Public Health Collaboration Edinburgh

I attended the PHQ conference in Edinburgh on 17 March 23. This was the first such meeting in Scotland and it was well organised, interesting and well attended.

Moira Newiss is on your far left of the photo in her navy dress and black boots. Moira organised the meeting and also spoke about her experience of having post viral fatigue twice in her life. This led her to explore the functioning of the mitochondria in our cells. She found that the mitochondria don’t function normally and become depleted in chronic fatigue syndrome and fibromyalgia but that primitive pathways in the cell using ketones for fuel are still active. She started a ketogenic diet and recovered completely from her chronic fatigue syndrome. She now runs for a hobby.

Dr David Unwin is standing next to her and is wearing a bow tie and suit. He is now 65 years of age and has been promoting low carb diets in his practice for the last ten years with great results. He is having so much fun that he doesn’t want to retire!

He found that in many cases type two diabetics can reverse their condition completely by the adoption of a low carb or ketogenic diet. Statistical analysis showed that the people most likely to reverse their condition had had been diagnosed in the previous 18 months. There is thus a great window of opportunity for advice and coaching to be provided to these patients at the earliest opportunity after diagnosis.

Results after 18 months are more variable, with a great improvement in diabetes seen, but sometimes not to the extent that complete remission occurs. Some medication support is often still necessary. Insulin may be able to be substantially reduced or stopped but some alternative medication may still be required.

Monitoring of patients blood sugars will still be required for both groups lifelong in case high blood sugars return. This can be due to secondary beta cell failure and may require tightening up of the diet, the addition of medication and sometimes insulin. If higher blood sugars and weight loss is reported, pancreatic cancer requires consideration and this is detected by urgent MRI scans. Sometimes a patient has been wrongly diagnosed as type two when they are really type one. In all cases they will need to see their GP for diagnosis.

Dr Iain Campbell is standing next to Dr Unwin and is wearing a waistcoat and white shirt. Iain told us about his struggles with bipolar disorder. There certainly could be a creative advantage to this illness, as Iain spent his young day in a rock band and even now is a successful composer. He has now settled into fatherhood and medicine and since starting a ketogenic diet has been mentally stable. My comment: Dr Christopher Palmer in the USA has also researched this phenomenon and there is a blog article on this site about him. Iain works at the university of Edinburgh, and has done preliminary studies in other patients who have bipolar disorder and has found that anxiety, depression, mood swings and impulsiveness all improve with a ketogenic diet. Further research is planned.

Dr Rachel Bain, on your far right, is a psychiatrist and works with Ally Houston, who is standing beside her, to promote coaching for mental health patients in the low carb diet. The site is

Rachel explained that the gut and brain are very intimately connected and share the same neurotransmitters. The gut microbiotica are affected by what we eat. This affects our mood. If leaky gut occurs inflammatory substances can gain access to our blood vessels and cross the blood /brain barrier to cause neuro-inflammation. This is one cause of degenerative brain conditions such as Alzheimer’s disease and Parkinson’s disease. The foods most likely to disrupt the junctions between the gut cells are sugar, starch, gluten and alcohol. She and Ally as well as other team members treat people who have Attention Deficit Disorder, Obsessive Compulsive Disorder, Binge Eating Disorder, Bipolar Disorder and Schizophrenia. They don’t aim for a person to stop their medication so much as to gain control of their lives.

Ally Houston used to be a physicist but is now a chef and low carb coach. Comment: Ally also appears in a previous blog post on the site. He explained what coaching was and wasn’t. It isn’t telling someone what to do. It is exploring with the person how their life works now and how they can introduce positive changes around eating sugar, starch, vegetable oils, exercise, stress reduction and sleep.

The services at are out with the NHS and there is a fee for the services, but it is very reasonably priced.

PHQ are expecting videos of the conference to be available on You Tube now or very shortly.

BMJ: Group programmes for weight loss are more effective than one to one sessions

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Adapted from BMJ 26 Feb 2022 NIHR Alert

Around one in four UK adults is living with obesity. Previous research has established that the most effective way to lose weight is through behaviour change with diet and physical activity counselling. It has not been clear whether one to one sessions or group sessions produce the better outcome. Thus a review of 7 studies which included 2,576 participants from the UK, US, Australia, Germany and Spain was done.

The study looked at the outcome of reaching at least a 5% reduction in body weight after a year. This means that a person of 100kg would lose 5kg.

Compared to one to one sessions, people in group sessions:

Lost on average 1.9kg more weight

Were 58% more likely to lose at least 5% of their body weight

Group classes had 12-55 hours treatment time and those in one to one sessions had 2.5 to 11 hours.

The costs of treating people in groups is also lower than one to one sessions. The quality of life of people who are obese would be more likely to improve and their would be fewer cases of diabetes, heart disease, stroke, and cancer that all require medical treatment.

NICE are intending to publish revised guidelines on the treatment of obesity in 2023.

Healthcare professionals can now confidently say that group educational programmes are at least if not more effective than one to one sessions when referring or advising patients. Social support in groups and more intensive interventions may account for greater success but for some people eg who are anxious in groups or who need translators, or even just patient preference, will mean that one to one sessions will still need to be offered. Further research into what specific factors improve results would be helpful.

PHC: How low carbing can help the NHS, meeting in Edinburgh

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The Public Health Collaboration is hosting a morning meeting on Saturday 18th March in Edinburgh from 9 am till 1pm.

The morning speakers will be explaining the role low carbing has on:

Improving mental health and particularly the results with bipolar disorder.

Improving weight and glycaemic control in type two diabetes.

Reducing the costs of managing type two diabetes.

Public education and group coaching initiatives in Scotland.

The PHC Ambassadors are having an afternoon meeting to discuss their projects.

The meeting is at the Quaker Meeting House in the old part of Edinburgh at the bottom of the castle and the fee is £15.

Please contact Sam Feltham at the Public Health Collaboration for more details and to register for the event.

Metabolic Multiplier: Help for type two diabetics who want to adopt a low carb diet

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The site Metabolic Multiplier have compiled a toolkit that you can use to educate yourself about the low carb diet and have included information that you can give to your doctor or other health care professional so that they will be more likely to help you monitor your condition.

I was part of the development group last year.

The dietician Adele Hite was extremely active in the group and always seemed so full of energy and enthusiasm. She put in many hours into the project as well as her day job. Little did I know that she had a returning cancer and that she was to die from it in less than a year. In retrospect, I think that this is what drove her. She was determined to leave a legacy to help others.

If you know of any newly diagnosed diabetics or any who are experiencing friction with their GPs or health care providers, please let them know about the Metabolic Multiplier site. It is organised by the highly efficient and versatile Cecile Seth.

GP apprenticeships will start in September 2023

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Adapted from BMJ 30 July 2022

The idea of GP apprentices has been discussed for a few years now, but at last the scheme is starting up in September 2023.

The new scheme hopes to solve a lot of problems with one fell swoop.

There is a great shortage of doctors in the UK and particularly in General Practice, the foundation of the NHS system. At the same time, the expense of becoming a doctor, with student debt on qualification reaching £100,000, is making it a difficult choice for students who don’t have wealthy parents.

Universities have limited places for medical students. Although a few new medical schools have opened their doors such as Buckingham University, which is entirely privately funded, this has been insufficient to maintain GP numbers which continue to fall.

For several years conversion courses for graduates from other disciplines have been running at for instance Dundee University. This results in qualified doctors after a four- year course.

Courses for physician assistants have also been taking in graduates from careers allied to medicine in for instance Aberdeen University. Yet, there are simply not enough physicians and physician assistants to fill gaps in provision, as many of our UK readers will have noticed, whether they are seeking a GP or a hospital appointment.

What is different about GP apprenticeships is that the student will earn a wage from their very first day. I don’t know what that wage will be yet. Hopefully enough to make the experience worthwhile and at least prevent them ending up in debt.

The aim is to make medicine more accessible to students from state schools and poorer backgrounds. They want to see students from diverse backgrounds rather than just the white upper middle- class students from private schools who currently predominate.

Apprentices will complete both academic and practical education and come out with a medical degree and licence to practice from the General Medical Council.

Dr Mark Cucuzella: Online resources for low carbing for patients and doctors

Adapting Medication for Type 2 Diabetes to a Low Carbohydrate Diet- Frontiers 2021

The above link gives the full paper from Dr Cucuzella about the medication adaptations, including insulin adaptations that need to be done if you are transitioning to a low carb diet. There is a helpful traffic light summary. Some medications do not need altered and these are discussed too.

Diet Doctor video on article “Why deprescription should be your new favorite word”

What your new diet will consist of and how to avoid unnecessary expense or complicated recipes is fully discussed in the following links. They are the same booklet but in different formats.

Our new “Low Carb on any Budget  – A Low-carb Shopping and Recipe Starter Begin a Life Free of Dieting and Indulge Yourself in Health” patient guide- Print and share with your patients

Pdf version

online flipbook

For clinicians through guideline central

These booklets are quite complex and are for doctors who want to know more about low carb diets and fine tuning of medication and insulin. The first is in USA units and the second is the UK format. It does no harm for any diabetic or their carers to read these too but bear in mind that they do go into some depth.

-Guideline Central: Low-Carbohydrate Nutrition Approaches in Patients with Obesity, Prediabetes and  Type 2 Diabetes

UK version – 

Want to pass that exam? Here’s how.

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Adapted from Human Givens No 1 2013 Dunlosky et al. Improving student’s learning with effective learning techniques. Psychological Science in the Public Interest.

Researchers have found that the best way to get good results in exams is to spread out your studying over time and to make sure that you quiz yourself on what you have learned.

They looked at ten common learning techniques and found that many of the most popular were of next to no benefit either in remembering information or passing exams. Some of these are the most common and are being recommended by teachers.

The most useless ways to revise are: highlighting and underlining, summarising, keyword mnemonics, use of imagery for memorising text and re-reading.

You may think you are doing something by adopting these, but you are kidding yourself!

Improved life expectancy for severe kidney disease on keto diets

Teresa Rodriguez is a Florida USA specialist dietician who has undertaken training with the Charlie Foundation to provide help to patients who have severe kidney disease of various types. Some conditions, previously thought to be untreatable, such as Polycystic Kidney Disease respond to the ketogenic diet and the quality of life and life expectancy for these people has been transformed.

Teresa sees patients in person and coaches them online and via Facebook. She is expecting her book, aimed at both physicians and patients, Keto for Kidney Disease, to be published in March 22.

Teresa comes from Puerto Rico and speaks fluent Spanish and American English and can provide learning in both languages.

I was one of several doctors who were treated to an online presentation by Teresa recently, and was amazed to see how different her approach and results are compared to NHS “usual” treatment and results.

I was taught that there wasn’t really much you could do about Polycystic Kidneys except for dialysis and transplantation when the kidneys eventually failed. She explained that PKD is actually a metabolic condition and that it responds to a ketogenic diet of usually 20g carbohydrate a day. There can be other aggravating factors such as oxalate overload and the kidney needs support to avoid the formation of kidney stones. Many patients will need to drink lemon juice in the mornings and have a much higher fluid intake than usual.

She optimises the patient’s diet based on the results of a detailed clinical history and blood and urine results. She finds that Cystatin C is a much more reliable predicator of kidney function than standard tests such as Creatinine Clearance. She often has to modify drug prescriptions. The blood pressure must be kept within normal limits to reduce deterioration in kidney function but Calcium channel blockers are not beneficial in PKD compared to ACE inhibitors and Sartans. Metformin, however is beneficial.

There is increasing interest in Ketogenic Diet Therapy and Therapeutic Carbohydrate Restriction worldwide.

Tim Noakes: Nutrition Network Courses for Health Professionals

Homepage | Nutrition Network (

Tim Noakes shot to fame in the low carb community by being accused of malpractice by two South African dieticians for giving dietary advice when he was not a registered dietician. After five long miserable years and the support of international colleagues he won the case. Anna Dahlquist, a Swedish GP had gone through the same thing a few years before this, and not only won her case, but managed to get the Swedish food guidelines for people with diabetes changed.

Professor Noakes has established online training for health professionals covering a variety of useful topics. Participants can be from all over the world and will receive accreditation. The full list of topics can be found by clicking on the homepage in BOLD above.

Public health collaboration online conference 2021

Sam Feltham has done it again. This year’s conference is now available on you tube right now.

Last weekend there were many contributors from diverse fields including members of the public, doctors, academics, and the scientific journalist Gary Taubes who gave the opening talk about ketogenic diets.

The courses that particularly interested me were about the experiences of type one diabetics who had adopted the low carb approach, how to achieve change, and how to increase your happiness.

There are talks about eating addiction and eating disorders, statins, and vegetable oil consumption.

Much of the material will be familiar to readers of this blog. There are some new speakers and topics which do indicate that a grassroots movement in changing our dietary guidelines is gaining ground.