Wednesday, 14 September 2011

Wheat and obesity

I've been reading on Tu diabetes of a new book that appears to claim that the wheat consumption in the US and their obesity levels are associated. I decided to look out some figures . As I couldn't work out how to post the relutant graphs I've put them here.

I managed to find this graph of wheat consumption in a set of countries
(as the print doesn't show up clearly, they are in order:

China,India ,USA ,Russia ,France,Canada,Germany,Turkey,Pakistan ,Australia,Ukraine, UK,Iran ,Argentina ,Kazakhstan,Poland ,Egypt ,Italy,Romania ,Uzbekistan .

I used data from the WHO to show the obesity levels in those countries

I really can't see any correlation at all.

Wednesday, 1 June 2011

Souvenirs of the London Marathon

A bit of an introspective post here.

It's taken over a month to get round to writing it and that's because it's taken that long to really want to think about it.
I had been looking forward to the VLM for a long time. I first entered within a few weeks of diagnosis and it's taken all that time to get in. The experience was a bit diasapointing.
Quite a lot of it was my fault. You have to put in the training and over the winter I didn't do enough. OK I can blame the weather, trotting backwards and forwards from the UK etc etc but basically I left it too late to build up the mileage. I managed some long runs in the month before the event but probably far too late and too big an increase in distance. The result was yes, I finished and I ran most of the way but in a desperately slow time. I knew I was running slowly but had hoped the event itself would help me to run a bit quicker, my fasted mile in recent years was done in the New Forest Marathon.

As for the event itself .
I really enjoyed the immediate build up.
We had a good day out at the Marathon Expo where you have to go to register . It was good knowing that my OH , daughter, son-in-law and grandchildren would be on the route to cheer me on.
The night before the marathon we spent in a Premier Inn near Tower Bridge. I'd booked it a year before. The hotel was full of runners and even served a carb loading pasta meal if you wanted it. I went for the normal menu. Next morning it was quite disapointing to be the 'healthy runner' and stick to muesli, red fruits and my nod towards extra carbs, a slice of wholegrain toast. OH had the full English cooked breakfast and very nice it looked.

I left early for London Bridge station and the train to Greenwich. Stupidly we followed advice and OH didn't come with me. The wait at the start was exciting but a bit lonely as most other people seemed to have someone with them. I almost spoke to a lady wearing a DUK vest but was a bit she, I wish I had now because I've now read her blog elsewhere and realise she was also wearing a pump. I tested BG whilst waiting and as I thought was fairly low, even though I'd had the extra toast at breakfast so I ate a cereal bar. I was determined to keep BG up during the run. The start of the race itself was a bit strange,. I was on the blue start, which isn't the one shown on the tele. After walking for a while I suddenly realised that I'd reached the start but it was hardly marked so it was a bit of an anticlimax.

I'm not going to go through a mile by mile analysis. Some things were great, the crowds as everyone tells you are fantastic, and a lot of them wait for the slower runners. I had the shock of my life when the first personyelled out my name, then I realised it was printed on my vest! It was great to see some of the character's There was a dinosaur . At one time I couldn't understand why sometimes a rhino overtook me and then I seemed to catch him up and overtake, there were several rhinos ! The man carrying a fridge, passed me somewhere on the course. He deserved far more than a medal. I passed the marching band, they were playing well at about 5 miles . I was glad to come across the centipede whilst they were taking a loo break, getting past a chain of 50 people cannot be easy!

It was fun running over Tower Bridge and great seeing the Houses of Parliament and brilliant running past Buckingham Palace with only a few yards to go but you see all the sights a lot better on the television than from the course.

Much of the course though goes through surburban London or Docklands and some of it is pretty boring. Also because so many bottles and gel packs are thrown down slower runners like me are surrounded by a sea empty bottles and the road gets wet from the spilt water and sticky from the gel. It's unpleasant.
The strangest part was I found it lonely. I've got used to running by myself, I don't even run with my OH much now. (and that's a mistake I think I was running faster when I ran with him). I also run in fairly isolated places, normally I might see a couple of tractors and the odd car but not much else. I think in consequence I run very much within myself , having lots of other people around me I just retreated into myself even more. Every 'official' photo of me has me with my eyes looking downwards. It didn't help when I missed seeing my husband , daughter and grandchildren. They weren't at the JDRF spot as I thought they'd be. I 'd been looking forward to seeing them and was really disappointed that they weren't there. (they had been at either end of Tower Bridge, OH had missed me when he tried to phone daughter. They saw me at that moment, but I didn't see them). For the next few miles my speed was really really slow , so it obviously affected me. I cheered up when I eventually saw OH at Docklands with about 8 miles to go and again when I at last heard the 'Go Granny' and saw everyone else about 4 miles from the finish.

Incredibly after the finish and a sandwich in St James's park. I felt fit enough to walk to Waterloo . My glucose levels were fine, I'd run with a reduced basal for the whole time and had taken in a lot more carbs than usual (about 100 including the cereal bar at the start) The lowest level was 5 and the highest reading was 7.8, though I doubt it was that high for long. So I really could have done better, I wasn't even sore the next day, just a bit down. In fact I was almost tempted to enter again for next year... but never again, I've done enough marathons. We have entered for the New Forest half though, it's my aim to get a bit quicker.

The fantastic thing about the London was the reaction of other people when I asked for donations for the JDRF. I was a bit reluctant to attempt to raise any money. I don't know many people so I didn't think I could raise much. I set up a just giving page and asked people. I was astonished by peoples generosity. When I saw the first few donations I cried, I was shocked! I managed to raise just over £400.

To all those people who gave can I again say thankyou.

To my anonymous donor, if s/he reads this thankyou also. I may not have totally enjoyed the event but knowing I was sponsored made it very worthwhile.

Saturday, 28 May 2011

Diet Transforms Canadian Community or there's more than one way to skin a cat

A little local trouble on a diabetes forum caused me to look the blog of a Canadian doctor. This particular blogger advocates the low carb/high fat approach. He has been working with groups from the Canadian First Nations.
On this blog I also noticed a favourable account of a doctor helping large numbers of people in his small community to loose weight. Stefan du Toit,a South African doctor now working in rural Canada is using a diet that is low carbohydrate, but at the same time not high in fat .The blog told me that he has so far helped over one hundred of his patients to, between them, loose over 3000lbs . Some have lost over 90lbs and many have managed to reduce medicines. Success indeed.

I thought I'd investigate this diet a bit more.
and second shorter video from CBS adds a bit more information

Looking elsewhere ,I found a short article on the British Columbian Medical Journal. The results are impressive and there was a chart for one man with diabetes. It showed an HbA1c dropping from over 10% in January 2009 to about 5.4% in November 2010. His total cholesterol/HDL ratio dropped from over 6 to about 3.5 and his blood pressure also fell..
I learned that the diet had 1100 calories allocated for women and 1500 calories for men. Apparently, in spite of the fairly low calorie intake there is only about a 10% drop out. And it appears that some people at least have stuck to it for 2years.

The details of the diet are rather sparse , the doctor deliberately doesn't reveal very much . He stresses that it needs to be followed under medical supervision and of course that's really important if people need to reduce medications. He also suggests that the changes of diet may lead to electrolyte imbalances in some people
Nevertheless, as an exercise I had a go at working out what the diet might 'look' like.

From the info in the article and videos
it's a healthy eating programme
It's a low GI/low carb diet
Avoids processed /refined carbs
Its not a high protein diet or a' ketosis' diet.
It's a balanced diet that conforms to the Canada Food guide. Therefore can't be high in sat fat
Exercise isn't included whilst the person is losing weigh.(The doctor claims this is because it stimulates appetite but when the person has lost weight exercise is started. I assume this may help with maintenance.)
There may be some sort of induction, the man interviewed talks about the first month
In the original blog the author said he thought that people are started off with 80g carb per day.
It has a high success rate and seems sustainable for up to 2 years
I found an article that said it included 3 meals and no confirmation of that though

The Canadian recommended dietary intakes are very much the same as elsewhere in the world
Recommendations for macronutrients for people over 19
45-65% carbohydrates
estimated average requirement is 100g .
The RDA and AI ( adequate intake) is 130g
10-30% protein
The EAR for protein is .66g per kilo,
the RDA and AI is 0.80g per kilo
25-35% fat
men should eat 45g unsaturated fat, women 30g.
Saturated and trans fats plus dietary cholesterol should be kept low.

I did some figure juggling, using the woman's calorie intake example.
I tried 80g carb
80g carb = 320 calories : 29% of 1100 so already below guideline minimum, to get the rest of the calories would require either protein or fat to be above the levels of the guidelines: it wouldn't be a balanced diet. The figures don't work. So if the diet does start at this low level it is perhaps only for a short time.

A bit more juggling comes up with a distribution that seems to fulfil the criteria I found. (aprox figures)
130 g carb = 47% of 1100 calories = 520 calories
34g of fat = 28% of 1100 calories = 306 calories
68g protein = 25% of 1100 calories = 272 calories
That (if I haven't made a mistake) works out at 1098 calories and conforms to the guidelines and is low carb, low fat and not high protein..
(though protein is higher than that often suggested for people with reduced kidney function as it would work out at more than 0.8g/k of most women's ideal weight)

The Canadian guidelines also include advice on eating lots of fruit and veg , some grain with a preference for whole grains, plus fish/meat/alternatives's suggested that pulses replace meat/fish for some meals, dairy and unsaturated fat (oil dressings)
It wouldn't be too difficult to work out the types of meals that you could eat. (my guess is that it will include lots of veg, some fruit, smaller portions of meat/fish and that he might make good use of low GI beans/lentils ) .

The difficulty with dieting; whatever the diet is sticking to it, to be honest I think a 1100 calorie would be hard for many people . Some people can stick with diets by sheer determination, you meet many such people on diabetes forums, the risks of high blood glucose levels forms the motivation. Not all people are that 'strong' though . I'm sure a charismatic doctor and the group sessions play a prime role in helping people maintain their diet. If a lot of people in a small community are following the diet, then this type of eating pattern becomes the norm. It must be much easier to stick t
Actually if I've got the type of diet right,(and this is only a paper and pen exercise to examine what it might look like.. Don't try it , I'm not a dietitian!), it doesn't seem that different to many commercial low calorie diets with support for example weightwatchers or Rosemary Conley.There are also lots of similar diets on the internet including one by Amanda Ursell, a well known member of the BDA, writing in the Times

Dr du Toit deserves big credit though, getting his community on board and been instrumental in improving so many of his patient's overall health. It would be great to see this sort of approach being tried elsewhere.
(I'm still not sure about the lack of exercise element though)