kaitiscotland

Jovina cooks Chinese: Szechuan Chicken stir fry

Apr 13, 2019Jan 26, 2019 kaitiscotland6 Comments

Asian Stir-Fry Dinner
by Jovina Coughlin

Szechuan Chicken Stir-Fry

Serves 4
Ingredients
Sauce Mixture
1 tablespoon dark sesame oil
1/2 cup chicken broth
2 tablespoons soy sauce
1 tablespoon rice vinegar
1 tablespoon chile paste (such as sambal oelek)
1 tablespoon honey
2 teaspoons cornstarch
Stir-Fry
2 tablespoons peanut oil
2 cooked (poached) chicken breasts, shredded
Half of a large red bell pepper, cut into thin strips
2 cups broccoli florets, cut into small pieces
1 cup diagonally cut snow peas
1 tablespoon grated peeled fresh ginger
1 tablespoon minced fresh garlic
1/4 cup (1-inch) slices green onion
Directions
Combine the sauce ingredients in a small bowl. Set aside
Heat a wok or large skillet over medium-high heat. Add the peanut oil; swirl.
Add bell peppers and broccoli and stir-fry for about 2 minutes. Add the next 4 ingredients (through garlic); stir-fry 1 minute. Add the shredded chicken, stir-fry 1 minute.
Add the sauce mixture; cook 30 seconds or until thickened. Add the green onions. Cook until heated through. Serve with the Cauliflower Rice dish or regular rice if you are not low carbing.
Asian Flavored Cauliflower “Rice”

Serves 4
Ingredients
10 oz pkg frozen cauliflower rice, defrosted or use the same amount of regular leftover cooked rice (or grate your own)
1 tablespoon sesame oil
1 teaspoon minced garlic
1 tablespoon rice vinegar
1 tablespoon soy sauce
1 teaspoon minced ginger
Directions
Let the riced cauliflower drain in a colander for about 30 minute. Then place it on a paper towel.
In a wide-bottom skillet, heat the sesame oil over medium heat. Add the garlic and saute for about 1 minute.
Add the cauliflower rice. Stir-fry until the grains are dry and begin to crisp.
Stir in the rice vinegar, soy sauce and ginger. Stir-fry for another minute or two. Serve with the chicken.

My comment: I’m pleased to see that frozen cauliflower rice is available in the USA. I’m not aware that we have it yet in the UK. You can pulverize raw cauliflower in a food processor to get a similar product. Then you can have a taste of the orient with this lovely meal.

Simone Miller’s Paleo Pizza Crust

Apr 8, 2019Jan 26, 2019 kaitiscotland2 Comments

For step by step directions with pictures see the link below:

http://zenbellycatering.com/2013/08/20/ny-style-paleo-pizza-crust-yes-really/?_ke=a2F0aGFyaW5lLm1vcnJpc29uQGJ0aW50ZXJuZXQuY29t

Simone is a chef living in San Francisco and she had numerous attempts to perfect pizza crust. She was keen to have the sort of base that would rise just like the flour based version.

She has some tips:

use a pizza stone if you have one

warm the bowl for the yeast mixture and measuring cup for the water by running hot water into it

You need to use high temperatures for this recipe to get the best result

You need to have the top almost completely cooked before you put your toppings on.

Ingredients:

1 tablespoon of gluten free yeast

1 tablespoon raw honey

1/4 cup of warm water

3/4 cup ground almonds

3/4 cup tapioca starch

3/4 teaspoon salt

1 tablespoon olive oil or other melted fat

1 tablespoon egg white (this is less than one egg)

1 and 1/2 teaspoons apple cider vinegar

+ your favourite toppings eg mozzarella, cheddar, mushrooms, peppers, onion, rosemary, oregano etc

Directions:

In the warmed large mixing bowl combine the yeast, honey and warm water. Leave for 5 minutes to get frothy.

In another small bowl combine the olive oil, apple cider vinegar and egg white.

In another medium bowl combine the almond flour, tapioca starch and salt.

Once the yeast if foamy, add the wet and dry ingredients to the bowl and mix on medium/high for 30 seconds and scrape the bowl to mix it well.

Using a rubber spatula form the wet dough into as much of a ball as you can.

Cover the bowl with a tea towel and put in a warm (but not hot) place. All it to sit for 75 -90 minutes. Check it at 75 minutes. It doesn’t rise like conventional dough but it should have risen somewhat. If not leave it a bit longer.

Turn your oven to 500 F 250 C or regulo 10 (for many of us as high as our domestic ovens will go).

If you have a pizza stone put it in the oven.

Lightly oil a sheet of parchment paper and turn the sticky dough onto it.

Oil your hands and flatten the dough into a 9 or 10 inch circle or so.

Carefully transfer the parchment with the raw pizza base onto the stone or sheet pan.

Bake in the lower third of your oven for 6-8 minutes till it starts to brown at the edges.

Add the desired toppings and cook for another 2-3 more minutes. Allow to cool for a minute before slicing.

Enjoy!

Chief Medical Officer Scotland: Vitamin D supplementation

Apr 5, 2019Feb 4, 2019 kaitiscotland3 Comments

From letter from Dr Catherine Calderwood Chief Medical Officer Scotland
24 November 2017

New Recommendations on Vitamin D Supplementation

Vitamin D plays an important role in maintaining bone health throughout life. Vitamin D deficiency impairs the absorption of dietary calcium and phosphorous. This can lead to:
 Infants having muscle weakness and bone softening leading to rickets;
 Adults having muscle weakness and osteomalacia, which leads to bone pain and tenderness.
The most recent National Diet and Nutrition Survey shows that a proportion of the UK population has low vitamin D levels, which may put them at risk of the clinical consequences of vitamin D deficiency.
Last year, the Scientific Advisory Committee on Nutrition (SACN) made new recommendations on vitamin D and health. The full report is available at:

Click to access SACNVitamin_D_and_Health_report.pdf

SACN considered all relevant evidence suggesting links between vitamin D and various health conditions and concluded that the risk of poor musculoskeletal health (e.g. rickets, osteomalacia) is increased with low vitamin D levels. SACN found insufficient evidence to draw firm conclusions on the impact of low vitamin D levels for non-musculoskeletal health outcomes.
The Scottish Government has now updated its advice on vitamin D in line with the new SACN recommendations as follows:

Everyone age 5 years and above should consider taking a daily supplement of 10μg of vitamin D, particularly during the winter months (October – March). Between late March/early April and September, the majority of people aged 5 years and above will probably obtain sufficient vitamin D from sunlight when they are outdoors, alongside foods that naturally contain or are fortified with vitamin D.
From October to March, everyone aged 5 and over will need to rely on dietary sources of vitamin D. Since vitamin D is found only in a small number of foods, it might be difficult to get enough from foods that naturally contain vitamin D and/or fortified foods alone.

Children aged 1 to 4 years of age should be given a daily supplement containing 10μg vitamin D. We recommend Healthy Start vitamin drops for all children in health.

A new-born baby’s vitamin D level depends on their mother’s levels near the birth and will be higher if the mother took a vitamin D supplement during pregnancy. Some mothers and babies have a higher risk of vitamin D deficiency, including those born to mothers who habitually wear clothes that cover most of their skin while outdooors and those from minority ethnic groups with dark skin such as those of African, African-Caribbean and South Asian origin.
However, as a precaution, we are now recommending that all babies from birth up to one year of age should be given a daily supplement of 8.5 to 10μg vitamin D. Babies who are formula fed do not require a vitamin D supplement if they are having at least 500ml per day, as infant formula already has added vitamin D.
We recommend Healthy Start vitamin drops for infants. Neonatologists and paediatricians may recommend alternatives for premature infants, children with clinical conditions or clinical presentations of vitamin D deficiency.
Advice for parents on vitamin D supplementation for breastfed babies must be carefully considered as there is a risk that infant formula could be viewed as superior to breastmilk. Breastfeeding is the normal way to feed infants. It has an important and lasting impact on the public health of the population and it is vital that we protect and support breastfeeding. It is recommended that you emphasise that the potential problem is related to a lack of sunlight in the UK, and that it affects the whole 
population, not just breastfed babies.
It is recommended that those at greatest risk of vitamin D deficiency take a daily supplement all year round. These groups include:
 pregnant and breastfeeding mothers
 children under 5 years of age
 people who are not exposed to much sunlight, such as frail or housebound individuals, or those that cover their skin for cultural reasons; and
 people from minority ethnic groups with dark skin such as those of African, African-Caribbean and South Asian origin, because they require more sun exposure to make as much vitamin D.
General information leaflets on vitamin D for both the public and healthcare professionals have been updated to reflect these new recommendations and are available online at: http://www.gov.scot/Topics/Health/Healthy-Living/Food-Health/vitaminD
New guidance has been developed for parents and healthcare professionals to support parents to follow this new recommendation. This includes advice on how to administer vitamin D drops to young babies. It is available at:
http://www.gov.scot/Topics/Health/Healthy-Living/Food-Health/vitaminD
From April 2017, Healthy Start vitamins for women (which provide Vitamin D, folic acid and Vitamin C) are provided free of charge to all pregnant women in Scotland for the duration of their pregnancy, regardless of their entitlement to the Healthy Start scheme.
Breastfeeding women and children up to age 4 who are eligible for Healthy Start can also get free supplements containing vitamin D. Further information on the Healthy Start scheme can be found at http://www.healthystart.nhs.uk
Healthy Start vitamin drops for babies and children currently contain 7.5μg per 5 drops of vitamin D, as well as vitamin A and vitamin C. The new recommended dose for vitamin D is 8.5-10μg and vitamins containing the new recommended dose will be available from October 2018. In the meantime, parents should be advised to continue to give the current dosage of 5 drops per day.
In Scotland, NHS Boards are responsible for supplying Healthy Start vitamin supplements universally to pregnant women and to breastfeeding women and children who are eligible for the Healthy Start scheme. NHS Boards are also able to sell Healthy Start vitamins to families who are not eligible for Healthy Start. Some Health Boards have chosen to provide additional free vitamins for infants.
We are not currently in a position to extend universal provision of vitamin supplements to the whole of the Scottish population or to additional at risk groups including the elderly, women in the pre-conception period, infants or young children.
Vitamin D supplements for adults and children are also available to buy from most major supermarkets, high street pharmacies and health food stores.



Liraglutide can improve fatty liver damage as well as blood sugars

Apr 3, 2019Jan 26, 2019 kaitiscotland6 Comments

Adapted from Glucagon like peptide-1 receptor agonists for the management of obesity and non-alcoholic fatty liver disease: a novel therapeutic option.

Gauri Dhir and Kenneth Cusi Endocrinology/Metabolism Review Volume 66 Issue 1 2018

Obesity is a major risk factor for type two diabetes and a cluster of metabolic factors that lead to poor cardiovascular outcomes. The amount of fat stored in the liver tissue closely mirrors insulin resistance and metabolic health.

Non alcoholic fatty liver disease (NAFLD) is now the commonest form of liver disease in the western world and can lead progressively to non alcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma.

NAFLD is present in two thirds of obese people and promotes type two diabetes. NASH is present in half of these. NAFLD is expected to become the most common cause of liver transplantation by 2020.

Pioglitazone and the newer drugs such as Liraglutide (Victoza) can be used, as well as various dietary therapies.

If a weight loss of 10% can be achieved, there is a significant improvement in the inflammatory process that results in cell death and fibrosis in NASH. But weight loss is difficult to achieve and maintain. Pioglitazone can improve NASH in two thirds of non- diabetic patients and by around half in those with diabetes or pre-diabetes. Vitamin E has also been shown to have some success in non diabetic patients.

Liraglutide and drugs of the same class affect insulin secretion in response to meals, beta cell proliferation, inhibition of glucagon secretion, delayed gastric emptying, and making you feel fuller with less to eat.

These effects result in worthwhile clinical outcomes in overweight or obese patients whether they have diabetes or not. Body weight is reduced by at least 5% in 30% of patients and by at least 10% in 30% of patients. Over three years this can result in complete remission of the diabetes or pre-diabetes in 30% of the patients. Cardiovascular outcomes are also improved.

Triglyceride accumulation in the liver cells is the mechanism that has been recently shown to cause insulin resistant adipose tissue. After 48 weeks of high dose Liraglutide (1.8 mg a day), resolution of NASH was seen on biopsy samples in 39% of the treated group compared to 9% in the placebo group.

The main side effects are nausea and diarrhea. There could possibly be more gallstone development but no increase in pancreatitis.

Scottish Diabetes Survey 2016: are we winning or losing the diabetes struggle?

Mar 19, 2019Jan 22, 2019 kaitiscotland3 Comments

In Scotland 5.4% of the population is registered as having diabetes. 10.6% have type one and 88.3% have type two. 1.1% have other types such as Maturity Onset Diabetes in the Young.

In type ones 37.3% are overweight and a further 26% are obese. So 36.7% are of normal weight. In type twos 31.6% were overweight and 55.6% were obese. So only 12.8% were normal weight.

The annual HbA1c was done in over 90% of diabetics in both groups. 24.5% of type ones and 58.6% of type twos met the target of less than 58 mmol/mol which is equivalent to 7.5%.

Over 84.9% of both groups had their blood pressure measured that year and 45% of type ones and 32.7% of type twos met the target of less than 130 mmHg systolic.

Cholesterol levels were done in 86.4% of patients and this met the target of less than 5 mmol/l in 69.1% of type ones and 78.4% of type twos.

22.9% of type ones were current smokers compared to 17.2% of type twos.

Eye screening was undertaken in 85.4% of diabetics that year. 59.1% had had their feet checked and the score recorded.

When it comes to end stage disease in type ones, 3.5% had had a heart attack, 2.6% had had coronary revascularisation, 1.4% had end stage renal failure and 1.1% had had a major limb amputation.

In type twos, 9.7% had had a heart attack, 7.5% had had revascularisation, 0.6% had end stage renal failure and 0.7% had had a major amputation.

Overall 10.8 of the diabetic population use insulin pumps.

My comments: It can be seen from the data that screening is doing very well. We have an average number of people with diabetes and the distribution between types one and two has not changed. Smoking is an issue in only about 20% of diabetics which probably compares favourably with social norms.

We have lost the battle of the bulge. Only 12.8% of type twos are of normal weight. Type ones are more like the “norm” for Scotland with just over a third being of normal weight.

Blood sugar control is very poor particularly in type ones with about three quarters of them with blood sugars over 7.5%.

When it comes to complications, type twos are much more likely to get cardiac problems whereas type ones are more likely to get renal failure and amputations.

Diet doctor: Naan Bread

Feb 28, 2019Oct 27, 2018 kaitiscotland7 Comments

Naan bread is one of the things many of us miss when having a curry. While meat and vegetable curries lend themselves very easily to low carb eating, you can’t say the same for Naan Bread. So it’s great to see a recipe for this first published in diet doctor and which came to my attention from our reader Shirley Yates who has her own low carb cooking blog.

Low Carb Naan Bread!
Published on June 21, 2017
Two pieces is only 3 net carbs!
Ingredients

¾ cup coconut flour
2 tablespoons ground psyllium husk powder
½ teaspoon baking powder
1 teaspoon salt
6¾ tablespoons melted coconut oil
2 cups boiling water
coconut oil, for frying
sea salt
Garlic butter

3½ oz. butter
1 – 2 garlic cloves, minced
Instructions
Mix all dry ingredients in a bowl. Add oil and then boiling water and stir thoroughly.
Allow to rise for five minutes. The dough will turn firm fairly quickly, but stay flexible. It should resemble the consistency of Play-Doh. If you find it’s too runny then add more psyllium husk until it feels right. The amount needed may vary depending on what brand of husk or coconut flour you use.
Divide into 6 or 8 pieces and form into balls that you flatten with your hands directly on parchment paper or on the kitchen counter.
Fry rounds in coconut oil over medium heat until the Naan turn a nice golden color.
Heat the oven to 140°F (70°C) and keep the bread warm while you make more.
Melt the butter and stir in the freshly squeezed garlic. Apply the melted butter on the bread pieces using a brush and sprinkle flaked salt on top.
Pour the rest of the garlic butter in a bowl and dip pieces of bread in it.
Recipe taken from The Diet doctor: https://www.dietdoctor.com/recipes/low-carb

When do you stop getting benefits from exercise?

Feb 25, 2019Jan 19, 2019 kaitiscotland2 Comments

From Danielle Baron’s article in International Medical News 10 August 18

As with many different health interventions, there is a sweet spot between doing enough of it and doing too much of it. Too little, and it is not effective. Too much and you could cause unexpected negative repercussions. The subject of exercise has been investigated regarding its effect on mental health.

Over 1.2 million USA citizens were asked about their exercise habits and their mental wellbeing between 2011 and 2015 by researchers at the Centers for Disease Control and Prevention.

All exercise types improved mental health but popular team sports were particularly effective in boosting mental health. The optimal duration of exercise was between 30 and 60 minutes a session, three to five times a week.

Sessions of longer than 90 minutes or done more than 23 times a month however, were related to WORSE mental health.

The authors conclude that blanket advice on exercise could be improved by being more specific about the types, durations and frequencies that were more likely to improve mental health and that further studies could be helpful.

Chekroud SR et al. Association between physical exercise and mental health in 1.2 million individuals in the USA between 2011 and 2015: a cross sectional study. Lancet Psychiatry. Published online 8 August 2018. doi: 10.1016/S2215-0366(18)30227-X

My comments: Oh dear! Well, I’ve got the duration right at 40 minutes but I hate team sports (because I’m useless at hand to eye or foot coordination) and I aim to exercise every day, which these researchers considered “excessive”. Maybe the team sports were more beneficial because of the socialisation aspect as well as the physical aspect. Maybe less than 23 times a month made it something to look forward to and a dopamine hit , “I’ve achieved that” rather than a black mark ” I failed to do my exercise session” as I tend to think about it. I can see the downsides of exercise addiction reflected in this piece of research.

High dose Vitamin D improves cardiovascular health markers

Feb 23, 2019Feb 20, 2019 kaitiscotland3 Comments

Adapted from UK Medical News 17 July 2018

Several different health measures, all which improve your cardiovascular outcomes, have been found to result from high dose vitamin D supplementation. You are likely to need to take at least 4,000 iu a day though, depending on how much extra sunshine you are exposed to regularly.

A meta-analysis of 81 randomised controlled trials looked at almost one thousand patients randomised to taking supplements or to a control group who did not. The active and control groups were both roughly 5,000 each. The durations of the trials varied but averaged out at ten months. The doses ranged from 400 iu a day to 12,000 iu a day. The average taken was 3,000 iu a day.

The outcomes were related to the blood level of vitamin D achieved. Levels had to be over 86 nmol/L to get benefits. You need to take over 4,000 iu a day to get vitamin D concentrations of 100 nmol/L or more. My comment:This does mean that the minimum levels advised by the Scottish Chief Medical Officer last year are way too low to see the benefits discussed here.

So what extra benefits do you see?

lower systolic and diastolic blood pressure.

lower high sensitivity C reactive protein.

lower serum parathyroid hormone.

lower triglycerides.

lower total cholesterol.

lower low density lipoprotein.

high density lipoprotein increased.

All benefits were numerically small but did reach statistical significance. Cardiovascular outcomes were not measured directly, only blood markers and blood pressure.

Mirhosseini N et al. Vitamin D Supplementation. Serum 25(OH)D Concentrations and cardiovascular disease risk factors: A systematic review and meta-analysis. Front Cardiovasc Med. 2018 July 12.

Yummy Lummy: Red hot chicken wings

Feb 10, 2019Jan 14, 2019 kaitiscotland3 Comments

These carry an Australian Government caution!

https://yummylummy.com/2018/01/06/super-hot-spicy-chicken-wings/#comments

Super hot and spicy chicken wings made with ground Queensland nuts, smoked almonds, iodised salt, black peppercorns, smoked paprika, dried mixed herbs, bird’s eye chillies, and chilli flakes.
• 8 Chicken wings
• 1 Handful Queensland nuts
• 1/2 Handful Smoked almonds
• 1 Tablespoon Iodised salt flakes
• 1 Tablespoon Whole black peppercorns
• 1 Tablespoon Smoked paprika
• 1 Tablespoon Dried mixed herbs
• 2 Dried bird’s eye chillies
• 1 Tablespoon Chilli flakes
• 2 Handfuls Shredded kale
• 1 Packet Coleslaw
• 1 Tablespoon French mustard
• 100 mL Pouring cream
1. In a coffee grinder, grind Queensland nuts, smoked almonds, iodised salt, black peppercorns, smoked paprika, dried mixed herbs, bird’s eye chillies, and chilli flakes.
2. Rub this into the skin of eight chicken wings.
3. Roast for 1 hour at 150 °C.

Metformin improves blood sugar and vascular health in type one children

Jan 31, 2019Jan 14, 2019 kaitiscotland4 Comments

From Diabetes in Control: Metformin Improves Vascular Health in Children With Type 1 Diabetes
Nov 18, 2017
In individuals with type 1 diabetes (T1DM), cardiovascular disease (CVD) is a major issue and the primary cause of death.

Vascular changes can be detected years before progression to CVD. Targeting blood sugar regulation early in patients at high risk of developing T1DM and in those already diagnosed with T1DM, could potentially help reduce vascular dysfunction risk and even reverse changes already made in vascular function.

Past studies have shown that in adults with T1DM, metformin reduces HbA1c, BMI, and required insulin doses. It has also been suggested that metformin leads to reduced cardiovascular events and better blood sugar regulation in patients with type 2 diabetes. Studies conducted on children with T1DM suggest the same benefits. However, there is currently no research on how metformin affects vascular function in children with T1DM.
A double blind, randomized, placebo-controlled trial was conducted to evaluate the association between metformin and vascular health in children with T1DM over a 12-month period. The study included a total of 90 children from a Women’s and Children’s Hospital in South Australia. Children were randomly divided into two groups to receive either the metformin intervention or the placebo intervention. Children who weighed 60kg or greater received 1gm of metformin twice daily and those who weighed less than 60kg received 500mg twice daily. Doses were then increased to the complete dose over a period of 2 to 6 weeks.
Follow-up was conducted at 3, 6, and 12 months from the start of the study. Vascular function was obtained at baseline and at every follow-up visit using the brachial artery ultrasound, HbA1C, insulin dose, and BMI were among some of the other outcomes measured.
Results show that vascular function defined by GTN improved over the 12-month period by 3.3% in the metformin intervention group regardless of HbA1c when compared to the placebo group (95% CI 0.3 to 6.3; P=0.03). GTN was found to be the highest in the metformin group at 3 months when compared to placebo. Children in the metformin group also experienced significant improvement (P=0.001) in HbA1c levels at 3 months (8.4%; 95% CI 8.0 to 8.8) (68mmol/mol; 95% CI 64 to 73) when compared to the placebo group (9.3%; 95% CI 9.0 to 9.7). At 12 months, the overall difference between HbA1c improvement between the two groups was lower but remained a significant 1.0% (95% CI 0.4 to 1.5) 10.9mmol/mol (95% CI 4.4 to 16.4), P=0.001. In addition, it was found that children in the metformin group had a decreased insulin dose requirement of 0.2 units/kg/day throughout the 12-month period compared to those in the placebo group (95% CI 0.1 to 0.3, P=0.001).
The following study determined that children with T1DM with above average BMIs and taking metformin saw a significant improvement in vascular smooth muscle function compared to those not taking metformin. The study suggested that in addition to vascular health, metformin also improved HbA1c levels and reduced total daily insulin dose. It was found that improvements in both vascular function and HbA1c were the highest at 3 months. This is most likely due to medication adherence being the highest around 3 months.
Practice Pearls:
In children with above average weight and who were diagnosed with type 1 diabetes, metformin provides a significant improvement in vascular smooth muscle function.
Metformin provides a significant improvement in HbA1c levels in children with type 1 diabetes.
In addition to vascular health and HbA1c benefits, metformin further aids in reducing daily insulin dose in children with type 1 diabetes.
Reference:
Anderson JJA, Couper JJ, Giles LC, et al. Effect of Metformin on vascular function in children with type 1 diabetes: A 12 month randomized controlled trial. 2017. J Clin Endocrinol Metab. 2017; 0: 1-16.