Tag Archives: diabetes


As a follow up of the blog posted recently which explains this scheme we can now give more details:-

Long Term Conditions – Self Management Programme for Ealing!
This programme is available to Ealing residents living with a long-­term condition such as:
Heart Disease
Pain conditions
Neurological condition
Pulmonary Rehab
High blood pressure


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The letter reprinted:

Mrs Diane Mellitus

6, Sweetwater Drive,

Andover B4 1LL

Dear Dr Down

Thank you for your letter and concern. I am so sorry that I have not been to see you but I have been so busy with decorating and doing jobs around the house and my sister has been ill and my mother was taken into hospital. Also, I couldn’t get an appointment for two weeks  to see you and when I go to the surgery I have to wait so long and I just haven’t got the time to wait around. As much as anything I was worried I might pick up something whilst I was waiting that I might pass on to my mother or sister.

Anyway, I have made an appointment next week to have my bloods taken and the following week I have made an appointment to see the nurse and one to see you.

Thank you once again for your concern.

Best Wishes

Diane Mellitus

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Posted by on March 30, 2015 in Training and Advice



Letter to a Diabetic




                                            Dr Brenda Patricia Down,

                                              Getwell surgery,

                                              Manuka Lane,

                                               Andover, B4 UD1


                                                                                       March 20th 2015    

Mrs Diane Mellitus

6, Sweetwater Drive,

Andover  B4 1LL

Dear Diane, 

I am writing to you as I am very worried that I have not seen you in surgery for sometime and your last blood tests were not good and showed that your diabetes is poorly controlled. I know that if you come to see me, together we can improve the situation considerably.

The problem is that, although you may not feel too bad, if your blood sugar is high for a long time your body is slowly becoming damaged. Gradually, the large blood vessels in your body will become clogged. As a result, you are more likely to have a heart attack, stroke or have difficulty walking without severe leg pain. It also effects the small blood vessels and this effects your eyes causing cataracts or damage to the back of your eyes and it may effect your kidneys. The high sugar effects the nerves, especially in your feet and hands, so that you can’t feel things properly.

I know you love sewing gifts for your family, but if your eyesight gets worse and you can’t do much with your fingers you will really miss making all those lovely gifts.  They so rely on you to do repairs and it won’t be that long before the grandchildren will be on the way! I also know how independent you are and how you like to get out and about.

Do you know that I saw a diabetic patient last week who has lost such a lot of weight and has been walking the new dog each day. I could not believe how his blood sugars have improved, his blood pressure has come down and his cholesterol is normal, which means I have been able to stop nearly all of his tablets. He is so happy that he will look better in his swimming trunks and with the money he has saved on quitting smoking he has decided to take his wife on a Caribbean cruise!

Please make an appointment soon so that we can get to grips with controlling your diabetes as it is not only me who is worried  about you, but your family must also be concerned and I know you are so important to them.

Best Wishes,

Dr  B.P. Down

Family doctor

PS Did you manage to get to that meeting with Right Start to learn more about diabetes? If you want to look up to find out more about Diabetes try it is a really good website. 

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Posted by on March 20, 2015 in Training and Advice


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Watch outDuring the last week I have been aware of 4 patients who have been sent fines for out of date prescription exemption certificates

If you suffer from one of the specified medical conditions you are eligible to hold a valid medical exemption certificate.


Medical exemption certificates are issued on application to people who have:

  • a permanent fistula (for example caecostomy, colostomy, laryngostomy or ileostomy) requiring continuous surgical dressing or requiring an appliance

  • a form of hypoadrenalism (for example Addison’s disease) for which specific substitution therapy is essential

  • diabetes insipidus or other forms of hypopituitarism

  • diabetes mellitus, except where treatment is by diet alone

  • hypoparathyroidism

  • myasthenia gravis

  • myxoedema (that is, hypothyroidism requiring thyroid hormone replacement)

  • epilepsy requiring continuous anticonvulsive therapy

  • a continuing physical disability which means the person cannot go out without the help of another person.

    (Temporary disabilities do not count even if they last for several months)

  • Or are undergoing treatment for cancer:
    including the effects of cancer, 
    or the effects of current or previous cancer treatment.


    When you visit the pharmacist it is important you show the certificate   when handing in the prescription. The pharmacist wil then indicate in the appropriate place that they have seen the certificate. If this box is not completed there is strong possibility that the business prescribing authorities will check their records and if the certificate is out of date you will be issued a fine.

    The letters I have seen show the fine is £50 for not possessing an up to date certificate.

    This can be appealed and may be waived if you are receiving income support. 

    How to apply for a medical exemption certificate

To apply for a medical exemption certificate ask your doctor for an FP92A form. Your GP, hospital or service doctor will sign the form to confirm that your statement is correct. You will also be given a pre-paid envelope. At your GP’s discretion, a member of the practice who has access to your medical records can also sign the form.

Your certificate will be valid from one month before the date that the NHS Business Authrority receives the application form.

The MedEx lasts for five years and then needs to be renewed. You may receive a reminder that your certificate needs to be renewed. If you don’t receive a reminder, it is your responsibility to ensure that it is renewed.

The certificate covers all prescription charges. Further details can be obtained from the following website:-

if you want more information about prescription costs including pre-payment certificates if is available on the following website:-

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Posted by on February 7, 2015 in Training and Advice


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Ealing Borough has one of the highest uptakes of free NHS Health Checks in the country. That means residents are reducing their risk of developing heart disease, stroke, diabetes and kidney disease.


If you are aged between 40 – 74years old , have not had a health check in the last five years and have not already been diagnosed with certain conditions you will  be invited for a Free NHS  Health Check. The checks only take 20 minutes and hopefully will give  you peace of mind and good advice on staying well.

Even if you feel perfectly well and lead a healthy life style it is worth having it. Some conditions do not have early symptoms. It is estimated that 850,000 people are unaware that they have type 2 diabetes. I remember when I first joined the practise on simple urine screening I picked up 19 asymptomatic diabetics in 6 months including a 19 year old young man.

We as GP’s are increasingly aware that people need to be educated as to what is a healthy weight, the safe levels of alcohol aswell as the importance or regular exercise. If after discussing your results you are found to be at risk of getting one of these diseases your healthcare professional can offer support to help lower the risks.

For more information visit


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imageWhen I first stated at 102 The Avenue I tested every single person’s urine for glucose and after 6 months I had picked up 19 new diabetics.

Those of you who have read one of my previous blogs may remember Sam, an 18yr old boy who came in nervously with his sister as he had been complaining of genital irritation which turned out to be thrush, which is a known presentation of diabetes especially in men.

He had no other symptoms but his urine contained glucose. When I told Sam he had diabetes his reply was, ” Am I going to die?” My reply was “I hope not as that means I am not a very good doctor. However, I suggest that you must not smoke and night’s out with the lads heavy drinking is not for you!” He replied,”Oh that’s good I don’t smoke and I am not fond of drinking I only drink an occasional lager”

I arranged for him to attend the diabetic clinic to be initiated on insulin as he was clearly a Type 1 diabetic.
Sam remains well still in the same job, although thinking of joining the fire service, married with 2 children, fit as a fiddle. Diabetes does not dominate his life, he has never been in hospital,continues taking insulin and sees his doctor every 6 months for regular check ups. That how the majority of diabetics live – they can have a lager or a bar of chocolate occasionally and can become organ donors and he will be assessed on his ability to be a firefighter and will not be turned down because he has diabetes.
Type 1 diabetes develops when the insulin-producing cells in the body have been destroyed and the body is unable to produce any insulin.

Who typically gets Type 1 diabetes?
Type 1 diabetes accounts for about 10 per cent of all adults with diabetes and is treated by daily insulin injections, a healthy diet and regular physical activity. Type 1 diabetes can develop at any age but usually appears before the age of 40, and especially y in childhood. It is the most common type of diabetes found in childhood. Type 1 diabetes can’t be prevented. The body’s immune system destroys the insulin-producing cells, and nobody quite understands why.
The vast majority of children with diabetes have Type 1 diabetes, but an increasing number are now developing Type 2 diabetes.

Notwithstanding, there are those for one reason or another develop complications but for the most part the majority of people like Sam lead a normal life.



The rest of those patients who I picked up with glucose in the urine were older.
I particularly remember Diane, who was a 55yr old teacher very overweight, and admitted she did very little exercise. She had come to surgery feeling tired and stressed but a routine urine showed glucose. I tried to suggest that she lost weight and even suggested Bariatric surgery but she was very negative, claiming she had tried every diet and didn’t have time for exercise. As time went by she was treated for hypertension and needed to have several types of diabetic medication and the diabetes was still not satisfactorily controlled and she was not only was her weight increasing but she was developing angina. Probably dreading hearing the same old advice – diet and exercise and the suggestion of insulin she started not turning up for her appointments. At the beginning or each year we audit our patients to review those that have not been checked and her name appeared and we then ask the receptionists or nurse to phone them to make an appointment. She did make an appointment and her blood tests showed her blood glucose was running very high. When I saw her she said that her job was now becoming so stressful that she was considering early retirement and that she was now prepared to have Bariatric surgery and look seriously at her health. I was thrilled it was worth waiting for that moment. She went on to have surgery and with the support of the multidisciplinary team of dietitian, psychologist and surgeon she became motivated to eat a healthier diet, exercise and gradually as the weeks went by she stopped one medication after another. She was transformed she looked more attractive, she was happier, free from both her diabetic and blood pressure medication and the angina settled. She was now retired and set to enjoy life outside London and as she came to say goodbye she said, “Why hadn’t I done this earlier?”
Who typically gets Type 2 diabetes?
Type 2 diabetes usually appears in people over the age of 40, though in South Asian people, who are at greater risk, it often appears from the age of 25. It is also increasingly becoming more common in children, adolescents and young people of all ethnicities. Type 2 diabetes accounts for between 85 and 95 per cent of all people with diabetes and is treated with a healthy diet and increased physical activity. In addition to this, medication and/or insulin are often required.
In Type 2 diabetes there is not enough insulin (or the insulin isn’t working properly), so the cells are only partially unlocked and glucose builds up in the blood.
In today’s press:-
More than one in three adults in England are on the cusp of developing type-2 diabetes, new research suggests.
If nothing is done to stop the trend, there will be a steep surge in this form of diabetes within the next few years, the authors of a report published in the British Medical Journal Open said.
People are classed as having borderline diabetes, also known as pre-diabetes, when they have blood glucose levels at the very high end of the ‘normal’ range. Those with the condition are at high risk of developing diabetes and its associated complications.
Their study found that in 2011, the number of people diagnosed with pre-diabetes tripled from 11.6 per cent in 2003 to 35.3 per cent.
We now regularly screen patients not just for urine glucose but for blood glucose in an attempt to prevent the onset of diabetes.

It is now reported that 80% of Type 2 diabetes can be prevented by diet and exercise alone

As I reflected it made me realise the enormous strides that have been made in medicine since I have been qualified regarding diabetes, firstly being able to diagnose it so easily with a simple dipstick and more accurate blood tests to recognise pre-diabetes as well as having the proven knowledge that leading a healthy lifestyle can prevent the onset. However, sadly many people don’t take heed of this and don’t eat healthily and live a life of a couch potato running a great risk of developing Type 2 diabetes.


I remember my first job as a surgical house officer there were always some patients on the ward with chronic leg ulcers, and those who had poor lower limb circulation both as a result of diabetes and who were on the surgical ward and inevitably ended up having an amputation. Many of these patients also had poor eyesight due to cataracts or diabetic retinal damage, others had had heart attacks or strokes and it was a concern whether they would able to cope with anaesthetic and had to have the surgery with a spinal block. Most of these diabetics went on to develop kidney failure but were considered unsuitable candidates for renal dialysis because of there array of other complications. They had to have peritoneal dialysis – a cumbersome way of ridding the body of liquid waste. It involved pouring large volumes of fluid into the abdomen and then flushing the fluid out. When I was a GP visiting these patients, who were discharged home for it to be carried out by the District nurse on a regular basis, sometimes daily, I remember having to squeeze past these piled up boxes in the hallway. There prognosis was poor and they often developed severe infections or went into end-stage kidney failure and died at in there 50’s. Hence, it is not surprising that many people fear this condition and feel it will alter their life.
Diets at that time consisted of large amounts of fat and sugar: the day started with a greasy cooked breakfast, puddings were a must and afternoon tea was accompanied by a selection of home-made cakes. Although exercise was part of a daily routine the television began to limit how much people did and more people bought cars, public transport improved but everyone continued with the same diet.
Diet and exercise
In 2001 Diabetes Prevention Program (DPP),a large trial was carried which was scheduled to last 4years comparing a group of people who were supervised strictly to adhere to exercise and a healthy diet and a group who were not educated but the trial had to be abandoned after 3 years because it was so clear that a highly significant number were developing diabetes in the non-educated group and it was considered non-ethical not to educate everybody.
Participants randomly assigned to intensive lifestyle intervention reduced their risk of getting type 2 diabetes by 58 percent. On average, this group maintained their physical activity at 30 minutes per day, usually with walking or other moderate intensity exercise, and lost 5-7 percent of their body weight.

It is reported that 80% of Type 2 diabetes can be prevented by diet and exercise alone

You can check your risk of developing diabetes by clicking on the link below:-

It is possible to delay the onset of Type 2 diabetes by lifestyle intervention.
Before you develop symptoms:-


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What is Diabetes? | Diabetes Matters

If you are interested to learn more about diabetes and how to manage it you may be interested to download a monitoring diary or view a short video using the link below:- image “

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Posted by on August 14, 2013 in Training and Advice


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The number of Britons diagnosed with diabetes hit three million this year for the first time – equivalent to almost one in 20 of the population.
The majority have Type 2 which is strongly linked to being overweight or obese, leading a sedentary lifestyle and an unhealthy diet.
What is diabetes?
Diabetes is an incurable condition in which the body cannot control blood sugar levels, because of problems with the hormone insulin. There are two main types of diabetes. In Type 1 diabetes the cells of the pancreas stop making insulin. In Type 2 diabetes, either the pancreas cells do not make enough insulin, or the body’s cells do not react properly to it. This is known as insulin resistance.
How does the body control blood sugar levels?
Your body uses blood sugar (glucose) for energy. Glucose is a basic ingredient of sweet foods such as sweets and cakes. It can also be produced by carbohydrates such as potatoes, pasta or bread when they are digested and broken down.
Under normal circumstances, the hormone insulin, which is made by your pancreas, carefully regulates how much glucose is in the blood. Insulin stimulates cells all over your body to absorb enough glucose from the blood to provide the energy, or fuel, that they need.
After a meal, the amount of glucose in your blood rises, which triggers the release of insulin. When blood glucose levels fall, during exercise for example, insulin levels fall too.

Types of diabetes and how they cause health problems.


Type 1 diabetes is an autoimmune condition, and the immune system attacks the cells of the pancreas. It tends to affect people before the age of 40, and often follows a trigger such as a viral infection.
I have diagnosed several younger diabetics that have presented with abdominal pain and vomiting or with thrush or abscesses  or during pregnancy. On closer questioning they admit to loss of weight( 10lbs/4.5kg unintentional weight loss) excessive thirst and frequency of urination with fatigue.
If people living with Type 1 diabetes don’t receive treatment they can develop very high blood sugar levels – hyperglycaemia – within days. As I remember being taught as a medical student in the days, when we were drilled like army cadets, the consultant Dr Byron-Evans proclaimed in a loud, authoritative, deep Welsh  voice ,” Now, good boys ( female medical students were an unusual presence-and not really recognised in those days!) this is the most important of medical emergencies be aware of it as it is slow to happen, undramatic  but potentially fatal”. How could I forget, I  tremble as I write this!
This occurs because  there is no insulin to drive the sugar from the blood into the cells, the kidneys try to remove the excess glucose. This leads to frequent urination, dehydration and intense thirst.At the same time, the body starts breaking down fat for fuel to counter the low levels of sugar available to the cells. This leads to toxic levels of acids building up in the blood – a life-threatening condition known as ketoacidosis.
 As we screen so readily now, and attempt to improve patient education diabetics presenting with hyperglycaemic ketoacidosis is less common but it still happens.
 About 16 years ago I remember seeing an  18 year old boy who came to the surgery  with his sister in an embarrassed state as he had thrush  and after testing his urine I diagnosed diabetes. He looked at me petrified and said “Am I going to die?” to which I replied ,” I hope not for a long time” . He was started on insulin and the diabetes was brought under control. He moved away from Ealing but recently I bumped into his sister in a local supermarket  and asked how he was. Indeed, he was well,  living a normal life and had never been admitted to hospital.
Those with Type 1 can also suffer a dangerous complication of treatment known as hypoglycaemia, which can cause a coma. This occurs when blood sugar levels fall dangerously low as a result of taking too much insulin, or sometimes by skipping a meal. The brain requires a constant supply of glucose from the blood otherwise it can’t function properly.

If treatment doesn’t effectively control high blood sugar levels, it leaves a person with diabetes more vulnerable to infections. Over time it can also damage the small blood vessels and nerves throughout the body, including the smaller vessels at the back of the eye, which can result in blindness, and the kidneys, leading to kidney failure.



In Type 2 diabetes, either the pancreas cells do not make enough insulin,  and it has been shown that when someone is diagnosed with Type 2 diabetes up to 50% of their pancreas is damaged  ie the beta cells are not functioning or the body’s cells do not react properly to it and this is known as insulin resistance.
The exact mechanisms that lead to Type 2 diabetes are not fully understood, but an underlying genetic susceptibility is usually present. This could be a family history of the illness, for example. The condition is then triggered by lifestyle factors – such as obesity – and it usually appears in people over the age of 40.
Type 2 diabetes tends to develop more gradually, which is one of the reasons why medical professionals think that so many cases go undiagnosed.
Most Type 2 diabetics are overweight but there  are some elderly patients who present in the same way as Type 1 diabetics by losing weight, excessive thirst and urination.
In the long-term, diabetes raises the risk of many conditions, including peripheral vascular disease (when the arteries to the extremities are damaged by atherosclerosis) and peripheral nerve damage. Together they can result in ulcers, infections, gangrene and amputations. It can also increase the risk of impotence, heart attacks and strokes. Over time it can also damage the small blood vessels and nerves throughout the body, including the smaller vessels at the back of the eye, which can result in blindness, and the kidneys, leading to kidney failure. On a dialysis unit the majority of patients are diabetics.
Cataracts are also common in diabetic patients.
Gestational Diabetes – During pregnancy, some women experience heightened blood sugar levels and can’t produce enough insulin to absorb it all. In most cases it develops between the 14th and 26th week of pregnancy, known as the second trimester, and disappears after the baby is born.
The mother and baby has to be closely monitored  during and immediately after delivery. She may need to take insulin during the pregnancy. A specialist diabetologist usually oversees this alongside the obstetrician . The outcome has improved considerably as I recall in the past  mothers delivered very large babies and in some cases they did not survive.
Neonatal diabetes – This is very rare. It is caused by a change in a gene that affects insulin production.
Maturity onset diabetes of the young (MODY) – Caused by a mutation in a single gene and is also very rare but now mor frequently being diagnosed. There is a specific blood test to make this diagnosis.
For further support and information:-

I trust after reading this you are better informed as to what a serious condition diabetes is and why I feel important to draw attention  to the recent survey which showed the importance of how you travel to work  and how this can potentially reduce your risk of developing diabetes.
Experts at Imperial College London and University College London examined how health is affected by the way people travel to work, using a survey of 20,000 Britons
They found cycling, walking, and using public transport were all associated with a lower risk of being overweight than driving or taking a taxi.
Those who walked to work were far less likely to have Type 1 or Type 2 diabetes than drivers, and had a 17 per cent lower risk of high blood pressure.


Cyclists were around half as likely to have diabetes as those who drove.
High blood pressure, diabetes, and being overweight are all major risk factors for heart and circulatory disease, the UK’s biggest killer.
In addition, riding to work or to the shops is one of the most time-efficient ways to incorporate regular exercise into everyday routine. You can get your daily exercise done without having to spend extra time or money at the gym. The simple act of riding your bike can burn between 750 – 1000 calories an hour, which helps both your health and fitness.
Several years ago a study was carried out by Diabetes UK whereby one group of people were strongly encouraged to exercise and another group were given no advise. The trial was to last 4 years and it was aimed at establishing  the importance of exercise in Diabetes prevention . After 2 years the trial was abandoned as it was found that it was shown  so strongly that exercise did prevent diabetes it was considered unethical not encourage everyone to exercise.
Recently when I was trying to help some 4th year students,who have to carry out a study looking at health prevention, it did cross my mind to look at those people who use public transport and see how many were overtly obese as the impression is that there noticeably  less obese people traveling on the underground. Hence, I was not surprised by the results.
They found wide variations in the modes of travel used in different parts of the UK. Public transport was used most in London, at 52 per cent, while only 5 per cent used it in Northern Ireland.
Of the working-age adults who used  private transport such as cars, motorbikes and taxis to get to work, 19 per cent were obese, compared to 15 per cent of those who walked and 13 per cent of those who cycled.
The researchers said people could reduce their risks of serious health problems such as heart attacks by avoiding using a car.
Anthony Laverty, from the School of Public Health at Imperial College London, who led the research, said: ‘This study highlights that building physical activity into the daily routine by walking, cycling or using public transport to get to work is good for personal health.
‘It demonstrates associations between active travel to work and a reduced likelihood of being overweight, having diabetes and having hypertension.’
Robin Hewings, of Diabetes UK, said the charity ‘recommends that the best way to reduce your risk of Type 2 diabetes is by combining physical activity with a healthy balanced diet that is low in salt, fat and sugar and rich in fruit and vegetables’.
He added: ‘Walking to work is a great way to improve your overall health and we recommend people walk where possible in place of a car or public transport.’
A study by Leicester University earlier this year found those at high risk of developing diabetes can reduce the likelihood by cutting the time they spend sitting by 90 minutes a day.
“We are recommended to have at least 30 minutes’ moderate exercise a day so only a 15-minute walk at either end and you have done your quota — although the longer the better,” Millett said. “It’s also more convenient than going to the gym because it can be factored in as part of your day without having to set aside any other time.”
All new patients are screened by urine testing but if you are concerned that you have symptoms of weight loss, thirst and frequently passing urine please ask for a  special blood test. If you are noticeably overweight and have a family history of diabetes, heart disease, strokes or kidney disease it would also be reasonable to be screened.
We are also actively assessing all patients with blood pressure as to how much exercise they do and if appropriate issuing them with an exercise prescription .
I trust I will see more of you walking or cycling in the streets of West Ealing!
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Posted by on August 13, 2013 in Training and Advice


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Diabetes Manager App

This is a useful App for all diabetics

Diabetes Manager by
We are keen for patients to take an interest in monitoring and understanding all aspects of their Diabetes. When you attend surgery for your review please bring your iPhone or iPad to load up the relevant information. If you don’t have either of these we will supply you with handheld written record of information.

Look out for further information about Diabetes
imageThe blue circle is the global symbol for diabetes, introduced by the International Diabetes Federation with the aim of giving diabetes a common identity, supporting existing efforts to raise awareness of diabetes and placing the diabetes epidemic firmly in the public spotlight.


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Healthy Eating

Healthy Eating
A healthy diet is one that helps maintain or improve general health. It is thought to be important for lowering health risks, such as obesity, heart disease, diabetes, hypertension and cancer. A healthy diet involves consuming primarily fruits, vegetables, and whole grains to satisfy caloric requirements, provide the body with essential nutrients, phytochemicals, and fibre, and provide adequate water intake. A healthy diet supports energy needs and provides for human nutrition without exposure to toxicity or excessive weight gain from consuming excessive amounts.
I think it is a good idea that we all stop and think about what we are eating. Many of us make numerous excuses not to eat properly – we haven’t time, we can’t afford to, we don’t like healthy foods, they don’t agree with me……….but at the end of the day.
If we take time to plan our eating perhaps 30-40 minutes each week all these excuses would disappear. It is so important that we stock our kitchen carefully. I know if there are only biscuits in the surgery then that is what I eat but if I organise myself I can snack and can eat very healthily with not much effort. Reading the news today I was saddened to read of children’s food ignorance. comes from plants and fish fingers are made of chicken, according to a significant number of children questioned on their knowledge of where food comes from.
The British Nutrition Foundation (BNF) included more than 27,500 children in the research and found that nearly a third (29%) of primary school children think that cheese comes from plants, and nearly one in five (18%) primary school children said that fish fingers comes from chicken.The survey also found that one in 10 secondary school children believe that tomatoes grow under the ground. The largest of its kind, the study was conducted as part of the BNF’s Healthy Eating Week, which is launched on Monday by The Princess Royal.More than 3,000 schools are participating in the week-long event, during which more than 1.2 million children will learn about healthy eating, cooking and where food come from. Roy Ballam, education programme manager at the BNF, said the high numbers of schools taking part shows there is an understanding of how important it is to encourage healthy eating. And so it goes on…….Most of us are aware what we should be eating and most supermarket produce relevant literature and children in school are taught formally about healthy food but despite that they remain ignorant. To find out more about healthy eating  refer to the section in nhs choices
Meals should be a social time to sit together to discuss the day, share each others concerns and as well as enjoy each others company. All members of the household whatever their age can help to prepare a meal and young teenagers ( before they want to opt out) can prepare a meal perhaps in the style of ‘come dine with me’ adding points for healthy eating. It is all great practice if they leave  home to go to University and learning to budget and cook healthily. Growing your own vegetables and herbs whether in a planter on a balcony or windowsill or finding a patch in the garden is very pleasing.  The supermarkets all seem to sell packets of seeds very cheaply and it so rewarding to eat your own. We are lucky to have a ‘Farmers Market’ in West Ealing on Saturday morning and look out for another one in Green Lanes, Hanwell.Healthy eating is an investment for future health and well being.

Written by Dr Jacqueline Bayer


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