The best diet for optimal blood sugar control & health
I will be speaking at the conference on the topic of VR Fitness.
It is even easier to access the talks as they will all be available on Saturday 16th and Sunday 17th May 2020. The conference, intended for Bristol had to be cancelled due to coronavirus.
Adapted from Abeysekera KWM et al. Prevalence of steatosis and fibrosis in young adults in the UK: a population based study. Lancet Gastroenterology and Hepatology. 2020 Jan 15.
A new study highlights just how common liver disease is becoming in young adults in the UK. One in five had fatty liver, known as steatosis. One in 40 had fibrosis, also known as cirrhosis. And the average age was only 24. These results show how harmful unhealthy eating and drinking habits can be.
Subjects for the study were recruited through the Avon Longitudinal Study of Parents and Children. Transient elastography and controlled attenuation parameter scores were used for assessment of steatosis and fibrosis.
Steatosis was found in 20.7% of the participants and this was severe in 10% of those affected. Being overweight or obese was the main factor for causing this after adjusting for alcohol intake, social class and smoking.
Fibrosis was reported in 2.7% of the participants. This risk was significantly higher in those who also had an alcohol problem or addiction and already had steatosis after adjusting for smoking and social class.
The authors conclude that the obesity epidemic is affecting the current and future health of young adults by increasing their risk of non alcoholic steatohepatitis related cirrhosis, hepatocellular carcinoma, and complications of metabolic syndrome.
Adapted from Wang QL et al. American Journal of Gastroenterology 1st January 2020
Metformin users were at a lower risk of developing oesophageal squamous carcinoma than non metformin users.
A growing number of observational studies have shown that metformin reduces overall cancer risk and a few specific cancer types such as colon, rectal, breast and stomach.
A population based cohort study included over 400,000 metformin and an equal number of non metformin users who were matched by age and sex.
There were 3.5 cases of oesophageal cancer in the metformin group per 100,000 person/years and 5.3 in the non metformin group. This finding was true for men, women and those in their sixties. The odds ratio was 0.68 for metformin use.
Piri-Piri Chicken with Piri-Piri Sauce
Piri-Piri (sometimes spelled peri-peri) is Swahili for ‘pepper pepper’, or ‘strong pepper’ and refers to an African-style chili sauce. Piri-Piri Chicken is marinated in a hot chile pepper marinade, then grilled. This dish evolved in Angola and Mozambique (once Portuguese colonies) after Portuguese explorers and settlers brought American chili peppers to Africa.
The most basic piri-piri marinade recipe calls for just oil, cayenne pepper or minced fresh hot chile peppers, and salt. Many piri-piri recipes add an acidic liquid (usually lemon or lime juice, or vinegar, or possibly wine or liquor) which adds a tang and tenderizes the chicken. More elaborate versions also include additional flavorings and spices.
This recipe makes quite a bit and since I cook for two most days, I cut the recipe in half. This dish is delicious and the chicken turns out quite tender and juicy. The sauce has a bit of a kick but not overly spicy.
6-8 servings
Ingredients
4 lb chicken cut into parts or 4 lbs of your favorite chicken parts, about 8 pieces.
Peri Peri Marinade
3 red chilies (reduce for less heat or remove seeds), finely chopped or use 2 tablespoons red chili paste
1 green chili, finely chopped
3 cloves garlic, peeled and finely chopped
1 small red onion, finely chopped
1 red bell pepper, finely chopped
2 tablespoons lemon juice
2 tablespoons apple cider vinegar
1/2 teaspoon black pepper
2 tablespoons brown sugar
1 tablespoon smoked paprika
1 teaspoon of sea salt
2 tablespoons chopped cilantro or parsley
3 tablespoons vegetable oil or olive oil
Peri Peri Sauce
3 tablespoons reserved marinade
1/4 cup water
2 tablespoons sugar
Directions
Combine all marinade ingredients in a bowl large enough to hold all the chicken parts and blend well.
Reserve 3 tablespoons of the marinade in a small storage container and the coat the chicken with the remaining marinade. Cover and refrigerate 4 hours to overnight.
Heat an outdoor grill or stovetop grill pan.
For the Piri-Piri Sauce
Add reserved marinade, water, and sugar to a small saucepan and bring to boil. Cook for 2 minutes, remove from the heat and keep warm.
To cook the chicken
Place chicken bone side down on the grill. Cook for 10 minutes. Turn chicken over and cook for 25-30 minutes. Turn chicken over once more and grill for another 5 minutes. Remove the chicken to a serving platter and drizzle the sauce over the grilled chicken.
African Cucumber Sambal
Ingredients
2 medium garlic cloves, minced
1 shallot, minced
1/2 green chili (jalapeno pepper), minced
1 teaspoon sugar or natural sweetener (honey, agave nectar, etc.)
1 (2-inch) piece of ginger, peeled and grated
1 tablespoon apple cider vinegar
2 mint leaves, minced
1 large cucumber, peeled, seeded, quartered and thinly sliced
Directions
Combine all of the ingredients in a mixing bowl. Stir and toss well to cover.
Cover and let sit at room temperature for at least 1 hour before serving.
The Sambal will store up to 4 days refrigerated in a tightly covered container.
New calculator improves diagnosis of diabetes
Lynam A & al. BMJ Open 26 Sep 2019
curated by Pavankumar Kamat UK Medical News 30 Sep 2019
Scientists have developed a new calculator tool to help clinicians determine whether a patient has type 1 or type 2 diabetes, ensuring appropriate treatment and fewer complications. The beta version of the calculator is available here.
https://www.diabetesgenes.org/t1dt2d-prediction-model/
Determining the type of diabetes remains a challenge for clinicians, and current blood and genetic tests are not robust enough to provide a definitive diagnosis. The tool utilises a model that incorporates patient data (age of diagnosis and body mass index) and blood test results to provide a personalised approach.
It is useful in determining the likelihood of type 1 diabetes in patients, thereby reducing misdiagnosis.
Researchers at the Universities of Exeter, Oxford and Dundee analysed data on 1352 individuals with diabetes and tested the calculator in an additional 582 individuals.
The new tool follows the footsteps of another calculator previously developed at the University of Exeter which helps clinicians determine the presence of diabetes sub-type MODY. The tool has been successfully used by more than 100,000 people.
Dr Angus Jones, the lead researcher, said: “The right diagnosis in diabetes is absolutely crucial to getting the best outcomes for patients, as treatment is very different in different types of diabetes. Our new calculator can help clinicians by combining different features to give them the probability a person will have type 1 diabetes, and assess whether additional tests are likely to be helpful.”
References
Lynam A, McDonald T, Hill A, Dennis J, Oram R, Pearson E, Weedon M, Hattersley A, Owen K, Shields B, Jones A. Development and validation of multivariable clinical diagnostic models to identify type 1 diabetes requiring rapid insulin therapy in adults aged 18-50 years. BMJ Open. 2019;9(9):e031586. doi: 10.1136/bmjopen-2019-031586. PMID: 31558459
4 Ingredient Tomato Soup
September 10, 2019 by trained chef, Alex Wojciak.
This tomato soup recipe couldn’t get any easier. If you don’t count the garnishes there are only four ingredients. I had an abundance of tomatoes – so many I had to pick a recipe that used up many of them. Soup seemed like a great idea.
Ingredients:
Tomato, 8 cups, fresh with the core removed, cut in half
Onion, 1 diced
Garlic, 6 cloves, minced
Chicken Stock, 3 cups
Extra Virgin Olive Oil, 2tbl
Method:
Begin by roasting tossing your tomatoes with the olive oil, and season with salt. Roast your tomatoes at 400 for about 20 minutes. Roast them long enough so you can peel off the skins with ease.
Meanwhile, heat a large sauce pot over medium heat and cook your onions until nicely browned and caramelized, about 7-8 minutes. If you season them with salt when you throw them in the pan, they will wilt and break down more quickly.
When the onions are nice and cooked, add in the garlic and continue cooking for 2 more minutes. Then, add the peeled tomatoes to the pot, along with the chicken stock, and bring to a boil. Purée the soup with an immersion blender (or a standing blender in batches). This might take longer with an immersion blender, but check the consistency to ensure it is smooth and velvety.
Taste for seasoning and adjust as necessary. Ladle into a bowl, and garnish with anything you’d like. I’ve garnished my soup with a dollop of crème fraiche and parsley.
In the last of our three part exploration of the cardiovascular disease epidemic, Irish doctor Ivor Cummings interviews Dr William Davis consultant cardiologist about what really prevents and reduces coronary artery atheroma. Also discussed is the most effective way to increase your magnesium intake which relaxes smooth muscle thereby reducing blood pressure.
Dr Cummings’s runs his blog known as the Fat Emperor.
In part two of this series on cardiovascular disease Dr Aseem Malhotra, consultant cardiologist explains why putting faith in statins to resolve the cardiovascular disease epidemic is misguided. He explains that they only extend life by a matter of a few days yet need to be prescribed for years at considerable cost to the health service. Furthermore, he thinks that their side effects are not being explained to patients.
This is a medium length article which contains information on statins not readily seen in a single document.
This is part one of a three part series on how we have ended up with a cardiovascular disease epidemic, what treatments we are using which don’t work, and what treatments do work.
The in first episode Belinda Fettke discusses the history behind the 7th Day Adventists who genuinely believed that they were bringing health to the USA population by promoting a grain based diet.
This is a long video but entertaining as well as informative.
Adapted from Intensive lifestyle counselling and cardiovascular outcomes in patients with diabetes. September 14 2019 Diabetes in Control by Nour Salhab. Pharm. D from Zhang et al Lifestyle counselling and long term clinical outcomes in patients with diabetes. Diabetes Care. Aug. 2019.
Intensive lifestyle counselling has been shown to improve blood sugars in the Look AHEAD study but it was too underpowered to show any significant conclusions regarding cardiac outcomes.
This new study looked at patients with both type one and type two diabetes who had HbAICs over 7% and were over the age of 18. Lifestyle counselling involved diet, exercise and weight loss management. The goal was to get the patient’s HBAICs under 7%.
19,293 patients were involved and the mean HbAIC at the start was 7.8%. My comment: This is a very good average compared to British diabetics!
The mean counselling sessions were 0.46 a month and the study ran for 5.4 years.
HbAIC reduced by 1.8% for patients who got monthly counselling and 0.7% for those who got less than monthly counselling.
The primary end point was time to the first episode of angina, heart attack or stroke or death from any cause. There was a small but significant decrease in the group who had monthly counselling compared to three monthly counselling.
The counselling occurred in academic centres so may not be applicable to other settings.
My comment: This level of counselling is much more intensive than can probably be delivered in the NHS population. The blood sugar levels in the patients was also much better to start with compared to the UK population.
Diabetes Diet 