For any lingering controversy regarding eggs and cholesterol and heart disease, this new study reveals a considerable association between egg eating and a reduction in cardiovascular disease.
Introduction: Considerable controversy remains on the relationship between egg consumption and cardiovascular disease risk. The objective of this systematic review and meta-analysis was to explore the association between egg consumption and overall cardiovascular disease events.
Methods: We systematically searched Ovid MEDLINE, Ovid Embase, Ovid Cochrane Database of Systematic Reviews, Scopus, and Web of Science from database inception in 1966 through January 2020 for observational studies that reported the association between egg consumption and cardiovascular disease events. Two investigators independently reviewed data. Conflicts were resolved through consensus. Random-effects meta-analyses were used. Sources of heterogeneity were analyzed.
Results: We identified 23 prospective studies with a median follow-up of 12.28 years. A total of 1,415,839 individuals with a total of 123,660 cases and 157,324 cardiovascular disease events were included. Compared with the consumption of no or 1 egg/day, higher egg consumption (more than 1 egg/day) was not associated with significantly increased risk of overall cardiovascular disease events (pooled hazard ratios, 0.99; 95% confidence interval, 0.93-1.06; P < .001; I² = 72.1%). Higher egg consumption (more than 1 egg/day) was associated with a significantly decreased risk of coronary artery disease (pooled hazard ratios, 0.89; 95% confidence interval, 0.86-0.93; P < .001; I² = 0%), compared with consumption of no or 1 egg/day.
Conclusions: Our analysis suggests that higher consumption of eggs (more than 1 egg/day) was not associated with increased risk of cardiovascular disease, but was associated with a significant reduction in risk of coronary artery disease.
This recipe makes plus/minus 18 cookies, and the ingredients include:
2 cups almond flour
1 ½ teaspoon baking powder
¼ teaspoon salt
⅓ cup butter, softened
1/4 cup Swerve sweetener
½ cup monk fruit sweetener
1 egg
2 tablespoons heavy cream
1 teaspoon vanilla
½ bag Lily’s Chocolate Chips
To start in a bowl mix in all the dry ingredients. So the Almond Flour goes in there along with the baking powder and salt. Whisk it all together until it is combined.
In a separate bowl we will be adding in our wet ingredient. We have our butter and then our two types of sugar, the Swerve Sugar and the Monk Fruit. Beat that together until it is combined.
Next we add in an egg and the vanilla flavoring as well as the heavy cream to the second bowl. Beat all of the together with the existing wet ingredients until nicely combined.
Start to slowly add in your dry ingredients into the the wet ingredients while beating and mic everything together.
Now it is time for the chocolate chips. We like the Lily’s brand of Chocolate Chips because there is now extra sugar added but is still sweetened using stevia. Use about half a bag of the chocolate chips for this recipe.
Once you have added in the chocolate chips you just give it a mix to make sure it is all incorporated in properly. And the you are done and ready to scoop!
Scoop them into 1 inch balls (Ice-cream scoop is perfect for this) and space the about an inch to an inch and a half apart in the baking tray. Pop the scooped dough in the tray into the refrigerator for about an hour.
Once you take it out of the refrigerator pop it into the over for about 12 to 15 minutes. Preheat the oven to 350 Degrees. Once baked you will have soft and chewy chocolate chip cookies that are perfect for the keto diet.
4 tablespoons extra virgin olive oil 1 large sweet onion, diced 2 celery ribs, diced 1 teaspoon salt ½ teaspoon black pepper 4 large garlic cloves, minced ½ teaspoon dried thyme ¼ teaspoon red pepper flakes ½ cup dry white wine 1 28-oz can whole cherry tomatoes 1 cup seafood broth 2 tablespoons capers 2 lb skinless sea bass fillet, about 1 ½-inch thick, cut into 4 pieces 8 large fresh or frozen medium shrimp, peeled and deveined 12 large sea scallops 1 teaspoon dried oregano, crushed ½ cup chopped fresh parsley leaves stems removed
Directions
Heat the olive oil in a large deep skillet with a cover over medium heat. Add onions, celery/ Cook, stirring regularly until softened (about 4 minutes). Add thyme, red pepper flakes, and garlic and cook briefly until fragrant (about 30 more seconds). Stir in the white wine. Bring to a simmer, and cook for 2 minutes. Add the tomatoes, broth, salt, pepper, and capers. Cook for 20 minutes over medium heat until flavors combine.
Pat the fish dry and season lightly with salt and pepper. Insert the fish pieces into the cooking liquid, and give everything a gentle stir. Bring to a simmer and cook for 5 minutes. Turn the heat off and cover the skillet. Let sit off the heat for another 5 minutes so that the fish will finish cooking. Fish should be flaky when gently pulled apart with a paring knife. Finally, stir in the chopped parsley. Ladle the hot fish stew into serving bowls.
Prue Leith, chef and restauranteur advised on the review of hospital food.
Adapted from BMJ 31 Oct 2020
An independent review of hospital food led by advisers including Prue Leith has produced a report including recommendations.
The government has said that it will establish and expert group of NHS caterers, dieticians, and nurses to act on the recommendations.
The group has advised that food be provided 24/7. Digital menus and food ordering systems should factor in dietary requirements. There should be professional standards agreed for NHS chefs. The role of nurses, dieticians and caterers should be increased in overseeing food services.
My comment: Here a some studies they should consider when it comes to formulating the meals.
BMJ 16 Feb 2021
The PURE study showed that those who had more than 350g of refined grains a day, or about 7 servings, had a higher risk of total mortality, major cardiovascular disease events compared to the lowest category which was less than 50g of refined grains.
The finding are robust and widely applicable as the study recorded more than 10,000 deaths or major cardiovascular disease events across the range of cereal grains, whole grains and white rice consumption. Different settings, cultures and dietary patterns were considered.
BMJ 20 March 21
The “Five a day” promotion of fruit and vegetable consumption originated in California in the 1990s from a partnership between the state health department and the agricultural and supermarket industries.
Five seems to have been chosen pragmatically as a realistic target rather than having been based on any nutritional evidence. But analyses of the Nurses Health Study and the Health Professionals Follow up study suggest that they got it right.
During 30 years follow up, the greatest mortality benefit was seen for five servings a day, and eating more didn’t give greater risk reductions.
Being employed seems to reduce the onset of dementia in women later on in life.
In the USA, 6 thousand women took part in the Health and Retirement study. Rates of memory decline were around 50% faster in those women who did not work for pay in the years after having children. Regardless of marital status and whether they had children, women who worked for pay in early adulthood and midlife showed slower rates of later life memory decline.
My comment: I wonder if the 80 years full time equivalent that I’ve racked up for the NHS will stand me in good stead then?
Once you are old, both men and women’s rates of memory decline from Alzheimer’s greatly accelerates if either experience the death of their spouse.
The Harvard Ageing Brain study did PET scans of participants’ brains at recruitment. They then had annual cognitive assessments. Those who had higher amyloid in the brain to star with deteriorated faster whether they were married or not, but the steepest drop occurred in those whose who were widowed.
This chickpea salad is simply a must. It not only takes just under 10 minutes to make but also will keep you satisfied for hours. This salad very quickly become my favourite lunch option during the times when I was on my journey of losing weight, as chickpeas are loaded with fibre, which keeps us feeling fuller for a long period of time. But that’s not all the benefits this salad has. Chickpeas are high in vitamins and minerals, that help with reducing blood pressure, cholesterol, and also are boosting our immune system.
This easy 2-step salad can be simply enjoyed on its own or as a side dish for slow-cooked Greek lamb or burgers.
A new study has found that regular use of proton pump inhibitors (PPIs), which are prescribed to treat acid reflux, is associated with a nearly 25 percent increase in the risk of developing diabetes.
This was an observational study, so it doesn’t prove that taking PPIs caused an increased risk of diabetes. But there are a few reasons to believe that the relationship might be causal:
They controlled for potentially confounding factors, like high blood pressure, high cholesterol, physical inactivity, sex, age, family history of diabetes, smoking, alcohol intake, diet, and regular use of anti-inflammatory drugs.
The risk of diabetes was highest in those who used PPIs for the longest time.
Other studies have shown that changes to gut bacteria may increase the risk of diabetes and that PPIs contribute to such changes.
This study adds to the enormous body of research linking long-term use of PPIs with a disturbingly wide variety of adverse effects, including:
Altered gut microbiota
Impaired nutrient absorption
Increased risk of cardiovascular events
Kidney damage
Cognitive impairment
Rebound reflux
Despite this, PPIs remain among the most popular classes of prescribed drugs. In 2014, Americans filled more than 170 million prescriptions for acid blockers, falling behind only statins in total cost expenditure worldwide.
What’s more, PPIs were approved by the U.S. Food and Drug Administration for only short-term use (two weeks). Yet many people have been taking these dangerous medications for years—and even decades.
The good news is that Functional Medicine offers a “root-cause” approach to successfully preventing and reversing gastroesophageal reflux disease (GERD) and reflux. To learn more about this, you can download my free eBook here.
Children on vegan diets were shorter than omnivores by an average of 3 cm, had 4-6% lower bone mineral content, and were more than 3 times more likely to be deficient in vitamin B12, found a study published in the Journal of Clinical Nutrition.
Vegetarian children showed a lower risk of nutritional deficiencies than the omnivores but had a less healthy cardiovascular profile.
The authors advised that children on plant based diets may need to take supplements of Vitamin B12 and vitamin D.
Adapted from Tong TYN et al. BMC Med 23 Nov 2020
The EPIC-Oxford study was undertaken between 1993 and 2001. There were over 29 thousand meat eaters, over 8 thousand fish eaters, 15.5 thousand vegetarians and almost 2 thousand vegans. After almost 18 years the number of fractures they sustained was measured.
Compared to meat eaters vegans had a higher risk of hip, leg and vertebral fractures. Vegetarians and fish eaters also had a higher risk of fractures than meat eaters. There were no differences seen in risks for arm, wrist and ankle fractures between the diet groups.
Adapted from NICE Clinical Guidance Summaries 11 Nov 2020
Diagnosis of CFS is based on a clinical diagnosis. It is characterised by debilitating fatigue not caused by excessive exertion and is not significantly relieved by rest. The symptoms get worse after activity, sleep is unrefreshing and their are cognitive problems.
It should be suspected if this pattern of symptoms goes on for over 4 weeks in children and 6 weeks in adults, were there is significantly reduced ability to engage in usual activities and the symptoms are new and have a specific onset.
There may also be associated symptoms such as pain, hypersensitivity to light, noise, touch, movement, temperature and smells, extreme weakness, difficulties in speaking and swallowing, sleep disturbance, gastrointestinal symptoms, and fainting when standing up or reduced blood pressure on standing.
The doctor is advised to take a full history of what makes symptoms better or worse, sleep quality, physical functioning and current and past use of medicines, vitamins and mineral supplements.
Doctors are advised NOT to offer medicines or supplements to cure or treat CFS but to develop a management plan with the patient that addresses information and support needs, support for the activities of daily living, education, training and employment support, self management, physical maintenance, symptom management, managing flares and relapse and ways to contact their clinical team.
My comment: this sounds much more in the realm of the Occupational Therapist than the GP!
The doctor assesses for and advises on the prevention of long term immobility. Unrestricted exercise is NOT advised. The patient is advised to take part in a supervised programme. My comment: The is what Physiotherapists do.
The doctor is advised to monitor for malnutrition, especially in severe cases. My comment: This is what dieticians do.
Doctors are further more advised to conduct a safeguarding assessment, help patients understand their energy envelope, help patients understand that they are approaching their limit, use a flexible tailored approach that allows for the need to pull back when symptoms worsen. Physio and OT again.
The doctor is meant to help the patient establish an individual activity pattern for example: reduce activity as a first step, plan periods of rest and activity, incorporate pre-emptive rest, alternate different types of activity, and break activities into small chunks. OT
Doctors are meant to emphasise adequate fluid intake and a balanced diet. Minimise nutritional complications of nausea, swallowing problems and difficulties in buying and preparing food. Dietician and Speech and Language Therapists.
They should refer to a dietician if weight plateaus in children or is lost in adults. It is recognised that patients with ME /CFS may be at risk of vitamin D deficiency, but otherwise there is insufficient evidence for routine vitamin and mineral supplementation. Vitamin D is available online for about £10 per year per patient.
To aid rest and sleep relaxation techniques may be helpful. Physiotherapy, OT, Mental health Mindfulness Apps.
If there is orthostatic intolerance the patient should be referred to secondary care and the GP should avoid prescribing unless advised by an expert in this.
For nausea, small and regular feeding and adequate fluids are advised.
For psychological support, Cognitive behavioural therapy may improve well being, quality of life, functioning and psychological stress. Explain that offering CBT does not indicated that beliefs or behaviours are the underlying cause. Mental health nurses. Psychology
Patients with CFS may be more intolerant to medication and may have more severe adverse effects so GPs should consider starting at a lower dose, have a more gradual increase in doses. Drug treatment for children should only be given under the care of a paediatrician.
Patients should respond to flares promptly by identifying possible triggers, temporarily reducing activity and monitoring their symptoms as some flares develop into a relapse.
For a relapse, the doctor or clinician or Physio or OT needs to review the management plan, reduce or stop some activities, increase rest periods and re-establish a new energy envelope.
My comment: There has been a huge increase in CFS due to Covid. With primary and secondary care services at well past broken point, it seems madness for a GP to attempt to follow this NICE guideline. There wasn’t the resources to do so before Covid and there are far less now with a much increased patient group. The most useful thing about this guideline is that it emphasises that there is no magic bullet for this condition. Medications don’t work. It looks to me like the establishment of online zoom classes for patients led by Occupational Therapists would be the most useful way to implement this. Patients could be diverted away from their GPs and referred to the appropriate other health care professionals such as physios, dieticians, social and mental health workers.
Diabetes Diet 