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.

Animal based foods tend to be the most nutrient dense

kaitiscotland2 Comments
Photo by Rachel Claire on Pexels.com

ORIGINAL RESEARCH article

Front. Nutr., 07 March 2022
Sec. Nutritional Epidemiology
Volume 9 – 2022 | https://doi.org/10.3389/fnut.2022.806566

Priority Micronutrient Density in Foods

Ty Beal1,2* and Flaminia Ortenzi3

  • 1Knowledge Leadership, Global Alliance for Improved Nutrition, Washington, DC, United States
  • 2Department of Environmental Science and Policy, University of California, Davis, Davis, CA, United States
  • 3Knowledge Leadership, Global Alliance for Improved Nutrition, Geneva, Switzerland

Background: Despite concerted efforts to improve diet quality and reduce malnutrition, micronutrient deficiencies remain widespread globally, especially in low- and middle-income countries and among population groups with increased needs, where diets are often inadequate in iron, zinc, folate, vitamin A, calcium, and vitamin B12. There is a need to understand the density of these micronutrients and their bioavailability across diverse foods and the suitability of these foods to help meet requirements for populations with high burdens of micronutrient malnutrition.

Objective: We aimed to identify the top food sources of these commonly lacking micronutrients, which are essential for optimal health, to support efforts to reduce micronutrient malnutrition among various populations globally.

Methods: We built an aggregated global food composition database and calculated recommended nutrient intakes for five population groups with varying requirements. An approach was developed to rate foods according to their density in each and all priority micronutrients for various population groups with different nutrient requirements.

Results: We find that the top sources of priority micronutrients are organs, small fish, dark green leafy vegetables, bivalves, crustaceans, goat, beef, eggs, milk, canned fish with bones, mutton, and lamb. Cheese, goat milk, and pork are also good sources, and to a lesser extent, yogurt, fresh fish, pulses, teff, and canned fish without bones.

Conclusion: The results provide insight into which foods to prioritize to fill common micronutrient gaps and reduce undernutrition.

My comment: There has been a recent rise in nutritional deficiency diseases in the UK in both adults and children. Organ meats, tinned sardines, dark green leafy vegetables, eggs, milk, pork and pulses are good value for money foods that could help.

Jovina cooks: Easy fish fillets

kaitiscotland2 Comments
Photo by Deane Bayas on Pexels.com

Parmesan Crusted Fish Fillets

Ingredients

1 lb grouper or other white fish fillets, about 1 lb

1/2 cup mayonnaise

1 tablespoon Dijon mustard

1 teaspoon paprika

3/4 cup shredded Parmesan cheese

Salt and pepper to taste

Cooking spray

Directions

Coat a 13×9 inch baking dish with the cooking spray. Preheat the oven to 400 degrees F.

Combine the mayonnaise, mustard and paprika in a small bowl.

Cut the fish into serving pieces,. Sprinkle with salt and pepper. Place the fish in the baking dish. Spread half the mayonnaise mixture over the fillets. Sprinkle half the cheese over the fish and press it into the fish. Turn the fish over and spread with the remaining mayonnaise and cheese.

Bake the fish for 15-20 minutes. Serve with green beans or other green vegetable and butter.

My comment: Another trick you can use with mayonnaise is to put it on meat that you are going to barbeque. Apparently it stops the meat from sticking to the grill but does not affect the taste of the meat. This tip is from India Knight of The Times.

Hypoglycaemia at the wheel is common in type one diabetics

kaitiscotland2 Comments
Photo by JESHOOTS.com on Pexels.com

Adapted from BMJ 27 May 23

In a study of 450 type one diabetic drivers in the USA, two thirds said that they had experienced hypoglycaemia while driving.

In the previous two years, more than 4% of them, had been in a road traffic accident as a result.

The factors that increase the risk of hypos at the wheel are older age, a long duration of diabetes, and having diabetic neuropathy.

My comment: The new flash monitoring systems of blood sugar should make it easier to monitor blood sugars on the go. Always keep fast acting glucose and starch in the car so you can prevent or treat a hypoglycaemic event.

BMJ: Spironolactone is effective for treating acne in women

kaitiscotlandLeave a comment
Photo by Anna Nekrashevich on Pexels.com

BMJ 20 May 2023 Adapted from Effectiveness of spironolactone for women with acne vulgaris in England and Wales by Santer M et al.

Women over the age of 18 living in England and Wales whose acne was bad enough to merit antibiotic treatment, were randomised to use either Spironolactone or placebo. They were allowed to continue the topical treatments that they were already using for their acne. Their scores on their acne specific quality of life were assessed by themselves and a clinical assessor evaluated their acne.

200 women were recruited to each group. The findings showed a small but statistically significant improvement after 24 weeks of spironolactone use at 100mg a day. Their average age was 29 years.

One fifth of those taking Spironolactone reported headaches.

The assessors thought that 19% of the women had noticeable skin improvement compared to 6% of the placebo group. The women themselves reported a quality of life improvement of 17 points in the placebo group and 21 in the Spironolactone group.

The authors think that this improvement is good enough to be a useful alternative to long term antibiotics.

My comment: Having suffered from acne since the age of 11 I am pleased to see another treatment being offered for this condition. Almost all teenagers of both genders get acne. In boys it tends to be more severe than in girls but it tends to resolve completely. For some women it never resolves and they have it persistently throughout their lives. If a woman still has it by the age of 24 the acne is likely the persistent type. Acne, even with the best treatment is very slow to respond, and at best will improve at 10% a month. This is for Roaccutane. I wonder what the effects would be over a longer length of time for the other women in the study. The results, though promising are not stunning, and diligent use of topical treatments and consideration of using anti-biotics and Roaccutane will also need to be considered to resolve symptoms.

Spironolactone is a diuretic that can be also used to control facial hair growth in women. It is sometimes used if someone has high blood pressure that does not respond to other drugs.

Jovina cooks: Creamy seafood stew

kaitiscotland1 Comment
Photo by julie aagaard on Pexels.com

Ingredients

3 tablespoons butter, divided
1 garlic clove, minced
1 cup chopped onion
1 cup chopped celery
1/2 cup chopped carrot
1/2 cup diced red bell pepper
2 cups seafood stock or clam juice
1 teaspoon seafood (Old Bay) seasoning
1 tablespoon fresh thyme leaves
1/4 teaspoon freshly ground black pepper
1/2 teaspoon salt
1/2 teaspoon crushed red pepper flakes (chili)
1 cup cherry or grape tomatoes, halved
1 lb firm boneless fish fillets (such as halibut, cod, red snapper, sea bass, grouper), cut into small cubes
8 oz medium shrimp, shelled, deveined, tails removed and cut in half
8 oz sea scallops, halved
1 cup heavy cream
1/4 cup minced fresh parsley, plus extra for garnish

Directions

In a large saucepan over medium heat, melt 2 tablespoons of butter. Add the onion, celery, carrot and bell pepper. Cook until the vegetables are tender, 3-4 minutes. Add the garlic and stir into the vegetables. Pour in the chicken broth and bring to a simmer. Cover the pan and cook the vegetables until tender. Remove the cover and the salt, pepper, chili flakes, seafood seasoning, thyme, and tomatoes. Sir well.

Add the fish cubes, Cook stirring the mixture gently for 2 minutes. Add the shrimp and scallops and cook for 2 minutes more or until the seafood is cooked. Add the cream, parsley, and remaining tablespoon butter, heating gently until the butter is incorporated. Garnish with chopped parsley. Serve in bowls immediately. A salad is a good accompaniment.

Jovina cooks: Gazpacho

kaitiscotland1 Comment
Photo by Alina Skazka on Pexels.com

Gazpacho

2 hothouse cucumbers, halved and seeded, but not peeled
3 red bell peppers, cored and seeded
8 plum tomatoes
2 red onions
6 garlic cloves, minced
46 ounces tomato juice (6 cups)
1/2 cup white wine vinegar
1/2 cup extra virgin olive oil
1 tablespoon kosher salt or to taste
1 1/2 teaspoons freshly ground black pepper

Roughly chop the cucumbers, bell peppers, tomatoes, and red onions into 1-inch cubes. Put each vegetable separately into a food processor fitted with a steel blade and pulse until it is coarsely chopped. Do not overprocess!

After each vegetable is processed, combine them in a large bowl and add the garlic, tomato juice, vinegar, olive oil, salt, and pepper. Mix well and chill before serving. The longer gazpacho sits, the more the flavors develop.

Commememuchos: Beef and Guiness Stew

kaitiscotland2 Comments
Photo by Engin Akyurt on Pexels.com

Adapted from a pie recipe kindly offered by Commememuchos.

Up to 25 grammes of wheat or wheat free flour

900g of veal or beef cut into inch squares

25 grammes of butter (about an ounce for the oldies like me)

1 tablespoon olive oil or coconut oil

2 large onions thinly sliced

2 large carrots cut in 1 to 1.5 cm slices

2 teaspoons of Worcester sauce or sherry vinegar or red wine

2 teaspoons tomato puree

500mls Guinness or other strong dark beer

300mls meat stock ( or use stock cubes. The Italian make Star do particularly good ones available from Amazon for about double the price from getting them in Italy. Thanks Alexandra for the tip!)

2 teaspoons sugar

2 tablespoons water

salt and pepper to taste

Method

You will need a large stove top casserole dish eg Le Creuset or similar. A sturdy large saucepan will do.

In a large bowl put in the flour and salt and pepper. Mix.

Coat the meat cubes in this.

In your casserole dish or large saucepan heat the butter and oil over a low heat till the butter has melted and then turn up the heat and sear the meat in batches. Once done set aside. This stage always takes rather a long time. It is good to listen to podcasts or music doing this.

Now fry the onion and carrots gently for about two minutes.

Add back the meat to the casserole dish and season with Worcester sauce, tomato puree, Guinness, hot meat broth and sugar. Add black pepper and salt. Bring to a boil.

Now cover the casserole and turn down the heat to a simmer for about 2 hours.

Casseroles are always tastier the next day but can be eaten immediately.

BMJ: Statins increase the risk of type two diabetes. So how can patients and doctors manage this risk?

kaitiscotland8 Comments
Photo by Skitterphoto on Pexels.com

Adapted from BMJ 20 May 2023 Risk of diabetes with statins by Ishak A Mansi et al.

Statin medications lower cholesterol and have an anti-inflammatory effect that shows benefits in cardiovascular morbidity and mortality, particularly for secondary prevention, when a heart attack or stroke has already occurred. Yet studies have shown a 46% relative risk increase for diabetes, possibly due to a direct toxic effect on mitochondrial pancreatic beta cells.

Based on some randomised controlled trials it is thought that for every 100 to 250 people who take statins for 2 to 5 years, on additional person will develop diabetes due to taking the statin. Studies also indicate that the risk is higher if the statin dose is higher. The risk is greatest in the first four months of treatment. People who already have diabetes may find that their blood sugar control worsens. If you already have impaired fasting blood glucose, metabolic syndrome, fatty liver, are over 65 in age, or have obesity, this can tip you into a diabetes diagnosis.

It is still thought that despite these problems, statin use is still more beneficial overall compared to not prescribing them, particularly for if you have already had a stroke or heart attack.

What can you do?

Exercise and adopt a low glycaemic diet. This will also reduce your cardiovascular risk independent of its beneficial effect on improving insulin resistance and lowering blood sugars.

What can your doctor do?

Consider prescribing Metformin or a glitazone if you are starting a statin and already have pre-diabetes.

Check blood glucose levels before starting a statin and at three months afterwards and then yearly.

Check Thyroid function as low thyroid levels can raise cholesterol levels.

Think twice about high intensity statins. Are they really necessary?

Change medications that already raise the risk of diabetes such as thiazide diuretics and beta blockers, particularly if there are no strong indications for these particular drugs.

Minimise drug interactions from other medications that raise the effects of statins in the body. These include: amiodarone, clarithromycin, diltiazem, grapefruit juice, itraconazole, ketoconazole, protease inhibitors as these increase the potency of simvastatin, atorvastatin and lovastatin.

Cyclosporin affects transport proteins and also raises the potency of statins.