sold to people who, while not powerless, are extremely vulnerable to the intensity of these companies’ industrial formulations and selling campaigns.

More on this New York Times story here.

Gut Bacteria Linked to Cholesterol Metabolism.

Researchers at the Sahlgrenska Academy, University of Gothenburg, Sweden, show that cholesterol metabolism is regulated by bacteria in the small intestine. These findings may be important for the development of new drugs for cardiovascular disease.

The influence of gut bacteria on human health and disease is a rapidly expanding research area. Fredrick Bäckhed's research group is a leader in this field and is investigating how gut bacteria are linked to lifestyle diseases such as obesity, diabetes and cardiovascular disease.

'If future research can identify the specific bacteria that affect FXR signaling in the gut, this could lead to new ways to treat diabetes and cardiovascular disease', says Fredrik Bäckhed, professor at the Sahlgrenska Academy, University of Gothenburg, who led the study.

More here.

Slow care leads to foot amputations !

Thousands of diabetes patients end up having a foot amputation because of slow treatment, a charity warns.

Diabetes UK says that up to 80% of foot amputations could be avoided if better care was in place.

Patients are suffering because many areas do not have services in place to quickly deal with foot ulcers and infections.

By 2015, the number of diabetes-related amputations is expected to rise to 7,000 a year.

When diabetes, both Types 1 and Type 2, is present for many years, especially if it is poorly controlled, it can cause complications such as reducing blood flow to vessels in the feet and nerve damage which reduces sensation.

This increases the risk of ulcers and infections that may lead to amputation.

A report produced in collaboration with the Society for Chiropodists and Podiatrists and NHS Diabetes points out that people with diabetes are more than 20 times more likely to have an amputation than the rest of the population.

More here.

Complacency Will Get You In The End

One hates to appear a little sniffy and disdainful but from posts on the ETYM forum make it difficult not to do so. Some examples

Pneu wrote

“The difference in the stance is that we believe in providing people with the information and letting them make a decision, history and experience tells us that most people make the right decision.”

However, documented results tell us otherwise (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 year

The response to such evidence? Check out the posts by a character called Ashleigh on the post “BGs – do we worry to much?” shortly followed by a LucyLocket:

“Thanks for asking Ashleigh, cos I am still confused too and how does the T1's table relate to the T2 figures? can someone explain those figures too please?”

Eddie and Graham I think you a doing a great job for those with an open and inquisitive mind but for the rest? Well there is one obvious reason why the statistical results above are very similar to those obtained in previous NHS audits over the past 5 - 6 year.!

Let them eat cake

John

Eat To Your Meter Banned Again !

"When soldiers have been baptized in the fire of a Battenberg, they have all one rank in my eyes." ~Napoleon Bonaparte 

Well what a surprise, banned from the forum Eat To Your Meter. I only needed one more banning to hold the Lonsdale Belt outright. I checked in after asking Pneu can you give me a list of members that hold non diabetic HbA1c numbers that do not lowcarb ? and I was banned ! On logging in I read “You have been banned! You do not have access to this function” Thems the breaks eh. As you can imagine I am mortified and have donned the black arm band. I wouldn’t mind, but I only posted again today to back up my good friend Dillinger and the lovely woman Indy.

So, there you have it. Personally I’m blaming Dillinger, I have known him for around five years and he has been a very bad influence on me for years. As you would imagine I will be keeping a very close eye on ETYM and it’s less than honest mods, and spreaders of misinformation. I really don’t know what the agenda is, but helping newbie’s is not part of it, lets face it, has a newbie ever joined the place ?

Eddie

Edit hot off the press.

For continued breaches of our rules you are now in receipt of a 7 day ban. Please take this time to reflect on your attitude towards our forum, its membership and its owners.

Regards

ETYM Admin

Eat To Your Meter forum. No freedom of speech allowed !

The paranoia and lies continue at the ETYM forum. ‘On a thread called BGs- do we worry too much’ I posted the post below in answer to the moderator Grazer. He immediately deleted the post stating “MODERATORS NOTE  I've deleted this post as it was off topic, and we don't want the thread derailed. The discussion is not about the merits of a low carb diet.”

I started a new thread, called ‘my deleted post’ posting the deleted post and stating “I did not mention lowcarb in the deleted post !” The post number was 14518 and was read by a forum member other than me. It was swiftly deleted. The forum has got to the stage where you have to telephone other forum members to witness your posts have been posted before mods with a bent agenda can delete them. What a sorry state of affairs.


My deleted post.

Grazer said.

“Many other things work. "work" means a thing does what the user wanted it to do. Don't worry, you'll get it one day.”

My post

“Works” We could discuss what works for ever I think. For example Stephenson’s Rocket worked but technology moves on, as does the best way to control diabetes. Perhaps we should look at what does not work. What clearly does not work is the dietary recommendations for diabetics from the NHS, DUK and other mis-information outfits. This failure is manifestly obvious when looking at the NHS audits published each year.

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.

BTW I do get it, I know what works, as do the best controlled on this and other forums. As I said in an earlier post, there is a gold standard, and that should be the target of all diabetics seeking long term avoidance of diabetic complications.

MODERATORS NOTE

I've deleted this post as it was off topic, and we don't want the thread derailed. The discussion is not about the merits of a low carb diet.

I did not mention lowcarb in the deleted post !


Regards Eddie

Edit.

In answer to forum member/owner xyzzy.


What’s the point, my posts get deleted when they don’t agree with some mods and forum owners. Check out the http://thelowcarbdiabetic.blogspot.co.uk/ for the truth.

You guessed it, deleted (but witnessed) almost immediately.

Why is the truth not wanted at ETYM ?

Eddie

Low-Carbohydrate Diet Review Shifting the Paradigm.

This is a must read paper for anyone following or considering a lowcarb diet or long term way of life. It is only seven pages long and you do not need the intellect of Albert Einstein to understand it. Diabetics or those wanting to maintain long term health will not be disappointed. Look at the charts showing the massive advantages of lowcarb against low fat. 

Eddie

What does a clinician need to know about low-carbohydrate (LC) diets? This review examines and compares the safety and the effectiveness of a LC approach as an alternative to a low-fat (LF), high-carbohydrate diet, the current standard for weight loss and/or chronic disease prevention. In short-term and long-term comparison studies, ad libitum and isocaloric therapeutic diets with varying degrees of carbohydrate restriction perform as well as or better than comparable LF diets with regard to weight loss, lipid levels, glucose and insulin response, blood pressure, and other important cardiovascular risk markers in both normal subjects and those with metabolic and other health-related disorders. The metabolic, hormonal, and appetite signaling effects of carbohydrate reduction suggest an underlying scientific basis for considering it as an alternative approach to LF, high-carbohydrate recommendations in addressing overweight/obesity and chronic disease in America. It is time to embrace LC diets as a viable option to aid in reversing diabetes mellitus, risk factors for heart disease, and the epidemic of obesity.

Abstract here.

Full paper here.

This 93-year-old has a message for us: “A beach body at 90 is no longer a dream

Charles Eugster may be 93, but he has no less spring in his step than he did as a young man. In this talk from TEDxZurich, he brings us a powerful statistic: 92% of Americans over the age of 65 have one or more chronic diseases. While many clearly cannot be avoided, Eugster points out that inactivity is to blame for many of the diseases those who have lived long lives endure.

During the golden years, people retire and tend to slow down  – and yet there is a connection between work and one’s physical and mental health. But life doesn’t need to finish after retirement, which Eugster calls “voluntary or involuntary unemployment for up to 30 years.” That’s why Eugster has taken up rowing. And weightlifting. Watch this TEDxTalk about the factors for successful aging from a formidable speaker, who urges us to “break off the shackles of convention!”



http://blog.ted.com/2012/12/05/this-93-year-old-has-a-message-for-us-a-beach-body-at-90-is-no-longer-a-dream/

Graham

Cauliflower featured great food of the week.

The cauliflower is one of the most versatile foods in the low carbers recipe book. From cauliflower cheese to finely grated as a rice substitute or mash with butter and use as a topping for shepherds and fish pies etc. With minimal carb content and over three times the vitamin C as potatoes, a truly great food.  

Cauliflower Cheese recipe

Ingredients:

1 cauliflower, broken into bite sized florets
140ml double cream
125g mature cheddar cheese
1-2 tea spoons dijon mustard
1 large free range egg
salt & pepper

Steam the cauliflower (in a colander over a pan of boiling water) until a fork passes easily through the stems. Remove to a baking dish and discard the water.

Pour the cream, cheese (reserve some to sprinkle over the dish) and mustard into the pan over a medium heat and stir until the cheese is melted. Remove from the heat and whisk in the egg. Now pour the mixture over the cauliflower and sprinkle the remaining cheese over the top. Bake in a fan oven at 170 until the cauliflower is golden brown (30-35 minutes).

Eddie

Much more on this great food here.

Lowcarb Black forest gateau.

Ingredients:
100g ground almonds
1 teaspoon baking powder
2 large eggs
1 tablespoon of melted butter
2 tablespoons of double cream
2 tablespoons of cocoa powder

100 grams of pitted black cherries

Method:
Mix all dry ingredients in a bowl.
Melt the butter I used a Pyrex jug, add the eggs, cream, then add the dry ingredients and mix. Pour into a 6" microwave proof dish. Microwave in a 700watt for 3 minutes. Allow to cool and cut in half. Spread on extra thick cream and 100 grams of pitted black cherries.. Serves four. 

Lowcarb hard to stick to, give me a break.

Eddie