Category Archives: Education

Christmas with diabetes – make it easy part 3!

How will you start your Christmas morning? Do you treat yourself to anything really special for the first meal of your day?

It’s worth thinking about – because it will set the tone for whether you will find yourself indulging in the inevitable nibbles, or whether you will be able to stave off cravings and resist temptation. The reality, as we’ve seen, is that your main Christmas meal isn’t the problem when thinking about blood sugar control. The problem often lies in the things you might pick at between meals – because these can really make for a carb-fest!

You can guard yourself against that with the right breakfast – one that is rich in proteins, which will keep you satisfied right up until your main Christmas meal. This is another opportunity to really spoil yourself too – make your breakfast a special meal too!

Here are some of my personal favourites:

breakfast 1 Smoked salmon with scrambled egg, and a little fresh dill

 

 

 

kippersKippers or smoked haddock topped with a soft poached egg

 

 

 

 

 

breakfast 2Eggs Florentine – soft poached eggs on a bed of lightly steamed spinach, topped with a dollop of Hollandaise sauce

 

 

 

breakfastNatural yoghurt with mixed berries (blueberries, blackberries and raspberries are my favourite) and mixed seeds (pumpkin, sesame, sunflower, hemp seeds)

 

 

Get your Christmas Day off to the healthiest and tastiest start!

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Christmas with diabetes – make it easy part 2!

Last week we looked at the Christmas lunch main course. OK – so what about the rest of the meal, and especially the pudding?!

Let’s start with the starters – because this is easy. There is an endless choice of low-carb starters that push all the right blood-sugar balance buttons:

Soup anyone? There is nothing more adaptable for a diabetes-friendly meal than a good soup. If this is a soup to complement a roast dinner then let’s avoid the starchy vegetable varieties – as you’ll be getting your share of starchy (and therefore glucose-forming) vegetables as part of your main course – think the carrots, parsnips, sweet potatoes here. So make your soup something without the starches. One of my favourite festive soups is mushroom and walnut. Or how about french onion with melted cheese? Or roasted red pepper soup? Delicious! But steer clear of the bread roll!

If you need any motivation to avoid the bread, then take Giles Coren’s line here. Bread was never intended to be a part of fine dining. It’s original purpose was to fill the bellies of hungry peasants who couldn’t afford better food. So maybe this year it has no place at your lavish Christmas table?

Not a soup person? Nor me really – I find soup too filling as a starter. I’m more for a baked camembert or brie – great with some fresh, sharp seasonal cranberries and a chicory garnish; or garlic mushrooms; or a small Caesar or Waldorf salad.
But I am a Christmas pud fan! There really is no such thing as a truly sugar-free Christmas pudding – how can there be when it’s packed full of dried fruits bursting with natural sugars? But the last thing your pudding needs is any added sugar – why would it? There’s a great recipe, courtesy of Nigella, I would like to share – click here – you’ll find others too I am sure. But if making your own is out of the question, it is perfectly possible to find a good artisan no added-sugar pudding to buy. Take a look at this one. Combine it with cream to slow down the rate at which those sugars find their way into your blood stream!

And enjoy! Just a little piece will do!

Regulate the food industry?

regulationI am reading with interest an article that suggests that Type 2 Diabetes can be halted if we regulate the food industry in the same way we regulate the tobacco industry.  That’s a very bold claim.  

On the one hand I think it’s true that tackling corruption in our food industry will go a long way to helping – at least finally exposing both the harm that so many manufactured food products do to our health, and the cynically flawed messages about healthy eating that the same industry expounds. On the other hand, tobacco regulation hasn’t (yet?) stamped out smoking, hasn’t prevented many millions still being made in tobacco profits, and hasn’t stamped out smoking-related illnesses.

But even if Type 2 Diabetes isn’t actually halted by such regulation, it may well be reduced significantly. Still a significant improvement!

I especially noticed this paragraph:

Larry Cohen, of the Prevention Institute, an institution that aims to prevent chronic diseases, states: “We cannot negotiate with them; we don’t want to let them look good by making it appear as though they are trying to work things out with us. Their primary goal is to make money and if they do that by selling unhealthy products, we need to make it very clear that that is not acceptable.” Mr Cohen’s views on the situation directly oppose the UK government’s approach which has welcomed processed food companies to influence food regulation policy.

For the record, it isn’t just Larry Cohen’s view that directly opposes the UK Government’s approach.  For one there’s mine! And for another there is the British Medical Association, as discussed in another article. That the UK Government’s approach is failing is clearly evident in the facts:

  • Type 2 Diabetes is still on the rise.
  • Obesity is still on the rise.
  • Food industry advertising continues apace, to relying on discredited messages: here’s a good summary by the BBC.
  • Think how many new “healthy low-fat” products have been launched since Harvard School of Public Health declared in 2012 “it’s time to end the low-fat myth!”

The food industry is continuing demonstrably to progress its mission to make as many millions as possible by continuing to promote unhealthy products and messages.  Mr. Cohen speaks the truth.

“So who is Larry Cohen?”, I wanted to know…and then I found the website for the American Prevention Institute. What a laudable organisation this appears to be – we need a UK equivalent!  Mr. Cohen, if you are reading this, please could we have a chat about bringing more of your good work to the UK?  

Does insulin make you fat?

Insulin makes you fat?  It’s an issue covered in an article that I read with great interest this morning.  A recent study suggests that having high levels of insulin in your body will cause you to store body fat.  The question, therefore, is whether insulin is an appropriate treatment for someone with Type 2 diabetes if they are already overweight or obese?

It’s a question that I have posed as part of the RebalanceDiabetes programme for some time.  But in my mind it certainly doesn’t stop with people with Type 2.  What about Type 1s too?  

insulin 2All too often someone with Type 1 is taught to count carbs and compensate for them with insulin, without any discussion about the appropriateness of eating those carbs in the first place. This is no different from someone with a working pancreas, who consumes too many carbs, secretes insulin to deal with that, and ends up overweight or obese…

So is the excess fat a result of the carbs, a sedentary lifestyle or the insulin itself?  Well it’s certainly true that when someone with Type 1 has been using insulin for a few years weight gain is a common ‘side-effect’.  Several of my own Type 1 clients have referred themselves to RebalanceDiabetes to shed the extra pounds because they know that despite maintaining the same diet the pounds have crept on since they introduced insulin into their daily regime.

In clinical trials, it’s quite normal to find differing views.  Where insulin is concerned some trials from about 2006-7 associate insulin with having an anti-inflammatory effect on the body.  Recent reports, however, claim that HIGH levels of insulin are associated with causing inflammation in the body.  Well, if these later views are shown to be correct then they would certainly support that insulin can make you fat, because obesity is increasingly seen as an inflammatory condition – along with Type 2 diabetes, insulin resistance and heart disease.

There is a gathering body of evidence that a high level of insulin is linked with inflammation and weight gain, and this issue has been reported also earlier this year.  So what to do?  Well, as in the old adage – better safe than sorry!  By eating to minimise the need for insulin you’ll be keeping yourself safe – safe from inflammation, from increased insulin resistance, obesity etc.  I’ll be very happy to show you how!

 

Is your G.P. doing enough for your diabetes?

Doctor waiting for a patientData from the National Diabetes Audit 2011/12, released last year, showed only 5% of diabetes patients were referred to a structured education programme during that 12-month period, and of those, just 1% took up the programme.”

But Dr David Payton, RCGP clinical lead for commissioning, warned that increasing self-care support for diabetes patients would require a ‘huge amount of training’ for general practice, which might not be feasible…

These excerpts, from a report I read recently, prompted me to wonder why there is such apparent apathy in meeting recommendations by the National Institute for Clinical Excellence (NICE) that EVERY newly diagnosed diabetic should be given access to structured education? Why would doing so need a massive amount of “unfeasible” training in general practice? 

Could there be another underlying reason? 

Could it be that G.P. targets for diabetes care are simply too lax?

You see, your G.P. practice has to meet specific targets, called QOF, in order to achieve its government subsidy.  Many practices are achieving these easily because they are simply too easy to achieve.

HbA1c is the measure used to reflect average blood glucose levels over a period of weeks.  For non-diabetics that measure is between 20 and 41 mmol/mol.  Get to 42 and you might be described as “prediabetic”.  At 48 a diabetic is thought to be in “good control”.  Above 59, a diabetic is at serious risk of severe complications from the disease.

G.P.s receive their maximum financial incentive when you reach 59.  They have no further incentive through QOF.  There is no financial benefit through QOF for your G.P. to help you reach “good control”.  

In my world that is not OK.  It’s simply not OK!

But this might tell us why doing more is “unfeasible“?  “Unfeasible” for your G.P.’s budget plan maybe.  But an absolute necessity in terms of your health!

health choicesThe big question this week is this:

“If you are simply not going to be given this opportunity within the NHS – what are you going to do for yourself?”

 

Harmful insulin?

Glad to see insulin being questioned in the news this week.  It’s something that RebalanceDiabetes has questioned all along. After all:

  • People on insulin gain weight after a while
  • Doses tend to increase over time – telling you it doesn’t work long term
  • It encourages poor dietary habits – eat what you like and inject insulin to compensate?

And it’s this last point that makes no sense at all.

If someone without diabetes eats to much sugar or too many refined carbs, their bodies naturally produce insulin.  But since these people are likely to go on to develop Type 2 diabetes it’s clear that insulin doesn’t protect from inflammation, insulin resistance, weight gain, Type 2 diabetes, and eventual complications associated with diabetes.

So how is injecting artificial insulin appropriate for people who already have problems with blood sugar?  It’s just not logical.

Of course those with Type 1 diabetes absolutely need some insulin.  Again though, how can it be appropriate to eat carbs freely as long as you compensate with fast acting insulin injections?

So it’s great that this issue is now being more widely recognised.

But what’s the alternative?

Take a look at my vids to see that it’s perfectly possible for Type 2s to live without insulin:

And for Type 1s to dramatically reduce theirs too:

 

 

Diabetes is a problem. What’s the solution?

tonightWas it just me, or was anyone else not just a little disappointed by the Tonight program about Diabetes on Thursday?

It had some good points – and nicely got across the rising tide of obesity related Type 2 diabetes in the UK.  It highlighted the good work being done by Diabetes UK to identify people with the disease or courting it by being at risk.  It highlighted the horrible complications such as amputation and loss of limbs.

It did nothing, however, to suggest a realistic solution to the problem.  Sure it featured the good work being undertaken by Newcastle University to show that a restricted 600-800 calorie diet will reverse the symptoms at an early stage following diagnosis.  But there was nothing on offer for the majority of people living with the disease or at risk in terms of good long-term nutritional and lifestyle advice.

And I have to conclude today that that’s because the mainstream medical profession continues to bury it’s head in the sand, along with the food industry and our government, about what really needs to be done.  As we hit the all time record high of 4 million diabetic people in the UK isn’t it time for a sea-change?

What do I mean?

  • Real education about how the body uses food – it’s not OK for a hospital dietician or nurse or doctor to suggest you can continue to eat pretty much as “normal”, as in the case of the recent ex-CE of the NHS.
  • Hard hitting evidence about the consequences of not dramatically changing the way in which we eat.
  • Personal responsibility – because we need to change our eating habits!
  • Corporate responsibility – because the food industry is knowingly feeding you the stuff that will make you fat, sick and tired!
  • Stretch targets for the medical profession – rather than government incentives for the bare minimum as the QOF framework currently provides.

Is it just me?  Let me know!

Opinions yo-yoing as much as weight loss?

yo yoAnother day, another theory in the world of mainstream medical science?  Last week the headlines ran with a story that weight loss at any age was beneficial – even if it ultimately was regained.  It’s not a story I chose to cover last week, because it was blatantly wrong in my opinion.  It absolutely matters if people lose and regain weight in that yo-yo dieting sense.  And it matters because it messes up body composition – causing a gradual exchange of healthy lean tissue for body fat.  This was identified in some good research a few years ago.  So the advice last week that:

A new study from the UK suggests it is never too late for adults to lose weight. No matter when in adulthood it happens and even if the weight goes back on again, it can still have a long-term beneficial effect on the heart and cardiovascular system.”

seemed pretty crazy to me! Even though it was a story reported in the Lancet, it was one that I couldn’t identify with at all.

And nor should the press have identified so readily with it – after all it’s a mere 3-4 years ago that the headlines warned of the dangers of dieting!  Then they said yo yo dieting was OK after all.  Then they said it was dangerous – again!

Was I wrong?  Well thankfully not – because the news reports this morning state the opposite of those headlines last week – that it is vital that weight lost stays off! This is a piece of reporting that I can happily share with you – because I know it backs up previous good quality research!

What this shows me – and what I want to share with you – is that it’s really important to understand the why behind the how when it comes to weight loss and health.  It isn’t enough to blindly follow advice without that advice having been explained in detail, and for you to understand exactly how the food you are being asked to eat will be processed in your body, what effects it will have, and what the outcomes are targeted to be.  And it isn’t enough for journalists to jump on a new headline without troubling themselves to look into exactly what they are reporting – because the result is another day another theory, and more confusion.  That’s not fair to those of you who are determined to look after your weight and health, but are being misinformed and misled by unsubstantiated reporting.

And that’s where RebalanceDiabetes is different: we don’t just tell you the how, we go to great lengths to educate you about the why.  At the end of a RebalanceDiabetes program you look and feel a whole lot better, but you also have the skills to look after yourself for life – no more confusion, just clarity!

Will the NHS collapse under the weight of obesity?

fat lassSo, according to Dr. Hilary Jones, the obesity crisis will be the thing that finally bankrupts the NHS?  Well I have no doubt that the costs associated with obesity and its consequences – diabetes, heart disease etc. – will indeed become an increasing burden on our health economy.

But I am thoroughly sick and tired of those responsible for creating the obesity crisis not being called to account!

First we have headlines that blame foods for our problems – I am thinking about the one that says “Fruit juice timebomb“, and the one asking “Why sugar is ruining our health“.  OK – again I have no doubt that these foods are harmful.  But foods do not promote themselves to us – people promote them to us!  The people who sell them; the so-called health professionals who promote them and advise patients to use them; and the policy makers who turn a blind eye to all this; they are the real culprits here: not the foods themselves.

In his article on his personal experience of dealing with diabetes the former Chief Exec of the the NHS, David Nicholson, openly tells us that his hospital dietician says that diabetics can “eat almost anything”.  Erm – NO!!

Then we have the lovely but totally misguided celebs who this week praised a massively overweight pole fitness performer on Britain’s Got Talent for being a great role model to young women.  Yes this girl has body confidence and pole-fitness talent, and I am truly glad she isn’t influenced by unhealthy skinniness, but to describe a 15-stone-heading-right-into-diabetes-and-other-health-problems-27-year-old-woman as a good example really doesn’t help the cause for a healthy nation. And before you get upset about me criticising Emma Haslam – I am not criticising Emma Haslam at all.  I have no idea why she is overweight despite obviously training so hard – but I am prepared to take a guess that she also is being criminally misled by the food and medical industries about just what constitutes healthy eating!

So this week I am right behind the calls for food regulation.

As David Nicholson identified for himself – he needed rules (not permission to eat anything he fancied – albeit on the background of a healthy diet).  He knew he wouldn’t hack it.  And now that we have a nation of people who believe they deserve, and can get away with, sugary treats on a daily basis, as the food industry would like you to believe, I sadly have to similarly conclude that many people can’t hack it either! And that’s because although I believe people really do try, their efforts are constantly undermined by mis-information!!

So sensible regulation it is then!

I am completely with Dr Tim Lobstein at the World Obesity Federation who said:

If obesity was an infectious disease, we would have seen billions of dollars being invested in bringing it under control. But because obesity is largely caused by the overconsumption of fatty and sugary foods, we have seen policy-makers unwilling to take on the corporate interests who promote these foods.”

And I am merely amused by Terry Jones’ (director of communications at the Food and Drink Federation) cynical claim that:

UK food and drink manufacturers were “already” supporting improvements to public health through many of the measures outlined in the recommendations.”

Sadly he does seem to be fooling an awful lot of people – along with those policy makers who have demonstrated a complete disregard for public health so far!

So will obesity cause the collapse of the NHS?  Well only with the help of the food industry, the medical profession and the government!

End days for the NHS?

moneydownthedrainSo last week my blog focused on the financial worries of the NHS, and how that might impact on diabetes care in the UK. Not as a distant concern, but an immediate one – taking into account a key report on the unsustainability of the NHS.

If the imminent collapse of this beloved institution seems overblown and far-fetched, you might be unnerved to find that GPs are considering charging for each visit to their surgeries, as reported by the Telegraph.

I love the quote, “But some leading doctors suggested the measure could put off patients with a genuine need for help, and could “hinder the doctor-patient relationship“.  Well for sure it will change it.  It hopefully means that patients will expect results for their money!  

And where diabetes is concerned it’s about time we expected some results for the £10 billion spent within the NHS every year!  For £10 billion we should be expecting a year-on-year improvement, yet the latest figures from Diabetes UK continue to make the same old gloomy predictions:

A report by charity Diabetes UK, seen by The Daily Mail, says managing the condition already accounts for about 10 per cent of the total NHS budget, with most being spent on complications such as amputations and strokes. Costs will continue to rise over the next 20 years, warns the charity, when diabetes is expected to account for 17 per cent of the NHS budget. Diabetes UK argues that money is often spent badly, with sufferers diagnosed late, meaning they have to spend extra days in hospital running up huge bills for the NHS. Barbara Young, chief executive of Diabetes UK, said: “The NHS is spending an eye-watering amount on diabetes but the money isn’t being used effectively, which is running up a huge bill for the future“.

In the same report Diabetes UK acknowledge that hope lies in education – yet reports that only 10% patients are being offered that.  And they are unlikely to be offered more care from a devoid financial pot I would suggest!

It just doesn’t pan out does it?  A need for a rise from 10% to 17% of the total NHS budget to be used for diabetes care is hardly likely to happen with the current financial predictions. How can it?

So will you spend your own cash at the GP surgery (on top of the billions in taxes they already receive how can you be sure this won’t be pouring your money down the drain)?  Or are you ready yet to take up access to the means for much better clinical outcomes for yourself and your loved ones?

Ready and willing to help for a fraction of what you might have to spend on existing NHS services – RebalanceDiabetes reporting for duty – click here!