The best diet for optimal blood sugar control & health
Author: kaitiscotland
I am a Scottish doctor who is working to improve the outcomes for people who have diabetes using a low carb diet, and advanced insulin techniques when necessary. Professionally I provide expert witness reports in the clinical forensic and family medicine areas and I also provide complementary therapies. I enjoy cooking, cinema, reading, travel and cats.
Nature has reported that an AI model called RETFound has been successfully trained to diagnose diabetic retinopathy from eye scans.
1.6 million unlabelled retinopathy pictures were used to teach the computer what a retina looked like. After this it was taught to diagnose specific conditions using a much smaller selection of images. The machine was excellent at diagnosing diabetic retinopathy and progress has also been made in teaching it to diagnose cardiac failure, stroke and Parkinson’s disease.
1 tablespoon olive oil 2 carrots, peeled and diced 2 celery stalks, diced 1 onion, diced 1 medium bell pepper, seeded and diced 1 pound Yukon gold potatoes, peeled and diced 1 garlic clove, minced 1 sprig of thyme 1/4 teaspoon celery seed 2 bay leaves 15 oz can chopped tomatoes 2 cups of seafood broth or clam juice 2 10-ounce cans of diced clams, drained with juice reserved Salt and black pepper to taste Chopped parsley Saltine crackers for serving
Directions
Heat the oil in a dutch Oven, Add vegetables and garlic, and cook, stirring frequently, until the vegetables are soft but not brown, approximately 10 to 15 minutes. Add drained clam broth, seafood broth, thyme and celery seed, and bay leaves.
Partly cover the pot, and simmer gently until potatoes are tender approximately 10 minutes.
When potatoes are tender, stir in tomatoes, and heat them through. Add chopped clams, stirring to combine. Add black pepper to taste. Let chowder come to a simmer, and remove from heat. Fish out the thyme and the bay leaf, and discard. Taste and adjust the seasoning.
The chowder should be allowed to sit for a while to develop flavor. Reheat it before serving, then garnish with chopped parsley. Serve with oyster crackers.
An analysis of data from 1.5 million people from 19 countries indicates that for every decade that someone is diagnosed with type two diabetes, they will lose 3 to 4 years of life expectancy.
In the USA if you are a 50 year old man, you would be likely to lose 14 years if you had been diagnosed at age 30, 10 years if you were diagnosed age 40 and 6 years if you were diagnosed aged 50, compared to someone who was not diabetic.
My comment: Given that there is a big rise in type 2 diabetes diagnosis in children and young adults, this is pretty concerning. Of course, there are ways to effectively manage the condition and even put it into remission. There are more effective drugs available but cutting out refined carbohydrates and regular exercise are two of the most effective thing that people can do for themselves.
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
Adapted from BMJ 7 Oct 2023
Engaging with a hobby is associated with better self reported health, happiness and life satisfaction and fewer depressive symptoms.
The proportion of people who report having hobbies varied considerably between countries.
Almost everyone in Denmark said they had a hobby and half of those in Spain had a hobby.
My comment: Having a hobby is dependent on having the free time to have a hobby. There also may be some expense involved. Often hobbies are a way of engaging with other people and sometimes they are solitary pursuits. They are a way of carving out time for yourself, doing something that you enjoy and can even nourish your body, mind and soul. One of the great joys of retirement that I have found is finally having lots of time to enjoy myself. I hope you are able to fit in a bit of what you enjoy into your weekly or monthly routine too.
Mortality in vegetarians and comparable nonvegetarians in theUnited Kingdom
Paul N Appleby et al. Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
ABSTRACT
Background: Vegetarians and others who do not eat meat have been observed to have lower incidence rates than meat eaters of some chronic diseases, but it is unclear whether this translates into lower mortality.
Objective: The purpose of this study was to describe mortality in vegetarians and comparable nonvegetarians in a large United Kingdom cohort.
Design: The study involved a pooled analysis of data from 2 prospective studies that included 60,310 persons living in the United Kingdom, comprising 18,431 regular meat eaters (who ate meat 5 times/wk on average), 13,039 low (less-frequent) meat eaters, 8516 fish eaters (who ate fish but not meat), and 20,324 vegetarians (including 2228 vegans who did not eat any animal foods).
Mortality by diet group for each of 18 common causes of death was estimated with the use of Cox proportional hazards models.
Results: There were 5294 deaths before age 90 in .1 million y of follow-up. There was no significant difference in overall (all-cause) mortality between the diet groups: HRs in low meat eaters, fish eaters, and vegetarians compared with regular meat eaters were 0.93 (95% CI: 0.86, 1.00), 0.96 (95% CI: 0.86, 1.06), and 1.02 (95% CI: 0.94, 1.10), respectively; P-heterogeneity of risks = 0.082.
There were significant differences in risk compared with regular meat eaters for deaths from circulatory disease [higher in fish eaters (HR: 1.22; 95% CI: 1.02, 1.46)]; malignant cancer [lower in fish eaters (HR: 0.82; 95% CI: 0.70, 0.97)], including pancreatic cancer [lower in low meat eaters and vegetarians (HR: 0.55; 95% CI: 0.36, 0.86 and HR: 0.48; 95% CI: 0.28, 0.82, respectively)] and cancers of the lymphatic/hematopoietic tissue [lower in vegetarians (HR: 0.50; 95% CI: 0.32, 0.79)]; respiratory disease [lower in low meat eaters (HR: 0.70; 95% CI: 0.53, 0.92)]; and all other causes [lower in low meat eaters (HR: 0.74; 95% CI: 0.56, 0.99)]. Further adjustment for body mass index left these associations largely unchanged.
Conclusions: United Kingdom–based vegetarians and comparable nonvegetarians have similar all-cause mortality. Differences found for specific causes of death merit further investigation. Am J Clin Nutr 2016;103:218–30.
ObjectiveIt is well known that total cholesterol becomes less of a risk factor or not at all for all-cause and cardiovascular (CV) mortality with increasing age, but as little is known as to whether low-density lipoprotein cholesterol (LDL-C), one component of total cholesterol, is associated with mortality in the elderly, we decided to investigate this issue.
Setting, participants and outcome measures We sought PubMed for cohort studies, where LDL-C had been investigated as a risk factor for all-cause and/or CV mortality in individuals ≥60 years from the general population.
Results We identified 19 cohort studies including 30 cohorts with a total of 68 094 elderly people, where all-cause mortality was recorded in 28 cohorts and CV mortality in 9 cohorts. Inverse association between all-cause mortality and LDL-C was seen in 16 cohorts (in 14 with statistical significance) representing 92% of the number of participants, where this association was recorded. In the rest, no association was found. In two cohorts, CV mortality was highest in the lowest LDL-C quartile and with statistical significance; in seven cohorts, no association was found.
ConclusionsHigh LDL-C is inversely associated with mortality in most people over 60 years.This finding is inconsistent with the cholesterol hypothesis (ie, that cholesterol, particularly LDL-C, is inherently atherogenic). Since elderly people with high LDL-C live as long or longer than those with low LDL-C, our analysis provides reason to question the validity of the cholesterol hypothesis. Moreover, our study provides the rationale for a re-evaluation of guidelines recommending pharmacological reduction of LDL-C in the elderly as a component of cardiovascular disease prevention strategies.
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mortality in vegetarians and comparable nonvegetarians in the United Kingdom2016
Paul N Appleby, Francesca L Crowe, Kathryn E Bradbury, Ruth C Travis, and Timothy J Key* Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
ABSTRACT Background: Vegetarians and others who do not eat meat have been observed to have lower incidence rates than meat eaters of some chronic diseases, but it is unclear whether this translates into lower mortality.
Objective: The purpose of this study was to describe mortality in vegetarians and comparable nonvegetarians in a large United Kingdom cohort.
Design: The study involved a pooled analysis of data from 2 prospective studies that included 60,310 persons living in the United Kingdom, comprising 18,431 regular meat eaters (who ate meat $5 times/wk on average), 13,039 low (less-frequent) meat eaters, 8516 fish eaters (who ate fish but not meat), and 20,324 vegetarians (including 2228 vegans who did not eat any animal foods).
Mortality by diet group for each of 18 common causes of death was estimated with the use of Cox proportional hazards models.
Results: There were 5294 deaths before age 90 in .1 million y of follow-up. There was no significant difference in overall (all-cause) mortality between the diet groups: HRs in low meat eaters, fish eaters, and vegetarians compared with regular meat eaters were 0.93 (95% CI: 0.86, 1.00), 0.96 (95% CI: 0.86, 1.06), and 1.02 (95% CI: 0.94, 1.10), respectively; P-heterogeneity of risks = 0.082.
There were significant differences in risk compared with regular meat eaters for deaths from circulatory disease [higher in fish eaters (HR: 1.22; 95% CI: 1.02, 1.46)]; malignant cancer [lower in fish eaters (HR: 0.82; 95% CI: 0.70, 0.97)], including pancreatic cancer [lower in low meat eaters and vegetarians (HR: 0.55; 95% CI: 0.36, 0.86 and HR: 0.48; 95% CI: 0.28, 0.82, respectively)] and cancers of the lymphatic/hematopoietic tissue [lower in vegetarians (HR: 0.50; 95% CI: 0.32, 0.79)]; respiratory disease [lower in low meat eaters (HR: 0.70; 95% CI: 0.53, 0.92)]; and all other causes [lower in low meat eaters (HR: 0.74; 95% CI: 0.56, 0.99)]. Further adjustment for body mass index left these associations largely unchanged.
Conclusions: United Kingdom–based vegetarians and comparable nonvegetarians have similar all-cause mortality. Differences found for specific causes of death merit further investigation. Am J Clin Nutr 2016;103:218–30
Helena Horder, PhD et al. Neurology® 2018;90:e1298-e1305. doi:10.1212/WNL.0000000000005290
Objective To investigate whether greater cardiovascular fitness in midlife is associated with decreased dementia risk in women followed up for 44 years.
Methods A population-based sample of 1,462 women 38 to 60 years of age was examined in 1968. Of these, 191 women completed a maximal cycling test to evaluate cardiovascular fitness. Subsequent examinations of dementia incidence were done in 1974, 1980, 1992, 2000, 2005, and 2009.
Dementia was diagnosed according to DSM-III-R criteria on the basis of information from neuropsychiatric examinations, informant interviews, hospital records, and registry data up to 2012.
Cox regressions were performed with adjustment for socioeconomic, lifestyle, and medical confounders.
Results Compared with medium fitness, the adjusted hazard ratio for all-cause dementia during the 44-year follow-up was 0.12 among those with high fitness and 1.41 among those with low fitness. High fitness delayed age at dementia onset by 9.5 years compared to low fitness and time to dementia onset by 5 years compared to medium fitness.
Conclusions Among Swedish women, a high cardiovascular fitness in midlife was associated with a decreased risk of subsequent dementia. Promotion of a high cardiovascular fitness may be included in strategies to mitigate or prevent dementia. Findings are not causal, and future research needs to focus on whether improved fitness could have positive effects on dementia risk and when during the life course a high cardiovascular fitness is most important.
My comment: Mr Motivator is right! Regular exercise is the best insurance you can ever take out. And you don’t have to run marathons to get fit. Don’t give up on fitness because of your job or because you have had kids. Get active. Spend that pension! Don’t give it away to the nursing home!
BMJ 20 May 2023 Adapted from Letter of the Week by Ellen Fallows, British Society of Lifestyle Medicine
Changing the mindset in medicine
Clinicians are often overwhelmed when they see patients with many complex conditions who have brought both physical and social problems to a long awaited but short consultation.
When medical guidelines are viewed in totality, it is clear that we can’t see the wood for the trees, have forgotten the person behind the disease, and are failing to tackle the root cause of their symptoms.
Basic science now describes a common underlying pathology to long term conditions: immune dysregulation resulting in chronic systemic inflammation. Key drivers include environmental and lifestyle factors influencing gene expression and our microbiome.
Our current medical model is however based on a reductionist and deterministic view of health that stems from the era of gene discoveries. This has led to a belief that diseases exist in isolation and we are powerless without medicine and drugs. This is not the case. If we step back from the relentless assessment, quantification, and labelling of disease and spend more time tackling its root causes, we can support people to reverse- or at least improve or delay-these conditions.
Fewer guidelines and assessments are needed, as well as more public health measures and more lifestyle medicine. Lifestyle medicine is a discipline that considers the socioeconomic drivers of behaviour, acknowledges the difficulties people face, and uses person centred techniques to support lifestyle changes to tackle nutrition, physical activity, social isolation, sleep, mental wellbeing, and consumption of harmful substances such as tobacco and alcohol.
This approach isn’t new or controversial- it is the first step in all major long term condition guidelines. But it is neglected, with funds for creating good quality education and an evidence base sorely lacking and requiring a policy shift.
The hardest behaviour to change however, is not that of patients but that within medicine itself.
My comment: I am so much in agreement with this letter. It was impressive that the BMJ published it so prominently.
5 cups (1/2-inch-diced) peeled eggplant/aubergine (1 pound) 2 large chopped leeks, white and light green portions 2 tablespoons minced garlic (6 cloves) 4 cups vegetable stock, preferably homemade 2 (28-ounce) cans of crushed tomatoes, preferably San Marzano 2 tablespoons sundried tomato paste 2 teaspoons whole dried fennel seeds 1 teaspoon dried oregano 1/4 teaspoon crushed red pepper flakes 1 tablespoon honey Kosher salt and freshly ground black pepper to taste 1 teaspoon fresh basil leaves Freshly grated Italian Parmesan cheese, for serving
Directions
Preheat the oven to 425ºF. Spread eggplant on a rimmed baking sheet, and toss with 2 tablespoons of oil and 1/2 tsp. salt. Bake for 25 to 30 minutes, tossing once halfway through, until soft.
Add 2 tablespoons olive oil to a Dutch Oven(eg a Le Creuset pan), add the leeks, and cook for 6 to 8 minutes, occasionally stirring, until the onion is tender but not browned.
Add the garlic and cook for one minute, stirring often. Add the stock, roasted eggplant, crushed tomatoes, tomato paste, fennel seeds, oregano, red pepper flakes, honey, salt, and black pepper.
Bring to a boil, lower the heat, and simmer uncovered for 1-hour stirring occasionally. Puree the soup with a hand blender.
Stir in basil and taste for seasonings.
Serve hot in large bowls sprinkled with Parmesan cheese and a drizzle of olive oil.
Diabetes Diet 