Category: health

Placenta derived diabetic foot ulcer treatment effective: but only available in the USA

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Neuropathic_heel_ulcerDiabetic foot ulcers that don’t respond to usual care can respond very well to a new membranous patch that is available to patients in the USA.

Dr Dan Fetterolf, head physician at the MiMedx Corporation,  gave an interview to Diabetes in Control this month and described how this treatment fits into therapy for foot ulcers.  The Epifix patches are derived from the amniotic membranes of women who have been screened for blood borne viruses and who are to be delivered by caesarean section. At delivery the placenta is put in a sterile container and sent to the USA production site.

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Diabetic foot ulcers are bad news for patients. In the USA the cost of ulcer treatment or amputation has to be borne between the patient and health maintenance organisation.  Thus there tends to be more interest in preventative treatments even when these are expensive. When an ulcer has not responded to the usual debridement, moist dressings and anti-microbial efforts after a month, these ulcers have a relatively poor prognosis and the use of amniotic membrane treatments make financial good sense.

Diabetics have a lifetime risk of getting a foot ulcer of 25%. Around a fifth of these people will go onto having an amputation. Many of these will have additional factors that increase the risk such as neuropathy that prevents people from feeling trauma to the feet, peripheral vascular disease that delays healing and obesity that adds to the pressure on the feet.  Once an amputation occurs that person’s life expectation reduces and their ability to earn decreases. They need much more in the way of social and medical support. These factors all affect the person’s family as well as the economy of the countries concerned.

Prevention of diabetic foot ulcers involves good glycaemic control, daily shoe and foot examination by the person with diabetes and regular foot examination and testing by health care professionals. If an ulcer does develop then tighter adherence to preventative measures becomes essential. Weekly follow up of patients is required.

To allow maximal healing it is important to offload weight on the affected foot as much as possible. Dressings should not be allowed to dry out or else the layer of protective epithelium can be removed at the same time the dry dressing comes off.

Chronic ulcers come with a whole collection of adverse healing factors. Most people will have neuropathy and at least a degree of peripheral vascular disease. The healing ability of the skin is reduced as inflammatory cytokines reduce the healing process. In addition the immune system is rendered less effective by the glycation of immunoglobulins and other factors.

Diabetes now affects 7-10% of the USA population and in certain countries it is higher. The Pima Indians have worldwide the highest proportion of adult diabetes at 50% partly due to genetics and partly due to their very high sugared drinks ingestion.  In the affluent areas of the Middle -East such as Dubai and Saudi Arabia levels are also very high. There is a genetic issue here but also a very high sugar intake.  Scotland is remarkably dreadful too. A lot of this is due to deprivation and our characteristically poor diet. Many families eat no fruit and vegetables at all.  Well, if we can’t beat England at football, we can certainly be winners when it comes to obesity- diabetes prevalence.

 

From our point of view on diabetesdietblog.com we welcome a strategic approach to reducing the number of people who develop diabetes, and improving the outlook for those who do develop the condition. Proper dietary education and provision in the public domain are essential. Only by doing this can glycaemic control be tackled in a robust manner. When a patient does develop an ulcer, resources to heal this effectively and reduce the progression to amputation is key. If this new treatment could become available in the UK it would be very much welcomed as a way to improve patient’s lives as well as cut back the nursing and medical costs associated with the prolonged treatment of ulcers.

 

 

 

Potatoes may give you gestational diabetes: but eat lots of them and base your meals around starch say Diabetes UK

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BakedPotatoWithButter

Potato-rich diet ‘may increase pregnancy diabetes risk’

  • Eating potatoes or chips on most days of the week may increase a woman’s risk of diabetes during pregnancy, say US researchers.

This is probably because starch in spuds can trigger a sharp rise in blood sugar levels, they say.

Their study in the BMJ tracked more than 21,000 pregnancies.

But UK experts say proof is lacking and lots of people need to eat more starchy foods for fibre, as well as fresh fruit and veg.

The BMJ study linked high potato consumption to a higher diabetes risk.

Swapping a couple of servings a week for other vegetables should counter this, say the authors.

UK dietary advice says starchy foods (carbohydrates) such as potatoes should make up about a third of the food people eat.

There is no official limit on how much carbohydrate people should consume each week.

Starchy carbs

Foods that contain carbohydrates affect blood sugar.

Some – high Glycaemic Index (GI) foods – release the sugar quickly into the bloodstream.

Others – low GI foods – release them more steadily.

Research suggests eating a low GI diet can help manage diabetes.

Pregnancy puts extra demands on the body, and some women develop diabetes at this time.

Gestational diabetes, as it is called, usually goes away after the birth but can pose long-term health risks for the mother and baby.

The BMJ study set out investigate what might make some women more prone to pregnancy diabetes.

The study followed nurses who became pregnant between 1991 and 2001. None of them had any chronic diseases before pregnancy.

What is gestational diabetes mellitus?

 

  • It is a condition where there is too much glucose (sugar) in the blood
  • About three in every 100 pregnancies are affected in the UK
  • Symptoms include a dry mouth, tiredness and urinating frequently
  • Gestational diabetes can be controlled with diet and exercise, but some women will need medication to keep their blood glucose levels under control
  • If not managed properly, it could lead to premature birth or miscarriage

Every four years, the women were asked to provide information on how often potatoes featured in their diets, and any cases of gestational diabetes were noted.

Over the 10-year period, there were 21,693 pregnancies and 854 of these were affected by gestational diabetes.

The study took into account other risk factors, such as:

  • age
  • a family history of diabetes
  • overall diet
  • physical activity
  • obesity

It found a 27% increased risk of diabetes during pregnancy in the nurses who typically ate two to four 100g (3.5oz) servings of boiled, mashed, baked potatoes or chips a week.

In those who ate more than five portions of potatoes or chips a week, the risk went up by 50%.

The researchers estimate that if women swap their potatoes for vegetables or whole grains at least twice a week, they would lower their diabetes risk by 9-12%.

Cuilin Zhang, lead study author, from the National Institutes of Health in Maryland, US, said the findings were important.

“Gestational diabetes can mean women develop pre-eclampsia during pregnancy and hypertension,” she said.

“This can adversely affect the foetus, and in the long term the mother may be at high risk of type-2 diabetes.”

But UK experts stressed there was not enough evidence to warn women off eating lots of potatoes.

Simple swaps that can lower GI

Switch baked or mashed potato for sweet potato or boiled new potatoes

  • Instead of white and wholemeal bread, choose granary, pumpernickel or rye bread
  • Swap frozen microwaveable French fries for pasta or noodles
  • Try porridge, natural muesli or wholegrain breakfast cereals

Dr Emily Burns, of Diabetes UK, said: “This study does not prove that eating potatoes before pregnancy will increase a woman’s risk developing gestational diabetes, but it does highlight a potential association between the two.

“However, as the researchers acknowledge, these results need to be investigated in a controlled trial setting before we can know more.

“What we do know is that women can significantly reduce their risk of developing gestational diabetes by managing their weight through eating a healthy, balanced diet and keeping active.”

Dr Louis Levy, head of nutrition science at Public Health England, said: “As the authors acknowledge, it is not possible to show cause and effect from this study.

“The evidence tells us that we need to eat more starchy foods, such as potatoes, bread, pasta and rice, as well as fruit and vegetables to increase fibre consumption and protect bowel health.

“Our advice remains the same: base meals around a variety of starchy foods, including potatoes with the skin on, and choose wholegrain varieties where possible.”

This is an article published today  BBC News

 

Gestational diabetes – NHS Choices

 

BMJ – British Medical Journal

 

Diabetes UK

 

 

Do you want to know your complication risk?

kaitiscotland2 Comments

Researchers in the United Kingdom have developed a validated risk assessment equation to show the 10-year risk of blindness and lower limb amputation in diabetes patients. Such tools have already been developed for the general population to assess heart attack, stroke and diabetes risk, and now the QDiabetes tool is the first  tool for diabetics that  gives  an accurate assessment of their risk of these most feared complications.

Data has been collected from English  General Practitioners  since 1998 from over 400,000 patients. The algorithms are based on variables that patients are likely to know or that can be found from asking your GP. Knowing your risk could be worthwhile so you would know  to intensify your control and monitor your condition more stringently.

For clinicians, complication risk  could enable screening programs to be tailored to an individual’s need for support  and the more rational use of scarce resources. Retinopathy could be done more frequently than once a year for those who need it and less frequently than once a year for those who do not.  Those at higher risk of amputation might benefit from a proactive targeted program to prevent lower extremity amputation (including more frequent checks, tailored patient education, specially designed protective footwear, and early reporting of foot injuries), as this has been shown to substantially reduce the risk of emergency admissions, use of antibiotics, foot operations, and lower limb amputation compared with usual practice.

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To see what your risk factors are click here:  QDiabetes® (Amputation and blindness) equations.

Based on an online article at Diabetes in Control.

Hippisley-cox J, Coupland C. “Development and validation of risk prediction equations to estimate future risk of blindness and lower limb amputation in patients with diabetes: cohort study.” BMJ. 2015;351:h5441.

 

Beanz Meanz #&!<Z! What are FODMAPS anyway?

kaitiscotlandLeave a comment

For many of us gastric distress is just intermittent but for others it is a constant source of discomfort, embarrassment and sometimes even pain. There are fermentable sugars released from various foodstuffs that increase the amount of wind generated in the gut. It is the distention of the gut by the wind that sometimes causes the bloating, discomfort and pain. And of course the gas has to go somewhere. 

When it comes to gassy foods there is a variation depending on the type and amount of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols in the food. You can cut down on high FODMAP food and eat low FODMAP food instead to see if this settles your guts down.

Vegetables, beans, pulses and legumes are probably the most well- known culprits.  

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Of the vegetables artichokes, asparagus, beetroot, broccoli, Brussel sprouts, cabbage, cauliflower, fennel, green beans, garlic, mushrooms, okra, onions, peppers, snow peas and squash top the list. This is a pity because many of these feature highly in low carb diets and also improve the taste of many dishes. 

For vegetables that are better tolerated try,  bean sprouts, bok choy, peppers with the skin removed (by searing and them removing), carrots, celery, cucumber, corn, aubergines, lettuce, leafy greens, pumkin, potatoes, tomatoes, courgettes and all fresh herbs. ( eat very sparingly or not at all on a low carb diet)

Some people don’t deal with lactose very well and for these people ice cream, milk, soft cheeses, yoghurt and cream may cause problems. Lactose free dairy products and hard cheeses don’t cause difficulty.

 Of the cereal group wheat products and rye may cause problems whereas spelt, gluten free bread products, rice, rice based breakfast cereals, quinoa and gluten free pasta may not.

Fruit tends not to aggravate the guts as much as vegetables but for some people avocado, apples, apricots, cherries, dates, dried fruits, figs, mango, nectarines, papaya, peaches, pears, plums, prunes and watermelon may give problems.  The lower FODMAP items in this class are bananas, berries, cantaloupe melon, grapes, grapefruit, honeydew melon, kiwi, lime, passion fruit, pineapple, rhubarb and citrus fruits.

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Food additives end to upset people especially the polyols in artificial sweeteners and foods with high fructose corn syrup or agave syrup.  Chutneys, pickles, coconut, honey and jams can also cause problems. Thankfully most spices and herbs, mayonnaise, olives, onion powder, olive oil, pepper, salt, maple syrup, mustard, wheat free soy sauce, chilli sauce, sugar and vinegars are better tolerated.

I found that my guts under went a great improvement from stopping wheat and adopting a low carb diet. I do bake and use polyols to sweeten baking products in preference to sugars. The main thing to remember is that many of the effects are dose dependent, so limit your intake accordingly.

 

Based in Irritable Bowel Syndrome: new and emerging treatments. BMJ 27 June 2015.

Did you overeat this festive period?

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 Sam Feltham is a personal trainer who likes to do experiments. On himself.

On a series of experiments he decided to overeat first fat, then carbs and then a vegan diet to see what would happen. Each experiment lasted three weeks, during which time he carefully monitored his calories in, his weight and his body fat.

As far as the physics goes and many people believe, a calorie is a calorie is a calorie. If so, the weight gain should be pretty uniform over each of the diets. Yet, we only start to obey the laws of physics once we die. Up till then we follow the laws of biochemistry. And the results are very different depending on where those calories come from.

 

 

Click on this link to see what happened: http://live.smashthefat.com/category/self-experiment-conclusions/

 

What helps and what doesn’t when type one diabetes is diagnosed in adolescence

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Some young people cope very well with type one diabetes right from the start and others flounder. Sometimes a young person’s failure to get to grips with the condition has very serious and long lasting effects. So, what things help and what things hinder?

Dr Emily Robinson is a counselling psychologist based in Leicester Royal Infirmary. She interviewed eight type ones aged 28-36 years who had been diagnosed in adolescence and asked them about their experiences. They had been diagnosed between the ages of 11 and 17.

Previous research has shown that how people think about their illness impacts on how well they self-care, their degree of metabolic control and how happy and adjusted they are to diabetes.

Most participants went through a stage of shock and grief around the time of diagnosis. Laura stated, “At first I thought my world had caved in. I was thinking, why me? It is really unfair. I did kind of feel that my life was over”.

Yet, although in the minority, some young people just sort of “got it” right away. No fuss. No muss. Craig said, “I don’t remember there being a sudden change in the way I was personally. I wasn’t panicking for feeling like my life had ended.”

All participants described that their freedom had been at least temporarily curtailed and that they had missed out on things compared to their friends of the same age. Tony said, “I felt I lost my freedom and my ability to do things at the drop of a hat. I had always been a very active child and I was used to going out in the morning, walking and playing in the fields and not thinking of coming back home till I was hungry.”

There is a stage in adolescence where no one wants to be seen as different from anyone else in their peer group. Karen spoke about how this had serious effects. She stopped giving herself insulin injections and ended up in hospital with diabetic ketoacidosis several times.

Most participants described a sense of intense loneliness at the time of diagnosis.  Not knowing any other young diabetics was a problem and sitting in medical waiting rooms along with just grown-ups and elderly did not help.  One young woman, Laura, actually had severe depression. She put this down to not getting the help she needed from her parents.

Indeed parental involvement has been found to be the single most important predictor of positive adolescent outcomes. The less parental involvement and the more responsibility taken by the adolescent the worse the control.  The growth of teenage diabetic transition clinics and internet forums may have made a good difference for todays newly diagnosed type ones.

Parental anxiety had a knock on effect on how well adolescents coped emotionally with their diabetes. “My parents were terrified and in denial”, said Laura.  The reaction of friends had lesser but significant impact too.

Health care professionals need to be really careful about how they speak about diabetes to the newly diagnosed because everything they say is taken to heart.  Jannine spoke of being shown pictures of gangrenous feet and being in a ward of people who had diabetic complications. The “shock treatment approach” left her so frightening and helpless that she avoided checking her blood sugars. “I have never quite forgiven them for that”, she says, over a decade later.

The way in which diabetes was explained at diagnosis has been found to be the strongest predictor of emotional response even two years after diagnosis.

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Laura remembers, “I was having a really terrible time and I said something like, if this was a war, I would be surrendering. At the moment I feel that I am really losing. The doctor said to me, I bet you would just like a couple of weeks off, wouldn’t you? And that was one of the most understanding things a doctor has ever, ever, ever said to me.

Seeing the same clinician regularly was very important to about half of the participants. Having a nurse educate her in a supportive and encouraging way, being given choices, setting her own treatment goals and reducing her sense of isolation were particularly important to Jannine.

Over time, everyone with diabetes adjusted to having the condition in a much more positive way. Tony said, “I see myself as being normal. I’m me. I have diabetes but I don’t consider it to be a huge problem. I didn’t think like this when I was 16 or 20 years old.”

Support groups were a help to some participants. “It was astonishing to know that everyone else had problems too”.

Currently transition services for young people still tend to result in high dropout rates, poor attendance and sub-optimal control.  Psychological input may help some people who are struggling at this time.  More frequent appointments, active follow up, and seeing the same clinicians have been found to help.

Between the late 20s and early 30’s has been found a significant time in the lives of type one diabetics. After all, this is when parenthood is most commonly anticipated. A wish to tighten up control in preparation for a life time with diabetes is common. Emily thinks that refresher courses in diabetes management, which don’t currently exist in many areas, would be a good idea at this time.

(Of course, from my point of view, I think that diabetics of all ages would be a lot less demoralised if they were told the best ways to manage their diet and insulin regime.)

So in summary:

What helps:   

Doctor gives an optimistic view of diabetes at diagnosis.

Parents, let your offspring do as much as their friends are doing and usual pursuits as far as possible.

Join family/ adolescent support groups at diagnosis.

Hospital managers provide adolescent clinics at different times from adult/complication clinics.

Outpatient management of insulin initiation avoids admission which can be distressing.

Treat parents as possible patients if they are very distressed. Do they need counselling? Do they need to meet other parents who are more experienced and coping well?

Health care professionals should make an effort to understand the person and the family who has diabetes.

Try to have the same clinicians see the family and patient regularly.

Tailor education to the individual.

Give as much control over to the individual as possible.

Consider psychological input if control is poor or distress is evident.

Provide consolidation courses for the 25-30 age groups.

 

What hinders:

Doctor gives a catastrophic view of diabetes at diagnosis.

Parents keep their child under a tight rein from diagnosis and inadvertently make child feel that they and their lives are very different now.

Being exposed as a new diabetic to very sick older diabetics at clinics or in wards.

Doctors and nurses not talking to parents on their own to see what they may be struggling with.

Too many cooks.

Generic courses.

Courses provided too early in the disease process that don’t seem relevant or where the family/ patient are too stressed to learn usefully.

 Resources for young people with type one diabetes:

https://www.youtube.com/user/type1uncut

http://joes-diabetes.com/pages/joes-rough-guide

http://twitter.com/OurDiabetes

 

Resources for health care professionals:

www.successfuldiabetes.com/working-with-diabetes-workshops/diabetes-workshops/item/111-supporting-young-adults-with-diabetes-a-one-day-workshop

www.diabetescounselling.co.uk

www.diabetes.org.uk/Professionals/Training/–competencies/Courses/Supporting-Young-Adults-with-Diabetes/

Diabetes Australia Position Statement (2011). A new language for diabetes. http://static.diabetesaustralia.com.au/s/fileassets/diabetes-australia/9864613f-6bc0-4773-9337-751e953777cd.pdf

Based on an article by Dr Emily Robinson in Practical Diabetes Nov/Dec 2015

 

 

 

 

“A cross-party long-term strategy is needed to combat obesity in children” says Brian Whittle

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Brian Whittle is a gold medallist runner who aims to introduce widespread after school childcare focussed on delivering high quality exercise and physical activities. This is a long term strategy which is fun for children yet could provide immense health benefits and even enhance academic performance.

There are studies which support the validity of Brian’s aims.  But do enough politicians have the long sightedness and will to ring fence funding that is needed?

In order to prevent obesity in our youngsters and the disorders associated with sedentary behaviour a culture change is needed. The unhealthy eating, snacking and reliance on screen based entertainment needs to be replaced by three good meals a day and movement to counteract the long hours sitting in the classroom. Many parents work long hours too, and would welcome group based physical activity for their children in a safe environment.

Brian is seeking support from leaders and health ministers from all parties.  Some headmasters are highly supportive and are delighted with the improved behaviour, reduced truancy and improved grades that they are seeing in pupils who have become more engaged as a result of fun activities after school.

More than 2.3 million children in the UK are overweight or obese and even the under 12s are showing signs of high blood pressure, cholesterol abnormalities, type two diabetes and liver disease.

Dr Tim Lobstein, director of the Childhood Obesity Programme says,  “ It will be tragic if it is not tackled. Chronic diseases are moving forward at an ever increasing rate. Our kids are eating themselves into an early grave. We will have the first generation to die at an earlier age than their parents. Britain along with some other southern European countries are at the top of the list. While soft drink and confectionery sales have rocketed, and TV watching, computer games, and other sedentary media have grown, exercise has fallen. Unless the obesity epidemic is brought under control we are facing the prospect of medicating kids at primary school and for the rest of their lives. If we can just find a way of encouraging healthy growth then we can avoid an enormous amount of grief in the future. Unless we start teaching our children in schools about raising children, feeding them properly, exercise and the difference between good and bad food, then we are just going to exacerbate the problem.”

Getting children to become more physically active and achieve normal weights has been found to improve attention, planning and thus have knock on effects on academic performance. ( Davis CL et al Pediatr Exerc Sci. August 6 2015)

Children who are more active in late childhood can demonstrate lower body weight and lower risk factors for cardiovascular disease and diabetes by their mid- teens.  This means an hour of moderate to vigorous exercise a day. A national approach involving the collaboration of various government agencies would be needed to produce widespread benefit. (Stamatakis E. Pediatrics Vol 135 No 6. 6 Jun 2015)

For younger children under the age of 6, three hours of activity, spread throughout the day is recommended by the US Institute of Medicine. They hope that such recommendations can help reduce overweight and obesity which is currently at 27% in this age group.

For adults at least 30 minutes of activity a day is recommended. The good news is that the earlier you get into exercise the more the habit is like to stick.  Swimming, dancing, walking, running, yoga, jogging, tennis, basketball and football are all suitable. The fitter you are in early adulthood, the lower your total mortality rate and cardiovascular disease rate. There is a clear dose response between exercise and fitness and fitness, well-being and mortality rates. (Shah et al. JAMA Internal Medicine 1-9)

Even if you have been sedentary for years or cannot tolerate 30 minutes a day, it is recommended by the American Heart Association that you start with walking.  Apart from benefits to the individual there is a benefit in health care costs in the future. ( AHA 6 Dec 15)

Emma and I are already into the exercise habit. It certainly is more of a challenge in Scotland with our awful weather and long, dark, winter nights. What good ways have you found to keep active and support your children to be active?

 

 

 

 

Inhaled Insulin

EmmaLeave a comment

A story on a Minneapolis news website caught our eye this week – it was the story of a New Richmond man who is using inhaled insulin at meals instead of boluses through his pump.

The insulin inhaler – Afreeza – is used instead of injected insulin boluses to cover meals.

Software developer Trevor Schug who was diagnosed with type 1 diabetes last year said he had started using the inhaled insulin this year and he had found that it gave him better control of his blood sugar levels.

On the news website, he said that he felt the inhaled insulin was absorbed into the blood stream more quickly and that it didn’t stay in your system as long, whioch was another bonus as far as he was concerned.

Schug explained that when he would take extra insulin through his pump, it sometimes lingered in his system too long after a meal.

Endocrinologist Dr Mark Stesin said dosing was not as precise for inhaled insulin, which might not make it as suitable for everyone.

The inhaled insulin isn’t recommended for people who smoke or who have recently stopped, or anyone who has chronic lung disease or asthma.

Can shared decision making thrive in the current medical culture?

kaitiscotlandLeave a comment

According to a Cochrane review patients are much more satisfied and have better health outcomes when their health care decisions are made in the context of full information and free choice. Patients said that “being in control” was what they most cherished.

At the present time the NHS doesn’t really support true shared decision making and options are likely to become even more limited with a shortage of doctors and strain on budgets. There also is considerable conflict when it comes to following guidelines which are designed for populations rather than individuals. Should a doctor really let the patient take the consequences of their individual choice or would they just be putting themselves at risk from a General Medical Council hearing?

Yet, not all patients want the most expensive treatments. When given full options a fifth of patients decided to avoid or defer surgery for instance.

What is meant to happen is that patients get given option grids with all the risks, benefits and uncertainties of possible investigations and treatments.  They are then asked, “What is the most important thing to you?” and then the doctor is meant to guide the patient accordingly.

Take bowel cancer screening. Currently all 50 year olds get sent a pack for this along with their birthday cards. Nice that someone remembers eh? They then get given the usual barrage of one sided messages about how bowel screening is really easy and could save your life.

If you care to look at this in more depth bowel cancer screening gives a total mortality benefit of six days to the screened population. The main problem is bowel perforation which occurs in 1 in 800 procedures. This is more likely to happen when going round the bends of the bowel.  Diagnosis of this can be delayed. Presumably with the shared decision making model all this is taken into account and the patient gets a truly informed choice.

Breast screening and statins are similarly pushed with considerable information asymmetry in the NHS.  There is no total mortality benefit to women from breast screening or statins yet that does not stop them being promoted. Not much has changed regarding how health care information is put across to patients in decades. An authoritarian stance is taken by the health care promoter and the patient is treated like an idiot.

With shared decision making it is likely that less money would be spent on useless investigations and treatments. If someone particularly wanted to avoid breast cancer “at all costs” they may be happy to be able to have screening perhaps more frequently than occurs at present, or perhaps they may be offered bilateral mastectomy. Many women would however decline to have mammography and that would be a saving not only for the procedure but for the unnecessary surgery and treatments that follow.

Shared decision making certainly doesn’t occur in diabetic clinics. The high carb / low fat diet is a product of “politics based medicine” rather than “evidence based medicine”.  Shared decision making is not for everyone. There will always be people and situations were doing what a doctor thinks is best is the most appropriate option.

But for a lot of non-acute health issues it is appropriate.  I can only hope that shared decision making doesn’t wither on the vine but a large shift in medical culture will be needed before it becomes regular practice.

Based on BMJ Learning module by Alf Collins.

Red Meat and Cancer Risk

EmmaLeave a comment

steakConfused about health headlines of late and worried that your low-carb diet might give you cancer?

That might be the case if you’ve been reading the reporting of a certain World Health Organisation (WHO) study looking into diet which said eating processed meat increased the chances of developing colorectal cancer by 18 percent, while red meat was “probably carcinogenic” but that there was less evidence.

It depends on where you read the news of course as certain reporting of the story (and other similar research) has blown it out of all proportion – at least with their sensationalist headlines. Take a bow the Daily Mail.

Zoe Harcombe’s blog dissects the research and the headlines. I’d recommend reading it for a more detailed take on the story.

Personally*, I buy good quality, unsmoked bacon and good quality red meat. I don’t eat ham and other processed meats, mainly because I don’t find them very filling – but I’m happy to eat chorizo occasionally. The headlines don’t bother me in the least.

I’ll keep buying and eating unsmoked bacon and good quality red meat because eating them helps me maintain a low-carb diet, which in turn helps me feel lively and energetic, instead of lethargic, grumpy and depressed.

 

*A disclaimer here – you must make up your own mind about what you choose to eat of course…