Public Health Collaboration Conference 2018: Achieving your optimal blood sugar target

Videos of the lectures given at the Public Health Collaboration conference 2018 which was held in May over the royal wedding weekend have now been released on You Tube.

You can see my talk, Achieving your optimal blood sugar target, as well as others, on the link below. There are a wide variety of lifestyle topics discussed. Happy viewing.

 

https://www.youtube.com/results?search_query=public+health+collaboration+conference+2018

Angela Coleby: Rosemary Goats Cheese crackers

Goats Cheese Rosemary Crackers – 2 Net Carbs
Published on July 13, 2017 at Shirley Yates low carb food blog.

These delicious goats cheese crackers are flavoured with fresh rosemary and make a great gluten free and low carb cracker to have alongside with a dip.

Course: Appetizer
Servings: 12 Crackers
Author: Angela Coleby
Ingredients
1/2 cup (56g) coconut flour
1 teaspoon baking powder
4 tablespoons butter
2 tablespoons Rosemary, fresh
6oz (168g) Goats cheese.

Instructions
Put all ingredients into a food processor and blitz until smooth.
Spoon the mixture onto a piece of parchment paper, then place another piece on top. Gently roll out the dough until about 1 cm thick.
Cut out with a cookie cutter or shape by hand.
Place onto a baking tray lined with parchment paper.
Bake for 18-20 minutes until firm and golden.
Allow to cool or place in the fridge overnight for best results.
Recipe Notes
Makes 12 crackers
Nutritional Info per cracker – 99 Calories, 8g Fat. 4g Protein, 4g Total Carbs, 2g Fibre, 2g Net Carbs

Natural low carb store: Chocolate cake

 

Ingredients

9 Eggs (medium)
300g Dark Chocolate (minimum 72% cocoa)
150g Inulin Powder
70g Unsweetened Cocoa Powder
30ml Double Cream
1 tsp Vanilla Extract

Method

(makes approx. 18 servings)

Pre-heat the oven to 140°C. Melt the chocolate in a heat proof bowl over hot water (bain-marie) then stir through the double cream. Whilst the chocolate is melting separate the egg yolks and egg whites into two bowls. Whip the whites to form soft peaks. Combine the egg yolks with the inulin very gently (do not mix). Add the melted chocolate mixture to the egg yolks then sift in the cocoa powder and add the vanilla and combine together. Fold in the egg whites. Pour into a large round spring form cake tin (buttered if non-stick or lined if not) and place in the oven for 40 minutes. Remove and allow to cool so the cake comes away from the sides of the tin slightly. Serve with berries and a dollop of cream!

BMJ: It doesn’t take much alcohol to damage your brain cells

Adapted from BMJ 24 February 18 Alcohol link to dementia is “robust” by Jacqui Wise

Chronic heavy drinking should be recognised as a major risk for dementia say French researchers.

They looked at over 31 million French adults discharged from hospital between 2008 and 2013. Over 1.1 million people had been diagnosed as having dementia.  In 57% of those with early onset dementia alcohol use was considered to be the cause.

Drinking more than 6 units of alcohol a day for a man and 4 units for a woman put you in the risk category of “heavy drinking” according to the World Health Organisation. This level will make both men and women more than three times more likely to develop dementia than they otherwise would.

Michael Schwarzinger said, ” The link between dementia and alcohol use is likely a result of alcohol leading to permanent structural and functional brain damage. Alcohol disorders also increase the risk of high blood pressure, diabetes, stroke, atrial fibrillation, and heart failure, which in turn increase the risk of vascular dementia. Heavy drinking is also associated with smoking, depression and low educational attainment which are also risk factors for dementia.”

Clive Ballard from the University of Exeter Medical School said, ” This study is immensely important. This evidence is robust and the public need to know about the relationship between alcohol consumption and dementia.”

My comment: I was really sad to read this report in the BMJ as I do love a nice glass of full bodied red when I’m eating a big lump of fatty spiced meat or a smelly gorgonzola. I was also dismayed to see what they regard as heavy drinking. 175 mls of most wines will be 2 units so two of them a day and you are three times more likely to get dementia, if you are a woman. I dread to think what a two week all inclusive holiday does to your brain. It is  always best to know these things before you get too batty to care. 

Low carb store: Strawberries and cream cake

This cake serves 8 and has 5.4 g of carb and 176 kcals a slice.

Ingredients

110g ground almonds

40 butter melted

50g inulin powder (or granulated sugar substitute)

2 eggs

1tsp vanilla extract

30mls double cream

100g strawberries

 

Method

Combine the ground almonds, melted butter, eggs and vanilla in a large bowl. Add the double cream and inulin. Chop the strawberries and add them to the mixture combining gently by hand. Pour into a buttered cake tin and bake in a pre-heated oven at 180 degrees for 18-20 minutes.

Robert Carrier’s Rare Roast Beef

Robert Carrier was a very popular television chef in the 80s. He was famous for ladling on butter, cream and booze onto anything on a plate and in due course fell out of favour with the fat police in the later stages of the 80s and into the 90s. Fortunately one of my flatmates bought me Carrier’s Quick Cook for a Christmas present in 1983 and I’ve used it ever since. As you know, we are not afraid to chuck fat or booze on our food and the lower the carbs in your diet, the more we encourage you to do so.

A few weeks ago I was visiting my son in Leeds and off we went for an outing to Harewood House. This elegant house is in amazing grounds landscaped by Capability Brown. It is a thought that this man laid out many Victorian gardens but never lived to see them attain their full glory.

The grounds include a gem of a second hand bookshop and there I purchased Robert Carrier’s New Great Dishes of the World.  I already have his original Great Dishes of the World and was thrilled to have more boozy, creamy, meaty recipes at my fingertips.

I am now going to describe the late, great, Robert’s method to get perfect, rare roast beef with minimum effort.  He insists that you must have at LEAST 2.5 kg of boned and rolled meat.  I bought  a stunningly expensive rib eye joint of this weight and having never had a disappointment in 34 years of cooking from Carrier’s books entrusted it to his experience.

This is what you do.

Take the meat out of the fridge at least 2 hours before cooking time and hide it from your cats.

Preheat the oven to 250 degrees centigrade or 500 Fahrenheit or gas 10 for at least 20 minutes ahead of time. The oven must be roasting hot.

Rub the joint with salt and pepper and spread it with dripping or butter. This could be about 4 tablespoons or so. Don’t skimp.

Put the meat on a rack in a roasting pan in the oven and cook for 5 minutes per 450g/lb and then switch OFF the oven BUT DON’T OPEN THE DOOR.

Leave it all on its own for two hours.

Touch the meat with your fingers. If it is warm take out and serve. If it is cool but the oven back on at 250 /500/10 for ten minutes or so to warm it before serving.

Enjoy!

 

 

 

BMJ: Diabetic foot

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Summarised from BMJ Clinical Update Diabetic Foot by Mishra et al Mumbai and London 18 Nov 17

Foot disease troubles 6% of people who have diabetes and includes infection, ulceration or destruction of tissues of the foot. It can affect both social life and work. Up to 1.5% of diabetic people will end up with an amputation. Good foot care, screening and early treatment of ulceration is hoped to prevent a foot problem developing into a need for amputation. This article gives an update on the prevention and initial management of the diabetic foot that can be expected from primary care.

A combination of poor blood sugar control, foot neglect, lack of appropriate footwear, insufficient patient education and failure to find and treat pre-ulcerative lesions cause increasing foot damage and worsens the outlook.  Nerve and blood vessel damage make damage more likely to go unnoticed and more difficult to heal.

A careful examination of the feet by the patient or carer every day is a good idea. A careful examination by health professionals also detects problems early. Fungal infections, cracks and skin fissures, deformed nails, macerated web spaces, callouses, and deformities such as hammer toes, claw toes, and pes cavus increase the risk of ulceration.  Cold feet can suggest poor blood supply and warm feet can be an indicator of infection.

Monofilaments are often used to detect neuropathy at annual assessments. Pain after walking a certain distance and pain at rest suggest peripheral arterial disease.

Assessments every three to six months is needed for medium risk feet and every one or two months for high risk feet.

As neuropathy is difficult to reverse once established, prevention is key. Optimal glycaemic control is extremely important. Smoking cessation, maintaining a normal weight and continued exercise help the circulatory system.  Patients also know how to check their feet and who to get help from if they find problems. New shoes should be worn in gradually to prevent blisters.

Health care professionals need to send urgent cases to a specialised diabetic foot centre if at all possible. Such cases would include foot ulceration with fever or any signs of sepsis, ulceration with limb ischaemia, gangrene,  or suspected deep seated soft tissue or bone infection.

Ulcers are best washed in clean water or saline with a moist gauze dressing.  Anti-microbial agents can be cytotoxic  and can affect wound healing. Weight bearing on the area needs to be avoided. Tissue will be taken for bacterial culture and antibiotics prescribed due to local policies.

Referral within a day or two is needed for rest pain, an uncomplicated ulcer or an acute Charcot foot. (suspected fracture due to neuropathy).

Patients with rest pain and intermittent claudication need vascular referral.

Here are the top tips for patients:

Inspect your feet daily including between the toes and if you can’t do it yourself get someone else to do so

wash your feet in warm but not hot water daily and dry carefully especially between the toes

use oil or cream on dry feet but not between the toes

cut nails straight across and if necessary go to a podiatrist for this

Don’t do home treatments for corns and callouses

Check your shoes for objects or rough areas inside them and wear socks with them

avoid walking barefoot

get your feet examined regularly by a health care professional

notify the appropriate health care professional if you develop a blister, cut, scratch or sore on your feet