Archive for category DIETS

Fructose : What does this mean?

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There are times doctors get pretty confused and frustrated by the research that is produced, particularly when it is not within their own specialty. What chance therefore do patients have?

Here is a paper telling us that too much fructose is bad for you. Now this upsets me because I have always considered I eat a healthy diet that contains vast amounts of fruit, which of course is teeming with fructose. Do I now need to reconsider that what I am eating? Is my high fruit intake unhealthy?

Although they are addressing the fructose content of corn syrup as an additive added as a sweetener by the food industry, what are the implications for those of us who do not eat many packaged foods but eat a diet full of fruits and vegetables where fruits predominate over vegetables?

I have just read the abstract of this paper. I suppose I’m going to have to study the whole paper in more detail and any subsequent follow-up papers too.

FRUCTOSE, INSULIN RESISTANCE AND METABOLIC DYSLIPIDEMIA

COUNTRY : CANADA

“Abstract
Obesity and type 2 diabetes are occurring at epidemic rates in the United States and many parts of the world. The “obesity epidemic” appears to have emerged largely from changes in our diet and reduced physical activity. An important but not well-appreciated dietary change has been the substantial increase in the amount of dietary fructose consumption from high intake of sucrose and high fructose corn syrup, a common sweetener used in the food industry. A high flux of fructose to the liver, the main organ capable of metabolizing this simple carbohydrate, perturbs glucose metabolism and glucose uptake pathways, and leads to a significantly enhanced rate of de novo lipogenesis and triglyceride (TG) synthesis, driven by the high flux of glycerol and acyl portions of TG molecules from fructose catabolism. These metabolic disturbances appear to underlie the induction of insulin resistance commonly observed with high fructose feeding in both humans and animal models. Fructose-induced insulin resistant states are commonly characterized by a profound metabolic dyslipidemia, which appears to result from hepatic and intestinal overproduction of atherogenic lipoprotein particles. Thus, emerging evidence from recent epidemiological and biochemical studies clearly suggests that the high dietary intake of fructose has rapidly become an important causative factor in the development of the metabolic syndrome. There is an urgent need for increased public awareness of the risks associated with high fructose consumption and greater efforts should be made to curb the supplementation of packaged foods with high fructose additives. The present review will discuss the trends in fructose consumption, the metabolic consequences of increased fructose intake, and the molecular mechanisms leading to fructose-induced lipogenesis, insulin resistance and metabolic dyslipidemia.”

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Herbs : Liver damage

In spite of being a user of calendula cream for many years and having an interest in the medically active ingredients in plants, I remain very sceptical when herbal products are promoted. Mostly they are used by practitioners of alternative medicine.

Herbal preparations are not well regulated and can sometimes do harm.

A paper is due to be published in “Internal and Emergency Medicine,” the official journal of the Italian Society of Internal Medicine warning of the dangers of damage to the liver by some products. As yet only the abstract is available. The full article will, when published require subscription to the journal.

HERBAL HEPATOTOXICITY : A HIDDEN EPIDEMIC

COUNTRY : ITALY

Abstract
Complementary and alternative therapies, including herbal products, have become increasingly popular in the general population and among patients and physicians. Regulations and pharmacovigilance regarding herbal drugs are still incomplete and need to be improved. In fact, herbals are commonly marketed on the Internet, and in many countries they are sold as food supplements, which are beyond the control of drug regulatory agencies. In Europe and the U.S., reports of hepatotoxicity from these products, including those advertised for liver diseases, are accumulating. Many herbal drugs are also commonly used in children, and in women during pregnancy and lactation, because they are believed to be “natural” and, therefore, “harmless.” One emerging problem is people preferring herbal-based slimming aids to conventional dietary and physical activity. In Italy, the use of non-conventional therapies has been reported for 13.6 % of the population, and 3.7 % freely use herbal drugs, unaware of the risks associated with a potential interaction with prescription drugs. In our review, we discuss the problem of the lack of standardization of herbal drugs, the lack of randomized clinical trials regarding the majority of these products, the unawareness of risks by the patients who buy and use them, and, further, the problem of underreporting. For the most commonly used herbal products and slimming aids, we describe their potential hepatotoxicity mechanisms, the causality assessment necessary for a correct diagnosis, and the clinical patterns for which these products seem to be responsible.”

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Have a daily chocolate spa!

Nobody really seems to know the reason why, but latest research appears to show that eating chocolate is good for you as long as it doesn’t make you fat! So I suppose the thing to do is go on a diet that is low on chocolate and other fattening things until your reach your ideal weight and then indulge yourself daily with chocolate, fruit, veg and all other things in moderation.

And exercise too of course!

CHOCOLATE CONSUMPTION AND CARDIOMETABOLIC DISORDERS: SYSTEMIC REVIEW AND META-ANALYSIS

COUNTRY: UK AND COLOMBIA

Abstract
Objective To evaluate the association of chocolate consumption with the risk of developing cardiometabolic disorders.

Design Systematic review and meta-analysis of randomised controlled trials and observational studies.

Data sources Medline, Embase, Cochrane Library, PubMed, CINAHL, IPA, Web of Science, Scopus, Pascal, reference lists of relevant studies to October 2010, and email contact with authors.

Study selection Randomised trials and cohort, case-control, and cross sectional studies carried out in human adults, in which the association between chocolate consumption and the risk of outcomes related to cardiometabolic disorders were reported.

Data extraction Data were extracted by two independent investigators, and a consensus was reached with the involvement of a third. The primary outcome was cardiometabolic disorders, including cardiovascular disease (coronary heart disease and stroke), diabetes, and metabolic syndrome. A meta-analysis assessed the risk of developing cardiometabolic disorders by comparing the highest and lowest level of chocolate consumption.

Results From 4576 references seven studies met the inclusion criteria (including 114 009 participants). None of the studies was a randomised trial, six were cohort studies, and one a cross sectional study. Large variation was observed between these seven studies for measurement of chocolate consumption, methods, and outcomes evaluated. Five of the seven studies reported a beneficial association between higher levels of chocolate consumption and the risk of cardiometabolic disorders. The highest levels of chocolate consumption were associated with a 37% reduction in cardiovascular disease (relative risk 0.63 (95% confidence interval 0.44 to 0.90)) and a 29% reduction in stroke compared with the lowest levels.

Conclusions Based on observational evidence, levels of chocolate consumption seem to be associated with a substantial reduction in the risk of cardiometabolic disorders. Further experimental studies are required to confirm a potentially beneficial effect of chocolate consumption.

Here is what The Guardian says about the research.

CHOCOLATE IS GOOD FOR YOU, DECLARES STUDY (WELL, SORT OF)

And here is a link to some of their chocolate recipes (only to be indulged in if you have reached your ideal weight!)

CHOCOLATE

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Foods to avoid during pregnancy

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For generations women have eaten what they felt like eating, and what was available to them throughout pregnancy and, as far as we know, mother and baby only very occasionally came to any harm. There are some foods that are now considered to pose varying degrees of risk. If you have eaten any of these in error don’t worry, the chances are you and the baby will be OK, but follow a guide like the one on the link below from now on to ensure any risk is negligible.

FOODS TO AVOID DURING PREGNANCY

COUNTRY: UK

Some types of cheese

Don’t eat mould-ripened soft cheese, such as brie, camembert and chevre (a type of goat’s cheese) and others with a similar rind, whether they are made using pasteurised or unpasteurised milk. You should also avoid soft blue-veined cheeses such as roquefort and gorgonzola. These are made with mould and they can contain listeria, a type of bacteria that can harm your unborn baby. Although infection with listeria (listeriosis) is rare, it is important to take special precautions in pregnancy because even a mild form of the illness in a pregnant woman can lead to miscarriage, stillbirth or severe illness in a newborn baby.
Don’t eat cheese made from unpasteurised milk. You can eat hard cheeses such as cheddar and parmesan, and many types of cheeses made from pasteurised milk such as cottage cheese, mozzarella, feta, cream cheese, paneer, ricotta, halloumi, and processed cheeses such as cheese spreads.

In summary, the foods to avoid are:

Some types of cheese
There is a whole range of cheeses that should be avoided. The risk is listeria.

Pâté
Avoid all types. The risk is listeria.

Raw or partially cooked eggs
Risk is salmonella food poisoning. Avoid all foods containing undercooked eggs e.g. home made mayonnaise.

Raw or undercooked meat
Risk is harmful bacteria such as salmonella, campylobacter, E coli 0157.

Liver products
Risk is may contain too much vitamin A.

Supplements containing vitamin A
Risk is too much vitamin A.

Some types of fish
Some types of fish may contain high levels of mercury. Others are safe. See link for details.

Raw shellfish
Uncooked shellfish may contain harmful microorganisms.

Peanuts
Risk once thought to be peanut allergy in infant. Advice has recently been changed regarding this. See link for details.

Unpasteurised milk
Only drink milk that has been pasteurised or UHT. Avoid all foods including cheeses that contain unpasteurised milk. Risk is infection.

Foods with soil on them
Wash all foods, veg and salads. Risk is microbiological contamination.

Caffeine
Risk of low birth weight. Click on link for safe amounts.

Sushi
Risk is parasites but only if not frozen first. Chech link for details.

Cold meats and smoked salmon
Risk is listeria but much lower than cheese. UK does not advise restriction but some countries do.

Alcohol
See separate post (to come soon).

FOODS TO AVOID DURING PREGNANCY

COUNTRY: UK

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The Mediterranean diet

Mediterranean diets like all others are variable but the general theme is that they tend to be high in fruit and vegetables, high in olive oil compared with dairy fats and lower in meat than in the UK.

A recent analysis of 500,00 people from 50 studies was published in the Journal of the American College of Cardiology was reviewed by the team at “Behind the Headlines.”

MORE EVIDENCE FOR THE MEDITERRANEAN DIET

“Importantly, some of the analyses combined studies that were very different from one another in terms of the sample size, study duration, trial quality and context of intervention. These analyses had a high ‘statistical heterogeneity’, which is a way of measuring whether it is appropriate to pool them or not (higher heterogeneity means pooling is less appropriate). The researchers say that this “introduces a warning about the generalisation of the present results”.
The outcomes were related to risk factors for cardiovascular disease, not the disease itself. It is, therefore, an extrapolation, although perhaps not an unrealistic one, to claim that this study proves that the Mediterranean diet has an effect on cardiovascular disease outcomes.

Overall, this research provides further evidence of the benefits of eating a Mediterranean-style diet and quantifies the benefit in terms of the individual risk components of metabolic syndrome.”

COUNTRY : MULTINATIONAL

COUNTRY : UK (COMMENT)

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Webwhispering Diet : Granny McAdam’s tablet

Warning! Here is The First Bad Red Egg. The first forbidden treat. One that most healthy diets would not allow!

If Granny McAdam was still alive she would be a great, great granny. She would be delighted to know her recipe for Scottish tablet was appearing on something that would bamboozle her – The World Wide Web. She would be a bit amazed to learn that a recipe brimming with all the diet nasties was being used in a healthy eating diet. Granny McAdam lived till she was nearly a hundred but I’ve no idea how much of her own tablet she ate and how much she gave away. Consequently, I can’t say that her tablet was related to her longevity. However, I know she always had some stored away in a tin box, and visitors were given a little bag of it as they went out the door and a little hand-picked bunch of flowers from her garden.

Probably most doctors and dietitians would disapprove of me having Granny McAdam’s tablet as part of a healthy eating/weight reduction diet. The beauty of having a blog that is not affiliated to anyone apart from myself means that I can tell you about my own approach to my own healthy eating, eccentric though it may be.

The aim is to eat absolute everything I like, but to adjust the amounts and frequency of consumption of each item until weight loss occurs (I am hoping to lose two stones slowly but steadily and keep that weight off for the rest of my life). If you follow any diet pyramid, tablet, sugar and butter will always be near the top – to be eaten in small amounts. Like Granny McAdam, I’m going to have treats available at all times. None of this “don’t have it in the house – it will tempt you” approach. The diet is not gong to control me, I’ll control the diet.

So here is the recipe:

GRANNY McADAM’S TABLET

UTENSILS

Scales or other measuring things
A big thick based pot
A long handled wooden spoon.
A greased square baking tray with edges high enough to prevent the fluid tablet from overflowing.
A knife.
A tin storage box

If you want to give it away some clear bags suitable for food.
If you want to make it really, really pretty, some ribbon to tie them with.

INGREDIENTS

1/4 lb butter
1 cup water
2 lbs white sugar
Vanilla pod or vanilla essence to taste.
1 tin Fussel’s condensed milk.
(Granny McAdam always used Fussels. Nothing else would do. However, since then companies have been buying each other over and nobody knows who’s who nowadays when it comes to condensed milk. They’ll need to use Carnation Light Condensed milk seems to be much the same recipe as Fussels NOT Carnation Evaporated milk…… THIS WON’T WORK)

PROCEDURE

Put butter and water in the pan and melt.
Add sugar then condensed milk.
Bring to the boil, stirring all the time.
(Granny McAdam used to say the secret was in the stirring. You must stir and stir without ceasing she said. For half an hour if necessary.)
When getting sugary at the sides of the pan, stir in vanilla pod and remove when flavour is right, or add vanilla essence to required taste.
Test consistency by spooning out a little into a cup of cold water. It should set sugary not runny.
Keep stirring all the time – it should turn into a deep golden colour.

When consistency and colour is just right, pour into greased tin.
Before it has cooled completely mark into even squares.
Break up into pieces when cold
Scrape every bit that remains in the pot, store it in a jar and use it for sprinkling on ice cream – another treat!

Enjoy!

It might take a bit of practice to get the consistency, colour and texture right. This is NOT fudge and it is NOT toffee. It is Scottish tablet, and this recipe once mastered, if you keep stirring according to Granny McAdam’s instructions, makes the best tablet in the world!

A real treat!

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Gastric banding : US FDA update

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You wouldn’t catch me contemplating gastric banding or any other surgical procedure simply to lose weight unless there were very exceptional circumstances. The reasons for this are as follows.

1. I would could consider weight control to be my responsibility and no-one else’s. Why on earth would I want a surgeon controlling the size of my stomach?

2. There are risks associated with all surgical procedures.

3. Patients undergoing the procedure must also be willing to make the lifestyle and dietary changes necessary to maintain weight loss. Why not make the changes anyway and do it all yourself?

4. It sounds like a cash cow for the private sector.

However, the Food and Drug Administration in the USA have given what is probably an amber light to one manufacturer. They have conceded to a degree but have not allowed the full set of indications as sought by the company.

GASTRIC BANDING
COUNTRY : USA

“FDA expands use of banding system for weight loss

The U.S. Food and Drug Administration has expanded the use of Allergan’s LAP-BAND Adjustable Gastric Banding System, a device implanted around the upper part of the stomach to limit the amount of food that can be eaten at one time.

The Feb. 16, 2011, approval expands the use of the LAP-BAND to include obese individuals with a BMI of 30 to 34 who also have an existing condition related to their obesity.

The FDA approved the LAP-BAND in 2001 for use in severely obese patients with a body mass index (BMI) of at least 40, those with a BMI of at least 35 and who also have an existing severe condition related to their obesity, such as heart disease or diabetes, or those who are at least 100 pounds overweight. BMI is a general measure of body fat based on an individual’s weight and height.

The LAP-BAND is intended to be used for weight loss in adults who have not lost weight using non-surgical weight loss methods. The newly-approved indication is limited to patients with a BMI of 30 to 34 and at the highest risk of obesity-related complications. This represents a narrower indication than originally sought by Allergan. The company had also proposed to expand the indication to include people with a BMI of 35 to 39 and no obesity related condition. Patients using the LAP-BAND must be willing to make major changes to their lifestyle and eating habits.

“Obesity is a major public health concern in the United States,” said William Maisel, M.D., M.P.H., deputy director for science at the FDA’s Center for Devices and Radiological Health. “A healthy lifestyle and weight loss are keys to improvements in health and a person’s overall quality of life.”

Use of the LAP-BAND in patients with BMIs between 30 and 40 was examined in a U.S. study. Results showed that 80 percent of patients lost at least 30 percent of their excess weight and kept it off for one year. Some patients in the study lost no weight, while others lost more than 80 percent of their extra weight.

In the same study, more than 70 percent of patients experienced an adverse event related to LAP-BAND, most often vomiting and difficulty swallowing. The events ranged from mild to severe but most were mild and resolved quickly.

Seven out of 149 patients needed other procedures after implantation: four to remove the LAP-BAND, two for port revisions, and one to reposition the LAP-BAND.

The LAP-BAND works by limiting the amount of food that can be eaten at one time and increasing the time it takes for food to be digested, to help people eat less. It is placed around the upper part of the stomach during a surgical procedure. The band creates a small stomach pouch that holds a small amount of food.

The LAP-BAND should not be used in certain people, for example, those who are poor candidates for surgery, have certain stomach or intestinal disorders or an infection, take aspirin frequently, or are addicted to alcohol and/or drugs. It should also not be used in those not able or willing to follow dietary and other recommendations.

The LAP-BAND is marketed by Allergan Inc., based in Goleta, Calif.”

You can read more about what the procedure involves here:

LAP-BAND® Adjustable Gastric Banding (LAGB®) System – P000008

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Food pyramid review

Here is yet another food pyramid with loads of carbohydrate on the base.

Once more, I am of the opinion that I could not under any circumstances devour a diet with such a large proportion of carbohydrate and have already decided that fruit and vegetables will be the predominant food in my own Webwhispering Diet.

What interests me is that there seems to be a nutrition expert questioning the wisdom of following a diet so rich in carbohydrates. He seems to think it might be making the American population fat. He also emphasise the needs for diets to reflect the individual rather than “one size does all.”

Cell Biology Professor Richard Feinman Discusses the ‘Food Pyramid’ Dietary Guidelines: MyFoxDC.com

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Webwhispering diet : organising the treats

This food pyramid, like the previous one, has pasta, bread and other carbohydrates at the base.

This is definitely not for me. I could never have a diet that predominates in these foods. Fruit and vegetables will need to be at the base of my pyramid, but I’m not sure yet what the middle layers will be.

One thing for sure though. Chocolate and sweets are bound to feature on the top layer of anyone’s food pyramid. The secret is to restrict these but at the same time not be aware that they are being rationed. At the moment my plan is to give myself a daily treat and look forward to this.  Because only small quantities are eaten they will become more and more of a treat.

I’m going to choose two of my home made favourites that will always be in my box of treats. By making them myself in my own kitchen, it will continually reinforce to me how much fattening stuff they contain – a reminder to restrict them.

The first treat will be “Granny MacAdam’s tablet.”

The second will be “Mum’s orange and biscuit no-bake cake.”

Oh, how I love these two fattening treats!

Recipes to follow soon.

I won’t start on this lifelong healthy eating diet until The Treat Tin is full.

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Webwhispering diet: food pyramids

It is fashionable to turn healthy eating into the form of a pyramid.

There are several types of food pyramid and each relates to cultural eating patterns. For example, there is a Mediterranean pyramid, an Asian pyramid etc.

It seems to me there is a problem. Nowadays in the UK we enjoy a multicultural diet, so what pyramid do we follow? Do we flit form one pyramid to another? If so, will that prevent losing weight to a healthy level because we convince ourselves we can eat all the foods freely from the bottom level of all the food pyramids?

I’ll need to prepare my own food pyramid before I start dieting. One thing for sure, it won’t be the one shown here. My “base” will be fruit and vegetables. There are two reasons for this. I love fruit and vegetables and wouldn’t want to restrict them much. Furthermore, a diet with a basis of fruit and vegetables means that it is possible to have very quick meals without any cooking involved at all – and this has a huge advantage if you don’t have much free time to spend in the kitchen.

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