Archives for the month of: November, 2015

Reblog: lessons on intervention from cardiology by Dr Bernard Lown.

“Our forty-year struggle essentially concerned medicine’s first and inviolate principle, primum non nocere. “First do no harm” is the litmus test sanctioning the privilege to practice medicine.”

Update: I had no idea who Dr Lown was before reading this post. And now I’m sitting here completely floored and grateful for his existence:

Dr Bernard Lown, wikipedia

And here’s a quote from his comment on the blog post above:

It is good to know that not every one tweets, some still consume a longer, probing essay.

Dr. Bernard Lown's Blog

Bernard Lown, MD

As I have just passed my 90th birthday, writing this essay reminds me of Machiavelli’s admonition when he was receiving final Communion on his deathbed. “Renounce the devil and embrace the Lord,” intoned the priest. A long silence. Then came Machiavelli’s whisper: “This is no time to make new enemies.”

Let me start with a confession: I not only harbored dangerously unorthodox views during my career; I practiced them. Being allowed to voluntarily retire from the practice of medicine in 2007, rather than having had my medical license revoked decades earlier, was either an egregious establishment oversight or an act of divine intervention. Though my medical transgressions were never obfuscated or hidden, few are aware of them.

My deviant behavior consisted of sharp departures from the accepted norms of medical practice. I deemed such behavior an act of civil disobedience, for which I was ready to accept…

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There’s currently a hearing happening down in South Africa over nutritional advice given to a mother (she asked) over Twitter.

 

The legalities are mildly interesting. What legally constitutes a doctor-patient relationship and would we need to look at refining that for future digital consultations? It’s really only mildly interesting, because honestly, at some point you have to leave people to make up their own mind given the information they came across.

 

The nutritionist who lodged the complaint did so out of genuine concern, I have no doubt about that. And it is sad that she is caught up in the nutritional dogma of the day, but what can you do. Most people don’t grasp that what they were taught is not the absolute truth forever.

 

So let’s look at what Tim Noakes thinks. Click on the picture below, or here, to go to YouTube. Somehow I couldn’t embed the video today… (?)

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Tim Noakes at the University of Johannesburg. Click on the picture to go yo the YouTube link.

And, ladies and gentleman, you’re all living in a zoo, eating zoo food.

Someone had to say it!

His proposal for the future is one I can get behind:

And I hope, Mr Vice Chancellor, that you will introduce cooking as a major course at this university…

Yes, why on earth not! Actually, let it happen in schools again. We used to have “home economics” and “health” classes. Somewhere there there has to space for learning about real food, zoo food and hyperinsulinemia.

Interesting times.

I won’t say anything about the hullabaloo of the Health Professions Council of South Africa vs Tim Noakes, no wait I want to: aaah so much noise on Twitter. And terrible, terrible reporting.

However, in another corner of the Southern Hemisphere, they seem to be giving up on health:

New Zealand obesity campaigner quits saying country has made ‘no progress’

“We live in an obesogenic environment with too much access to and promotion of energy-dense, nutrient-poor food,” she told the Guardian. “The rates aren’t improving because we’ve done nothing to make them change.

Sure, we do live in an obesogenic environment (but let’s get a proper definition of that term,that we can agree on), but that is coupled with the fact that the great majority of normal people out there have no idea what healthy eating literally looks like on a plate.

Campaigns, like the following:

The New Zealand government has just launched an advertising campaign featuring New Zealand sports stars to try and encourage New Zealanders to make healthier lifestyle choices.

are all good and well, but if someone doesn’t understand what “healthier lifestyle choices” means, they will invariably go to some or other version of moderation and balance (this is my assumption, at least). This is where the problem lies.

Fast food places are all around us and the food is generally cheap. This is a problem. However, we need to be telling people why a pizza is unhealthy. Literally tell people which ingredients on there are the unhealthy ones.

This is what used to confuse the crap out of me: pizza is bad, even a vegetarian pizza, we all “know” this somehow, but a plate of lovely al dente pasta with broccoli and peppers suddenly makes me a health conscious person. The only difference I can spot is the cheese, so cheese must be the issue here. But then people are telling me I shouldn’t eat too much bread. So is it the wheat as well? So what about the pasta? Does this mean I should just be eating rice? Oh shit no why did I just gain 3kg this month. I give up.

The wonderful irony is that this is happening in the country that produced the What The Fat book.

Get the right information out there. People do actually want to be healthy.

The search for gainful employment in Norwegia seems pretty darn futile at the moment, but the gloom was lifted yesterday by this interesting job posting:

As Field Medical Advisor you will be part of a dedicated and dynamic medical affairs team. Together we are responsible for the medical and scientific information supporting appropriate use of [company name] innovative treatments of well-established and future products as well as local ongoing clinical trials. As Field Medical Advisor you will build strong long standing relationships with key stakeholders within the diabetes community, with the aim of ensuring optimal delivery of scientific information, ultimately leading to better treatment for patients with diabetes.

Oh, really! I’d love to be on board and talk about some innovative and better treatments for patients!

Your main responsibility will be to provide medical and scientific support to health care personnel, in strong collaboration with sales, market access and marketing in [company name] . You will initiate and drive medical activities within [location], facilitating development of symposia, meetings and education seminars for health care providers, as well as supporting advisory boards.

This is fascinating. And starkly revealing.

I would actually relish the opportunity to be involved in this work in order to get an insider’s perspective, and I’m almost desperate enough right now to apply, but my soul is not quite ready to be sold. Not yet, in any case.

I’m not against medical treatment when it is necessary, especially for anyone suffering from the effects of diabetes, but holy cow the job description above gives me the heebeejeebees.

In all fairness, the company could be rolling out some very effective medication that could really improve the quality of life of some people. Let me not be too cynical today.

I haven’t really ventured into the world of making low-carb “substitutes” at all. My Pinterest list may suggest otherwise, but I always end up making eggs or something with mince or lamb instead of anything mildly exciting. (And I’m totally happy with that.)

But somehow I ended up with three tubs of cream cheese in the fridge with a looming “best-by” date. Okay, let’s see this as an opportunity. Let’s try those funky Oopsie rolls!

…And wow these are easy to make! They are cream cheese-meringues, although they fall flat after baking. While baking they rise beautifully, just look:

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Rising oopsie buns in the oven.

After baking they become a nice golden colour, but sadly they’re not so wonderfully round anymore.

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Finished golden oopsies.

I tasted one right after baking and it was okay, but I didn’t put in the mustard powder as the recipe said and I think it will make a difference to the taste. They were good enough without it, but there is always room for improvement. Next time I’ll be better prepared and armed with more than just eggs and cream cheese.

The next day was a different story. I was tempted to pop them in the toaster, but then I went for the pan instead. I pan-toasted them in a little olive oil (watch out-they burn quickly) and went on to to create a real brunch burger!

Toasting oopsie buns, the morning after.

Toasting oopsie buns, the morning after.

I started with some spinach on one, cheddar on the other. (Side note: why is cheddar considered a special cheese in Norwegia?! Not complaining though, the cheddar I got was fantastic.)

The next layer was a very easy-over egg and some bacon, crispy and fresh out of the oven.

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Build-a-breakfast.

Oh my ****. This was delicious! And this is perfect if you are like me and dream of hot runny egg yolks, because now there is something to soak up the yolk from the plate! Practicalities are important, especially when you’re not alone and can’t just lick the plate clean… (Yes I do that, a lot.)

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More please! (Bonus: I just realised you can see the growing canoe polo/paddling callus on my thumb if you know where to look.)

I still have an embarrassing amount of cream cheese in the fridge, so there will be a few more rounds of oopsies on the way. I just need to remember to buy the mustard powder! And tinker a bit with other potential ingredients.
Can’t wait!
Yumyumyumyumymuymuummuumummm.

The last week has delivered two absolute gems to my screen.

The first, Strong Medicine by Dr Blake F. Donaldson, is available to read and download on Babel!

I accidentally came upon it via Ash Simmonds and his HighSteaks blog. His meat-filled twitter feed is also recommended. (I have to admit that I’m getting absolute grills, Afrikaans for the heebeejeebees, mentioning some stranger’s twitter feed. StalkerPro here.)

The book itself is quite the entertaining read! A lot of pervasive life truths are punctuated by some boldly stated and highly cringeworthy thoughts straight out of a totally different cultural era. It is a bit of a rollercoaster, but Doc Donaldson pulls out some great one-liners that keep me reading, consider:

“It seems to me there are three horns to the dilemma of the fat man.”

and

“There are probably only two perfect foods-fresh fat meat and clean water.”

Always cutting straight to the point, as he also was in his recommendations to patients:

“Unless you are willing to stop eating flour now and forever, I don’t want to take care of you.”

But the zinger award must surely go to:

“You are out of your mind when you take insulin in order to eat a Danish pastry.”

And then there are musings on medical science that shows some perceptions really have not changed, not one little bit:

“…cholesterol has been made a whipping boy, which is unjustified.
Since the determination of its importance much of the research work on cholesterol has been abandoned, though some is still going on. Talk about cholesterol is old hat, forget it, and certainly it would never help you with weight reduction.”

Sigh.

Donaldson put his patients on a very strict but simple regimen, mostly fatty red meat and coffee three times a day. After the desired sustainable weight was reached, meals could be expanded to include four ingredients. I had a look at my breakfast of eggs, chorizo and tomato cooked in ghee and thought, ja, why overdo the ingredient list and make it more complicated for my body. It’s just a machine, after all.

The man had a sympathetic heart to make up for his stern and strong medicine. He recalls his experiences of working in a hall of soldiers in varying stages of recovery or death, or both, after mustard gas exposure. He crafts a striking image of a Hungarian violinist coming to the hospital ward to play beautiful songs by request from the suffering men, but the doctor, having built up strong armour to defend against the daily horrors of slow deaths, is suddenly overwhelmed by the atmosphere:

“As the strains of that old melody swept through the hall I had to leave. Some things in life you just can’t take.”


The other goodie was another one of the lectures from the Low Carb Down Under series: Marty Kendall on “Managing Insulin to Optimise Nutrition”.

If you know someone who is unlucky enough to have Type 1 Diabetes, have them watch this talk. There is no sensationalism and the explanation behind why Marty and his wife eat like they do is wonderfully clear and logically explained.

But also, this is science communication done right! Yay!

By this I mean that someone has not only made an effort to understand the underlying science, but has taken the extra (and necessary) step of translating it beautifully so that I can get an intuitive grasp of what the hell you are on about. I don’t want to spend two minutes figuring out your graph and axes in a short lecture. Stick some proper labels and pictures in the graph so that I can see what’s up! I think it can be even better, as is always the case, but this is already great to see. Clear, concise and pretty.

Marty Kendall’s blog is over at Optimising Nutrition. Go have a look.

A friend went home to Germany recently and brought back some quark for me! (Thank you!)

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“Speisequark”

Technically a spreadable cheese, however I use it as a yoghurt, i.e., grab a spoon and ship to mouth. The taste and texture are about halfway between a Greek-style yoghurt (henceforth known simply as “yoghurt”, since everything else is adulterated crap in my mind) and cream cheese, but also not quite cottage cheese. Actually, I suppose it is a cottage cheese of sorts, just smoother.

I have seen another brand with higher fat, but here is the breakdown for this particular tub, per 100g:
9,8g fat
9,3g protein
3,8g cho.

It is a dairy product, so the protein is mostly casein, which doesn’t seem to gel well with some people. Luckily I seem to be okay with it (phew).

“Ja!”

The Sugar Coated documentary is finally available!

You can rent or stream/download it on vimeo:

I just finished watching it and it’s more than worth the money.

It still makes me so angry that what we now consider common sense was so heavily formed by the marketing ploys of an industry transforming the world a generation ago. The terms “balanced” and “moderation” in particular are in serious need of re-defining.