British Society of Lifestyle Medicine Conference

106 Replies

On the weekend of the 1st July I am giving a talk at the British Lifestyle Conference in Bristol UK.

This is a great grassroots movement of people, and many doctors, who are trying to achieve a more holistic approach to health. I hope some of you can come along. Here is what the organiser, Dr Rob Lawson, has put together for a mention on my blog.

Vital optimism at work – and play.

“Lifestyle Medicine has been shaped by the natural evolution of Medicine. It is an established approach that focuses on improving the health and wellbeing of individuals and populations. It combines the broad facets of modern healthcare practices with the deeper understanding of being human. In the 21st century it has never been more important as a concept. And that is to create a society and an environment, from cell to community, which nurtures healthy longevity.

It requires an understanding and an acknowledgement of the physical, emotional, environmental and social determinants of disease and wellbeing. Hence the LM practitioner will engage with us as patients and operate within a boundary of evidence-informed medicine. A boundary in which our ideas, values, mind-set and social context blend not only with the clinicians’ expertise but also with clinical research outcomes.

Importantly, Lifestyle Medicine has a wider responsibility to recognise upstream determinants of disease and to promote population health, to protect ecological health and to reduce health inequity. This requires a realistic team approach and recognition that not one discipline or profession alone can meet our health needs.

On 1st July 2017 in Bristol Dr Malcolm Kendrick will be joining other world renowned speakers in Bristol at the inaugural Conference of the British Society of Lifestyle Medicine, the Science and Art of healthy longevity, https://bslm.org.uk/event/vital-optimism/, to which you are warmly invited. If you have never heard him speak – this is your chance! No better way to spend a Saturday in July“

106 thoughts on “British Society of Lifestyle Medicine Conference”

  1. Ann Burchnall

    I have always tried to consider the whole person when treating a patient. Why is this a new thought?

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    2. Andy S

      Symptoms are considered diseases and are quicker to treat. Health and lifestyle changes are a patients responsibility. Unfortunately dietary advice from authority figures has turned out to be detrimental to health, this needs to be corrected. Studies with faulty premises and conclusions is another problem.

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  2. KidPsych

    I am grateful that I found this site and your good work. I think that looking at my wife’s struggles with blood pressure has been ameliorated by the knowledge gained here. First, Dr. Kendrick clued me into the concept that high BP was not a disease as much as a symptom of disease. In my wife’s case, it was accompanied by dyspepsia. Trying to consider holistic ways of treating her, she started on a regimen of pre- and probiotics, along with supplements that target blood flow/BP, like L-Arginine and Magnesium. I also scoured the web and found a handful of odd, but helpful studies (like this one that showed a 20 point drop in BP with a switch to sesame oil – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1942178/table/T1/ and another that showed benefits of coconut water) or reviews (like this one – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935060/) that focused on dietary interventions. A mere few months into this, her BP has fallen from 170 systolic (without meds) to below 110 with only a small fraction of the original meds. It’s astonishing to both of us, and she is clearly thrilled with the change. Of course, in taking a holistic approach, there is no way of knowing (outside of elimination) which factor has been most salient. I told her I don’t really care, as long as she’s feeling better about herself. So, from across the Atlantic, cheers, Dr. Kendrick. You’ve been a wonderful help.

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    1. biddy99

      Would you mind telling me what and how much she takes. I also suffer with high bp. Takes meds but would like to get off them. Thanks

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      1. KidPsych

        Hi, Biddy. I assume you mean from the intervention side of things. She takes 6g L-Arginine/1.5g L-Citruline daily. The powder we take also contains vitamin D, B6, B12, Folate and some others. She has been vigilant about prebiotics in the form of a couple of teaspoons of potato starch or tiger nut flour. I just started taking Inulin, which I like a lot. She takes various probiotics (I unscientifically pick ones with the most billions of the little buggers). Her gut cleaned up prior to the drop in BP. Beyond the supplements, she cut out wheat from her diet, which might be the biggest factor of them all? She takes 2g magnesium, a 12 ounce glass of coconut water and cooks with the sesame oil. Finally, she takes collagen daily in a powdered form in her tea.

        Again, I don’t think there is a magic formula. The reason for the above changes were based on the idea that gut problems might be related to poor diet, which was causing inflammation and disrupting multiple bodily functions. Perhaps she was prediabetic and the change to a lower carb/low wheat one was beneficial. Considering the increase in magnesium and potassium (from the coconut water), there are other aspects of functioning at the cellular level that might have been impacted. Oh, and she started sunning herself again.

        I chose interventions that seem quite benign so at least I wouldn’t be doing any harm. That her BP has lowered so much was actually astonishing. It’s like being a kid and creating some fantastic soup in the kitchen, just tossing everything in, and then discovering that you made something delicious. Maybe the take-away is being mindful of how everything is interconnected.

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  10. AH Notepad

    I’d love to be able to come, but unfortunately I won’t be able to. As repsort says, a video (not an edited one) would be an excellent idea, and possibly help to fund the conference. I’d buy a copy.

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  11. Millie Thornton

    i can’t be there but I wish you all well and hope that this idea catches on with younger doctors and enables them to look at patients as whole beings instead of individual parts.

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  12. James Maiewski

    Slightly off-topic, but I wonder if you have a comment on the science behind the correlation between sedentary habits and poor cardiovascular health. Specifically, a comment on this excerpt:

    “This is, Ashley Cooper explains, partly due to the fact that humans have particularly big muscles in their legs. If you fail to use these fir an hour or so at a time, then the cells can undergo a process known as ‘downregulation,’ meaning they produce less of certain proteins. This, in turn, is associated with poorer cardiovascular health and worse handling of glucose, increasing the risk of diabetes.

    “‘There’s quite good evidence in adults that, regardless of activity levelβ€”unless your a completely mad athleteβ€”then high or prolonged levels of being sedentary is associated with worse health outcomes.”

    -“How Cycling Can Save the World,” P. 26

    While this might not be in your wheelhouse, it certainly seems germane to this conference’s focus.

    Sent from my Padi

    >

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    1. Dr. Malcolm Kendrick Post author

      Thanks. I am a great believer that exercise is a good thing. I am not sure how much is required, and I am not a fan of the ‘you must exercise very hard for prolonged periods of time’ philosophy. I think it puts people off taking any exercise at all.

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      1. chris c

        “Move slowly a lot, run very fast occasionally, lift heavy things” – Mark Sisson, ex-athlete.

        ps/ am I back yet?

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      2. Joyce

        Shame on you Malcolm! You’d think you were”old”. I’m 72, walk miles, go to the gym twice a week, run up escalators(honest!). Mind you, it took a cardiac arrest, and losing two stone to motivate me! lol

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      3. dearieme

        “I am a great believer that exercise is a good thing”: I find that plausible but I do wonder what the evidence is.

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      5. David Bailey

        Chris,

        I am definitely not a fan of “lift heavy things”, I have always made a point of never lifting anything close to my full capacity, because once you damage your back, you may never exercise much ever again!

        I think it is important to find some activities that you enjoy doing, otherwise you won’t keep up activity. I ice skate and cycle (off road) plus a bit of hill walking.

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      6. chris c

        It’s a way of growing more muscle mass. You don’t need to lift that heavy until you have worked up to it. Start with a small potato sack in each hand. When you have progressed to lifting them to shoulder height try with a large potato sack. When you can do that satisfactorily you can start putting potatoes in the sacks (old joke).

        I do kettlebell exercises with a watering can, you can adjust the weight by adding more water – and if you get the form wrong you get wet.

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    2. Andy S

      Exercise and diabetes connection: When your liver and muscle cells are topped up with glycogen and fat cells are maxed out then it is time to get out the chainsaw and metabolize the extra glucose that has nowhere else to go. Sedentary lifestyle increases muscle atrophy limiting how much glucose can be used. Glucose in should equal glucose out. Blaming high blood glucose on “insulin resistance” is a red herring argument.

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      1. AH Notepad

        Carbohydrate intake = high blood glucose. Avoiding carbohydrate intake = normal blood glucose. Sedentary lifestyle is definitely not helpful, but carbohydrates are the primary risk.

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      2. Gaetan

        to AH Notepad,

        if that were the case, the human race would have been wiped out already. What you think the Greeks and Romans in old times were mainly eating? just to name a few. In my opinion the real culprits are the herbicides, pesticides, GMOS and hybridization, which is the same as engineering new plants which would not survive in nature, and this is what our modern carbohydrate are made from mostly…

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    3. Hugh Mannity

      I can’t ride a bike — the traffic round here is lethal and the roads are in bad shape. I’d do myself more damage from the stress of dealing with traffic than I’d do good by cycling.

      I have an exercise bike which I do use. But to counteract the bad effects of sitting and staring at a computer for 8+ hours a day (I’m a data analyst — there’s no other way to do my job) I have a HOVR (https://hovr.pro/ ) which keeps my legs moving pretty much all day. It’s non-weight-bearing which might be a slight disadvantage to most people, but I’ve had both my knees replaced, so I find it more comfortable.

      It’s improved my blood glucose and blood pressure withoutmy making any other changes recently.

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  13. AH Notepad

    Until recently I thought that mainstream medicine was the scientific branch and the “alternative” therapies were a bit like sky hooks and purely belief driven. Now I think there is a lot of respect deserved by the alternatives, and that the mainstream has become so profit driven that much of it is tantamount to fraud, incompetence and almost criminal acts. A very sad thing for many dedicated people who work in it, some are brave enough to speak out, but they possibly become targets for the Big Pharma thugs.

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  14. ROISIN COSTELLO

    I would just love to attend. I’m babysitting Friday night overnight and I live in Tipperary . I’ll still see if it’s possible to make a mad dash . I do believe the whole concept of medicine needs a paradigm shift . Indeed is probably faced with one
    And I believe you yourself are one of the pioneers of medicines new frontiers
    Cheers

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  15. Brian Griffin

    Apropos the previous comment will there be any way of viewing/listening to your (or anybody else’s) talk post the event? I am in the colonies.

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  16. foodnstuff

    Would love to come, but Australia is a long way away! Here’s hoping the organisers put videos of the speakers up on the Web.

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  19. Diana Whyte

    I would dearly love to have a DVD of this event as I live too far away from Bristol to attend the conference.

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  21. Sylvia Brooke

    “it got forgot by many a doc”
    How true Dr. Kendrick. Thank goodness that you’re not one of them

    Enjoy next weekend, and we look forward to your shared thoughts afterwards. I only wish I could be there, and like everyone else, I hope there will be a video available.

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  22. chris c

    Beware of the mini-roundabouts! Last time I went to Bristol (I used to live there) they seem to have imported loads, probably from Milton Keynes or Basingstoke. This causes STRESSSSS!

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      1. chris c

        OMG I’m having nightmares now, trying to thread a truck through all the cars going round that thing/those things.

        Old joke about Milton Keynes

        “Mummy! Is that a concrete cow?”
        “Yes!”
        “is that the same concrete cow?”
        “Yes!”
        “Is that the same concrete cow?”
        “Yes!”
        “Can we go home now?”
        “Yes!”

        Even back in my day there were times when to get from one side of Bristol to the other it was quickest to start in the opposite direction, go round the edge and come back in again. STRESSSS!

        Enjoy the conference though.

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  23. Helena Azzam

    Hello Dr Kendrick, I have read your books, read your blogs and have completely changed my diet. The numbers are all going in the right direction, apart from that on the scales, which is being stubborn. However I am not contacting you about that, but about John Yudkin. I have just read more about him and wonder did he ever get the recognition he so rightly deserved and deserves still? Much like Alan Turing he changed the face of The British diet, or would have if he had not been so vilified and if the Government had listened to him instead of the Americans. Can we do anything now? The man should be post-humously knighted or something. All that work proved so right now. It is just not fair that he still seems to be unrecognised. Just a thought. Enjoy Bristol. I look forward to reading your account of it and keep up the good work. Best wishes Helena Azzam

    >

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  28. Nigella P

    I’d love to go but will be taking my son to a Uni open day for Med School. I’ve done everything I can to put him off, as I have huge concerns about the future of medicine in this country, but he is most persistent!
    I’d also love to hear any of the conference that could be made available.

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    1. chris c

      Another inside person would be good though. My spies tell me the number of low carb doctors is currently around 100 – 150

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  29. Andy S

    JDPatten, awesome endarterectomy video and question generator.
    What I observed was the removal of a diseased endothelium that separated easily from the internal elastic lamina. New endothelium layer is formed after operation. No blood clotting problems arise as would be expected from endothelial damage. Blood vessels penetrating internal elastic lamina would seal by clotting and terminated.
    Brief summary from various sources:
    1)- There are no blood vessels present in the endothelial layer until necrotic core develops and SMC migration occurs.
    2)- intraplaque hemorrhage of new blood vessels in stepwise progression increases plaque size.
    3)- Tissue factor increased by oxLDL, AGE’s, macrophages, smoking, etc., possible role is to increase clotting rate to limit damage in case endothelial blood vessels rupture.
    4)- Final step, rupture of thin fibrous cap over vulnerable plaque exposes tissue factor to bloodstream and results in blood clot.

    Getting too bogged down in details is counterproductive, very complex with too many unknowns. The important thing is to generate a few guidelines for everyday living.

    To limit plaque formation: fix metabolic syndrome by limiting carbs, sugar, fructose, and seed oils. Excessive LDL oxidation and AGE formation appears to be the initiating factors.
    Periodic fasting beneficial to give body a chance to repair any damage.

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  30. Sue Richardson

    Would love to go like others here, but too difficult from where I am. I really hope you – or someone else, tells us about it and how it goes.

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  32. Dirk

    GPs urged to use action plans to manage statin pain

    Antony Scholefield | 28 June, 2017 | 0 comments Read Later
    People who develop muscle pains when taking statins should be given an action plan to avoid being taken off the drugs unnecessarily, GPs are being told.

    NPS MedicineWise has released a guide to help GPs identify and manage statin-associated muscle symptoms, with a written β€˜patient action plan’ that offers several options for responding to muscle pains and weakness.

    The guide emphasises many kinds of muscle pain may not be statin related, and provides an algorithm based on CK levels for differing interventions.

    Patients whose CK levels are less than five times the upper limit of normal (ULN) may stop statins for 2-4 weeks, while those with CK levels more than five times the ULN are advised to stop statins for 6-8 weeks.

    If symptoms improve, patients can resume the statin at a reduced dose or try a different statin.

    Related News: Statin muscle pain a ‘nocebo’: study

    One of the main messages in the guide is that many people who experience muscle symptoms can keep taking their statin at a lower dose, and up to 90% are able to tolerate a different statin without problems.

    β€œ[The] perceived high incidence of statin-associated muscle symptoms risks compromising adherence to an otherwise highly efficacious and generally well-tolerated class of medicines,” they say.

    Perth GP Dr Brett Montgomery said formal guidelines and action plans for muscle pain might help convince statin users that their doctor was not β€˜making it up as they go along’.

    β€œThese guidelines back up what I already do, which is reassuring,” he told Australian Doctor.

    He said he was sometimes sceptical about patient claims that statins had caused muscle pain, but it was difficult to be sure.

    “I haven’t done alternate-day dosing but I have stopped statins and then started patients on a low dose of a different statin,” said Dr Montgomery, an associate professor of general practice at the University of WA.

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    1. David Bailey

      That sounds frightening advice!

      I mean presumably most of those who end up with permanent muscle damage (plenty have described that here), or who suffer rhabdomyolysis as a result of extreme muscle damage from taking statins, push on taking the pills for a while after feeling the initial symptoms before disaster strikes.

      I would argue that not enough is known about what causes those muscle pains – or indeed how to treat them if they don’t go away when they stop taking the statins.

      I don’t think statin ‘muscle pains’ should be considered trivial, here are some of the actual effects that people report for Simvastatin (there are reports for a range of statins on that site if you look around):

      http://www.askapatient.com/viewrating.asp?drug=19766&name=ZOCOR

      My own experience of statin ‘muscle pains’ was far more like the experiences of those on that website, than of anything that could reasonably be called ‘muscle pains’.

      I accept that some people can take statins without side effects, but to encourage people who can’t to keep trying these drugs might disable a lot of people!

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      1. AH Notepad

        They haven’t found a way of making me take them, and they also have to deal with my crusade of telling people about them and lending or giving copies of “The Great Cholesterol Con” to anyone interested.

        I can’t see why TPTB should have concerns of people unnecessarily stopping taking statins, after all, they were prescribed them unnecessarily in the first place. Perhaps all MPs over 50 should be mandated to take statins.

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    3. Andy S

      Can statins cause back pain?
      Muscles and tendons hold the spine in alignment, without this support back problems can develop. Statins affect both muscles and tendons.

      PLoS One. 2017; 12(3): e0172797.
      Published online 2017 Mar 6. doi: 10.1371/journal.pone.0172797
      PMCID: PMC5339395
      Simvastatin and atorvastatin reduce the mechanical properties of tendon constructs in vitro and introduce catabolic changes in the gene expression pattern

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    4. chris c

      Simpler algorithm: if it says “statin” on the box don’t take them.

      Stolen unashamedly from a tweet which said the same thing about choosing breakfast cereal.

      There was a recent scare story about how “Crossfit causes rhabdo!!!” My immediate though was “were they on statins?”

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  33. Eric

    Totally off topic, but if posted in the sunshine is good for you entry, nobody would see it now.

    In that thread we kind of had established the people who get real sunlight including UVB may get more total skin cancers but less melanoma, whereas those exposed to UVA mainly (by living behind glass and using UVB sunscreen) go get melanoma. I wonder what the spectrum of commercial tanning lights in the US is. Mainly UVA because it is so safe?

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  34. Jean Humphreys

    Never mind – I do my bit. Early for a blood test today, and there was a continual flow of crumblies like me, for diabetic retinopathy testing. All discussing their drugs. So I put in my ten pennorth on the way they fail to tell you that statins can cause diabetes. Sent a few on their way with a bit to think about.

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    1. AH Notepad

      Well done Jean, they will have a lot to think about, probablyy the most thinking they have ever done, or dismiss you as a suitable case needing treatment.

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  35. chris c

    Jim, I wrote a long reply about peripheral arterial disease which turned into a rant and was deleted, so here’s a shorter version.

    I started getting symptoms of obvious “diabetic neuropathy” shortly after visiting a dietician and eating her infernal high carb very low fat diet – though I had many symptoms of diabetes and “conditions common in diabetics” ever since childhood this was a new one. “Stocking and glove” distribution of tingling and “feet going to sleep” after eating, and numb patches. This reversed after a while of low carb eating and stayed away for about ten years until my thyroid blew up. High glucose gradually shreds the nerves from the periphery in, and this may affect the control of the arteries.

    After going hyperthyroid my leg arteries became rapidly chewed up, not just postprandially, and for some reason it’s my left leg which is worse than the right one. A toe became infected and started going black (an ingrowing toenail/infection was involved) and the vicious cow of a receptionist REFUSED to let me see the “minor injuries nurse” but said I could make an appointment to see an ordinary nurse.

    More follows

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    1. chris c

      Instead I got an emergency appointment with a non-NHS podiatrist, who is a friend and low carber. She was a bit horrified and rang my GP. Doctor was fully booked for over a month and “the computer” wouldn’t let her make an appointment so she suggested I see a colleague.

      He correctly diagnosed the hyperthyroid (I forgot I was also collecting fluid around my ankles and base of stomach, my BP was through the roof and my heart was thumping) he referred me to a surgeon to have the toe lopped off. He also snottily told me I was not diabetic and had never been prediabetic because “the only thing that is important is HbA1c and yours is normal”. Yeah well I stopped eating carbs, you eejit!

      The surgeon was highly clueful, he told me the toe could be saved with good care (which I got from said podiatrist) and that though he could stent me he’d rather not, suggesting I hobble through the pain instead of stopping (I did slow down a bit) and I would grow collateral circulation.

      He was spot on and I did so well he dismissed me from his clinic. He also pointed out that toe/foot amputations are rare in nondiabetics unless due to trauma.

      Basically I continued low carbing (at which he didn’t have the usual medical panic attack) and pushed on walking as far as I could before stopping or turning back. Once I went a bit too far up a farm track and was having serious doubts as to whether I could make it back to the car, but fortunately the gamekeeper (another friend) came by and gave me a lift back. He was yet another having problems with the GP surgery, he was long overdue for a hip replacement, and was also bemoaning the fact that they used to be excellent and had turned to crap (which later reversed when the PCT and previous Practice Manager went away, and which the actual doctors were pleased and relieved about)

      More follows

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  36. chris c

    (Sorry to make a mess, Malcolm, I’m trying various experiments to try to find out why I get blocked on blogs NOT by the blog owners, or apparently by Akismet)

    Since then I’ve been walking further, especially in the sun even in the middle of winter, to keep my D and NO up, I’m slower than I was, especially on hills like you but I’m up to about a mile nonstop, and 2 – 5 miles in total. Apart from low carb/keto I avoid wheat and O6 seed oils and anything that might contain them, and thanks to Malcolm and others I’ve trialled extra C, K2 (on top of what’s in my grass-fed butter and cheese), Co-Q10, l-Arginine, magnesium, fish/krill oil in addition to my usual fish, grass-fed meat and game, all in an attempt to reduce the plaque, Keeping my thyroid in range is important, through direct or indirect mechanisms it’s a definite player – when it goes high my walking ability becomes impaired and when I overtreat it and it goes low I can walk but don’t have the energy. I’m uncertain as to just how much effect the various supplements have over and above the diet and walking, but belt and braces, you know!

    Now off to eat a massive Hereford rump steak with broccoli, a glass (or two) of Chilean Carmenere and a square of 85% chocolate for pudding. Maybe some strawberries with clotted cream, ground flaxseed and brandy later. DAMN, this low carb thing is hard . . .

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    1. Antony Sanderson

      Chris . . . your experience paints an all too realistic portrait of where we are in the National Health Service. Summed up: It is hit and miss . . . you just hope for more hits than misses . . . hope you get more of the good guys than the second raters.

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      1. chris c

        So far not, I have a MUCH better ratio with dentists though, and there are not a few clueful consultants, but too many of what I call intellectual idiots – like the GP who is highly intelligent but has an absolute belief that everything he reads from NICE, NHS Evidence, WebMD, Medpage etc. is “evidence based” and everything else is “dangerous nonsense” from “cranks on the internet” – which includes not only the likes of Malcolm and David Unwin but three quarters of PubMed. He probably thinks Frank Hu is OK though. You’ll find similar types on Twitter, blogs and forums, indignantly defending Conventional Wisdom while ignoring the appalling outcomes.

        I on’t know how much this guy sucked up to The Management while the practice was being wrecked, but some of the others, including my official GP who is often too busy to make an appointment with, are a bit relieved they can now think for themselves again. I’ve heard tales of clueful GPs elsewhere running scared, being told that they Must Not encourage or even discuss low carb diets, or prescribe test strips to Type 2s for example.

        Yup I like simple tasty meals like fatty meat and greens, and also alternate with more complicated ones with more ingredients including herbs and spices etc. for the micronutrients. So far for twelve years now I have avoided the “inevitable” scurvy, halitosis, etc. along with the “inevitable” amputations, retinopathy, nephropathy etc. so something must be working. The record holder I knew died at 89, by which time he had had Type 2 diabetes for 42 – 43 years, and it had never progressed – which he put entirely down to the fact that he had been put on a low carb diet back when it was SOP over 50 years ago, and never switched to HCLF. There are still a few long termers like him around, but I don’t expect many current diabetics to do so well 😦

        This week, lamb’s liver, pheasant breasts, rump steak, Gloucester Old Spot sausages, a kipper, salmon, samphire, broccoli, multicoloured peppers, chillies, garlic, olives, mushrooms, butter, cheese and of course bacon. It’s a hard life but someone has to do it . . . oh and I forgot the instantly lethal coconut oil.

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    2. Dr. GΓΆran SjΓΆberg

      Chris

      Rump steaks have the LCHF benefit of being the most nutritious part of the animals where they accumulate their fat with preference. On the reindeer in northern Sweden this part is considered the most delicious and to my own experience this is very true. The fat layer here can easily be an inch thick. In other words – no food for “modern” fat scared people.

      At the time of the autumn slaughter there are special events where only cooked reindeer meat is served and basically nothing else. This reminds me of what the Greek historian Herodotos claimed 2500 years ago. The Ethiopian who only lived on cooked meat could reach an age of 140 versus the Persians who at that time were farmers living on bread only reached the age of 80 at most.

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      1. Ray Davies (@DrdsalesRay)

        “…most nutritious part of the animals where they accumulate their fat with preference…”

        That is why it’s so infuriating to find nearly every butcher cuts the fat off! I asked why they did this in a supermarket and, also, in a local butcher’s shop. I was told it was due to public demand. This illustrates the level of brainwashing that’s been hammered into us for so long.

        Ray

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        1. Frederica Huxley

          For the past twenty plus years, pigs have been bred to be unnaturally lean. The resultant meat is horribly dry and tasteless.

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      2. chris c

        Yes I’ve heard of people elsewhere asking their butcher to reserve the spare fat for them and even getting it for free.

        That’s why I favour the old fashioned breeds like the Gloucester Old Spots, also wild boar, and Hereford, Angus, Suffolk Red Poll etc. beef. They grow slower, especially when properly grazed, but are far tastier and tender. Easier to care for too, they look after themselves with much reduced vet’s bills – a bit like some of us I suppose.

        One farmer down the road exports some of his beef to Japan, which is otherwise next to impossible. Lincolnshire Reds which graze on the watermeadows and marshes and stay out all winter.on the less low lying paddocks.

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  37. Jo

    The sheer joy of eating simple, wholesome and tasty food free from the constraints of low fat is so evident here. People living to eat, not just eating to live. That’s so good to hear.

    I know a lot of you take magnesium…
    I’ve been researching magnesium supplements recently. In particular, looking at mag citrate in powder form. I’ve actually been taking this for around 6 months and feel great. No more restless legs or sleepless nights – heaven! The thing is, on close inspection, I notice that recommended dosage varies considerably between different suppliers. For example one well known brand suggests ‘2 teaspoons (4g) provides 350mg elemental magnesium’. In contrast, another well known brand states that ‘a half teaspoon (2.5g) gives 375mg elemental mag’. More from less??? There are many other versions with substantially different numbers out there.
    For those who (like me) didn’t know it, magnesium citrate is a mixture of elemental magnesium & citric acid. If I understand correctly, the citric acid is necessary to activate the magnesium. My question (any chemists out there?) is, can magnesium citrate be composed of varying ratios of mag:citrate or should there be a definite quantity of each? I would assume there’s a set formula, but my research tells me otherwise! I’ve read variously that magnesium is 16%, 14%, 11% & even 50% of magnesium citrate. So confused and also a bit concerned that many people could be overdosing themselves.

    Malcolm, I wish you an enjoyable conference. Sorry I can’t be there but hopeful that you’ll put in an appearance in London before too long! Looking forward to the recorded version.

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    1. David Bailey

      Wiki describes two chemicals known loosely as magnesium citrate:

      Magnesium citrate is a magnesium preparation in salt form with citric acid in a 1:1 ratio (1 magnesium atom per citrate molecule). The name “magnesium citrate” is ambiguous and sometimes may refer to other salts such as trimagnesium citrate which has a magnesium:citrate ratio of 3:2.

      It isn’t quite right to say that these compounds are mere mixtures of magnesium metal and citric acid – any more than ordinary salt is a mixture of metallic sodium and hydrochloric acid! A mixture obviously suggests no specific ratio between the ingredients.

      I guess the existence of these two salts explains the discrepancy (note the ratios in the above quote relate to molecular ratios, not weight). If in doubt as to how much to take, I would follow the label, but perhaps it would be worth checking that your particular teaspoons (ours vary quite a bit) do deliver the desired weight of chemical!

      Some salts also crystallise with one or more molecules of water, so I won’t try to convert the above into weights.

      Reply ↓
      1. Jo

        ‘Magnesium citrate is a magnesium preparation in salt form with citric acid in a 1:1 ratio (1 magnesium atom per citrate molecule)’

        Thanks for your input David.
        I also read the wiki description. That’s where I got the 50% idea from!
        I understand a bit more now, though still not clear how different suppliers recommended dosage varies so much. Do manufacturers create their own versions of mag citrate containing differing amounts of elemental magnesium – their own ‘cocktail’ if you like. Or is there a specific ratio they should adhere to? Oh, and having tried a different brand recently I can say they definitely taste different.
        Just curious really…

        Reply ↓
      2. Anne

        Elemental magnesium is not available freely in nature, in fact none of the earth and alkali metals, ie calcium, magnesium, strontium, sodium, potassium, and so on, are available as free elements, they are all bound with other elements in nature as they are not stable. I remember at school an experiment the chemistry teacher did lifting a very weeny piece of pure elemental sodium out from it’s holding container with some tweezers where it was in some fluid without using a special combustion cabinet to demonstrate what would happen – it exploded with a massive bright light – we all laughed as she squealed in horror at what she had done !

        Magnesium is reactive too, here from wikipedia: “Magnesium occurs naturally only in combination with other elements, where it invariably has a +2 oxidation state. The free element (metal) can be produced artificially, and is highly reactive (though in the atmosphere, it is soon coated in a thin layer of oxide that partly inhibits reactivity β€” see passivation). The free metal burns with a characteristic brilliant-white light.”

        Anne

        Reply ↓
      3. Jo

        So, Anne, David – anyone else?..
        Does that mean that magnesium citrate is a naturally occurring substance in it’s entirety? No one mixes the components together?.. and therefore it may occur with differing ratios of mag:citrate depending on its source? Or is there only one source? I have no idea where it comes from. Thanks for your patience!

        Reply ↓
      4. Martin Back

        Anne,
        At my primary school the science teacher’s party trick was to assemble the whole class at the swimming pool and toss a tiny piece of sodium into the pool. It would skitter across the surface, sparking and smoking, something small boys loved to watch.

        The sodium came in bars stored in a jar of liquid paraffin. The teacher would cut a small piece off one of the bars with a penknife for the demonstration.

        One day he struggled to open the jar, and when the lid came off with a jerk a whole big bar of sodium fell into the pool. There was an explosion and it blew a chunk of cement out of the side of the pool. I wasn’t there to witness it, but it was the talk of the school for a week. We would reverently examine the damaged pool and wish we were the ones to witness such excitement.

        Reply ↓
      5. Anne

        Jo – I don’t think magnesium citrate is naturally occurring, it’s a β€˜preparation’. I’ve been trying to find out about that and other sources of magnesium – it occurs naturally in dolomite and magnesite and in several other minerals. I wonder if magnsium chloride is a naturally occurring source ?

        Martin – wow – thanks for recounting what happened with the sodium and swimming pool at your school ! Must have been a massive explosion !

        Anne

        Reply ↓
  38. Randall

    I use Magnesium Taurate, but a good all-around one is non-buffered magnesium bisglycinate chelate.

    Reply ↓
    1. Dr. GΓΆran SjΓΆberg

      Randall

      I am a strong believer in supplements – not least vitamins.

      Dr. Mercola often brings this subject up on his blog and for obvious reasons – his large team is making a living on supplements. Anyway I find his recent post on vitamin D well worth reading.

      http://articles.mercola.com/sites/articles/archive/2017/07/03/too-much-vitamin-d.aspx?utm_source=dnl&utm_medium=email&utm_content=art1&utm_campaign=20170703Z2&et_cid=DM149667&et_rid=2066252366

      Reply ↓
  41. Errett

    Format: AbstractSend

    Cell Stress Chaperones. 2017 Jul 1. doi: 10.1007/s12192-017-0827-4. [Epub ahead of print]
    Melatonin protected cardiac microvascular endothelial cells against oxidative stress injury via suppression of IP3R-[Ca2+]c/VDAC-[Ca2+]m axis by activation of MAPK/ERK signaling pathway.
    Zhu H1, Jin Q1, Li Y1, Ma Q1, Wang J1, Li D1, Zhou H2, Chen Y3.
    Author information

    Abstract
    The cardiac microvascular reperfusion injury is characterized by the microvascular endothelial cells (CMECs) oxidative damage which is responsible for the progression of cardiac dysfunction. However, few strategies are available to reverse such pathologies. This study aimed to explore the mechanism by which oxidative stress induced CMECs death and the beneficial actions of melatonin on CMECs survival, with a special focused on IP3R-[Ca2+]c/VDAC-[Ca2+]m damage axis and the MAPK/ERK survival signaling. We found that oxidative stress induced by H2O2 significantly activated cAMP response element binding protein (CREB) that enhanced IP3R and VDAC transcription and expression, leading to [Ca2+]c and [Ca2+]m overload. High concentration of [Ca2+]m suppressed ΔΨm, opened mPTP, and released cyt-c into cytoplasm where it activated mitochondria-dependent death pathway. However, melatonin could protect CMECs against oxidative stress injury via stimulation of MAPK/ERK that inactivated CREB and therefore blocked IP3R/VDAC upregulation and [Ca2+]c/[Ca2+]m overload, sustaining mitochondrial structural and function integrity and ultimately blockading mitochondrial-mediated cellular death.

    In summary, these findings confirmed the mechanisms by which oxidative injury induced CMECs mitochondrial-involved death and provided an attractive and effective way to enhance CMECs survival.

    KEYWORDS:
    Apoptosis; Calcium overload; Endothelial; IP3R; Melatonin; Reperfusion injury; VDAC
    PMID: 28669047 DOI: 10.1007/s12192-017-0827-4

    Reply ↓
  42. Errett

    Antioxidants (Basel). 2017 Jun 29;6(3). pii: E49. doi: 10.3390/antiox6030049.
    Vitamin C and Microvascular Dysfunction in Systemic Inflammation.
    Tyml K1,2.
    Author information

    Abstract
    Sepsis, life-threatening organ dysfunction caused by a dysfunctional host response to infection, is associated with high mortality. A promising strategy to improve the outcome is to inject patients intravenously with ascorbate (vitamin C). In animal models of sepsis, this injection improves survival and, among others, the microvascular function. This review examines our recent work addressing ascorbate’s ability to inhibit arteriolar dysfunction and capillary plugging in sepsis. Arteriolar dysfunction includes impaired vasoconstriction/dilation (previously reviewed) and impaired conduction of vasoconstriction/dilation along the arteriole. We showed that ascorbate injected into septic mice prevents impaired conducted vasoconstriction by inhibiting neuronal nitric oxide synthase-derived NO, leading to restored inter-endothelial electrical coupling through connexin 37-containing gap junctions. Hypoxia/reoxygenation (confounding factor in sepsis) also impairs electrical coupling by protein kinase A (PKA)-dependent connexin 40 dephosphorylation; ascorbate restores PKA activation required for this coupling. Both effects of ascorbate could explain its ability to protect against hypotension in sepsis. Capillary plugging in sepsis involves P-selectin mediated platelet-endothelial adhesion and microthrombi formation. Early injection of ascorbate prevents capillary plugging by inhibiting platelet-endothelial adhesion and endothelial surface P-selectin expression. Ascorbate also prevents thrombin-induced platelet aggregation and platelet surface P-selectin expression, thus preventing microthrombi formation. Delayed ascorbate injection reverses capillary plugging and platelet-endothelial adhesion; it also attenuates sepsis-induced drop in platelet count in systemic blood. Thrombin-induced release of plasminogen-activator-inhibitor-1 from platelets (anti-fibrinolytic event in sepsis) is inhibited by ascorbate pH-dependently. Thus, under acidotic conditions in sepsis, ascorbate promotes dissolving of microthrombi in capillaries. We propose that protected/restored arteriolar conduction and capillary bed perfusion by ascorbate contributes to reduced organ injury and improved survival in sepsis.

    KEYWORDS:
    P-selectin; coagulation; connexins; electrical coupling; endothelial cells; microvessels; nitric oxide; plasminogen-activator-inhibitor-1; platelets; sepsis
    PMID: 28661424 DOI: 10.3390/antiox6030049

    Reply ↓
    1. JDPatten

      Errett,
      This should be strike three… or four or five.. for this stuff.
      I was given a double dose of omeprazole a few years ago, ostensibly to prevent uncontrolled inflammation from creating an atrioesophageal fistula and bleed-out in the weeks following atrial fibrillation ablation. Well, it gave me violent diarrhea after only six days. I unilaterally quit the stuff but the d continued for the better part of a year.
      PPIs are also used, as the theory demands, to prevent cancer in Barrett’s Esophagus. It’s now implicated as the CAUSE of precancerous changes!
      Once you’re on it for a while, and it has reduced your stomach acid to the point that you no longer can extract full benefit from your meals, it’s very difficult to get off the stuff because of painful acid rebound. It must be managed very slowly and carefully.
      And, in the U S at least, it’s available over-the-counter.
      Insidious.

      Reply ↓
      2. Errett

        PPIs are nasty and having them available OTC seems insane to me—even at a somewhat lower dose—-omeprazole was one of the first PPIs—I believe—so there seems to be more data on it concerning SE—-thanks for sharing your experience—errett

        Reply ↓
  45. chris c

    I got lucky, I was only on PPIs briefly and then moved and the new GP put me on an H2 blocker instead.

    I was on the things for years and was most disappointed when LCHF failed to eliminate the heartburn, as it so often does. Cutting out wheat fixed it though. Also so common as to be unremarkable. Pity doctors aren’t taught this.

    Reply ↓
    1. David Bailey

      I was on PPI’s for some months (while I was taking diclofenac which increases stomach acid), and aftrewards I discovered that I became somewhat dependent on the PPI’s – so I got heartburn without them. Who knows if H2 blockers are the same. I solved the problem by using Gaviscon, which blocks the acid reflux in a mechanical way, and after a couple of weeks or so, I was back to normal.

      Reply ↓
      1. chris c

        I would get an immediate rebound from stopping the H2 blockers, which would then diminish, then the heartburn would return slowly. Until the final time. . . oh thanks for reminding me, I started with Gaviscon before I was put on the hard stuff, thinking about it I can taste it now.

        I suspect after any chronic medication – or long term diet – it takes a finite time for your body to rebalance its enzymes etc. to cope with the new version of reality.

        Curiously I just had to take a Rennie, I may get indigestion a few times a year. No clue why, I just had a lamb chop with rosemary and broccoli, a thickly buttered oatcake, a glass of Malbec, a square of 85% chocolate, and a lie down. Maybe I should have stayed upright a bit longer first.

        Reply ↓
        1. Sasha

          If that lamb chop was eaten in the second half of the day, closer to the evening that will be the direct cause of indigestion. The body is not designed to process animal proteins later in the day because the peak of HCl production in the stomach happens in the morning and early afternoon. Eat animal protein during that time, avoid them in the evening and you will most likely see indigestion disappear.

          Reply ↓
  47. Randall

    I used Aloe Vera juice and glutamine to help with my burn stomach lining from anti inflammatory drugs. Not a total cure but better.

    Reply ↓

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