Diabetes – The Medical Facts. (WARNING – Disturbing Images)

You hear a lot about diabetes, but you possibly do not get detailed information about the actual processes involved in its development, nor about the specific and, frankly, disturbing consequences of living with this debilitating disease.

This blog goes into some detail and shows some disturbing photos of the results of diabetes. If you do not wish to see these images, you can contact me for a copy of this blog without any images.

I have a very specific reason for covering this issue in such vivid detail: It is no exaggeration to claim that diabetes, particularly but not exclusively type 2 diabetes, is becoming an epidemic in the western world, and not just starting in middle age, but appearing in younger generations. There is solid and reliable evidence that this is due to the western diet – dependent on animal products, low-fibre, high-sugar and fat processed foods, and deficient in whole plant foods.

I will present other articles in defence of this assertion but, for the time being, I want to focus on the disturbing reality of those people who live with diabetes – a largely avoidable chronic disease which has been shown to be both avoidable and reversible by eating a whole food plant-based diet.


Diabetes mellitus (1.) (DM) is caused by complete absence, relative deficiency of, or resistance to the hormone insulin.

The most common forms of DM are categorised as type 1 diabetes mellitus or type 2 diabetes mellitus.

Definitions

Type 1 diabetes mellitus

  • previously known as insulin-dependent diabetes mellitus (IDDM)
  • mainly occurring in children and young adults
  • onset is usually sudden and can be life threatening
  • severe deficiency or absence of insulin secretion due to destruction of β-islet cells of the pancreas
  • treatment with injections of insulin is required
  • usually evidence of an autoimmune mechanism that destroys the β-islet cells
  • genetic predisposition and environmental factors, including viral infections. Diet/lifestyle are also implicated

Type 2 diabetes mellitus

  • previously known as non-insulin-dependent diabetes mellitus (NIDDM)
  • most common form of diabetes, accounting for about 90% of cases
  • causes are multifactorial and predisposing factors include:
    • obesity
    • sedentary lifestyle
    • increasing age: predominantly affecting middle-aged and older adults but increasingly affecting younger groups
    • genetic factors
  • onset is gradual, often over many years
  • frequently undetected until signs are found on routine investigation or a complication occurs
  • insulin secretion may be below or above normal
  • deficiency of glucose inside body cells occurs despite hyperglycaemia (high blood sugar) and high insulin level, possibly because of:
    • insulin resistance, i.e. changes in cell membranes that block insulin-assisted movement of glucose into cells.
  • treatment involves diet and/ or drugs, although sometimes insulin injections are required

Pathophysiology (disease processes) (2.) of DM

1. Raised plasma glucose level

After eating a carbohydrate-rich meal the plasma glucose level remains high because:

  • cells are unable to take up and use glucose from the bloodstream, despite high plasma levels
  • conversion of glucose to glycogen in the liver and muscles is diminished
  • gluconeogenesis (non-carbohydrate glucose production) (3.) from protein, in response to deficiency of intracellular glucose.

2a. Glycosuria (sugar in urine) (4.) and 2b. Polyuria (excessive urination) (5.)

a. Glycosuria results in electrolyte imbalance and excretion of urine with a high specific gravity.

b. Polyuria leads to dehydration, extreme thirst (polydipsia) and increased fluid intake.

3. Weight loss

Cells “starved” of glucose – leading to:

  • gluconeogenesis from amino acids/body protein, causing muscle wasting/tissue breakdown/further increases in blood glucose
  • catabolism of body fat, releasing some of its energy and excess production of ketone bodies (6.)
    • very common in type 1 DM
    • sometimes occurs in type 2 DM

4. Ketosis (7.)and ketoacidosis (8.)

  • generally affects people with type 1 DM – in absence of insulin to promote normal intracellular glucose metabolism, alternative energy sources must be used instead and increased breakdown of fat occurs. Results in:
    • excessive production of weakly acidic ketone bodies, which can be used for metabolism by the liver
    • ketosis develops as ketone bodies accumulate.
    • excretion of ketones is via the urine (ketonuria) and/ or the lungs giving the breath a characteristic smell of acetone or ‘pear drops’.
    • ketoacidosis develops owing to increased insulin requirement or increased resistance to insulin.
    • if untreated it can lead to:
      • increasing acidosis (↓ blood pH) due to accumulation of ketoacids
      • increasing hyperglycaemia
      • hyperventilation as the lungs excrete excess hydrogen ions as CO2
      • acidification of urine – the result of kidney buffering
      • polyuria as the renal threshold for glucose is exceeded
      • dehydration and hypovolaemia (9.) (↓ BP and ↑ pulse) – caused by polyuria
      • disturbances of electrolyte balance accompanying fluid loss:
        • hyponatraemia (10.) (↓ plasma sodium) and hypokalaemia (11.) (↓ plasma potassium)
        • confusion, coma and death

5, Acute complications of DM

  • Effects and consequences of diabetic ketoacidosis are outlined above
  • Hypoglycaemic coma:
    • occurs when insulin administered is in excess of that needed to balance the food intake and expenditure of energy
    • sudden onset and may be the result of:
      • accidental overdose of insulin
      • delay in eating after insulin administration
      • drinking alcohol on an empty stomach
      • strenuous exercise
      • insulin-secreting tumour
    • Common signs and symptoms of hypoglycaemia include:
      • drowsiness
      • confusion
      • speech difficulty
      • sweating
      • trembling
      • anxiety
      • rapid pulse.
      • May progress rapidly to coma without treatment
      • Rapid recovery with treatment M

6. Long-term complications of DM (Type 1 and type 2)

  • Cardiovascular disturbances
    • DM is a significant risk factor for cardiovascular disorders
    • Blood vessel abnormalities (angiopathies) may still occur even when the disease is well controlled by medication
    • Diabetic macroangiopathy (12.). Most common lesions are:
      • atheroma
      • calcification of the tunica media of the large arteries. Resulting in:
        • Often serious and fatal consequences for Type 1 diabetes at a relatively early age.
        • For both Type 1 and Type 2, the most common consequences are serious and often fatal:
          • ischaemic heart disease (angina and myocardial infarction)
          • stroke
          • peripheral vascular disease.

  • Diabetic microangiopathy (13.). This affects small blood vessels and can result in:
    • thickening of the epithelial basement membrane of arterioles, capillaries and, sometimes, venules. Leading to:
      • Peripheral vascular disease, progressing to gangrene and ‘diabetic foot
      • Diabetic retinopathy (14.)
      • Visual impairment
      • Diabetic nephropathy (15.) and chronic renal failure
      • Peripheral neuropathy (16.) causing sensory deficits and motor weakness
    • Infection
      • DM predisposes to infection, especially by bacteria and fungi, possibly because phagocyte activity is depressed by insufficient intracellular glucose. Infection may cause:
        • boils and carbuncles
        • vaginal candidiasis (17.)
        • pyelonephritis (18.)
        • diabetic foot
    • Renal failure
      • This is due to diabetic nephropathy (15.) and is a common cause of death.

  • Visual impairment and blindness
    • Diabetic retinopathy (14.)
      • commonest cause of blindness in adults between 30 and 65 years in developed countries
      • increases the risk of early development of cataracts
      • increase the risk of early development of other visual disorders

 

 

  • Diabetic foot
    • Many factors commonly present in DM contribute to the development of this serious situation:
      • disease of large and small blood vessels impairs blood supply to and around the extremities
      • if peripheral neuropathy (16.) is present:
        • sensation is reduced
        • a small injury to the foot may go unnoticed, especially when there is visual impairment
        • in DM healing is slower and injuries easily worsen if aggravated, e.g. by chafing shoes
        • often become infected
        • an ulcer may form
        • healing process is lengthy, if at all
        • in severe cases the injured area ulcerates and enlarges
        • may become gangrenous
        • sometimes to the extent that amputation is required.

Why risk or suffer from this truly dreadful disease if the most effective prevention and cure (a WFPB diet) has no side-effects other than improved overall health?

What an unfathomable species we are…

 

 


Glossary

  1. ” Of or pertaining to honey” – https://en.wiktionary.org/wiki/mellitus.
  2. “The physiological processes associated with disease or injury” – https://en.wiktionary.org/wiki/pathophysiology
  3. “The metabolic process in which glucose is formed, mostly in the liver, from non-carbohydrate precursors” – https://en.wiktionary.org/wiki/gluconeogenesis
  4. “The presence of sugars (especially glucose) in the urine, often as a result of diabetes mellitus” – https://en.wiktionary.org/wiki/glycosuria
  5. “The production of an abnormally large amount of urine; one symptom of diabetes” – https://en.wiktionary.org/wiki/polyuria
  6. “Any of several compounds that are intermediates in the metabolism of fatty acids” – https://en.wiktionary.org/wiki/ketone_body#English.
  7. “A metabolic state in which the body produces ketones to be used as fuel by some organs so that glycogen can be reserved for organs that depend on it. This condition occurs during times of fasting, starvation, or while on a ketogenic weight-loss diet” – https://en.wiktionary.org/wiki/ketosis.
  8. “A severe form of ketosis, most commonly seen in diabetics, in which so much ketone is produced that acidosis occurs” – https://en.wiktionary.org/wiki/ketoacidosis.
  9. “A state of decreased blood volume” – https://en.wiktionary.org/wiki/hypovolemia#English.
  10. “An abnormally low concentration of sodium (or salt) in blood plasma” – https://en.wiktionary.org/wiki/hyponatremia#English.
  11. “The condition of having an abnormally low concentration of potassium ions in the blood” – https://en.wiktionary.org/wiki/hypokalemia#English.
  12. Angiopathy of the larger blood vessels” – https://en.wiktionary.org/wiki/macroangiopathy.
  13. Angiopathy of the small blood vessels” – https://en.wiktionary.org/wiki/microangiopathy.
  14. “Non-inflammatory disease of the retina” – https://en.wiktionary.org/wiki/retinopathy.
  15. “Damage to, disease of, or abnormality of the kidneys” – https://en.wiktionary.org/wiki/nephropathy.
  16. “Any disease of the peripheral nervous system” – https://en.wiktionary.org/wiki/neuropathy.
  17. “A fungal infection of any of the Candida (yeast) species” – https://en.wiktionary.org/wiki/candidiasis. Also called “thrush”.
  18. “An ascending urinary tract infection that has reached the pelvis of the kidney” – https://en.wiktionary.org/wiki/pyelonephritis.

Main source of material: Waugh, Anne; Grant, Allison. Ross & Wilson Anatomy and Physiology in Health and Illness E-Book (p. 236-8). Elsevier Health Sciences. Kindle Edition.

Shining A Light on Vitamin D

Sunshine and Elegant Lady.jpg

Vitamin D is not really a vitamin

Vitamin D is essential for good bone health and for most people sunlight is the most important source of vitamin D. The time required to make sufficient vitamin D varies according to a number of environmental, physical and personal factors, but is typically short and less than the amount of time needed for skin to redden and burn. Enjoying the sun safely, while taking care not to burn, can help to provide the benefits of vitamin D without unduly raising the risk of skin cancer.

So what is vitamin D?

Vitamin D is not an essential nutrient, classically defined as any substance that we must consume in our diet because we cannot make it adequately on our own. Our skin can make vitamin D from ultraviolet B (UVB) radiation in sunlight. In fact, very few foods even contain vitamin D naturally. Fish liver, mushrooms, certain types of fish and a few other foods contain some vitamin D. Cow’s milk has been artificially supplemented with vitamin D. It is often considered a nutritional issue because if you don’t get enough from sun exposure, you can eat vitamin D and absorb it through your gastrointestinal tract.

Why is vitamin D important?

Vitamin D deficiency has been linked to cancers, multiple sclerosis, frailty, falls, and many other ailments (1). However, there have not been consistent results that show that supplementing with vitamin D in a pill actually does anything useful for chronic diseases(2). Vitamin D has been shown in the some studies to slightly reduce the risk of falls, especially in deficient people (for example, institutionalised older adults) (3). And whilst I currently advise clients to take a vitamin D supplement, I am open to further research on the efficacy of this. For the time being, I personally take a Veg-1 supplement from the Vegan Society which contains 20µg (micrograms) of vitamin D3*. This amount is considered to represent 200-400% of the minimum recommended daily dose, depending on which advice you follow, of course. At the moment there is some variation between the views of eminent doctors such as Dr Michael Greger, who currently advocates vitamin D supplementation, and the like of Dr John McDougall and Prof. T Colin Campbell who are somewhat less convinced about vitamin D supplementation. This is a subject that you can be sure I will revisit in future blogs…

*Non-animal derived Vegan Society vitamin D3 (cholecalciferol) comes from lichen. Vitamin D2 (ergocalciferol) is also non-animal derived and is a compound produced by irradiating yeast with ultraviolet light. “Studies have consistently shown that, functionally, vitamin D3 is at least 300% more effective than D2. … Vitamin D3 supplementation has also been shown to maintain serum vitamin D levels in the long run, especially in the winter months when sunlight is scarce.” (6)

vitamin d sunshine on blackboard.jpg

How much sun do I need?

Factors that make a difference in how much vitamin D you make include skin colour (the darker your skin colour the less you make), time of day, length of day, and skin covering, including sunblock. Some sources say that if you have exposure to the midday sun (between 10 a.m. to 3 p.m.) for 5-30 minutes twice a week on the arms and legs you would get sufficient vitamin D(4). For pale skin you might need as little as five minutes, and for dark skin you might require at least 30 minutes. It’s important to note that you can make vitamin D even on cloudy days. Clouds, shade, and severe pollution/smog clouds reduce vitamin D synthesis by about 50-60%(1) yet you’ll still be making vitamin D. Windows block UVB radiation but not all of the ‘tanning’ radiation, UVA, so you won’t make any vitamin D driving in a car unless the windows are down. Sunblock of any SPF strong enough to stop a sunburn will stop almost entirely all vitamin D synthesis(5)on the skin to which it is applied.

Populations most at risk of vitamin D deficiency

Severe vitamin D deficiency causes rickets and osteomalacia, which are problems with bone mineralisation resulting from inadequate calcium and phosphorus. Vitamin D helps with calcium absorption in the intestine. Very low vitamin D causes very low calcium absorption, which triggers other changes including low phosphorus and hormone system changes. Rickets and osteomalacia are uncommon but they are very real risks for certain populations. Populations at risk are included in Table 1.

Table 1

Populations at risk of vitamin D deficiency (darker skin pigment increases risk across all groups)(4)

Mild to moderate risk of vitamin D deficiency:

  • People dwelling at northern latitudes, during winter months.
  • Elderly (they are able to make less vitamin D)
  • Obese
  • Those taking certain medications (anticonvulsants, steroids, AIDS therapy)

Moderate to high risk of having vitamin D deficiency:

  • Institutionalised people (nursing home residents, for example)
  • Women who for religious reason cover all of their skin
  • Exclusively breastfed infants
  • Those people with certain kidney or liver diseases
  • Endocrine disease (thyroid and parathyroid problems), as well as some other ‘granulomatous’ disease (sarcoidosis, tuberculosis, lymphomas)

People who should be concerned about possible vitamin D insufficiency include institutionalised people, people living in the northern US/Europe or at higher latitudes who have long winters, and exclusively breastfed infants and their mothers. Exclusively breastfed infants should take vitamin D, at a level of 400 IU/10µg day. This can be administered as a droplet placed in the baby’s mouth. Those individuals over the age of nine who fall into these categories should take 600 IU/15µg of vitamin D a day while elderly institutionalised people should take 800 IU/20µg per day. Keep in mind that more is not better. It is possible to have too much vitamin D. The maximum adult dose is 4000 IU/100µg per day, and it is significantly lower for children.

Should I regularly check my vitamin D levels and/or see my GP?

There do not appear to be any recommendations based on unequivocal scientific evidence, but Dr Thomas Campbell offers the following guidelines. He checks vitamin D levels on those individuals with calcium, bone or parathyroid hormone problems and will also often screen those people in the categories from Table 1 as well as pregnant or breastfeeding women. For those not in a higher risk category, he does not suggest routine vitamin D screening. Rather, he simply encourages everyone to get as much outdoor time as possible while strictly avoiding any sunburn, along with weight bearing exercise for good bone health. However, he does suggest a vitamin D supplement of 600IU/15µg a day for both adolescents and adults during the winter months .

winter sunshine.jpg

Dr Michael Greger’s view on this issue:

[youtube https://www.youtube.com/watch?v=DnQwcmmCu8k&w=854&h=480]


Joe’s Additional Comment

As is common with nutrition-related issues, there are few easy answers. However, the safest way of ensuring optimal health is shown repeatedly to be achieved through eating a whole food plant-based diet, avoiding added oils, salt and sugar, keeping away from all that processed junk, taking regular exercise, sleeping well and avoiding unnecessary stress. Contact me for help in designing you own Wholistic WFPB Programme.

N.B. I always recommend discussing this and other medical issues with your GP before making any major dietary changes or taking supplements of any kind.


References

  1. D​ietary Supplement Fact Sheet: Vitamin D. Office of Dietary Supplements, 2011. (Accessed April 15th, 2012, at http://ods.od.nih.gov/factsheets/vitamind-HealthProfessional/.)
  2. IOM (Institute of Medicine). Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press; 2011.
  3. ​Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Guidelines for preventing and treating vitamin D deficiency and insufficiency revisited. J Clin Endocrinol Metab 2012;97:1153-8.
  4. ​Holick MF. Vitamin D deficiency. The New England journal of medicine 2007;357:266-81.
  5. ​Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics 2008;122:398-417.
  6. Lehmann U1, Hirche F, Stangl GI, Hinz K, Westphal S, Dierkes J. Bioavailability of vitamin D(2) and D(3) in healthy volunteers, a randomized placebo-­controlled trial. J Clin Endocrinol Metab. 2013 Nov;98(11):4339­45. doi: 10.1210/jc.2012­4287. See https://www.globalhealingcenter.com/natural-health/vitamin-d3-vs-vitamin-d2/ for additional details,

Thanks to Thomas Campbell, MD for selected source material.

Thomas M. Campbell, MD is the Medical Director of the T. Colin Campbell Center for Nutrition Studies, co-author of worldwide bestseller, The China Study and author of The China Study Solution. He is also the Medical Director of the University of Rochester Weight Management and Lifestyle Center at Highland Hospital.

 

Nearly half of children are dangerously overweight in parts of Britain

Childhood Obesity.png

 

Nearly half of children are perilously overweight in some parts of Britain, according to the first ever map tracking the waistlines of primary school pupils.

 

The research by Public Health England shows that children with the most and least healthy lifestyles are living cheek by jowl, with just five miles between the areas with the best and worst record.

44 per cent of 11 year olds in the London borough of Brent weigh too much.

Other areas with the highest levels of excess weight include the London borough of Barking and Dagenham, Wolverhampton and Sandwell in the West Midlands, and the London borough of Westminster.

The data shows clear links between levels of deprivation and obesity. In the poorest areas, children are almost four times as likely to be classed as severely obese, the data shows.

The royal college is calling for curbs on advertising of unhealthy foods before the watershed on television, and action to limit the number of fast food outlets opening near schools.

Earlier this week, it warned that four fifths of obese children could expect to remain obese as adults, cutting overall life expectancy by up to 10 years, and “healthy life expectancy” by as much as two decades, with later lives likely to be spent battling diabetes and heart problems.
The findings, which come from surveys of primary school pupils, show that overall, 32.4 per cent of children are overweight or obese by the age of 11 – a rise from 30 per cent in 2006/7. The figures are worst for boys, with 36 per cent classed in these categories – a rise from 33.2 per cent a decade ago.

The statistics also show boys are most likely to be classed as “severely obese” – with almost 5 per cent of boys reaching this point by the end of primary school, compared with 3.3 per cent of girls.

The report also shows significant variation between ethnic groups, with more than 9 per cent of Black Caribbean children classed as severely obese, compared with 3.4 per cent of White British children.

Tam Fry, from the National Obesity Forum, called for an end to “buy one get one free” deals on junk foods, chocolates and fizzy drinks, limits on junk food outlets, and an end to advertising of unhealthy foods during family viewing.

“Making sure that the wider environment in which children live helps support healthy lifestyles is crucial. That means protecting children from junk food advertising, limiting promotions on unhealthy products and the food industry taking significant steps to make the food they produce healthier.”

Source of Data: Public Health England, NCMP local authority profile, January 2018 update ​

Source of article: Telegraph


Joe’s Comment

Once again, the elephant in the room is the government- and industry-sanctioned and promoted Western diet. The poorest and least well-educated are likely to select the easiest and cheapest options to put on their plates. But until there is a widespread understanding of how the SAD (Stand American Diet – highly animal-based, processed, fatty, sugary foods) is slowly killing us, one would expect the obesity figures to continue rising.
The first generation that will die younger than their parents?
Let’s have your comments….

A Couple of Readers’ Dinner Recipes

S&Y's Lunch.jpg

S & Y’s Chilli with….vegetables!!

Here we go!!!

Courgette 50 g, chickpeas 50g, black beans, 50g, 1 small red pepper, black pepper, parsley and basil. These ingredients were stewed. In addition, we added: 1/2 small onion raw, one clove of garlic, 3 cherry tomatoes raw.
Stewed potatoes 100g. Then smashed them and add 50 ml soya milk.
Enjoy!!!
It’s more than delicious!!!

Maggie’s Tasty Lasagne

This is my third time of making this tasty lasagne dish. The recipe is sufficient for six portions so I shall have an easy supper for the next few weeks.

Maggie's Tasty Lasagne 01
There is no need to stray from the recipe, although I did slightly. I used some home made tomato sauce from the freezer, probably trebled the amount of nutritional yeast and probably only about a third of the lemon juice, because that is what was ready prepared in the fridge.
Maggie's Tasty Lasagne 02
I also added a layer of dry-fried chestnut mushrooms, because I had them available and thought they make a tasty addition. But be assured, there is plenty of taste to this recipe just as it is written. Oh, and I used spinach lasagne sheets rather than the zucchini noodles. I have used the zucchini previously and it was very good.
Maggie's Tasty Lasagne 03
I precooked the lasagne sheets for a few minutes because the sauce is quite thick and I don’t think there would have been sufficient moisture for the pasta sheets to soften properly.
maggies-tasty-lasagne-04.jpeg
I layered as I would a normal lasagne…tomato sauce, **pasta sheets, spinach sauce, tomato sauce,repeat from ** then finish with a final layer of pasta covered with tomato sauce and a sprinkle of faux parmesan and panko crumbs.
Maggie's Tasty Lasagne 05
I am always getting tempted and side-tracked by recipes that pop up in my media feed, but I am going to ignore all other lasagne recipes now. This works so well and is quick and easy.

Joe’s Comments

Both recipes look great. Thanks! You know what I am like with anything fried in oil or where oil has been added – so you can guess my opinion on panko crumbs, although I have never used them and they do sound really tasty. Would Maggie’s recipe work just as well with non-oil home-made breadcrumbs? Let me know if you try it…
If you have any recipes or cooking tips, let me have them!
And if you haven’t bought Dr Greger’s How Not To Die Cookbook yet, please consider doing so – ALL green light foods.
How Not To Die Cookbook

How Do You Poo?

fibre

One of my clients mentioned some concern about the fact that he is pooing more since starting his WFPB programme than he did when he was on his previous diet.

If this is something that also concerns you, then read on…

It is quite normal to visit the loo more when eating whole plant foods because your GI (gastrointestinal) tract is working as it should. This is largely because of the extra soluble and insoluble fibre that you are eating. Whilst fibre is not technically an essential nutrient (because you can survive without it), there are huge benefits for having high levels of fibre in your diet. And remember, there is ZERO fibre in animal foods. It ALL comes from plant foods.

Soluble fibre does dissolve in water. It forms a gel-like material. It can help lower blood cholesterol and glucose levels by minimising glucose and lipid absorption (any of a class of organic compounds that are fatty acids or their derivatives). It also makes you feel more satiated by blunting the postprandial (post-meal) blood glucose response – this allows you to last longer without getting hungry.

Insoluble fibre (including cellulose, hemicelluloses and lignindoes – the structural parts of plant cell walls) does not dissolve in water. It is really important for the health of the billions of “good” bacteria that live in your colon (the large intestine). These little chaps are vital for optimal intestinal health and do not do well on a meat-rich diet. Insoluble fibre also bulks out the material and aids smooth passage through the intestines – thereby helping to prevent such problems as constipation, haemorrhoids and irregular-shaped faeces. You might also note that it generally makes your poo float – a good sign!

constipation.jpg

Both types of fibre are thus beneficial to the body. But how much fibre should we aim to get in our diet?

Dr Greger suggests that we should aim for a minimum of 25 grams a day of soluble fibre (concentrated in beans, oats, nuts, and berries) and a minimum of 47 grams a day of insoluble fibre (concentrated in whole grains – wheat bran, corn bran, rice bran, the skins of fruits and vegetables, nuts, seeds, beans).

For your information, this is my consumption of fibre over the past 3 months:

Joe's Fibre.jpg

This sort of data on a wide range of nutritional markers is available to all my clients when they participate in one of my WFPB programmes.


More info from Dr Greger:

“The under-consumption of unrefined plant foods in our diet has resulted in a low fiber intake. The standard American diet is highly lacking in fiber. Sadly, one-third of preschoolers have been found to be constipated. Nine servings of fruits and vegetables a day at a minimum are recommended. Fiber causes an increase in stool size, which has been associated with a decreased cancer risk, specifically colon cancer, as well as lower risk of ulcerative colitis, Crohn’s disease, appendicitis, constipation, and diverticulitis.

A plant-based diet high in fiber can flush excess estrogen and cholesterol out of the system. This may help explain why high fiber intake is associated with reduced breast cancer risk. The target minimum fecal output is about half a pound a day. The amount of time it takes food to travel through the body perhaps ideally should be 24-36 hours. And at the same fiber intake, antioxidant rich foods reduce inflammation better than less nutrient-dense foods.

Foods relatively rich in fiber include: dates (date sugar has fiber since it’s just powdered dates), chia seeds, flax seeds, veggie chicken, flaked coconut, dark green leafy vegetables, and beans.

It used to be thought that fiber just passed through us with no effect other than providing bulk. However, it is now known that metabolites are actively produced by our gut bacteria that eat fiber. These compounds may have anti-inflammatory, anti-cancer, anti-obesity and blood sugar control effects. Fiber has also been found to bind nutrients, so if you juice, you are losing more than just the fiber. Smoothies on the other hand allows for greater absorption of nutrients, although depending on what is in the smoothie, disrupting the fiber may lead to a higher insulin spike.

High fiber diets may also reduce the risk of stroke, high cholesterol and potentially heart disease.

Fiber intake also has possible benefits for hiatal hernia, brain loss, kidney stones, COPD, Parkinson’s disease, diabetes, weight loss, improved immunity, and ultimately increased longevity, possibly because fiber may help mimic some of the benefits of calorie restriction.”

(https://nutritionfacts.org/topics/fiber/)

WFPB Through the Back Door?

Joe’s Comment

The following article about a podcast on BBC 5 Live appeared today on the BBC News website. I am not advocating all the ingredients or recipes used (honey, Quorn or fish are NOT part of a WFPB diet!), but it is interesting how healthier, more plant-dense foods are being introduced to the general population without seeming to overtly mention the “V” words.

It could be argued that this is an attempt to introduce the population to plant-based eating without risking the predictable resistance encountered when the words Vegetarian or Vegan are used.

In a similar way, WFPB nutrition avoids the “V” words – why? Well, there are plenty of vegetarians and vegans eating unhealthy foods, even though they may contain little of no meat products. All I need to recall is a cousin of mine who became a vegan at the age of 4 and has remained a vegan to this day. She existed into adulthood with a dislike of fruit and vegetables and existed on a diet consisting mainly of chips, crisps and confectionery – I kid you not!

So, when asked if I am a vegan, I reply with a resounding “No!” I simply eat whole plant-foods and avoid all fractional elements like oils, processed foods, added salt and sugar. This is not to say that I do not share with many vegans the same general concerns about animal welfare and the environmental impact of the food choices we make; but our task of helping ourselves and others to eat healthily without labels getting in the way. What do you think?

 


The Article:

Fit & Fearless: How to fuel your fitness with food

In this week’s Fit & Fearless podcast, Tally, Vic and Zanna talk all things nutrition – you can’t be fit and fearless without giving your body the right fuel!

To help you build a healthy relationship with food, they’ve enlisted help from nutritionist Rhiannon Lambert (AKA “Rhitrition”, pictured), who believes “eating is a chance to nourish”.

Here’s Rhiannon’s meal plan for a healthy day!

Breakfast: Banana toast

Quick and easy if in a rush. Wholegrain toast is rich in fibre keeping me fuller for longer and banana with nut butter and a dash of honey is heavenly! This is a perfectly balanced breakfast with healthy fats, protein and carbohydrate.

Lunch: Buddha Bowls

Often a Buddha Bowl, I like to pick and mix my lunch items and add as much colour as I can possibly get my hands on. I believe lunch should always be a fulfilling meal with a chance for you to get your hands on a variety of nutrition.

Snack: Roasted chickpeas

I often make a batch on a Sunday evening and store them in an airtight container for a few days. They taste so good and you can add different spices and flavours to suit you.

Dinner: Re-Nourish Shepherd’s Pie

This is honestly one of my favourite childhood dishes and I love to make a veggie version with quorn mince as I can then freeze portions to get me through the next week. I sometimes cook a family sized dish to ensure I minimise cooking time throughout the week taking portions to clinic for lunch.

“Is My Blood Pressure Too Low?”

Blood Pressure Chart.jpg

A Success Story in the Making

One of my WFPB clients is 11 days into her new nutritional programme – eating whole plant-based foods with minimal amounts of added salt, oil and sugar.

When she first contacted me, she had four main aims:

  1. Lower her high blood pressure.
  2. Lower her blood cholesterol.
  3. Lose weight.

We will have to see about 2. when she has her blood test in a few weeks, but 1. and 3. are already showing encouraging signs.

While her weight has dropped from 64.5 kg to 62 kg and her waist from 93 cm to 88 cm, perhaps the most significant improvement was communicated to me in an email from her this morning. She wrote:

“Hi Joe,

Just thought I would let you know that today my blood pressure is

[1st reading] 99/66 pulse 69
2nd reading 108/70 pulse 67 and
3rd reading 113/67 pulse 66
is that not too low ?”

 

On starting the diet only 11 days ago she had a history of hypertension as recorded by her GP. From the start of our WFPB programme, and under my direction, she began to monitor her own blood pressure and pulse on a daily basis with a home blood pressure monitor – sphygmomanometer (how it works) – that was able to empower her with the kind of valuable information that we so often delegate wholesale to the medical profession. Her blood pressure readings have been dropping consistently over the past days, from an initial reading of 156/96/68.

In my my reply email to her I indicated that her results are NOT too low! This is simply what happens when your body receives optimal nutrition. And, as with every client I have the pleasure of working with, I always supply supporting evidence for my assertions. Some of this is outlined below.


Is the ideal blood pressure for a 100 year old person the same that they had as a child? Is diet really a significant significant causal factor in the decade-by-decade rise in blood pressure we commonly see in our ageing population?

Dr Michael Greger in his remarkable best-selling book “How Not To Die” can help us with this:

“…do omnivores who are as slim as vegans enjoy the same blood pressure? To answer this question, researchers…compared…hard-core athletes to two groups: sedentary meat eaters who exercised less than an hour per week and sedentary vegans who ate mostly unprocessed, uncooked plant foods. How did the numbers come out? Not surprisingly, the endurance runners on a standard American diet had a better blood pressure average than their sedentary, meat-eating counterparts: 122/ 72 compared with 132/ 79, which fits the definition of prehypertensive. But the sedentary vegans? They averaged an extraordinary 104/ 62. (115)”

He continues:
“Doctors used to be taught that a “normal” systolic blood pressure is approximately 100 plus age. Indeed that’s about what you’re born with. Babies start out with a blood pressure around 95/ 60. But, as you age, that 95 can go up to 120 by your twenties. By the time you’re in your forties, it can be up to 140— the official cutoff for high blood pressure— and then keep climbing as you get older. (35.) What would happen if, instead of consuming ten times more sodium than what your bodies were designed to handle, you just ate the natural amount found in whole foods? Is it possible your blood pressure would stay low your whole life? To test that theory, we’d have to find a population in modern times that doesn’t use salt, eat processed food, or go out to eat. To find a no-salt culture, scientists had to go deep into the Amazon rainforest. (36.) Strangers to saltshakers, Cheetos, and KFC, the Yanomamo Indians were found to have the lowest sodium intake ever recorded— which is to say the sodium intake we evolved eating. (37.) Lo and behold, researchers found that the blood pressures among older Yanomamo were the same as those of adolescents. (38.) In other words, they start out with an average blood pressure of about 100/ 60 and stay that way for life. The researchers couldn’t find a single case of high blood pressure. (39.)”

 

If you or anyone you know is interested in finding out more about WFPB nutrition, please contact me by email or telephone/Skype (0044 20 8133 8780 / 0044 7816 093686 / Skype ID joe.bath). I am always delighted to give free advice and support to whoever genuinely wants it.

References

(115) Fontana L, Meyer TE, Klein S, Holloszy JO. Long-term low-calorie low-protein vegan diet and endurance exercise are associated with low cardiometabolic risk. Rejuvenation Res. 2007;10( 2): 225– 34.
(35.) Celermajer DS, Neal B. Excessive sodium intake and cardiovascular disease: a-salting our vessels. J Am Coll Cardiol. 2013;61( 3): 344– 5.
(36.) Oliver WJ, Cohen EL, Neel JV. Blood pressure, sodium intake, and sodium related hormones in the Yanomamo Indians, a “no-salt” culture. Circulation. 1975;52( 1): 146– 51.
(37.) Mancilha-Carvalho J de J, de Souza e Silva NA. The Yanomami Indians in the INTERSALT Study. Arq Bras Cardiol. 2003;80( 3): 289– 300.
(38.) Celermajer DS, Neal B. Excessive sodium intake and cardiovascular disease: a-salting our vessels. J Am Coll Cardiol. 2013;61( 3): 344– 5.
(39.) Mancilha-Carvalho J de J, de Souza e Silva NA. The Yanomami Indians in the INTERSALT Study. Arq Bras Cardiol. 2003;80( 3): 289– 300.
Quoted passages from Greger, Michael; Stone, Gene. How Not To Die: Discover the foods scientifically proven to prevent and reverse disease (Air Side Edt). Pan Macmillan. Kindle Edition.
Chart source: http://thenewarktimes.com/african-americans-continue-suffer-high-blood-pressure/

AR’s Lunch Idea

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Ingredients

Rocket, lambs lettuce and kale salad with parsley, cucumber, tomatoes, sesame seeds, ground flax seeds.
Humous with paprika.
Beetroot with turmeric.
Cooked pears with soaked raisins, cinnamon and walnuts.
Washed down with fennel tea.
Yummy!


Joe’s Comments

No wonder you’re doing so well with your WFPB diet – blood pressure, weight and waist size dropping by the day; feeling more energised and positive…

…the ideal client! Keep it up.

England’s Obesity Hotspots

England's Obesity Hotspots.png

Source of Map: The Telegraph 23/1/18

Joe’s Comments

Humans have not changed so much over the past decades that they have lost all will-power to resist the temptation of alluring foods (usually those ready-meal processed fast-foods, packed with saturated fats and added sugars); nor has human nature changed so much that we have lost our intelligence and common-sense to know which foods are likely to harm us.

So why is obesity (and all its associated chronic diseases) increasing so rapidly year on year?

It may be argued that the answer will be found by following the money. While our bodies are getting fat, whose bank balances are getting fat? Unilever, Kraft, Pepsico, Coca-Cola, McDonalds and Subway are but a small proportion of the thousands of companies that profit from producing, distributing, marketing and selling ultra cheap junk food.

Persuasive and all-pervasive advertising ensures we can’t get away from it – in every location from schools and hospitals, cereal packets, clothing, toys, games, movies, TV shows, internet sites, magazines, newspapers, bill boards, the sides of buses, every square metre of supermarket display space….everywhere and anywhere that it can possibly be advertised in association with happy, carefree, beautiful lifestyles that we aspire to have for ourselves.

And we humans conform to the simplest rules that apply to all life forms:

  1. We avoid pain.

  2. We seek pleasure.

  3. We conserve energy.

So when we are told over and over again that we need these foods to survive, that they will not harm us (if consumed in moderation – which they rarely are), that we see everyone else eating them (and so the food MUST be okay), then we make them part of our normal diets.

These products are specifically developed in laboratories in order to stimulate the pleasure receptors on the tongue and in the brain, so our bodies cannot help but crave them.

And, finally, they are made incredibly easy to find and buy – where can you go now without a Costa accosting you at every turn? Which town centres can you walk through without there being a line of fast-food shops on almost every street? Which websites, TV programmes, magazine, newspapers and movies can you look at without being exposed to everything from luscious chocolate treats to crunchy cheesy snacks?

Simply put – it’s too easy. Our natural tendency to conserve energy means that we just give in to what’s easiest, most convenient to buy, prepare, digest, grow fat and ill on.

And this also applies to what is easiest for our brains and emotions. Just think about it – is it easier or harder to simply carry on eating like everyone else does at home, in the restaurant and at friends’ houses? We are creatures of habit who opt for the easiest way of doing things; and because habit requires less energy consumption, we just continue doing what we and everyone else around has been doing, without sparing too many thoughts about whether it is good for us or not.

The Telegraph reporter (Laura Donnelly, health editor) writing in connection with the above UK obesity map says:

” [we are witnessing] the Child obesity crisis: Millions doomed to early death as doctors call for urgent action over junk food. Children are being doomed to an early death by their lifestyles – with four in five obese school pupils destined to remain dangerously overweight for life..One in three school pupils are overweight or obese by the time they leave primary school…Fifty per cent of pregnant women are overweight or obese, which has a severe impact on the health and weight of the developing foetus.”

The government faces enormous pressure from the food, pharmaceutical and medical industries to maintain the status quo. Who can tell when and what will bring about a real turning point in the nation’s self-harming love affair with the modern unhealthy diet?

Do we really expect industry, government or the medical profession to do much about this horrendous state of affairs?

Perhaps all we can do as individuals is to ensure that we eat a whole food plant-based diet, as organic in origin and unprocessed in form as possible. It is argued that simply doing this will allows us as individuals to have the most positive impact on the three main areas involved when discussing human eating habits:

  1. Human health.

  2. Animal health.

  3. Environmental health.

Pushing a boulder uphill.jpg

Of course we can encourage and advise others to transition to the optimal diet for health and well-being; but one thing I have come to realise about this whole complex and fascinating area of diet and nutrition is that it appears easier for most people to stop smoking cigarettes or drinking alcohol than it is for them to radically change their eating habits.

 

 

 

 

Nutrition Recommendations

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One of my clients has been concerned about the amount of vitamin B12 she should be taking.

You will find a variety of views about how much of this or that micronutrient (vitamins and minerals) you should have each day. As a general rule, optimum nutrition comes from making sure that we eat diet full of beans, whole grains, nuts, seeds, fruit and vegetables – especially dark green leafy veg and lots of berries – while cutting out the meat, dairy, eggs processed foods, and added SOS (salt, oil and sugar).

However, there are some specific areas that do need to be carefully monitored*:

  • Vitamin B12 (taken as cyanocobalamin) on an empty stomach as chewable, liquid or sublingual supplement for adults under 65 years of age, at least 250 mcg daily (micrograms – also sometimes also written as µg ), or 2,500 mcg weekly or three portions of B12-fortified foods a day (check B12 quantities in portions and compared with the above figures). For those over 65 years of age, take at least 1,000 mcg daily. (1., 2.)
  • Omega 3250 mg daily. Careful to choose yeast- or algae-derived long-chain omega-3 fatty acids (DHA/EPA) that are guaranteed pollutant free. (3., 4.)
  • Vitamin D (The “sunshine” vitamin?). Well, yes, if you are getting enough sun; but vitamin D deficiency is shockingly common around the world (5.). Some authorities (6.) recommend as little as 10 mcg daily, while others (7.) recommend 50 mcg daily. I personally take 20 mcg daily. (I suggest you check out the map below to see where you are in the world). Then check out Dr Greger’s specific advice about when you should take supplements and when you should be able to get enough midday sun exposure: usually between 15-30 mins depending on skin type and time of year. (8.) If you are still not sure about how much sunshine and vitamin D supplementation you need, there’s much more specific information here.

Vitamin D and World Map.jpg

  • Calcium – Minimum of 600 mg daily from calcium-rich plants – low-oxalate (9.) green leafy vegetables. You might want to do some reading about the validity of concerns about kidney stones and consumption of high-oxalate green leafy vegetables such as spinach, chard, beet greens. (10., 11.)
  • Iodine – 150 mcg daily supplement. I am cautious about suggesting eating seaweeds and sea vegetables as a source of iodine because of the high levels of toxins detected in many samples, especially hiziki (12.), and the excessively high levels in others, for instance kelp (13.). Wakame is regarded as having a lower concentration of toxins and safer levels of iodine, as well as some health benefits (14.). Iodised salt is recommended by some people, but I personally would never advise you to take this because it’s easy to overdo the quantity and….well, it’s salt! (15., 16.)
  • Iron – Eat a variety of legumes, vegetables, nuts and seeds.**
  • Selenium – Eat 4 Brazil nuts once a month. Simple! (17.)

 

 

*If you are considering making the transition from the traditional meat-based western diet to a whole food plant-based diet, I recommend having a blood test taken to check the baseline levels of the above. Then I would suggest having the same blood test taken 6 months later to monitor changes – and there are likely to be some welcome changes to levels. (I would always advise consulting your GP whenever you are considering making major changes to your diet.)

** Vitamin C (from foods) aids iron absorption. Do not consider taking any iron supplements before checking with your GP. Heme iron (in meat) is best replaced with iron from just eating a variety of plant foods. (18., 19.)

Most of my recommendation are based on advice from Dr Greger. You can have it from the “horse’s mouth” by clicking on the doctor’s mouth!

Dr Greger


References

  1. https://nutritionfacts.org/2014/12/18/the-vitamin-everyone-on-a-plant-based-diet-needs/
  2. https://nutritionfacts.org/questions/which-type-of-b12-is-best/
  3. https://nutritionfacts.org/video/should-vegans-take-dha-to-preserve-brain-function/
  4. https://nutritionfacts.org/topics/omega-3-fatty-acids/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4018438/
  6. https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/
  7. https://nutritionfacts.org/topics/vitamin-d-supplements/
  8. https://nutritionfacts.org/2011/09/12/dr-gregers-2011-optimum-nutrition-recommendations/
  9. https://my.clevelandclinic.org/health/articles/11066-kidney-stones-oxalate-controlled-diet
  10. https://nutritionfacts.org/topics/greens/
  11. http://www.pcrm.org/health/health-topics/nutrition-and-renal-disease
  12. https://nutritionfacts.org/topics/sea-vegetables/
  13. https://nutritionfacts.org/video/too-much-iodine-can-be-as-bad-as-too-little/
  14. https://nutritionfacts.org/topics/wakame/
  15. https://www.ncbi.nlm.nih.gov/pubmed/17344781
  16. https://www.ncbi.nlm.nih.gov/pubmed/10667088
  17. https://nutritionfacts.org/video/four-nuts-once-a-month/
  18. https://www.pcrm.org/health/cancer-resources/diet-cancer/nutrition/iron-the-double-edged-sword
  19. https://nutritionfacts.org/topics/iron/