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Thursday 31 March 2016

Diabetes meds vary in safety and effectiveness, study shows

(HealthDay)—A study of nearly a half-million people with type 2 diabetes shows there are pros and cons to nearly every form of drug therapy for the disease.

In the British study, researchers looked at patient outcomes from a large U.K. database of almost 470,000 adults with type 2 diabetes, tracked between 2007 and 2015.

Julia Hippisley-Cox and Carol Coupland, of the University of Nottingham, sought to parse out differences among a variety of diabetes drugs. They accounted for complicating patient factors such as age, sex, smoking and poverty, as well as how long a person had been diagnosed with type 2 diabetes.

The researchers also focused on five major outcomes linked to diabetes: blindness, amputation, severe kidney failure, and high or low blood sugar.

Reporting March 30 in BMJ, they found that when a class of drugs called glitazones (Actos, Avandia) was prescribed along with the standard diabetes drug metformin, there was a higher risk for kidney failure than with metformin alone.

The same was true when another class of meds called gliptins (Januvia, Onglyza and others) was combined with metformin.

However, there were "up" sides to these drug combos as well. People who took a gliptin or a glitazone plus metformin had "significantly lower" risks for high blood sugar than those who took metformin alone, the research found.

Finally, the study looked at "triple" therapy: patients taking metformin, a gliptin or a glitazone, and a sulphonylurea, another type of diabetes drug. This combination was linked to "significantly higher" odds for episodes of potentially dangerous low blood sugar, the British researchers said, compared to people taking metformin alone.

On the other hand, triple-therapy users had a reduced risk for diabetes-linked blindness, compared to the metformin-only group.

The study doesn't establish direct cause-and-effect relationships between the various drugs and these outcomes. Still, according to experts, the findings support the notion that diabetes care is never a "one-size-fits-all" endeavor.

"There are many treatment options for diabetes—they have the benefit of lowering blood sugar levels, but they also carry risk," said Dr. Robert Courgi, an endocrinologist at Northwell Health's Southside Hospital in Bay Shore, N.Y.

He said that standard guidelines typically list metformin as a first-line therapy against type 2 disease, but additional drugs may be needed. "Ultimately, the physician and the patient need to work together to find the best treatment possible," Courgi said.

Dr. Gerald Bernstein coordinates the Friedman Diabetes Program at Lenox Hill Hospital in New York City. He believes the field of diabetes care is constantly evolving.

"Treating type 2 diabetes used to be like a singles pingpong game—give a pill, lower blood sugar," he said.

However, "over the last 75 years or so we have learned that it is more of a team effort, because the process of safely lowering blood sugar is more complicated than previously thought," Bernstein explained. "The goal of treatment for all diabetes is to prevent complications and have a high quality of life."

Different medications have different targets and effects, he said, and "the art of treatment today mixes and matches these medications depending on age, weight, activity."

http://medicalxpress.com

Ditch the drugs go Low Carb and achieve the desired results without the side effects simples

Graham

Lamb and Red Wine Casserole Recipe : Plus More About Lamb


I recently read that "The UK is the world’s third largest lamb exporter – after Australia and New Zealand – with just over a third of the market", and that "Farmers have called on retailers to do more to support the British lamb industry, with only one major supermarket chain selling entirely UK-grown lamb for Easter." 

Lamb is a popular meat and can be enjoyed cooked as Roasts, Grills, casseroles ... and more! So wherever you may buy your lamb, whether it be home grown or imported I hope you may enjoy this 'Rich Lamb and Red Wine Casserole' recipe suggestion.    

Ingredients:
Serves Six (amend recipe to suit)
2 lbs Lamb leg meat
2 tbsp oil
12 shallots
2 cloves garlic
4 rashers rindless bacon
1 cube lamb stock
250 millilitres red wine
2 tbsp tomato puree
2 tsp fresh thyme leaves
1 bay leaf
350 grams button mushrooms
1 tbsp cornflower
freshly ground black pepper


Method and Preparation:
1. Preheat the oven to 190C/Gas 5.

2. Season the lamb with ground black pepper. Heat 1tbsp of the oil in a large frying pan and fry the meat in three batches until well browned, turning frequently, adding a little more oil if necessary. Transfer the lamb to a large flame proof casserole and set aside.

3. Heat the remaining oil in the frying pan and cook the shallots and garlic for 4-5 minutes until lightly browned. Put on a plate and set aside.

4. Add the bacon to the pan and cook for 2-3 minutes until crisp. Add the mixture to the lamb.

5. Dissolve the stock cube in 400ml/14floz boiling water and pour over the lamb. Add the red wine, tomato puree, thyme and bay leaf. Bring to the boil, then cover and transfer to the oven. Cook for 1 hour.

6. Remove casserole from the oven and stir in the shallots, garlic, mushrooms and cornflour paste. Return to the oven for a further 30 minutes until the lamb is tender. Season to taste and serve with a selection of vegetables. 

Tip - Use a leg of lamb, either remove the meat from the bone yourself or ask your butcher to do it, or use diced lamb as purchased from the butcher or supermarket, thawed if frozen.

Original recipe from here

lay the table and enjoy some great food

More about Lamb:

Any sheep that is less than a year old is classified as lamb. The red meat is lean and mild. Lamb is more popular than beef in many parts of the world. As a crown roast (circular racks) or “guard of honor” (two rib racks crossed), it is one of the most elegant presentations anyone can prepare.

Varieties

• The typical cuts of lamb seen in grocery stores are from a lamb between the ages of five months and one year. Specialty markets may carry whole “hothouse” or baby lamb and Spring (Easter) lamb. Some ethnic recipes will include “mutton” or “yearling,” which should not be referred to as lamb. They are older and stronger in both texture and taste.

• Cuts from the rib section will be expensive. They are tender and juicy and include “rack of lamb,” “crown roast,” and chops.

• Loin cuts are also superior in tenderness and flavor and even pricier than rib meats. These include roasts, the saddle, tenderloins and chops.

• Shoulder meat tends to be less tender and more bony than leg sections and cost the least.

• Only the back legs are processed for commercial sale.

• Ground lamb is the main ingredient in moussaka, a traditional Mediterranean dish.

• Lamb is graded in a manner similar to beef: prime, choice, and good (along with “utility” and “cull”). Choice and Prime are the most commonly available. The numbering system – one-five – refers to the meat to fat ratio per animal.

Buying Tips

• Stew meat can be purchased in chunks, or larger sections, which can be cubed at home. These should be from the less expensive parts of lamb.

• For sautes, choose medallions or chops that are no thicker than one inch. Cook dry for a perfect sear.

• If packaged, be sure that there is little or no liquid inside. Meat should not be shiny, but may have a membrane called the “fell” adhering to part of the surface.

• Calculate about one pound per person when buying a leg roast. Reduce to one-half pound per person if the cut is boneless. A rack of about eight ribs will typically serve two-three people.

Storage Tips

• Do not use any lamb beyond the “sell by” date if it has not been frozen.

• Chops and small portions should be refrigerated and used with two-three days. Keep in freezer for about four months.

• Large cuts will last up to five days if kept cold and tightly wrapped. Freeze for about eight months.

• Do not leave fresh meat un-refrigerated for more than hour.

These 'more about lamb' facts and further links can be found here

All the best Jan

Wednesday 30 March 2016

Carb-Loading Is Bad for the Heart

Think Before You Grab a Carb Shake:

A high carbohydrate shake can cause negative effects on heart function, according to researchers from the Vanderbilt University Medical Centre and the University of Alabama at Birmingham (UAB). Apparently, the glucose from the carb-loading diet can decrease the heart’s production of atrial natriuretic peptide, the hormone that reduces blood pressure and gets rid of excess salt by up to 25 percent.

The study published on Feb. 23 in the Journal of the American College of Cardiology explains the process that involves the molecule miR-425, which inhibits atrial natriuretic peptide (ANP) production. The glucose causes the cells to make more of this molecule, decreasing ANP production as a result.

The researchers add that the atrial natriuretic peptide (ANP) production is reduced in obese people, causing them to retain more salt and experience high blood pressure. Because of this, the team advice that a carbohydrate-loading diet is not ideal, especially to obese individuals.

The study involved recruiting 33 participants and giving them a shake that contains 264 calories. The research team analysed their blood levels for six hours.

These participants were on a standard diet two days before the study. The team found that the shake resulted to ANP production by up to 25 percent for several hours. The main reason for the reduction is the increase in glucose.

“When you take in a high-carb shake a lot of things happen, including increases in glucose and insulin,” says senior author Thomas Wang, the chief of the Division of Cardiovascular Medicine at Vanderbilt University Medical Centre. “However, the increase in glucose appears to be the main thing driving the drop in ANP levels.”

In collaboration with first author Pankaj Arora from UAB, Wang comments, “The carbohydrate load had a significant and notable effect on circulating ANP levels. Experimental studies suggest that it’s not good to make less ANP.”


Graham

Poached eggs with avocado, beetroot and spinach


I always think poached eggs make a nice change, and in fact I enjoyed one this morning for breakfast ... you may prefer two! A nutritious poached egg can make a great start to the day, and if you wish to try this recipe idea the addition of a few more great tasting foods, just make this poached egg and avocado breakfast recipe, packed with potassium, protein and vitamins B and C a great start to the day. 

For those who may like to know - here is the Nutritional info per serving:
Calories 366kcals
Fat 28.4g (6.4g saturated)
Protein 21.7g
Carbohydrates 7.4g (6.5g sugars)
Fibre 5.2g
Salt 0.9g

Ingredients:
Serves 2 - 4
½ ripe medium avocado
4 cooked baby beetroot, quartered
Handful of baby leaf spinach
Drizzle of extra-virgin olive oil
Small handful of blanched and toasted hazelnuts, roughly chopped
Squeeze of lemon juice
4 (very fresh) large free-range eggs

Method:
1. Peel, stone and slice the avocado, then gently toss in a bowl with the beetroot, spinach, olive oil, hazelnuts and lemon juice. Season and set aside.
2. To poach the eggs, heat a large pan of salted water until it just bubbles gently. Crack an egg into a ramekin, then slide the egg into the water, lowering the ramekin as close to the water as possible. Using a dessert spoon, gently fold any stray strands of white around the yolk. Repeat with the other eggs. Cook for 2-3 minutes, then remove with a slotted spoon and put on kitchen paper to dry.
3. Divide the avocado mixture among 2 - 4 plates, then serve the eggs on top, sprinkled with salt and pepper.

Did you know:
When poaching eggs, the fresher, the better (ideally less than 4 days old). A fresh egg white clings more closely to the yolk in the simmering water.

Recipe idea from here

The original recipe idea serves two, but some may find one egg is sufficient, so amend recipe to suit ...

All the best Jan

Tuesday 29 March 2016

'Something is rotten in the state of Western medicine,' says Dr Aseem Malhotra



Pulse Live London Big Debate: Is impractical clinical guidance putting patients and doctors at risk? 

Dr Aseem Malhotra, cardiologist and expert in prevention, diagnosis and treatment of heart disease argues that issues with scientific journals, pharmaceutical companies and their regulators are leading to a culture of misinformation. 

Read more detail on his speech here: http://bit.ly/1q3H7xF


Graham

Provençal Chicken


Provençal Chicken - a favourite : Especially for low carbers - LCHF 

There are quite a few 'Provençal Chicken' recipe ideas around and you may indeed have your own particular favourite. Recipes to me are to be shared, enjoyed, sometimes amended to suit your particular likes and needs.

We try and bring a variety of recipe ideas to this blog, and not all may be suitable for you. If you may have any food allergies, or underlying health issues these must always be taken into account. If you are a diabetic and not sure how certain foods may affect your blood sugars, test is best, i.e. use your meter.

Now, how about the aroma of some great ingredients wafting ... whilst this tasty dish is bubbling in the pan! Then you can enjoy the taste of France at your table! 

Ingredients:
Serves Four
4.0g carbohydrate per serving


1 tbsp oil
100 g lean smoked bacon medallions, roughly chopped
1 red onion, cut into wedges
1 courgette, halved and cut into chunks
1 aubergine (eggplant), cut into small pieces
4 tomatoes, cut into large wedges
3 cloves garlic, finely chopped
1 red chilli, chopped
500 g carton passata
half a chicken stock cube, crumbled
460 g chicken thigh fillets
14g of fresh flat leaf parsley, washed and roughly chopped
2 tsp mixed herbs

Method:

1. Preheat the oven to 200°C, 180°C fan, gas 6. In a large oven proof pan, heat the oil and cook the bacon for 5 minutes until crispy. Remove and reserve for later.
2. Add the onion, courgette, and aubergine (eggplant) to the pan and fry for 5 minutes. Then add the tomatoes, garlic, chilli, passata, 50ml water and chicken stock cube. Bring to boil, then reduce the heat and simmer for another 5 minutes.
3. Add the chicken thigh fillets, half of the parsley, reserved bacon and mixed herbs. Stir to coat the chicken in sauce and cook for 30 minutes in the oven. Remove from the oven and serve straight away garnished with the remaining parsley and seasoned with freshly ground black pepper.

Make it veggie: Leave out the bacon and chicken, and replace the chicken stock cube with a vegetable stock cube. Cook the vegetables and serve with a nut roast.

Original recipe can be seen here

Bon Appetit.
... possibly a glass of rose wine too!



All the best Jan

Monday 28 March 2016

Statins associated with a 54% increased risk of brain haemorrhage.

Abstract

OBJECTIVE:

Although a concern exists that 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) might increase the risk of intracerebral haemorrhage (ICH), the contribution of these agents to the relationship between serum cholesterol and disease occurrence has been poorly investigated.

METHODS:

We compared consecutive patients having ICH with age and sex-matched stroke-free control subjects in a case-control analysis, as part of the Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy), and tested the presence of interaction effects between total serum cholesterol levels and statins on the risk of ICH.

RESULTS:

A total of 3492 cases (mean age, 73.0±12.7 years; males, 56.6%) and 3492 control subjects were enrolled. Increasing total serum cholesterol levels were confirmed to be inversely associated with ICH. We observed a statistical interaction between total serum cholesterol levels and statin use for the risk of haemorrhage (Interaction OR (IOR), 1.09; 95% CI 1.05 to 1.12). Increasing levels of total serum cholesterol were associated with a decreased risk of ICH within statin strata (average OR, 0.87; 95% CI 0.86 to 0.88 for every increase of 0.26 mmol/l of total serum cholesterol concentrations), while statin use was associated with an increased risk (OR, 1.54; 95% CI 1.31 to 1.81 of the average level of total serum cholesterol). The protective effect of serum cholesterol against ICH was reduced by statins in strictly lobar brain regions more than in non-lobar ones.

CONCLUSIONS:

Statin therapy and total serum cholesterol levels exhibit interaction effects towards the risk of ICH. The magnitude of such effects appears higher in lobar brain regions.

Caramelised onion, cheese and hazelnut salad


Now some may say why not "Start your week right with a healthy Monday lunch" but you can eat this sort of salad any day of the week!

Ingredients:
Serves 8
( 7.4g carbohydrate per serving )
1 tbsp olive oil 
4 medium red onions, sliced
2 yellow peppers, washed, de-seeded and thinly sliced
50 g blanched hazelnuts
1 tbsp white wine vinegar
1 tsp Dijon mustard
2 tsp clear honey
100 g mix of watercress, spinach & rocket salad 
125 g Abergavenny goats cheese (or similar), crumbled

Method:
1. Heat the olive oil in a large frying pan over a medium-low heat. Add the onions and peppers, and cook for 20 minutes, stirring occasionally until tender and caramelised.
2. Meanwhile, in a small frying pan, toast the hazelnuts over a medium heat for 4-5 minutes, stirring frequently until just golden. Tip the nuts on to a chopping board and roughly chop.
3. To make the dressing, whisk the vinegar, mustard and honey together and season with freshly ground black pepper.
4. Divide the salad leaves between 8 small plates. Top with the caramelised onions and peppers, then scatter over the crumbled goats’ cheese and toasted hazelnuts. Drizzle with the dressing and serve immediately.

Recipe idea from
here

Why use goats cheese ...
Cheeses are made from goats’ milk in every country where the animals are farmed, but usually this is on a small, domestic scale. France produces by far the largest range of commercial examples, from young, soft cheeses suitable for use in desserts to tangy, aged varieties that can be grated like parmesan.



In recent years, thanks to an increasing taste for goats’ milk products, many British versions have come onto the market – they are particularly common in Wales. The younger cheeses may be flavoured with herbs, pepper or fruit and spread like pâté, and older hard cheeses can be eaten in much the same way as Cheddar. Some people who have an intolerance to cows’ milk may find goats’ milk cheeses easier to digest.

Hope you may sit down soon and enjoy this salad.

All the best Jan

Sunday 27 March 2016

Saturday 26 March 2016

Katie Melua - The Flood

Katie Melua is one of those singers who can perform live and not just in the studio, besides being talented those eyes of hers are truly mesmerising beautiful lady
Graham

Reef - How I Got Over

Seeing as were on a religious theme tonight this is my contribution, a new song from Reef  with a gospel choir well sort of lol !! enjoy

Graham

"The Lord Keeps Blessing Me" - Mississippi Mass Choir

Carrying on the religious theme, some contrast. I wonder if many young kids into music, realise almost every modern musical genre was either started by, or heavily influenced by Black people. In the grim days of slavery, Black people would sing as a choir in the fields, to relieve the tedium and grim working conditions. When they became free, they built their own Churches and gospel music was born. From gospel came soul, blues, rhythm and blues and onto rock. Eddie  

Royal Choral Society: 'Hallelujah Chorus' from Handel's Messiah

Saturday night again and Saturday is music night on this blog. This being such a special weekend for Christians, this short extract seems most appropriate to start tonight's music.The Royal Choral Society has performed Handel's Messiah on Good Friday at the Royal Albert Hall every year since 1878. The RCS filmed their performance on 6 April 2012 by kind permission of the Royal Albert Hall and the Royal Philharmonic Orchestra. Eddie

Eight years yesterday.

According to Jan's diary I have been a diabetic for eight years as of yesterday. Jan notes down just about everything, a true paper work star, which is just as well, because I would rather dig trenches than get involved with paperwork and officialdom.  I am far too busy sorting out fishing gear, than get involved with trivia such as paying the bills and getting cars insured etc. Typical bloke, 66 years of age, going on 17. affraid 

I am spoilt rotten, our morning routine. First one up makes the tea. Jan has a shower first, while I read all the on-line newspapers, then she cooks a full English breakfast (low carb version). After breakfast I have a shower, believe it or not, while showering Jan lays my clean clothes out on the bed, who said ya can't get the staff these days. She then informs me of her plans for the day, taking care not to include me in any of the activities, unless I have been given plenty of advanced warning (with lots of reminders). I have had a problem with authority all my life, the last thing I need is a wife playing the camp commandant.

All meal planning and cooking is down to Jan. In the first three months of low carb, I did most of the food selecting and cooking. Thereafter, and being happy Jan's training and culinary skills had reached the required standard, I kept out of the kitchen. On the rare occasions I am out shopping with Jan (I detest it) if I pick up a food item we have not had before, before my eyes focus on the label, she will say, no way far too carby, she is an expert on food labels and nutritional values etc. I never argue, the item goes back on the shelf, I don't need the grief of a lecture on blood glucose control. Well, not in public anyway.  mrgreen 

For a long while Jan kept away from the forum and blogging scene, she did join the forum of flog some years ago. She was swiftly banned, reason given just said "You're Eddie's Wife" just admitting to knowing me can get you banned from the flog. The good news is, as all know here, she has become very active on blogs and the low carb diabetic forum, which is a win win situation. It reduces my work load, and means the general populous hears a lot less of me, that can't be bad, just ask Mo and a few others. rofl 

So, there you have it, in the overall scheme of things, diabetes has been positive for me in many ways. If I had not become a diabetic, I doubt I would have had tests which discovered my heart was on it's last legs, sorted seven years ago, with angioplasty and stents. I have made some very good friends via blogs and forums (and a few enemies) I am probably eating the best food of my life, and I will argue with anyone, who says I have not got the best nurse in the world.


Eddie

Hazelnuts ... are rich in dietary fibre, vitamins, and minerals


Hazelnut:
Pronounce it: hay-zl-nut

Grown in Europe and the US, hazelnuts are encased in a smooth, hard brown shell but are most commonly sold shelled. The sweet-tasting, cream-coloured kernel is small and round, with a pointed tip. Its thin, dark brown skin is faintly bitter, so some people like to remove this before eating.

Also known as cobnuts or filberts, hazelnuts are good eaten raw but the flavour takes on a more mellow, sweeter character when they are roasted. Like almost all nuts, they have a high fat content, which means they'll go rancid pretty quickly if not refrigerated.


Choose the best:
Hazelnuts in their shells look good, but they will go rancid more quickly. Ready-shelled nuts in airtight packaging last longer.

Prepare it:
Hazelnuts in their shells can be opened using a nut cracker. To remove the dark skin, place the nuts on a baking sheet in a single layer and bake on a medium heat for 10-12 minutes. They are ready when the skins begin to split and the kernels turn golden. Tip them into a clean tea-towel and rub - the skins should come off quite easily.

Store it:
Unopened packets of hazelnuts should be stored in a cool, dry place - they'll last for up to 3 months. Once opened, they should be kept in an airtight container.

Cook it:
Raw as a snack, or added to muesli. Chopped and used in cakes or crumble toppings. Ground finely to make flour for baking.

Alternatives:
Try almond, macadamia nut or pecan.

Above details from here

Health benefits of Hazelnuts:

Hazelnuts are very high in energy and loaded with numerous health-benefiting nutrients that are essential for optimum health. 100 g nuts carry 628 calories. 


They are rich in mono-unsaturated fatty acids like oleic as well as essential fatty acid, linoleic acid that helps lower LDL or bad cholesterol and rise HDL or good cholesterol. Research studies suggest that Mediterranean diet plentiful in monounsaturated fatty acids help to prevent coronary artery disease, and strokes by favoring healthy blood lipid profile.

The nuts are rich in dietary fiber, vitamins, and minerals and packed with numerous health promoting phyto-chemicals. Altogether, they help protect from diseases and cancers.

Hazels are exceptionally rich in folate, which is a unique feature for the nuts. 100 g fresh nuts carry 113 µg; that is, about 28% recommended daily intake of this vitamin. Folate is an important B-complex vitamin that helps prevent megaloblastic anemia, and most importantly, neural tube defects in the newborn. Good news for the expectant mothers!

Hazel nuts are an excellent source of vitamin E; contain about 15 g per 100 g (providing 100% of RDA). Vitamin E is a powerful lipid soluble antioxidant required for maintaining the integrity of cell membrane of mucusa and skin by protecting it from harmful oxygen-free radicals.

The nuts, like in almonds, are free from gluten, and therefore, safe alternative food sources that can be employed in the preparation of gluten-free food formulas for gluten-sensitive, wheat allergic, and celiac disease patients.

Besides being rich in folates, they are packed with many other important B-complex groups of vitamins such as riboflavin, niacin, thiamin, pantothenic acid, and pyridoxine (vitamin B-6).

They are rich source of minerals like manganese, potassium, calcium, copper, iron, magnesium, zinc, and selenium. Copper and manganese are essential co-factors for anti-oxidant enzyme, superoxide dismutase. Iron helps prevent microcytic-anemia. Magnesium and phosphorus are important components of bone metabolism.

Hazelnut oil has a nutty aroma and has excellent astringent properties. It helps keep skin well protected from dryness. The oil has also been used in cooking, and as “carrier or base oil” in traditional medicines in massage therapy, aromatherapy, in pharmaceutical and cosmetic industry.

The above health benefit details taken from here


Now here's a recipe suggestion for you. Take a plate of ordinary green beans ... 



and turn it into a plate of Green Beans with Hazelnuts and Lemon.
You'll find the hazelnuts and lemon zest add a delightful touch to green beans.

Serves: 8
675g (1 1/2 lb) fresh green beans, trimmed
2 tablespoons olive oil
1 1/2 teaspoons lemon zest
30g (1 oz) chopped toasted hazelnuts
salt and freshly ground black pepper to taste

Method:
Time Guide Prep:10min › Cook:10min › Ready in:20min 

In a large pot of salted boiling water, cook beans 3 to 8 minutes or until tender. Drain and place in a large bowl.
Add olive oil, lemon zest, hazelnuts, salt and pepper.
Beans may be made 1 day ahead, chilled and covered. Reheat beans to serve.
Recipe suggestion from here

Why not go nuts ... Hazelnuts!

We try and bring a variety of recipe ideas to this blog, and not all may be suitable for you. If you may have any food allergies, or underlying health issues these must always be taken into account. If you are a diabetic and not sure how certain foods may affect your blood sugars, test is best, i.e. use your meter.

All the best Jan

Friday 25 March 2016

BDA endorse new Eat Well Guide for T2 diabetics


37% should come from this selection of starchy carbs 


https://www.gov.uk/

Pity the newly diagnosed T2 diabetic that gets a referral to a BDA dietitian and receives advice based on the Eat Well Guide, it can only lead to a fast progression to a multi medication regime.

Graham


Cakes Decisions For Easter : All Low Carb Using Almond Flour

You don't have to eat a lot of sugar / carbs when choosing cakes.
Take these suggestions, they are all made using almond flour, so perhaps we can all enjoy a slice.
The only problem, which one will you choose.
Decisions, decisions ...

Will it be a slice of black forest gateaux
see recipe here

or a piece of coffee and walnut cake


see recipe here

or how about a refreshing piece of lemon sponge cake


see recipe here

although I did see some tasty strawberries so I could make one of these

strawberry sponge cake -mmmm Yum!

see recipe here

So I wonder which one will you choose?

All the best Jan

Thursday 24 March 2016

Simple days.

I have just been watching a program tonight about the days of steam railways. That was my world as a kid. Imagine the change I have seen, from steam railways to Concord and beyond. From the days of waiting months for a phone line (often a shared party line with next door neighbours) to the internet, and instant communication with almost anyone in the world.

So much progress, but in many ways, I miss the time when I grew up. The annual holiday was spent down in Ramsgate with my Grandmother, who lived in a very big four story terraced house. We travelled down by steam train, which was very exciting. At my Grandmothers I shared a huge and very high double bed with my brother. The place reeked of lavender polish, and in the bedrooms we had very large china bowls and huge china jugs filled with water for washing our faces and hands in the morning. No on suite bathrooms in those days.

My old Granny was a bingo nut, and always had lots of great stuff she had won for me and my brother. Stuff like cowboy hats and cap guns. She was a lovely old lady and never a cross word, she died from diabetes complications at around 65 years of age. One of my earliest memories was the day she died. My Mum was doing the washing with an old fashioned boiler, stirring the washing with a big stick, (when we received a telegram we did not have a phone). The telegram informed my Mum, her Mum had died. It was the only time I saw my Mum cry.

I remember searching among the rock pools on the beach, and staring in wonder at the sea. On the way back to my Grannies, we would stop at the Eagle pub. In those days kids were not allowed in pubs, so while my parents had a pre dinner drink inside, my brother and myself would sit outside with a bottle of pop and a bag of crisps. Simple days, but I could understand those days. These days, I am not so sure.

Eddie

Thank you to our readers.

Over the last couple of days, we have received messages that makes it all worth while.

A comment.

Dear Jan, Eddie and Graham - I just wanted to say again what a delight this informative website is; Recipes, Research studies, the latest information and science regarding medications, light hearted humour and a bit of Rock N Roll on a Saturday night! You have taken the notion 'evidence based practice' to a whole new level - and shows what is possible! Thank you, what a delight to read.

Kath 


An email.

Hello, I came across your website last night and just wanted to say how informative, honest, positive and true it is! I am a dietitian and often despair at the rubbish I see/hear being given to newly diagnosed people with Diabetes in the NHS and the misguided and confused media messages. What you have done is fantastic and I will be recommending it to anyone I speak to who has Diabetes. I also love the recipes at the end!

Very Best Wishes, Vicky. 


Eddie

Post edit.

I sent this email to Vicky.

Thank you Vicky so much, as you can see I have thanked you publicly without posting your full name. 

The very best of luck and health to you and yours.

Vicky replied.

Thanks, I will be recommending your website to my patients with Diabetes. This far outweighs the advice from Diabetes UK.

Best Wishes, Vicky

Cavolo nero have you discovered it yet?


Well I had heard of kale, I had heard of cabbage but when my blogging friend Kezzie recently commented on this post here and mentioned "Cavalonero cabbage", I had to investigate ...

"Cavolo nero
Pronounce it: ca-voll-oh nee-ro


What is cavolo nero?
Cavolo nero is also known as black kale, black cabbage, Tuscan kale, or by its Italian names lacinato and nero de Toscana and is a cousin to the popular Italian vegetable cavolo fiore (similar to cauliflower). 
Some people spell this 'cavalo nero'. 

Choose the best:
Look for crisp, unblemished leaves, with no holes. Avoid cores that are split or dry. With its distinctive long, dark green, almost black leaves, cavolo nero originates from the fields of Tuscany where it was first believed to be grown in 600BC.

Generations of Italians have appreciated the delights of cavolo nero and now the British are catching on to its benefits too. Like its cousin kale, cavolo nero is a member of the brassica family and used in many traditional Italian dishes, from soups through to main meals.

Whilst cavolo nero enjoys all the benefits of traditional kale, it has a delicious and rich taste all of its own. The good news for UK kale lovers is that cavolo nero is now being grown in Lincolnshire, renowned for its fertile, loamy soil and where so many of our home-grown vegetables come from.

Availability:
It is available, July through to early October - but also available from most leading supermarkets chopped and ready to use.

Prepare it:
Remove old or damaged outer leaves, cut the leaves free of the core and slice out any tough central stalks. Rinse, then chop or slice.

Store it:
It will keep in a cool, dark place or the vegetable drawer of the fridge for several days.

Cavolo nero is an extremely versatile vegetable with a marvellous rich, intense and slightly sweet flavour, which means it can be used in a number of different ways. It is great in hearty meals like minestrone soup, but is also delicious in lighter dishes such as salads.

Cavolo nero also makes a fantastic accompaniment, complementing a number of meat and fish dishes – and not just Italian ones!

And if that isn’t enough to tempt you – cavolo nero is a good source of lutein, vitamins K, A and C, a significant source of the B vitamins, fibre and calcium as well as containing manganese, copper, iron and many other elements.

Alternatives:
Try cabbage or kale."

Above picture and words from here and here

Celeriac, cavolo nero & bacon mash


Ingredients
Serves Six
9g carbs per serving

1½ kg celeriac, peeled and cut into chunks
200g smoked bacon lardons
250g cavolo nero, or green cabbage, finely shredded
50g butter
4 tbsp double cream 

Method:
1. Boil the celeriac in a covered pan for 15-20 mins or until tender. Meanwhile, heat a frying pan and cook the bacon for 5 mins until golden and crisp. Add the cavolo nero or cabbage and cook over a low heat for 5 mins.

2. Drain the celeriac and blitz with a hand blender until smooth. Stir in the butter and cream. When the butter has melted, add the bacon and cavolo nero or cabbage, and stir well. Season to taste.

Recipe idea from here

Buon appetito

All the best Jan

Wednesday 23 March 2016

Type 2 diabetes in teens: Out of control?

Half of teens fail to control blood sugar

One-third of children and teens in the U.S. are considered overweight or obese, putting them at greater risk of developing Type 2 diabetes.

A recent study found that nearly half of newly-diagnosed teens failed to control their blood sugar, and one in five had serious complications. Keep reading for more information about what the leaders of this study learned — and how we can help.

What is Type 2 diabetes?
Complications

Type 2 diabetes is a serious disease, and even if your child is feeling fine in the early stages of diagnosis, management of the disease must be taken seriously. If not properly controlled, the condition can adversely affect the kidneys, eyes, heart and nerves. While long-term complications develop gradually, once they develop they can be quite disabling or potentially life-threatening. Teaching teens to properly control their blood sugar levels greatly increases their chances of avoiding serious complications.

According to information provided by the Mayo Clinic, Type 2 diabetes develops when the body becomes resistant to insulin or when the pancreas stops producing enough insulin. Factors such as excess weight, inactivity and heredity play an important role in determining who is affected by Type 2 diabetes and who isn’t. Type 2 diabetes is not the same disease as Type 1/juvenile diabetes, even when it occurs in children.

Diagnosis of Type 2 diabetes in children is on the rise, causing concern amongst physicians. Managing this condition requires a high level of parental involvement and dedication on the part of the diabetic teen. The rise in teen obesity in recent years has certainly contributed to the increase in childhood cases of Type 2 diabetes — rarely seen in children or teens in the past. Between 1999 and 2008, the percentage of teens diagnosed with either pre-diabetes or Type 2 diabetes increased from 9 percent to a whopping 23 percent.

Why is it harder with teens?

We spoke with Scott Isaacs, M.D., F.A.C.P., F.A.C.E., a board-certified endocrinologist. Dr. Isaacs is the medical director for Atlanta Endocrine Associates and author of the new book Hormonal Balance: How to Lose Weight by Understanding Your Hormones and Metabolism (third edition).

Dr. Isaacs says the problem with most teenagers is that they don’t want to listen to what their parents say — an overweight teen diagnosed with Type 2 diabetes is not any different. “They’re going to eat what they want, and the major source of calories in teenagers is going to be sweetened beverages, sodas, snack foods — all the things that are the worst thing for diabetes,” he says.

How can parents help?

If your teen has been diagnosed, the most important thing you can do is to help them make better food choices going forward. Many of these teens have had unhealthy eating habits for quite some time, and will resist change. “Taking a restrictive, punitive-type approach to eating never works, and it often backfires,” says Dr. Isaacs. Instead, he recommends taking the more positive approach of telling teens what they can add to their diets. Adding in fruits and vegetables and other healthy foods helps people feel full sooner and takes the place of other unhealthy foods.

Dr. Melissa Arca, pediatrician, takes the same approach. "With an alarming increase in teens being diagnosed with pre-diabetes (up from 9 percent to 23 percent of U.S. teens) and then Type 2 diabetes, it's absolutely critical that parents and pediatricians work together to support and encourage a healthy lifestyle among our adolescents," she says. "The most important thing I like to stress to parents is that this is absolutely a 'family' affair. We cannot expect our teens to eat a well-balanced diet of whole grains, fruits, vegetables and water and get 60 minutes of daily activity if we aren't willing to accept and carry out these lifestyle changes ourselves as parents." Dr. Arca encourages parents to think of their teen's diabetes as something completely manageable and by the whole family.

Help your teen learn to control his blood sugar by involving the whole family. His life depends on it.


I feel for these children and teens being so young many won't understand or be able to come to terms with the severity of uncontrolled diabetes

Graham

Watercress : Contains Iron, Calcium, Vitamins A, C and E


With deep green leaves, and crisp, paler stems, watercress is related to mustard and is one of the strongest-tasting salad leaves available. It has a pungent, slightly bitter, peppery flavour and is highly nutritious, containing significant amounts of iron, calcium, vitamins A, C and E. It's sold in either bunches or bags, and is good combined in a salad with milder leaves, or made into soup.

Availability:
Watercress is available all year round but is at its best from April until September.

Choose the best:
Go for crisp, dark green leaves, with no sign of yellowing or wilting.

Prepare it:
Wash and shake dry just before you're about to use it. Both the leaves and stems are edible - just trim off any tough roots.

Store it:
Watercress is highly perishable, so store it in a perforated bag in the fridge and eat it within a couple of days. Alternatively, treat it like a bunch of flowers and put in a glass of water in the fridge, covering the leaves with a plastic bag - it can last a little longer that way.

Cook it:
In a salad with rocket and orange segments; combine with potatoes in a soup; use in tarts and omelettes; use to make sandwiches or as a garnish for cooked foods such as game.

Alternatives:
Try rocket.

Above words and picture from here


Now, here are two recipe suggestions:


Roasted Cod with easy watercress sauce & roasted cherry tomatoes
For a no-fuss fish dish, see recipe here


Oriental glazed salmon with a watercress, cucumber and radish salad
This dish is suitable for a BBQ, or can be cooked indoors, see recipe here

Hope you may include some watercress in your dishes soon.
Happy Eating

All the best Jan

Tuesday 22 March 2016

How High Is Too High for Triglycerides and Cardiovascular Risk?

TEL-HASHOMER, ISRAEL — In patients with coronary heart disease, even triglyceride levels on the high side of normal (100 to 149 mg/dL) are associated with an increased risk of death, new research shows[1].

"The current threshold for the definition of elevated triglycerides levels for patients with CHD may be higher than desired," Dr Robert Klempfner (Sheba Medical Center, Tel-Hashomer, Israel) and colleagues write in their study, published online March 8, 2016 in Circulation: Cardiovascular Quality and Outcomes.

To clarify the association between different triglyceride levels and long-term all-cause mortality, the authors evaluated 22-year mortality data on 15,355 patients with proven CHD who were screened between 1990 and 1992 for the Bezafibrate Infarction Prevention (BIP) trial, a secondary-prevention trial.

Patients were divided into five groups based on fasting serum triglyceride levels at screening: low-normal triglycerides (<100 mg/dL), high-normal triglycerides (100–149 mg/dL), borderline hypertriglyceridemia (150–199 mg/dL), moderate hypertriglyceridemia (200–499 mg/dL), and severe hypertriglyceridemia (>500 mg/dL).

Most patients were men (81%) and had a history of a previous MI (72%). Notably, more than 90% of patients had received no lipid-modifying medication.

Age- and sex-adjusted survival was 41% in the low-normal triglyceride group vs 37%, 36%, 35% and 25% in groups with progressively higher concentrations of triglycerides (P<0.001), according to the authors.

When the investigators assessed triglycerides as a continuous measure, each unit of natural logarithm triglycerides elevation was independently associated with a 26% increase in all-cause mortality adjusted for age and sex only. This association remained significant after adding HDL-C to the model (HR 1.12; 95% CI 1.06–1.18), they report.

Shorter follow-up from the BIP registry also found a stepwise increase in age-adjusted 5-year mortality with increasing triglycerides, but the association was not statistically significant after adjustment for HDL-C and other covariates.

The parent study reported a nonsignificant 9.4% reduction in fatal and nonfatal MI or sudden death with the fibrate drug bezafibrate[2]

"An interesting lesson could be derived from the BIP study: despite a significant HDL-C increase in the bezafibrate treatment arm, the overall benefits were nonsignificant. However, the benefit of bezafibrate in the subgroup of patients with high triglyceride levels was impressive," Klempfner writes. "In all the available five randomized control trials, the beneficial effects of fibrates were highly significant in patients with hypertriglyceridemia."

The study was limited by the inability to adjust for potential confounders such as morbidity and treatment given and the lack of information on cause of death, he notes. Mortality data were obtained by matching patients' identification numbers with their vital status in the National Population Registry.

The authors presumed the deaths were cardiovascular because higher triglyceride levels remained independently associated with all-cause mortality after excluding patients who developed incidental cancers. Further, 8-year follow-up data in randomized BIP patients showed that about 58% of deaths were due to a cardiovascular cause, they note.

This assumption seems to be valid but remains a limitation nonetheless, Drs Karol Watson and Dr Philipp Wiesner (University of California, Los Angeles, CA) write in an accompanying editorial[3].

Other limitations that temper enthusiasm include the lack of follow-up lipid values, follow-up medication use, and ascertainment of important comorbidities, such as diabetes.

Still, the study, with its large numbers of patients and long follow-up, provides useful information and takes on "special importance given that elevations in triglycerides are increasingly common in current-day society," the editorialists write.

National Health and Nutrition Examination Survey (NHANES) data from 1988 to 2010 reveal that 47% of Americans had triglyceride levels >150 mg/dL and 1% had levels >500 mg/dL.

Clinicians have debated for years how to tackle this problem. While lifestyle interventions remain an effective method, trials like ACCORD, AIM-HIGH, and HPS-2 have failed to show a benefit with adding agents, primarily targeting triglycerides, on top of statins.

Antisense apolipoprotein C-III inhibitors have been shown to be effective and safe in lowering triglycerides in early clinical trials, but whether these drugs will be able to improve cardiovascular outcomes remains to be seen.

"Although we search for the true significance of elevated triglycerides in cardiovascular risk and potentially the optimal method to lower triglycerides, we congratulate Klempfner et al on an important study, which provides support for the idea that triglycerides should be taken more seriously as a future target to improve patient outcomes," Watson and Wiesner write.

http://www.medscape.com/

Low carb is the optimal way to lower Trigs.

Graham


Brighton. Bleasdale. Brilliant. Broccoli !

It is quite a few years that I last visited Brighton, and although I have been around the Forest of Bowland area, I don't think I've ever visited Bleasdale ... it may be something to put right later this year? So why are you writing about them I hear you ask ...

Well sometimes on my visits around the many blogs I visit, I may just see an image that strikes a chord, and I really like it. Take this one below, the big bike and the 'oh so sweet' bike. It was taken by Ian Charters, who writes on a blog called 'Just Us and A Few Friends'. I like to visit his blog for the stunning scenery images, and to know a little bit more about the wonderful areas he visits. Just look at his Great Langdale photo's here, now that is a place where Eddie and I have visited...



This photograph was taken in not such good weather, at the Bleasdale Circle Fell Race. Apparently car parking was in short supply at Bleasdale School, so to encourage runners to leave their cars at home there was a discount for anyone who cycled to the race. Clearly it proved attractive to all ages...

Above photo from Ian's blog here ... thanks Ian 


So now to Brighton, you can see some sort of theme here - the letter B! Now Brighton came to mind because it has recently been voted as a top destination to visit during 2016 see here.



Not only does it have interesting places to visit like the Royal Pavilion pictured above and 'The Lanes' for it's many shops, but it holds the annual London to Brighton Bike Ride and also the London to Brighton Veteran Car Run, so much going on! In fact family members have taken part in the cycle run ... me I'm just a supporter LOL!  



getting ready for the London to Brighton Bike Ride, see here





it was a foggy day in London - November 2015 - see more here
what a great vehicle it dates to 1899, and how about the classic London Red Bus


Well, now onto 'Brilliant' ... again it was a photo I couldn't resist. It's two of our wonderful, and of course brilliant, grandchildren - perhaps following in their Daddy's footsteps - he is a professional photographer... and who knows? 

How about this? I thought is was great ... but then I would, wouldn't I ...



I'm glad they had their warm hats on. I'm told it was a chilly day and they went home and enjoyed a nice chicken and broccoli dinner. They've both always loved broccoli - I think their dish was similar to this.





Chicken Fillets with Cheesy Stuffed Mushrooms and Green Vegetables
You can see the low carb recipe, including broccoli,  here

Thanks for reading.

All the best Jan