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Blogs relating to foodstuffs which have health benefits with related stories

CHAMPIGNONS – WHAT TO EAT TO BENEFIT YOUR HEALTH

In October many French country people were busy gathering various types of fungi to dry, bottle or use in their cooking.gathering of edible fungi will resume in the Spring and I shall look forward to gathering Girolles or Chanterelles one of my favourites.

As they have been something I have come across in French life as well as in my studies of Traditional Chinese Medicine (TCM) I have decided to publish my thoughts and research on this topic.

When I arrived in France back in October the grass in front of the house was covered with an imageabundance of different mushrooms and low and behold I was thrilled to find a cluster of Cèpes (Boletus edulis) outside the back door. They are considered a prize find, an ingredient in various foods. B. edulis is an edible mushroom held in high regard in many cuisines, and is commonly prepared and eaten in soups, pasta, or risotto. As they are so valued anyone owning woodland where cépes are abundance there are signs forbidding people to pick them and French Law would support the proprietor in prosecuting someone found picking mushrooms on their land.

Interdit picking cepes
The French are very secretive about where their mushrooms are located and are even reluctant to tell their close family and there is only one French friend who will allow me to go collecting mushrooms with her.

Cèpes have a distinctive appearance and can be usually recognised easily. However, some mushrooms can be confused with similar poisonous species and if unsure when picking them in France they can be taken to the local Pharmacist who is trained to identify Mushrooms which are edible. The mushroom is low in fat and digestible carbohydrates, and high in protein, vitamins, minerals and dietary fibre.

imageMany years ago I remember when I was working as a junior paediatrician several children were admitted following eating ‘magic mushrooms’ which grew on the local hillside in Wales.
‘Magic mushrooms’ is a slang word for psilocybe semilanceata or ‘liberty cap’ mushrooms (the most common type of ‘magic mushroom’ in the UK) and contain the psychedelic drugs psilocybin and psilocin. These mushroom, when eaten produce hallucinations and sometimes, can cause disorientation, fatigue,vomiting and can give abdominal pains or diarrhoea. There are records of their use in different parts of the World by many ancient civilisations. When these children were admitted together there was absolute chaos on the ward as they effected the children in different ways. Fortunately, no child had any long term effect.
They are Illegal to use

If you want to know more about the effects of these and also to draw attention an FRANKexcellent website regarding any drug abuse:-
http://www.talktofrank.com/drug/magic-mushrooms

While medicinal mushrooms have been used in China and Japan for more than 3,000 years to boost immunity and fight diseases such as cancer, only in the last decade has their power begun to be recognized in the West. In more scientific terms, a number of compounds in fungi have been found to stimulate the function of the immune system, inhibit tumor growth and boost intestinal flora. Particularly, mushroom substances called terpenoids help kill bacteria and viruses and exert anti-inflammatory effects, while complex chain-like sugars called polysaccharides have been shown to exert antitumor and immuno-stimulating properties. – The Natural Foods Merchandiser, March 2005
Chanterelles
Mushroom stallI managed to buy some white Chanterelles ( Cantharellus subalbidus)
from the market carefully gathered by an expert and I carefully prepared them and fried them in crème fraiche, seasoned with garlic and parsley imageas instructed by my expert (stall holders in the market love to advise you how to cook their produce) and served with chicken escalope.
Our ancestors would certainly have eaten them and they would have been gathered by peasants throughout history, with these and truffles, peasant food wasn’t too bad, although of course such food is seasonal with chanterelles being found mainly in the spring and autumn or in imagethe rainy seasons. Traditionally mushrooms particularly chanterelles have been assumed to be aphrodisiacs, with the 11th century Normans in Britain feeding them to grooms at their wedding feasts. The minerals they contain along with the amino acids and vitamins, probably make them good for the libido, especially for men with erectile dysfunctions.
Chanterelles have an affinity with certain trees and particularly birch, beech, oak, and pine in descending order, as they seem to like birch trees best, but they also seem to quite like larch and sweet chestnut trees too. They grow in soil which is damp, but not swampy or marshy ground.
If you go picking them, make sure that you wash them thoroughly and clean the gills. This is best done with a soft toothbrush.
They are great added to soups and stews and go well with eggs, but can be used to accompany any meat dish. Treat them as you would any other mushroom as far as cooking goes. Personally I love them and am always happy when I find them either in woods or in the market as I did this Autumn and the man proceeded to give me a lesson on how mushrooms grow and how important the climatic conditions have to be – the temperature, air pressure, amount of rain and sun and the consistency of the soil and the site where they grow . The spore starts to grow about a metre below ground and a fine filament a couple of millimetres thick grows upwards to the surface and if the conditions are right will form a fungi.image
Like other mushrooms they contain vitamins A and D as well as some of the B-complex ones. They contain all the essential amino acids and glutamic acid is believed to boost the immune system and may help fight cancer, infections and rheumatoid arthritis. There is evidence that it inhibits blood clotting, which is valuable in the fight against heart disease. As for minerals, they contain potassium which regulates blood pressure and the contractions of the heart muscle; copper, manganese, magnesium, calcium, zinc and selenium which is good for the mood and the brain

Oyster Mushrooms
I wanted to include this mushroom which you will see on the shelves of your local Oyster mushroomsupermarket and has particularly good cholesterol lowering properties.
Pleurotus ostreatus, the oyster mushroom, is a common edible mushroom. It was first cultivated in Germany as a subsistence measure during World War I and is now grown commercially around the world for food. The oyster mushroom may be considered a medicinal mushroom, since it contains statins such as lovastatin which work to reduce cholesterol.
Pleurotus Ostreatus) is a fleshy, gilled mushroom growing in shelf-like fashion on wood that is a good food and promising medicinal. Protein quality is nearly equal to animal derived protein. Low fat content is mostly of the good unsaturated kind. Also contained are carbohydrates, fiber, vitamins B1, B2, plus minerals, especially iron and an antioxident. This mushroom shows activity against cancer and high cholesterol. It has shown activity in the following areas: antitumor, immune response, anti-inflammatory, antiviral and antibiotic.

Shiitake Mushrooms 香菇 xiāng gu
The Shiitake (Lentinula edodes) is an edible mushroom native to East Asia, which is cultivated and consumed in many Asian countries.
Shiitake Fresh and dried shiitake have many uses in the cuisines of East Asia. It is thought that have been used in cooking since pre-historic times in China,Japan and Korea. In Japan, they are served in miso soup, used as the basis for a kind of vegetarian broth, and also as an ingredient in many steamed and simmered dishes.
More information can be found on:-
http://www.whfoods.com/genpage.php?dbid=122&tname=foodspice
A 1980 study found that a virus in shiitake mushrooms could produce interferon, effective in treating cancer but also to boost the immune system. When I was studying Chinese herbs (TCM) during the Swine flu epidemic and on the weekend I attended the tutor was very keen to advise us to make a soup to protect us from catching the flu. The tutors claimed that in China that as it was so difficult to vaccinate such large numbers of people instead shops were urged to stock large quantities of the ingredients especially thee Shiitake mushrooms so that every household could make the soup. I will share this recipe with you should you need it in the coming months.
At that time I duly got home and made the soup and emailed to my student children.. No- one caught the flu!

Recipe For Chicken and Mushroom Soup – ideal on coming back from work, after exertion especially to boost the immune system

4 Chicken thighs
2 Onions
12 Garlic Cloves
4 inches Ginger
2 Red Chillies
12 Shitake Mushrooms
5 Stock cubes
2 litres water
Dried Goji Berries soaked in cold water (optional)

Method
Chop onions,garlic and ginger and fry lightly in oil until soft
Fry chicken thighs until golden brown
Chop chillies and mushrooms and add to above
Add water and stock cubes bring to the boil and simmer for 1-1.5hrs.
Before serving add the Goji berries.

WarningWhilst I have written about several types of fungi, which can add a lovely flavour to our food and at the same time have remarkable health benefits please beware of their potential poisonous properties and never pick them unless you are absolutely certain of what they are.

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Posted by on December 29, 2013 in Training and Advice

 

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CHRISTMAS IN FRANCE -OYSTERS AND CHAMPAGNE

” Le plateau des fruits de mer” can be essential to a French Christmas and New Year as it is to balmy summer days by the sea. The fact that it may well be served in a grotesque imageceramic boat is neither here nor there. Christmas Eve often means the gathering of several generations of a family sitting round a table covered in white linen, or even white paper, upon which are displayed the elevated trays of the freshest seafood of many types of shellfish preferably with lobster and crab and most certainly with a generous number of oysters. They tackle this feast with an arrangement of eating instruments and consider it a harmonious, pleasurable shared experience. This may be repeated during the Summer months but imageChristmas is a time when fishmongers are selling custom made platters in abundance.
At the very least everyone will be buying oysters by the box or at least a dozen from supermarkets stacked with boxes of oysters transported from the coasts of Brittany or imageNormandy. Alternately corners of the streets or outside small greengrocers there are small pop up stalls selling oysters which are graded by size numero zero (the largest) to numero 5 (smallest for garnish) and most people buying numero 3 or 4 but families buying boxes or 2 dozen. They are enjoyed as a starter for the Christmas meal with a glass of Champagne.

My personal introduction to oysters was when I was in my late teens when I was hiking through Northern France with a group of English and French students. We had met in the West coast of Ireland the year before in an International camp and it was evident at that time that the French boys were skilled at collecting shellfish and knew how to serve them. When we met them in France we camped in the grounds of various farms and were introduced to the delicacies of local delicious French soft cheeses,Crêpes aswell as cider and Calvados. The imagelast visit was to the home of Alain who was about to join the French Navy for his National service. He happily took us out in his boat and after a coastal trip then moored in a small cove and told us wanted to give us a surprise. The next thing this swarthy French young man dived off the boat armed with a knife. He soon returned with a bag of oysters he had harvested deftly from the rock something he had being doing for several years. He then prepared them by prising open their shell and demonstrating swallowing them whole . Under the circumstances I found no difficulty in acquiring the taste instantly. I have to say at that time I was not aware they are considered to have Aphrodisiac properties!
Like so many foods, oysters are an acquired taste. The thought of eating them raw remains deeply repellent to some, though if you enjoy other seafood there should be little difficulty in getting to grips with them. While Jonathan Swift once remarked that “he was a bold man that first ate an oyster”, the slithery beauty of a fresh oyster is a unique taste most definitely worth acquiring! Many discover a lifelong enthusiasm and will choose oysters in preference to any other item on a restaurant menu. I include myself in that category.
Hence, since 1989 when I have been frequently visiting France I have very rarely missed having oysters for Christmas and with a glass of Champagne.
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When I drink a glass of champagne I always think of miners trapped underground, when I worked in a Welsh Mining valley I was told on good account that on occasions when miners were trapped a tube was introduced into the cavity where they were stranded and champagne was delivered as those above ground believed it was good nourishment. Interestingly, in April 2007, the Journal of Agricultural and Food Chemistry published the results of a recent joint study by the University of Reading and University of Cagliari that showed moderate consumptions of Champagne may help the brain cope with the trauma of stroke, Alzheimer’s disease, and Parkinson’s disease.

Oysters do have health benefits. Don’t worry if you chip some of the shell when preparing the oysters as the shell is a Chinese Herb known Mu Li is also named Concha Ostreae, 牡蛎Concha Ostreae) and is used to treat menopausal symptoms and “calms the spirit”, treating anxiety.
The oysters themselves as well as being rich in protein, they are also low in fat and in calories. They contain significant amounts of zinc, calcium, iron, iodine, copper, magnesium and selenium. Legendary properties have also been attributed: it is believed by some that oysters are the Viagra of the sea. A team of American and Italian researchers analyzed bivalves and found they were rich in amino acids that trigger increased levels of sex hormones. Their high zinc content aids the production of testosterone.
Oysters themselves can and do change gender several times during their lives!

Candles

HAPPY CHRISTMAS!

 
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Posted by on December 24, 2013 in Anecdotes...little stories

 

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HOW HEALTHY ARE YOUR SPERM?

Yes you did read correctly…..

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Could two handfuls of walnuts a day improve the sperm shape, movement and vitality of your sperm?
It seemed appropriate to write about this as September 29th in France is the day people harvest their walnuts and that is what I shall be doing during the next week.
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he tao ren | 核桃仁 | Juglandis Semen:walnut

This Chinese herb has been used for many hundreds of years in traditional Chinese medicine (TCM) to reinforce and Tonify the Kidney and Lung Yang. In Western terms this means that if you are ageing, a cold person, tendency to being overweight, backache, knee pain, breathlessness, constipation and infertility. These type of herbs particularly walnuts can gradually ( over a minimum period of 3 months) improve these problems along with other other lifestyle measures.
The Walnut tree is a common sight in the Dordogne,France and it is interesting that it always grows alone or with other walnut trees and has been has been harvested for many years for the nuts or taken to mills to make walnut oil,which is used for salad dressing and is very high in Omega-3 fats with all the health benefits.
imageThe mills are at intervals along the Dronne and are often in the shape of a boat(bateau) and the wiers associated with these mills make exciting canoeing! Most are not in use but there a few which still produce walnut oil. It is possible to take the harvested nuts,after drying them over the winter, to the mill and collect the oil at a later date.Sitting by an open fire cracking nuts in the winter months,watching a good film can be pleasant winter pastime. Old dordogne kitchen tables have large dents in the table surface after years of family nut cracking with a mallet. The new nutcracker is much easier…
imageBut since I read about a small study carried out in Californis and written up in the journal Biology of Reproduction suggesting that eating around two handfuls of walnuts a day improves sperm health in young men harvesting walnuts has a new meaning.
This study involved 117 men between the ages of 21 and 35, who were divided into two groups. One group added 2.6 ounces (75 grams) of whole-shelled walnuts to their daily diet.
The other group continued their usual diet but avoided eating tree nuts. Both groups ate a typical Western-style diet.
Lead author, Prof Wendie Robbins from UCLA’s Fielding School of Public Health said: “We found a significant improvement in sperm shape, movement and vitality in men who added walnuts to their diet over 12 weeks.”
“The men who ate no tree nuts saw no change.”
The fatty acids Omega-3 found in these nuts are thought to have helped sperm development. It is not known if this would help improve male fertility.
About one in six couples are infertile, with 40% of these due to a male factor.
The researchers say the next step is to work with couples who are attending infertility clinics to determine if placing sub-fertile men, with poor semen quality, on a walnut diet results in better success conceiving.
When I resd this I wondered whether it was a signifant result but Dr Allan Pacey, senior lecturer in andrology at the University of Sheffield said: “It would be relatively easy to poke fun at studies like this, but there is increasing evidence to show that aspects of a man’s diet can affect the number and quality of sperm produced by his testicles.”

Moreover,all those young men that need to improve the health of their sperm and potentially their fertility

*Avoid cigarettes and illicit drugs, especially anabolic steroids
*Avoid exposure to toxins such as pesticides and heavy metals
*Limit alcohol intake
*Eat a healthy diet and maintaining a healthy weight
*Take care to keep your scrotum cool, because heat slows sperm production. Avoid hot baths and hot tubs, wear boxers instead of briefs, and avoid pants that are tight or restrictive.
AND
EAT WALNUTS!!
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Posted by on September 28, 2013 in Training and Advice

 

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A TREASURE OF RICHES

What better way of eating tomatoes but by picking them straight from the vine and immediately devouring them especially when they are grown without any chemical intervention. The next best is slicing them and topping them with fresh basil and a drizzle of olive oil, light seasoning and eating them as a starter or snack. image Anyone can grow tomatoes on a windowsill, on a balcony or in a garden and after careful nurturing you also can have that pleasure. When I bought my plants I was advised by an elderly couple who were buying a plant each to put on their windowsill. I was surprised when I ended up with a red variety and a yellow variety. But research showed me that the yellow variety is richer in antioxidants than the red. image Lycopene is a carotenoid pigment that has long been associated with the deep red colour of many tomatoes. A small preliminary study on healthy men and women has shown that the lycopene from orange- and tangerine-colored tomatoes may actually be better absorbed than the lycopene from red tomatoes. This is because the lycopene in deep red tomatoes is mostly trans-lycopene, and the lycopene in orange/tangerine tomatoes is mostly tetra-cis-lycopene. In a recent study, this tetra-cis form of lycopene turned out to be more efficiently absorbed by the study participants. image

I didn’t realise the antioxidant protection as being important for bone health, but according to a study carried out whereby Lycopene was withdrawn from postmenopausal women’s diet for 4 weeks and after this short period of time there were increased signs of oxidative stress in their bones and unwanted changes in their bone tissue implying that tomato lycopene (and other tomato antioxidants) may have a special role to play in preventing osteoporosis.

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Intake of tomatoes has long been linked to heart health. Fresh tomatoes and tomato extracts have been shown to help lower total cholesterol, LDL cholesterol, and triglycerides. In addition, tomato extracts have been shown to help prevent unwanted clumping together (aggregation) of platelet cells in the blood – a factor that is especially important in lowering risk of heart problems like atherosclerosis. Dietary intake of tomatoes, consumption of tomato extracts, and supplementation with tomato phytonutrients (like lycopene) have all been shown to improve the profile of fats in our bloodstream. Specifically, tomato intake has been shown to result in decreased total cholesterol, decreased LDL cholesterol, and decreased triglyceride levels. It’s also been shown to decrease accumulation of cholesterol molecules inside of macrophage cells. (Macrophage cells are a type of white blood cell that gets called into action when oxidative stress in the bloodstream gets too high, and the activity of macrophages—including their accumulation of cholesterol—is a prerequisite for development of atherosclerosis.)

imageAnti-Cancer Benefits

Tomatoes have repeatedly been show to provide us with anti-cancer benefits. The track record for tomatoes as a cancer-protective food should not be surprising, since there is a very large amount of research on tomato antioxidants and a more limited but still important amount of research on tomato anti-inflammatory nutrients. Risk for many cancer types starts out with chronic oxidative stress and chronic unwanted inflammation. For this reason, foods that provide us with strong antioxidant and anti-inflammatory support are often foods that show cancer prevention properties.

image Prostate cancer is by far the best-researched type of cancer in relationship to tomato intake. The jury verdict here is clear: tomatoes can definitely help lower risk of prostate cancer in men. One key tomato nutrient that has received special focus in prostate cancer prevention is alpha-tomatine. Alpha-tomatine is a saponin phytonutrient and it’s shown the ability to alter metabolic activity in developing prostate cancer cells. It’s also been shown to trigger programmed cell death (apoptosis) in prostate cancer cells that have already been fully formed. Research on alpha-tomatine has also been conducted for non-small cell lung cancer, with similar findings. Along with prostate cancer and non-small cell lung cancer, pancreatic cancer and breast cancer are the two best-studied areas involving tomatoes and cancer risk. Research on tomatoes and breast cancer risk has largely focused on the carotenoid lycopene, and there is fairly well documented risk reduction for breast cancer in association with lycopene intake.

In multiple studies other health benefits associated when tomatoes included in the diet include reduced risk of some neurological diseases (including Alzheimer’s disease). Tomato-containing diets have also been linked in a few studies with reduced risk of obesity and age-related macular degeneration.
And it could boost the skins ability to protect itself against UV rays.

I think that covers many of the dreaded diseases we all fear so tomatoes eaten raw or cooked in many different ways are a must in our diet.
That’s why before leaving my garden to return to London I harvested the ripe tomatoes and those I didn’t dry in the sun I roasted in the oven with garlic, fresh basil, seasoning then whizzed the mixture in a food mixer, stored in the freezer to make a sauce ready for soups and sauces to welcome me on my return.
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Posted by on September 3, 2013 in Training and Advice

 

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GUT WEEK – 2013 – LOVE YOUR GUT – IT STARTS AT THE MOUTH

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The digestive system (or gut) is responsible for processing all that we eat and drink so that the essential nutrients can used to keep our body  provided with fuel.  There are millions of people in the UK who suffer with digestive problems but for most of us, abdominal issues may just be warning signs that we are doing too much, things are upsetting us, or we are eating the wrong foods and not giving ourselves enough time to relax and digest it. But there are some symptoms that could be caused by gastrointestinal disease, for which you need to see a doctor.As I thought about this blog I noticed that when I was doing my out of hours sessions that more than 50 % of those attending the Urgent Care Centre were complaining of abdominal pain with or without vomiting or bowel symptoms. They are anxious  and fearful and  attend at all hours
One father attended with his daughter who had come home from school gone to the fridge, drunk cold milk and the had instant abdominal pain. The father put her in the car and rushed her to A&E worried she might have had a serious reaction.
There are those that attend who have eventually plucked up courage to admit they are experiencing significant problems.
  Many people appear within an hour of vomiting and very concerned about starving and nearly always ask the  question “when can they eat?”
To understand our gut we need to start at the beginning….
imageIt starts at the mouth and the desire for nourishment starts the moment we are born. I remember my third child, who was ‘born in the car’ on her way to the hospital,  within minutes off birth was rooting for food and indeed she had her first feed  before she arrived at the hospital. I was also ravenous after delivery and enjoyed not only my breakfast but my husbands aswell. He was driving and  lost his appetite as he had the task of sorting out the car and caring for the other two children.
 I now understand why when I  witnessed my first births in Africa that the women always rushed to the entrance gate of the hospital to get food from the food sellers after they had delivered.
This illustrates how there is an instinctive need to eat,  but in times of fear and anxiousness(fight and flight) the desire goes away. We all know that lack of appetite before an examination or important social occasion.
The mouth is an important entrance to the gastrointestinal tract and it should guarded carefully
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Now less people are in touch with their bodies they lose that instinct and eat out of habit rather than real need . Plates are piled high and many feel they have to finish every morsel whether they need to or not. We often don’t give ourselves enough time to eat and think carefully what we are eating and  whether the plate is  showing a balanced diet and whether our body actually needs it. There is an argument for saying grace at the beginning of a meal,as I remember in school, to allow the body to prepare itself for eating, activating the salivary glands and reflecting on what was to be eaten and starting the pace leisurely rather than leaping forward like an Olympic runner aspiring to win the race. Saliva not only lubricates the food but also contains enzymes that start chemically digesting your meal and special chemicals that help bacteria causing infections. Teeth break down large chunks into smaller bites. This gives a greater surface area for the body’s chemicals to work on. Recently articles have appeared in the press talking about a study of brain samples from deceased dementia patients and how unusually high levels of Porphyromonas gingivalis, a type of bacteria which causes gum disease were found.
Although the bacteria live in the mouth, they can enter the bloodstream during eating, chewing, tooth brushing or dental surgery, and potentially reach the brain, experts explained.
Inflammation caused by gum disease-related bacteria has already been linked to various health problems including diabetes, heart disease and stroke.
Researchers say they have uncovered how bacteria may set off a chain reaction leading to bowel cancer.
Fusobacteria, commonly found in the mouth, cause overactive immune responses and turn on cancer growth genes, two US studies reveal.
Dental care has deteriorated due to dental costs to patients and less care taken by individuals regarding dental hygiene and poor diet.
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If you haven’t visited the dentist recently perhaps this will be a good promptThis is the link for our local dentists in and around West Ealing :-
http://www.nhs.uk/Service-Search/Dentists/W138la/Results/12/-0.319475322961807/51.5176773071289/3/0?distance=25
The same link can be used to find dentists throughout England.
imageIt is so important to introduce chewing foods at an early age as this encourages the appropriate muscles to work together around the mouth and jaws and to stimulate  the production of saliva containing enzymes to. break down food into a  more digestible form. It is also important in the development of speech in formation and articulation. Many years ago, when I was doing paediatrics looking after children with cerebral palsy, the speech therapist fed the children initially to start the therapy  and emphasised the importance of chewing foods.
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It is through the mouth that we can introduce substances that damage our health seriously whether its excessive carbohydrates,
image alcohol, drugs or simply placing a cigarette between the lips.
imageFizzy drinks, cakes, biscuits, crisps and desserts are frequently eaten despite the fact that they may increase the risk of bowel cancer, according to a new study.
The tongue
The taste buds on the tongue allows use to experience the sensation of taste.
A bad taste in the mouth could be linked to a number of issues, including; constipation, loosely fitted crowns and gingivitis (inflammation of the gum tissue). A sour taste may be linked to acid reflux, where regurgitated stomach acid enters the mouth. Metallic tastes in the mouth may occur in women at the start of pregnancy, individual taking antibiotics, or those with a zinc or vitamin B12 deficiency.
The tongue is important manipulating food in mastication and in phonetic articulation of speech.Lips are a visible body part at the mouth of humans. They are soft, movable, and serve as the opening for food intake and in the articulation of sound and speech.
Trying to open a child’s mouth  is extremely difficult,like a vice, to keep things out and to keep things in. It is these muscles that allow us to suck fluids with a straw.
Lips are a tactile sensory organ. I always remember my mother checking if the washing was dry by putting the crisp shirts to her lips and seeing if eggs had not gone off by putting each en to her lips. Try it – one end should be warmer than the other.
They are the sensory gates and we have a choice what we allow to enter.

But we must not deny the fact they are tactile sensory organ giving pleasure in kissing! What better way of reminding us to love our gut…..
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Posted by on August 19, 2013 in Training and Advice

 

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Aside

When I see someone with depression at their lowest ebb when everything seems black and whatever I suggest is met with profound negativism. They present in many different ways and may have some insight or may be in total denial.
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Churchill referred to his depressive episodes as ‘the black dog’ and it has been suspected that it was Churchill’s recurrent episodes of depression that allowed him to realistically assess the threat of Germany.
Psychiatrist Anthony Storr described how Churchill used his experiences of depression to inform his political decisions: “Only a man who knew what it was to discern a gleam of hope in a hopeless situation, whose courage was beyond reason and whose aggressive spirit burned at its fiercest when he was hemmed in and surrounded by enemies, could have given emotional reality to the words of defiance which rallied and sustained us in the menacing summer of 1940.”
The quote that I find illustrates what I want to say is:-
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“A pearl is a beautiful thing that is produced by an injured life. It is the tear [that results] from the injury of the oyster. The treasure of our being in this world is also produced by an injured life. If we had not been wounded, if we had not been injured, then we will not produce the pearl.” Stephen Hoeller
Over the years I have seen a huge variety of people with depression, head teachers, lawyers, research scientists, doctors, infact people of all ages from all walks of life. They all present with hopelessness and dwindling lack of interest in life and I see it as my job to help them discover a gleam of hope in order to work themselves out of this painful state.
They usually claim they have tried everything but nothing works, they don’t trust anyone and they don’t see a way forward.
However, as I reflected on the different people I have seen over the years and followed them up I feel uplifted by the fact that most of them have emerged out of this state to be happier, more fulfilled people and have turned around their lives in a positive way and this empowers me to feel hopeful about true recovery.
Something that I have suggested on many occasions that has been a help to some people is a simple idea based on the fact that collecting lots a minute pieces of positive experiences that would normally go unnoticed can subtly create a gleam of hope.
These minute positive experiences could be some food that tasted pleasant, making a note of a random smile from someone, the sun shining or simply a ray of sunshine through a crack, a pleasing picture or piece of music, anything that Seems momentarily pleasing. Saving a bus ticket, wrapper or newspaper cutting or putting a word on a scrap of paper as a reminder and then saving them in a ‘ chocolate box’ or equivalent and putting the box in a drawer( I suggest an underwear drawer – somewhere private) and to get the box out on a black day and trawl through these personal items.It is surprising how these minute events mount up in a short time and the overall effect can make life seem less hopeless.
When this gleam of hope is found and this may take a variable length of time and may need several consultations to build up a mutual trust in working together then a patient can embark on the 7 steps of recovery.

1)firstly in depression aswell as other chronic illness,it is important to accept help from people who really want to help us, from people who are really interested in our problems and listen to us, not just because it is their duty as doctors, but because they really want to help, and those people prescribe us medication, give us advice, and cognitive therapy. Allow yourself to accept such help, as it is genuine.
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2) that you have to understand yourself. Meditation, yoga, anything. And above all, ask yourself, why did this mental illness occur? If you can answer this question, and I am sure you can, then this is already a great step forward.
We are now talking about the concept of mindfulness which I will be writing a separate blog shortly.

3)Change your eating habits.
We know that omega-3 fatty acids have innumerable health benefits. Recently, scientists have revealed that a deficit of omega-3 fatty acids is associated with depression. In one study, researchers determined that societies that eat a small amount of omega-3 fatty acids have a higher prevalence of major depressive disorder than societies that get ample omega-3 fatty acids. Other studies show that people who infrequently eat fish, which is a rich source of omega-3 fatty acids, are more likely to suffer from depression.
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Sources of omega-3 fatty acids: fatty fish (anchovy, mackerel, salmon, sardines, shad, and tuna), flaxseed, and nuts.
Sources alpha-linolenic acid (another type of omega-3 fatty acid): flaxseed, canola oil, soybean oil, walnuts, and dark green leafy vegetables.
Also it has been found that people with low Vitamin D and or folic acid (spinach and advocado) tend to be more depressed.

4) We also need to change the way we communicate with others.
As one psychiatrist quoted,
“When a patient tells me his wife nags him I tell him to turn the tables on her. When she says: ”look at you in front of the TV again watching too much TV Football leaving me to do the washing up once more”, stand up and say:«you are right dear, I will do the washing up today.”
I think she will feel weak at the knees and you will gain something, because you have surprised her and, by doing so you have gained, and become more charming because you reacted differently. When the patient comes to me the following week he says: ”I surprised her, but I didn’t do the washing up”.”
I have used this in consultations using personal situations. Many years ago I remember this series of consultations.
Mr T had been going on holiday by himself for a few years because his wife was too miserable and depressed and I suspected he was depressed but in denial. When she went in hospital he came to have a routine blood pressure and complained how his wife was in hospital and even more miserable. She had seen me before going into hospital and complained as to how unsympathetic and miserable he was and how glad he was going on holiday by himself. (As patient confidentiality is paramount in any consultation neither party knew I had consulted the other.)
When I saw Mr T I suggested that it would be good if he took her flowers when he went to see her although it was something he had not done in many years.
When I saw Mrs T after she was discharged I reviewed her and she then said with a smile on her face “guess what doctor, my husband visited me in hospital and he brought me flowers!” I replied ” how lovely, I hope you said ‘thank you’ ” she replied, ” oh dear, I don’t think I did”
When Mr T consulted again he said, ” I did what you said doctor and eventually she even said ‘thank you’!
When I consulted them a few months later each one in turn gave me a bar of chocolate from Spain and reported how they had had a nice holiday together.
On each occasion I just smiled and later shared the chocolate with my family when they greeted me in the evening with “late again for supper,mum”!

5)We all need to find a better balance between work and leisure, find another pattern. Some of us have a pattern of 20 hours to 4 hours. It would be much better to have a pattern of 20 minutes to 4 minutes. Or better still 4 hours: 1 hour. Changing the rhythm doesn’t mean that you have to work less, just change the rhythm. Otherwise you risk burnout.
I often suggest to those people, who adamantly claim that they have to work late every night, to choose one or preferably 2 days a week to leave ‘on time’. The first week colleagues will question this ‘leaving early are you?’ But hold the head up high and leave with no reason given. The second week on leaving ‘on time’ the comments may be ‘leaving early again’ and again leave with head held up high and no reason given. The third week as you linger dreading a comment it will probably be ‘isn’t it today you leave early?’ It works and can be a chance to develop space for leisure even a quiet undisturbed cup of tea or a walk in the park.

6)Change your interaction with nature. To those of you who enjoy being outdoors I say: ”What do you think about when you for a walk in the park . About your problems. Why? Why is this wrong? Because every muscle cell has a memory. When we do stomach exercises, all our stomach cells are attuned to work with us . When we do push-ups, all our cells do push-ups. If we think about our problems every time we run uphill, then our cells will be full of problems whenever we run uphill. So, when we get depressed, somatisation causes pain in all those cells. It’s very simple. Every cell has a memory. I suggest that it is a good idea to change – go to Tai Chi before going for a run or alternatively concentrate on something else. When you run, imagine yourself in an ideal situation with the perfect partner, the perfect job or in a dream location.
Change your interaction with nature. If you used to go mountaineering take up caving, jogging take up rambling.

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Take a trip to ‘Lammas Park or Walpole Park instead of Pitshanger Park. In short: make a change, because by doing this you will move from West Ealing to another place. Even if only for half an hour a day.
“Trying something new alters the levels of dopamine, which is associated with pleasure, enjoyment, and learning.”

7)What is most important?

For me the most important thing is to change your attitude towards music and dance. Listen to music for fun, sing or hum along with it with ear phones or in the shower if you don’t want to upset the neighbours. Sing in the car on your own, with your partner or children with feeling and passion!! Great on the school run…

Dance on you own, with your partner or children or your imaginary partner!
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Dance to have fun try ‘strictly come dancing’ or karaoke in your own home  or wherever… If you used to dance the Foxtrot, then dance the Waltz. If you used to dance the Salsa then dance the Zumba…
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How to find a recovery from depression

 
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Posted by on August 15, 2013 in Training and Advice

 

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HOW TO PREVENT OR DELAY THE ONSET OF DIABETES

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.
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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.

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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.

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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:-

http://www.diabetes.org.uk/

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.

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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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GARLIC HALVES THE RISK OF LUNG CANCER

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This week I took my usual trip to he market to enjoy the ambiance and see what foods are in season. There are two major categories of garlic in France—that planted in spring and that planted in the autumn. Both are harvested in July. One of the more distinctive varieties is the mild ail rose de Lautrec, with a rigid central stem that makes it impossible to braid and the heavy bouquets are seen hanging from the stall’s canopy.
Although my introduction to the use of garlic in cooking was when I lived in Wales.
We associate garlic with the French and I remember when I was in Cardiff every week the ‘Shoni winwns man'(Onion Johnnies) stood against their bicycles selling red garlic and onions at the market. imageThey had brought their bicycles and onions from Roscoff, Brittany and conversed quite happily with the Welsh speaking customers as both the Breton and Welsh language have many similarities. These men disappeared fro the streets in about 2002 after 175yrs of trading.
Garlic is used in French cooking but also used chopped raw and added to lettuce as part of a meal or on bread with butter. It is often mixed with parsley which tends to neutralise the breath. This makes French green beans taste even better.
Interestingly, the other countries that use large amounts of garlic in their cooking are Italy and China.

When I read an article in the news this week that garlic had potentially healing and preventative properties in lung cancer this did not come as a surprise.

A previous study at the University of South Australia concluded that garlic could decrease the risks of bowel tumors by as much as a third, while other studies have found that garlic can help to repress common colds and assist with inflammation with its anti-bacterial properties. This natural antibiotic is effective against toxic bacteria, viruses, and fungus.

Garlic has been shown to be beneficial for the heart in that it lowers blood pressure and thins the blood by reducing the platelet cells stickiness. It lowers serum triglycerides and LDL-cholesterol ( the bad type) levels and increases serum HDL-cholesterol (the good type) and fibrinolysis (the process through which the body breaks up blood clots.)

Previous studies have also suggested garlic can protect the lungs against various conditions as it acts as an expectorant but also Garlic is known to stimulate T-lymphocyte and macrophage action, promote interleukin-1 levels, and support natural killer cells. Strong activity of these key cells promotes healthy immune system function, and strengthens the body’s defenses.

In the latest investigation, scientists at Jiangsu Provincial Centre for Disease Control and Prevention compared 1,424 lung cancer patients with 4,500 healthy adults.

Each one was questioned on their dietary and lifestyle habits, including how often they consumed garlic and whether they smoked.
The results, published online in the journal Cancer Prevention Research, showed those who ate raw garlic at least twice a week were significantly less likely to get lung cancer, even if they smoked or were exposed to high-temperature cooking oil fumes, which is thought to be another trigger for the disease.
It’s not clear whether cooked garlic would have the same effect.
Previous research suggests the key ingredient seems to be a chemical called allicin, released when the clove is crushed or chopped.
It is thought to dampen down inflammation in the body and act as an anti-oxidant, reducing damage from so-called free radicals to the body’s cells.

In the case of colon cancer substances such as allicin, have been shown not only to protect colon cells from the toxic effects of cancer-causing chemicals but also to stop the growth of cancer cells once they develop.
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Adults regularly consuming raw garlic as part of their diet were 44 per cent less likely to suffer from lung cancer.
Even when they allowed for whether people smoked – the biggest single cause of lung cancer – the scientist found garlic still seemed to reduce the dangers by around 30 per cent.
Around 40,000 people in England and Wales are diagnosed with lung cancer every year, and it is the deadliest form of the disease.
Smoking is thought to cause at least 80 per cent of cases and fewer than one in ten sufferers are still alive five years after their diagnosis.

China is by far the biggest producer of garlic globally accounting for 77% of the worlds production.
Evidence that people who eat garlic are more likely to escape cancer comes from a comparison of garlic eating in two Chinese counties in Shandong province.

Gangshan County residents eat about 20 g. of garlic a day (about seven cloves) and have a gastric cancer death rate of 3.45 per 100,000 population.

In nearby Quixia County, the residents care little for garlic and eat it rarely; they die of gastric cancer at the rate of 40 per 100,000.

The non-garlic eaters have an almost twelve times greater risk of deadly gastric cancer.

Should we eat raw or cooked garlic?
Although numerous studies have highlighted certain health benefits from eating raw garlic, they have yet to determine whether or not cooked garlic might possess the same capabilities.
Garlic has to be raw to kill bacteria, boost immune function and probably help prevent cancer. But cooked garlic can lower blood cholesterol and help keep blood thin and perform as a decongestant, cough medicine, mucus regulator and bronchitis preventive. The best advice: eat it both ways.

 
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Posted by on August 13, 2013 in Training and Advice

 

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Rat poison to be replaced?

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Warfarin has been used to thin the blood to decrease the tendency for thrombosis or as secondary prophylaxis (prevention of further episodes) in those individuals that have already formed a blood clot (thrombus) since I was born – for many years.
As GP’s we are now committed and compelled to take part in clinical-led commissioning and I shall be referring examples of this frequently.
Clinically-led commissioning is a continual process of analysing the needs of a community, designing pathways of care, then specifying and procuring services that will deliver and improve agreed health and social outcomes, within the resources available.
One such example is the provision of anticoagulation therapy services and for many months in Ealing Central Commissioning Group (ECCG) have been reviewing
how anticoagulation therapy is currently initiated including looking at recommendations for the new oral anticoagulants (noac) dabigatran, rivaroxaban and apixaban and the anticipated reduction in need for vitamin K antagonist monitoring services (INR monitoring).

You may be aware that anyone who takes warfarin must be monitored on a regular basis by blood test(INR) which until recently involved regular visits to the hospital to attend a clinic. As part of the commissioning we have taken over the monitoring of INR in general practise. But due to the complexity of initiating and stabilising treatment commissioning has been a long involved process to assure generalised commitment, safe practise and most of all taking into account the full cross section of patients needing this treatment.
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The discovery of warfarin was centered in Canada and the United States1. In the early part of the 20th century, farmers in the northern prairie states of Canada and the USA began planting sweet clover plants imported from Europe. Although the sweet clover proved to be nutritious when used as fodder, it also brought a fatal disease which decimated cattle herds and horrified farmers: sweet clover disease, in which affected cattle developed relentless, spontaneous bleeding. Schofield, a veterinary pathologist in Alberta, reported in 1921 that the disease was caused by consumption of spoilt sweet clover hay. The fresh plant was known to contain the compound coumarin, which was not pathogenic. The mystery of why spoilt hay caused the disease was solved by Karl Paul Link and his co-workers in 1940 : in mouldy hay, coumarin is oxidised to 4-hydroxycoumarin and then coupled with formaldehyde and another coumarin moiety to form dicoumarol, an anticoagulant. This was responsible for the disease. Dicoumarol was patented in 1941 and was therapeutically used as an anticoagulant.
In 1951, a navy recruit unsuccessfully attempted suicide with 567 mg of warfarin. His surprising full recovery induced research into the anticoagulant potency of warfarin in humans. It was found to be far superior to dicoumarol. Clinicians quickly discarded dicoumarol in favour of “rat poison” warfarin : it was introduced commercially in 1954. In that same year, President Eisenhower was treated with warfarin following a heart attack.
As an aside I remember several years ago a delightful 98year old lady appearing in surgery asking to register provided she was not too old. She had been the Professor of Agriculture of Warsaw ( and honorary Professor at Glasgow)and believe or not in the waiting room at the same time she rediscovered an old student ( at that time 88yrs) a patient well known to me and he had been a farrier and a reputable breeder of Welsh mountain Ponies in South Wales before retiring to Ealing. It turned out that she had introduced sweet clover to Poland!

Warfarin is used used by more than 75,000 patients for short term or long term use and not only is it cheap at 2p a tablet but its anticoagulant effect is well tried and tested and its effect can be easily reversed in the event of gastro-intestinal bleeding or need of surgery. The anticoagulant level is easily measured. However, warfarin is slow to take effect and stabilise; constant monitoring is necessary as there is significant interaction with alcohol and some medication, food stuffs commonly leafy vegetables and cranberry juice and all foods containing Vitamin K and should be taken carefully
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diet sheet
http://www.atrialfibrillation.org.uk/files/file/Publications/120426-st-FINAL-Warfarin%20and%20Diet_pdf.pdf

Patients must be totally compliant and maintain a record of INR readings(the yellow book)image
there is a risk of bleeding but someone would have to fall 200 times to have significant blood loss ie from bruising.
Recently a new class of drugs have been released and Rivaroxaban will be the drug of choice in Ealing- this decision has been met after consultation with our local consultant cardiologists, who we meet with in the surgery or at joint meetings. At present it will only be used in those patients who may need to be travelling frequently, with a uncontrolled INR, adverse effect with Warfarin or those who have had a stroke whilst taking Warfarin. As it is a new drug careful monitoring needs to take place and trials carried out to support a more widespread use.

 
 

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Spice of life

Sir Michael Caine reveals  he eats turmeric to keep his brain sharp
Screen legend Sir Michael Caine has revealed his secret to keeping a razor-sharp brain – the Indian spice turmeric.
The 80-year-old double Oscar winner says a supplement containing the spice helps him ward off the effects of ageing.
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And Caine is grateful to his Indian-born wife of 40 years Shakira for introducing him to its health benefits. Speaking to Hollywood chat show host Larry King backstage after a fundraising event for Alzheimer’s research, Caine said: ‘I am married to an Indian lady and have learned about Indian culture.
‘I looked into what they got and didn’t get. And one of the things they don’t get is Alzheimer’s.
‘They eat a great deal of turmeric in their food. I have been taking turmeric tablets for 30 years and I have a memory like a computer. I remember everything.’
I learnt about the health benefits of turmeric when I studied Chinese herbs but realised it had been imported from India several hundreds of years ago and is now used in traditional Chinese medicine under the name of 姜黄 is also named Jiang Huang ( yellow ginger), Rhizoma Curcumae Longae
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Curcuma Longa/Cúrcuma is a small perennial herb native to India bearing many rhizomes on its root system which are the source of its culinary spice known as Turmeric (Cúrcuma – rizoma secco in polvere) and its medicinal extract called Curcumin (Cúrcuma extracto refinado).
The name comes from Arabic kurkum meaning “turmeric
A relative of ginger, turmeric is a perennial plant that grows 5 – 6 feet high in the tropical regions of Southern Asia, with trumpet-shaped, dull yellow flowers. Its roots are bulbs that also produce rhizomes, which then produce stems and roots for new plants. Turmeric is fragrant and has a bitter, somewhat sharp taste. Although it grows in many tropical locations, the majority of turmeric is grown in India, where it is used as a main ingredient in curry.
The roots, or rhizomes and bulbs, are used in medicine and food. They are generally boiled and then dried, turning into the familiar yellow powder. Curcumin, the active ingredient, has antioxidant properties. Other substances in this herb have antioxidant properties as well.
Turmeric is widely used in cooking and gives Indian curry its flavor and yellow color. It is also used in mustard and to color butter and cheese.
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The problem with the pill is that it is very insoluble in water.The better way to take it, is to use it in your cooking very extensively. If you have any sauté, just sprinkle it in. The moment you heat oil and add turmeric.
It has a mellow, smoky flavor despite its bright color. It tastes great in sautéed vegetables of all kinds and if you are a meat-eater, you can use it in a rub. You can use as little as one-quarter to one-half teaspoon in your cooking, depending on the dish. But there is nothing wrong with using more in intensely flavored dishes like curry. It makes white rice more digestible and in milk it helps with an upset stomach – several of my Asian patients have shared this with me.

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Turmeric has been used in both Ayurvedic and Chinese medicine as an anti-inflammatory, to treat digestive and liver problems, skin diseases, and wounds.
Growing evidence suggests that turmeric may afford protection against neurodegenerative diseases. Epidemiological studies show that in elderly Indian populations, among whose diet turmeric is a common spice, levels of neurological diseases such as Alzheimer’s are very low. Alzheimer’s disease results when a protein fragment called amyloid-B accumulates in brain cells, producing oxidative stress and inflammation, and forming plaques between nerve cells (neurons) in the brain that disrupt brain function.Turmeric Boosts Amyloid Plaque Clearance in Human Alzheimer’s Patients.In healthy patients, immune cells called macrophages, which engulf and destroy abnormal cells and suspected pathogens, efficiently clear amyloid beta, but macrophage activity is suppressed in Alzheimer’s patients.
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I realise that there are conflicting studies and many of the studies have been carried out in test tubes and animals but there a reasonable amount of evidence to suggest that this spice has amazing anti-inflammatory,anti-cancer (One of its anti-cancer benefits comes from its ability to induce apoptosis (natural cell death) in cancer cells),anti-thrombotic and prevents build of plaque aswell asother properties shown above. It is a natural painkiller in view of its anti-inflammatory properties it helps in diseases such as asthma, arthritis, colitis,stomach ulcers and can lower blood sugar. Many Asians particularly older generation Asians acknowledge it as the ‘spice of life’
and it’s wide ranging health benefits and anti-ageing properties.
Now turmeric will become an important spice in my kitchen and there will be no mustard left on the side of my plate!

 
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Posted by on July 15, 2013 in Training and Advice

 

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