Category: health

Obesity makes asthma particularly difficult to control

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From British Thoracic Society Winter Scientific Meeting December 2017 London

Researchers have demonstrated that diet induced obesity leads to the development of airways hyper-reactivity through the interplay of an immunological and metabolic pathway.

Resultant asthma can affect children as well as adults. Unfortunately obesity associated asthma responds poorly to standard asthma medications including steroids and can result in more hospitalisation and a reduced quality of life.

The most effective obesity treatment is probably bariatric surgery to achieve sustained weight loss. In contrast dietary management and drugs are far less effective.

Gestational diabetics seven times more likely to get type two diabetes

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From RCGP Brian McMillan et al

Reducing risk of type 2 diabetes after gestational diabetes: a qualitative study to explore the potential of technology in primary care.

April 2018

Although women who have experienced gestational diabetes have are seven times more likely to develop type two diabetes than other pregnant women, there is as yet no formal testing arrangement in primary care.

These women may benefit from annual Hbaic and ongoing dietary and advice on weight management.

If these women have a HbA1c of more than 42 they can become eligible for the National Diabetes Prevention Programme. Otherwise not.

Women in this situation were interviewed and told researchers that they would welcome advice regarding diet and the help of other women in the same situation. They said they would value technology to give them the information to enable personalised self management.

Vitamin B12 and Diabetes

Emma7 Comments
vitamin B12 bottle on the Diabetes Diet
Vitamin B12 Gummies by icethim on flickr. Reproduced thanks to Creative Commons 2.0

In the news this week was an article about Vitamin B12 and its deficiency in those with type 2 diabetes*.

A new study by Nottingham researchers has shown that most people (64 percent of those assessed) people taking metformin (for type 2) were not being routinely tested for levels of vitamin B12 in their bodies. The assessment is needed to check for signs of nerve damage, a painful side effect of diabetes. Vitamin B12 is an essential vitamin the body requires to work properly.

The study’s author, Dr Kaenat Mulla from Hucknall Road Medical Centre said: “Current British Society of Haematology guidelines recommend that vitamin B12 levels are checked only when there is clinical suspicion of deficiency. However, peripheral neuropathy is irreversible and it may be too late once symptoms have developed.”

In an article on diabetes.co.uk, she stressed her warning wasn’t intended to discourage people from taking metformin, but she wanted to encourage doctors to monitor vitamin B12 routinely so deficiencies are picked up quickly and can be treated.

Before you all rush to Holland & Barrett to stock up, there are plenty of food sources that are rich in Vitamin B12. And funnily enough, we have a few recipes that feature them… Here’s what you might want to consider.

Liver and kidneys

Animal organ meats are a good source of the vitamin. A lot of people find the taste too strong—and I for one am never going to eat kidneys as their function puts me off—but chicken liver is more delicate than lamb’s for example, and might be more palatable.

Sardines

Sardines are another source and they are one of the few fish where Omega 3 levels survive the canning process. They are also cheap as chips and packed full of calcium as again the canning process softens the bones enough for you to eat them (and not notice you’re doing so).

Tuna, trout and salmon

More fish products that are super high in vitamin B12. You can find recipes on our site for salmon here and here, and trout here. I prefer trout to salmon as I find the flavour more delicate and it’s a heck of a lot cheaper too.

Dairy products

Milk, plain yoghurt and cheese have decent levels of the vitamin. Make a delicious sweet treat using Greek yoghurt, two teaspoons of good cocoa powder and a tablespoon of granulated sweetener and you’ve got a calcium, protein and magnesium packed pudding. And as for cheese, is there anyone out there who doesn’t love, adore like it? Hard, soft, strong, mild blue or from the cow, goat or sheep, there’s one that suits all. Want to make the most of it? Try our cauliflower cheese, broccoli and Stilton soup or our aubergine and pepper parmigiana.

For more information on vitamin B12 levels in food, check out healthline.com

*Please note—this article doesn’t constitute medical advice.

Diabetes awareness mama: managing mood changes in your type 1 child

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This article is from the mother of a type one son who has recently started school. She discusses ways to help other parents of children in the same situation in her blog.

https://diabetesawarenessmama.com/2017/07/05/managing-mood-changes/

Managing mood changes
July 5, 2017
Hannah Foreman-Wenneker
Today I would like to open the doors on what goes on behind the scenes of a T1D child. What do they feel that we parents cannot see? What do they want to tell us but are too young to possess the vocabulary or verbalise their emotions? These, and many more questions, often race through my mind. Taking on the full time job of a pancreas isn’t just about calculating carbohydrates, night time blood tests or insulin pump therapy; it is equally as important to understand the side effects this disease has on your child’s brain and subsequently, personality.
It all starts with the physiology of diabetes. I will never be able to fully appreciate what our son physically and mentally feels when he experiences a hypo or hyper, I can only describe to you what I have been told. According to the experts: diabetics, when a child is having a hypo they feel weak, dizzy, confused and shaky. This fantastic 3 minute video of four woman describing how they physically feel and mentally react during a hypo is well worth your time.
It is quite common for a T1D to suffer from ‘hypo-unawareness‘, particularly in young children who are naturally less aware of their body and how it functions. Hypo-unawareness is physically dangerous, but it is also a mental battle for the patient and for those who care for them. When our son Noah, is feeling these symptoms his insulin pump will give me a warning alarm (caveat: there is a 20 minute, give or take, communication delay between his body and the pump) and I can treat the hypo for its physical effects.

There is no medical treatment for the mental effects of a hypo. In our experience, Noah morphs from an adorable kitten to a roaring lion in a nano-second. He goes from “Mummy I love you to the universe and back” to a vein-popping, red faced animal screaming inaudible words that make no sense anyway. Unlike typical child-like tantrums (which he naturally has too, yey! these appear as is if from nowhere.

Sometimes his behaviour is quicker to burst forth than the pump’s warning alarm and we can tell he is having a hypo simply from his monumental meltdown over inconsequential nothingness. Even though I know his diabetes is just ‘having a conversation with me’, I confess, I sometimes feel embarrassed when we are out in public. There are occasions when I have been in the supermarket or walking down the street and Noah’s diabetes wants to have another ‘chat’ with me. Millions of parents know the look you get from strangers on the street; you know the one, it appears that you cannot control your own child. I get those same looks but sometimes I just want to scream ‘you have no idea what he battles with inside!‘

Noah can also become confused during a hypo and he finds it difficult to concentrate. Whilst these are less fiery side-effects they cause me more long-term concern than the tantrum-style behaviour. I know the meltdowns will become easier as he gets older but he has already started school and now I find myself wondering how hypos will affect him in the future. How will Noah cope with T1D together with his education? Will it impact his academic ability? How can we help him now to learn to overcome these issues down the line?
According to this scholarly article we are already using the best possible therapy to support Noah’s mood and behaviour. ‘Continuous subcutaneous insulin infusion’ or insulin pump therapy has been very effective in reducing the frequency of hypos in T1Ds and the results show improved mood and behaviour changes in young children. So is that all that we have at hand to help? My answer to this is: I don’t think so.

Whilst it is notoriously difficult to measure neurological impact of T1D and, from what I can gather, is something that experts vary in opinion on, frequently the following cognitive elements are reported to be affected by T1D: intelligence (general ability), attention, processing speed, memory, and executive skills. I am not a scientist and I haven’t done any research into this, I am also only two years in as a T1D carer but my firm belief today is that all of these cognitive domains can also be greatly influenced by the parents, teachers, siblings, social circles, mentors and extended family etc. who surround the child.
And what about hypers? Someone once described to me that a hyper is like having a massive hangover, but without the nausea part. The patient is very thirsty, has severe headaches and lethargy. It isn’t rocket science to realise that these are not attributable feelings to a productive day at school or work.

For the last year, Noah experiences an (as yet) unresolved hyper every morning after his breakfast. His glucose levels soar, sometimes triple the amount of a non-T1D and try hard as we might, we haven’t yet fixed this ‘bug’ in his daily routine. Nevertheless, off he marches every morning to school, feeling like he drank himself under the table the night before. For now, I simply admire his strength but I worry about when he becomes a teenager, how will he find the will to keep concentrating on math, or history or grammar when he mentally becomes aware that he has a choice?
And speaking of teenagers, puberty is a notoriously challenging period for many diabetics, but I will leave this topic for another day, another year even. The underlying point here is that T1D presents enormous challenges both physically and mentally. Both require a bachelor degree level of understanding to deliver optimal short and long term care. Both take place behind the scenes and in front of a crowd but T1D is so massively misunderstood by many (including me before my son’s diagnosis) that raising awareness and understanding is a monumental challenge, but one that many can be proud to be passionate about.
#weneedacure

 

Polycystic ovary syndrome is linked to autism in offspring

kaitiscotland2 Comments

Cambridge University Autism Research Centre has found that compared to women who do not have polycystic ovary syndrome, women who do have this have about double the risk of having a child with autism.  The risk was slightly higher in male children compared to female children.

Cherskov A et al. Polycystic ovary syndrome and autism: At test of the prenatal sex steroid theory. Transl Psychiatry. Aug 1 2018. doi:10.1038/s41398-018-01867.

The UK and US are the only western countries where life expectancy is falling

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Researchers looked at 17 high income countries to evaluate trends in national mortality.

In the UK there has been a drop of a few months in life expectancy for both men and women over the age of 65. Degenerative diseases were the main cause such as respiratory disease, circulatory disease, Alzheimer’s disease, nervous system disease and mental disorders.

In the USA drug overdoses were responsible for the decline in life expectancy.

The study looked at mortality between 2014 and 2015. A sixty five year old in the UK at that time would have been born in 1950, after the start of the NHS.

We will need to wait to see if this trend will reverse or not.

British Medical Journal. UK life expectancy drops while other western countries improve. National Health Services. 2018 August 16.

Younger age at diagnosis predicts earlier death in type one diabetes (on standard treatment)

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Researchers in Sweden have found that the earlier children are diagnosed with type one diabetes, the less their life expectancy is. Matters are worse for women than men. They think that adults diagnosed in childhood need increased input to deal with cardiovascular risk factors as they get older. Currently age of onset is ignored when it comes to stratifying risk.

Those diagnosed under the age of 10 had 4 times the hazard ratio for all cause mortality, over 7 times the risk of cardiovascular disease, 4 times the risk for non cardiovascular mortality,  over 11 times the risk of cardiovascular disease, 31 times the risk of having a myocardial infarction, over 6 times the risk for stroke, 13 times the risk of heart failure, but almost the same risk as controls for atrial fibrillation.

There is a better outlook for those diagnosed in their late twenties. The risk was almost 3 times the background rate for total mortality and the most prominent risk was again for cardiovascular mortality coming in at 6 times the background rate.

What this means is that if you are a girl diagnosed with type one under the age of ten, you may expect to live almost 18 years fewer than your classmates and if you are a boy, 14 years fewer.

My comment: More effort could also be given to youngsters on diagnosis achieving normal blood sugars by advising parents about the easiest ways to control blood sugars such as the adoption of a low carb diet and advanced insulin techniques. Although these statistics are shocking to see, it doesn’t have to be like this at all. Many diabetics have changed their life expectancy around and reverse some complications by adopting practices that improve glycaemic control and metabolic factors such as we describe on this site.

Rawshani A et al. Excess mortality and cardiovascular disease in young adults with type 1 diabetes in relation to age at onset: a nationwide, register-based cohort study. Lancet 2018;392:477-86;doi:10.1016/S0140-6736(18)31506-X

 

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

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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

Extra Virgin Olive Oil and Diabetes

Emma6 Comments

olive oil pic taken by Emma Baird, author of the Diabetes DietWe’re just back from Crete and enthused with the joys of extra virgin olive oil (EVOO). Yes, readers, splash it everywhere with gay abandon just as the Cretans do.

The island’s average inhabitant consumes 36 litres of the stuff every year—more than any other nation in the world. Even the Italians, also fond of the EVOO, manage only ten litres of it and they are the third highest consumers.

Does it have implications for we sugar-challenged folks? The factory I visited while there had a sign claiming health benefits for sufferers of all kinds of things, including type 2 diabetes. The Cretans produce mainly EVOO (and they harvest the olives by hand rather than machine), and they don’t bother with the ‘rule’ that you only use it for salads or to dress vegetables. They stick it in marinades, cook with it and even use it to deep-fry chips.

Positive benefits

In the Mediterranean region where olive oil is the main dietary fat, there are lower levels of deaths from cardiovascular disease. A Medicine News Today article also claimed positive benefits for stroke risk, breast cancer, liver protection, Alzheimer’s, ulcerative colitis, acute pancreatitis, maintenance of healthy cholesterol levels and even depression. [The article quoted from different studies, all of which used the words ‘appear to’.]

Anyone with diabetes has an increased risk of all the above conditions. The so-called Mediterranean ‘diet’ isn’t that dissimilar from the low-carb diet we promote. Broadly, eat tonnes of vegetables, some fruits preferably berries, plenty of fish, full-fat dairy, some beans and pulses if you can tolerate them and dress your salad and veggies with plenty of olive oil*.

Apart from the health benefits, a decent splash of EVOO does miraculous things. Steam some broccoli and then finish it off in the pan frying it with olive oil, thin slices of garlic and sea salt and you get to eat something that is three hundred times nicer than the boiled stuff.

The best Greek salad

And naturally a Greek salad needs the stuff… the best ones are simple. Large chunks of cucumber (peeled for purists) and tomatoes, black olives, thin slices of red onion and topped with a slab of feta cheese, plenty of salt and pepper and a generous drizzle of EVOO.

Sadly, because we’d opted for the hand luggage only flight, we could only bring back a 100ml bottle. One of the big issues with olive oil, and especially the extra virgin variety, is fraud. Most olive oil distribution is done through Italy, including the Cretan stuff. Investigations in recent years have uncovered wide-scale issues where virgin olive oil is passed off as extra virgin. There have even been cases where the oil was blended with sunflower oil and others..

The Guardian has a useful article that contains advice about buying genuine EVOO. Basically, it’s best to buy it in small quantities and if you think that stuff in supermarkets is too cheap to be the real thing, you’re probably right.

Olive oil recipes

Meanwhile, if you’re looking for olive oil recipes here are some suggestions from our blog:

What’s your favourite olive oil recipe or use?

*If you are overweight, you might want to be a little more cautious with your use of it, as it is calorie dense.

 

 

 

Angela Coleby: Rosemary Goats Cheese crackers

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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