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Five Questions with Richard Shaw, author of Conquer Type 2 Diabetes

CRAB & RADISH STACK (VARIATION) PAGE 83

Type-2 diabetes doesn’t have to be a lifelong condition; for many people, especially those who have been recently diagnosed, it’s possible to reverse the symptoms of this malignant disease.  But how can that be done? Inspired by results obtained from research done at Newcastle University, Richard Shaw decided to try and kick the disease by following a carefully structured, low-carb, whole-food diet and starting a modest exercise regime. Conquer Type 2 Diabetes describes what he did to lose 31 kilos and all his diabetes signs (high blood sugar, high cholesterol, high blood pressure) and symptoms. We caught up with Richard to ask him a few questions about his new book and his amazing recovery. 

What was the inspiration behind your book?

When I started this I really wanted to talk to someone who’d managed to put their own T2D into remission: not a doctor, not a dietician, not a medical professional but someone who had had first-hand experience of doing it for themselves.  I couldn’t find anything that really told me what it was like from the patient’s point-of-view, so I thought it might be worth writing my own. Plus, because I like food so much, I really wanted to write some decent recipes to make the point that it’s not all about bland salads, tasteless soups and intermittent fasting.

CRAB & RADISH STACK (VARIATION) PAGE 83
Richard’s book is full of amazing recipes, like this crab and radish stack.

What was the most challenging part of writing the book?

It can be tough to write a book and hold down a full-time job.  I did it by getting up every morning at 4am, writing for 2 hours and going back to bed for a while before heading into work. I wrote it as I went through the process and there was a part of me that worried that if it didn’t work it might all be a bit of a wasted effort.  In hindsight, I think writing the book probably gave me motivation to keep going and made me even more determined to see it through.

What has been the most satisfying part of the writing process?

I’ve collaborated with other writers on books about food and cooking in the past so, to be honest, it was amazing to finally produce something that had my name on the cover. And even a slim book like this goes through so many versions, eventually having your editor tell you one day that it’s finally done is an enormous relief. I also took huge satisfaction from my GP agreeing to write the foreword, she was incredibly generous with her comments.

FRENCH OMELETTE WITH GRUYERE
French omelette

Did anything surprise you while writing Conquer Type 2 Diabetes? 

I spoke to dozens of other people as I was writing it and I was surprised to find so many people attempting to come off the meds and resume a normal life.  Putting T2D into remission is a very active and passionate grass-roots movement but it hasn’t really translated into mainstream medicine yet.  By and large much of the medical profession is treating this disease in exactly the same way, as it was 30 or 40 years ago, with lame public health advice, generic exhortations to adopt a healthier lifestyle and by prescribing a raft of meds that treat the symptoms rather than the underlying cause.  So finding other people doing exactly the same thing all over the world provided enormous encouragement to keep going.

What sort of people would benefit most by reading your book?

Professor Roy Taylor’s work from the DiRECT trials tells us that the earlier we attempt put T2D into remission after diagnosis the greater the chances of success. And for many people this doesn’t have to be a ‘forever’ diagnosis, – something I took at face value for several years. It’s a story for people who want to take a shot at reversing their condition and testimony that (if addressed soon enough) it may not have to be a lifelong, meds-dependant, progressive illness. And if someone who’s as hopeless at exercise as me, who likes food as much as I do and who’s as much of a slacker as I am can do it, then so can many others.

For more information about Richard’s new book,  go to  his website here,  or join the conversation on Facebook.

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Five Questions with Antonina Mikocka-Walus, author of IBD and the Gut-Brain Connection

What was the inspiration behind your book?

As a scientist interested in the gut-brain links in IBD, I collect articles on the topic. There are hundreds of them scattered around my various computer drives. One particularly rainy summer, when I still lived in York, I thought I should organise these articles and collate my scribbled notes into something meaningful, so that I could use it for my future papers. However, this organisational task proved more entertaining than I initially predicted. I found some fascinating studies I forgot about, and as I read on I thought: There is so much out there. It must be hard to make sense of it when one is a patient. Many of the papers also triggered some memories from my own experience as an IBD patient, negotiating my way through the healthcare systems of the three countries in which I have lived. That’s how the book came about, though until it was finished I considered it merely my personal diary, a collection of interesting studies and anecdotes. I then showed this manuscript to a friend, another IBD psychologist, who enjoyed reading it and encouraged me to publish it. And the rest, as they say, is history.

What was the most challenging part of writing the book?

It was to move away from scientific writing, to make what I write interesting and accessible to a lay person, but also, more importantly, sharing my life story. I do not hide that I have IBD but in this book I go beyond merely admitting I am a patient as well as a health professional. I discuss my symptoms and recall a bit of my family history. I believe these snippets from my own life make the story I tell more real but as is the case when one chooses to share their private matters with the whole world I feel vulnerable, and that’s not always pleasant.

What has been the most satisfying part of the writing process?

The most difficult part – sharing my life stories – was also the most fulfilling. When I decided this manuscript would become a book, I wanted to make it different to a book about IBD written by a health professional. But I also wanted to offer my readers more than my own stories, to go beyond ‘Me and my IBD’ narrative. I reached to what I love, science, and I merged interesting science findings about IBD with something personal. I hope I found a happy compromise in combining the perspectives of a patient, psychologist and scientist.

Did anything surprise you while writing IBD and the Gut-Brain Connection? 

Not the science itself because that’s my daily bread but the amount of the data, the presence of mutually exclusive recommendations. I followed the principles of evidence-based medicine to interpret what I read for the readers without a medical background. But nothing, even in science, is completely objective. I introduced the readers to systematic reviews, a scientific technique to try to make sense of the many studies out there and being critical about the evidence which surrounds us. I hope people find this technique of filtering evidence useful. On the other hand, I decided to also include my completely subjective perspective on IBD when I shared my own stories. The truth is somewhere on the verge of science and a personal human experience, I think.

What sort of people would benefit most by reading your book?

The book is addressed to patients living with IBD, their family and friends, to people of all ages and educational backgrounds, to anyone who wants to learn more about this fascinating condition. The brain-gut links and the gut bacteria have finally become topical and I feel really privileged to be able to speak openly about the gut health. Who would dare to discuss bowel movements publicly a few generations ago? Now, it’s becoming normal and I am happy to be part of this social revolution.

If you would like to learn more about IBD and the Gut-Brain Connection, the first chapter of Antonina’s book is available to read here

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Five Questions with Paul Brice, author of COPD Innovative Breathing Techniques

Paul Brice and patients

What was the inspiration behind COPD?

I had been working with COPD patients for nearly 7 years when I first considered writing this book. Initially this was because patients kept on telling me that they felt so much better using the techniques I used, and even people who had previously undertaken pulmonary rehabilitation told me that they had not been shown these exercises before. I did not think I was doing anything special until I researched what other pulmonary rehabilitation programmes delivered to their patients.

Without realising it, the skills and knowledge I had acquired as an athlete and a high-performance sports coach had helped me recognise how to use posture and movement to modify breathing and exercise capacity. I had found a way to communicate this to my patients in what they told me was clear, simple and logical.

I had developed a series of techniques to show my patients how they could use their bodies to breathe in a more natural and relaxed state, and a system to help them become more aware of the things that made them breathe poorly.

Only once patients had become more aware of how they could help themselves to breathe and move comfortably, would I introduce them into what could be called real exercise. The style and the intensity of exercise were staged and the rate of progress depended upon the individual patient.

Patients tell me they appreciate this gradual approach to their treatment, and I reiterate the fact by threatening to break into the song: ‘It ain’t what you do it’s the way that you do it….That’s what gets results!”

I started to write the book aware of the fact that the emphasis on posture and natural breathing meant that other conventional COPD techniques I had been taught were either no longer needed or were no longer relevant. It is with this in mind that I named the programme the ‘Brice Method’. I am very much aware that my method is likely to challenge some aspects of the conventional wisdom of breathing and exercise for COPD patients.

I had to write this book as I am passionate about helping other people with COPD benefit from the simple and effective techniques that my patients have benefitted from.

What was the most challenging part of writing the book?

There were two challenging aspects to writing COPD Innovative breathing techniques.

The first challenge was to ensure that the book was written at a level that would be suitable for patients with COPD, their friends and their families and not at a level for health professionals or practitioners.

When I started out writing the book, I was aware that other health professionals might skim read the book and look for evidence, references and a bibliography at the end of each chapter, all standard practice for medical/ health books. Quickly I realised that referencing the book in this way would make it totally unusable for the people who would gain the most from the book.

I was however, aware that because some of the postural techniques used at the start of the book can so dramatically modify the shape, size and mechanics of the patient’s lungs, there are a number of breathing techniques that follow, which would challenge the standard practice, and might stir up a bit of a furor amongst fellow professionals. In truth, I now welcome that latent debate.

The second challenge was to make patients aware that their COPD may not be the most restrictive health condition that they have. A high percentage of my patients find that once they have modified their postural habits and their breathing techniques, that their lungs are not the limiting factor when it comes to physical activity, but it is another health issue. Arthritis, chronic back or neck pain, acid reflux, shoulder immobility, and poor balance are all issues that can often restrict the patient’s ability to exercise. I believe that relaxed, natural breathing can only be done when the whole body is in a relaxed state and when it is relatively pain free. The unfortunate truth is that moving when you have not exercised in a while is going to be uncomfortable, so there is a section on identifying the difference between discomfort and pain, which is referred to at stages throughout the book.

What has been the most satisfying part of the writing process?

Having spent quite a lot of time on my own writing the book on my apple mac, taking the pictures and working with my daughter Lucy to adapt the images, the most enjoyable part of the book has been witnessing my simple word document morph into what I could recognise as being a proper book.

Before I started the project, I had a vision of how the book would look, and working with the publishing team has been a real eye opener as to the amount of work and expertise that goes into producing a completed book.

Surprisingly, having written the book, it has been particularly rewarding to search the top online book stores and see that the book is ready to order. I have searched for so many books over the years, wanting to learn things from other people, and to be referred to as an author on the likes of Waterstones, Amazon and Foyles will a take a little time getting used to.

What sort of people would benefit from reading the book?

The book is aimed fairly and squarely at the person who has been diagnosed with COPD, or a friend or family member. COPD is an overarching term that comprises many chronic lung conditions such as chronic bronchitis, bronchiectasis and emphysema, plus many more.

In reality there are a large number of people who have problems with their breathing, who might benefit from the techniques used in the book. The techniques are split into specific sections and even if a person has physical imitations that mean they cannot do the more active, later chapters in the book, most people seem to benefit with their breathing with the postural exercises and breathing techniques that make up the first half of the book.

Paul Brice and patients

Try this simple exercise to see if the book might help you.

You sit down comfortably on a dining chair and take a deep breath. If you can listen to where you feel the air going into the chest. If you feel any of the following…..

  • That you have to suck hard to get the air in
  • That the breath is short and unsatisfying
  • You cannot feel your chest expand
  • You only feel the air going in the top of your chest
  • You use your shoulders to lift the chest

…then the likelihood is you will get some benefit from the exercises and techniques in the book

I believe that breathing should be as natural and relaxed as possible, and the whole aim of the book is to help anyone with COPD breathe more easily.

How will people benefit from reading the book?

The aim of the book is to help show people with COPD how to get the most out of the lung function that they have remaining.

The book is structured so that the reader can learn what they need to do using a tried and tested step-by-step approach. They are encouraged to take things at their own pace, and only move forwards to the next stage once they feel they have mastered the section before.

Firstly the book shows the reader how they should use their lungs, and help them recognise what bad habits they might have developed that could prevent them from breathing more naturally.

I explain what they need to do to help overcome their bad habits using basic changes to their posture and make them aware of how simple body movements can be sequenced with the breath to help the body find a more natural breathing pattern.

The book explains how you can learn to maintain these new breathing techniques, using a homework plan, these are essentially micro workouts of 4 or 5 exercises that last between 3 and 5 minutes that can be done up to 4 times a day. This is how my patients overcome decade’s worth of inactivity, poor posture and bad breathing patterns within weeks or sometimes within days!

The book then goes on to suggest a range of exercises to improve the readers stamina and strength, whilst explaining what pitfalls to look out for along the way.

There is a landmark test that the reader can take at several stages throughout the book to help them monitor their progress and check that they are on the right path before moving on to the following stages.

If you would like to learn more about COPD, the first chapter of Paul’s book is available to read here

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Inflammatory Bowel Disease: The invisible illness

Inflammatory-Bowel-Disease-The-Invisible-Illness

What is inflammatory bowel disease?

Inflammatory bowel disease (IBD) is an umbrella term for diseases which cause either whole or part of the digestive tract to become sore and inflamed. It commonly starts in younger people aged 10 to 40, although younger and older people may be affected too. The two most common types of IBD are Crohn’s disease (CD) and ulcerative colitis (UC); the symptoms for both can be similar but with some distinguishing characteristics. In the 19th and 20th Centuries prevalence of IBD increased with industrialisation and the highest rates in the world are still in developed countries such as the UK, Canada, the USA and Western Europe – although cases are now increasing in China and India.
Crohn’s disease may affect the whole digestive tract from your mouth to your anus; ulcerative colitis affects only the colon. Crohn’s disease can be more serious as it not only affects the lining of the gut but can also extend deeper into the wall of the bowel and this sometimes results in severe complications. Both can be extremely painful and debilitating, leading to weight loss and fatigue, and have a great impact on your quality of life, affecting your ability to digest food and absorb nutrients from it, as well as the frequent trips to the toilet.

Why is IBD increasing?

Studies in the UK have found that the number of children affected by IBD has risen by 15%; in Scotland the number of childhood cases has risen by 76% since 1995, according to research by the University of Edinburgh. Experts are also worried because the average age of onset of symptoms is now much earlier in childhood rather than late teens/early 20s because, as I said before, the symptoms are more severe in childhood.
Although scientists have identified a genetic basis for IBD by pinpointing many different genes, especially the variants in a gene called NOD2 in Crohn’s disease – and a positive family history remains the strongest risk factor for IBD4 – genes are clearly not the whole story. Experts refer to IBD ‘as a complex genetic disorder that is influenced by environmental risk factors’. Certain genes may give you a susceptibility to IBD, but the prevailing theory is that IBD is caused by a combination of genes and exposure to environmental risk factors. It’s the interaction between these environmental risk factors and your normal (nonharmful) gut flora that is believed to lead to an increased immune response which results in chronic inflammation.

What are the symptoms of Crohn’s disease compared to ulcerative colitis?

The short answer is that many of the symptoms overlap (around 10% of IBD sufferers have a mixture of both and this is called indeterminate colitis). There are some key distinguishing characteristics your doctors will be able to tease out – see the table below.

Ulcerative colitis (just affects the colon) Crohn’s disease (can affect the whole gut)
Bloody diarrhoea and colicky abdominal pain, usually before passing a stool Abdominal pain and diarrhoea (sometimes with blood, pus or mucus). Pain is caused when food or faeces build up after eating in an area of the intestine damaged/ narrowed by inflammation
Some of or the whole colon is inflamed/ ulcerated, but other parts of the gut are usually unaffected Patches of the gut are inflamed and ulcers may develop but there are sections that are unaffected. It mainly affects the terminal ileum (the last part of the small intestine). Sometimes Crohn’s only affects the colon
Only affects the lining of the gut Inflammation may be confined to the bowel wall but can sometimes cause deep ulcers which also penetrate deeper through the muscle layers of the bowel wall causing fistulas (an abnormal connection between one area of the body and another). Often these are around the anus. Other complications include scarring and narrowing of the intestines, sometimes leading to blockages
Inflammation is usually continuous from the rectum Inflammation often skips segments of bowel which appear normal
 
Weight loss from inflammation

Weight loss from inflammation and reduced absorption
Tiredness and fatigue (anaemia is common) Tiredness and severe fatigue (anaemia and other deficiencies occur)
Feeling feverish Sometimes fever and night sweats can be caused by abscesses or collections of inflammation
Inflammation can involve the joints, skin, liver and eyes and cause mouth ulcers Inflammatory symptoms are similar to those of UC and may spread to other parts of the body causing mouth ulcers, red eyes, painful joints and rashes

Sources: Core charity and Crohn’s & Colitis UK

More about Crohn’s disease

Crohn’s disease affects around one in 1,000 people and in about one in five cases if you have Crohn’s disease you will have a family member who is also affected.

As discussed in the table above, Crohn’s disease may affect any part of the gut but most commonly causes inflammation in one particular area called the terminal ileum – this is the last section of the small intestine. The first part of the colon, called the caecum and the next, the ascending colon, are often involved. In many people only the colon is affected. Inflammation sometimes skips a segment of gut which is normal, rather than being continuous. Only a few people with Crohn’s will have involvement of the stomach or the upper intestine.
Mild forms of Crohn’s result in patches of inflammation – these look similar to mouth ulcers. In moderate to severe cases the intestine is damaged, and becomes thickened so it blocks the passage of digested food, causing cramp-like pain. Deep ulcers can also penetrate the bowel wall causing infection or even an abscess; this often happens around the anus. It is called a fistula when an inflammatory connection goes through the skin surface, the vagina, the bladder or another part of the bowel. When inflamed tissue heals, scar tissue may form, posing a further risk of blockages in the bowel.

More about ulcerative colitis

Ulcerative colitis is the medical name for when tiny ulcers form on the surface of the lining of the large intestine. It mainly affects the rectum and lower colon, but may affect the whole of the colon. It’s more common than Crohn’s disease, affecting an estimated one in 420 people. It seems to be more common in white people of European descent, particularly among Ashkenazi Jews who originated from Eastern Europe and Russia. It affects non-smokers and ex-smokers more than smokers, although doctors say the risks of smoking still far outweigh the possible benefits so do not take this as a licence to smoke! Men and women are affected by UC in equal numbers.

There are three types of ulcerative colitis:

  • Proctitis. This is where only the rectum is inflamed. Fresh blood in the stools is the main symptom, plus an urgent need for the loo (‘urgency’) and perhaps a feeling that you have not completely emptied your bowels. You may have normal stools, diarrhoea or constipation.
  • Left sided. This is inflammation that starts at the rectum and continues up the left side of the large intestine (the sigmoid and descending colon). Symptoms include passing diarrhoea with blood and pain on the left side of the abdomen, plus an urge to pass a stool even when your bowel is empty.
  • Total colitis. This is sometimes called pan colitis and is when the entire colon is affected to some extent. It causes very frequent bouts of diarrhoea, severe painful stomach cramps, weight loss and often fever and generalised illness.

This extract was taken from What’s Up with your Gut? By Jo Waters and Professor Julian Waters

 

 

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Prevent and Cure Diabetes – The blood-sugar roller coaster

The blood-sugar rollercoaster

Sugar is extremely damaging to the body for many reasons. It is damaging to the body in high levels, it is damaging to the body in low levels, and the swinging of levels between the two is additionally damaging because of the hormonal response to those rapid changes. I call this the blood-sugar rollercoaster – it is often described as a ‘hypoglycaemic tendency’ (‘hypo’ meaning ‘below’, from the Greek) – but it is the whole rollercoaster that causes metabolic havoc – not just the dips. If we constantly eat carbohydrate foods, this is a rollercoaster which just keeps on going, and along with the metabolic havoc, there are associated mood swings which mirror the ride. These emotions are very similar to those documented by Barry Ritholtz, in his financial writings on the rollercoaster ride experienced by investors in risky stocks. People who are regularly feeling these emotions, and in particular are experiencing them cyclically, are most likely already on the blood-sugar rollercoaster: Returning to the medical case in point, in metabolic syndrome and diabetes any or all of the following problems can result. In each case, a description of the problem is followed by symptoms and diseases that may result from that problem, thereby giving clues as to whether this may be an issue in a particular individual.

The financial rollercoaster ride

The blood-sugar rollercoaster

The blood-sugar rollercoaster, as I explained earlier, is my name for the process of rapidly rising levels of blood sugar prompting a release of insulin and the ‘happy’ brain neurotransmitters followed by rapidly falling levels of blood sugar causing a release of adrenaline. This combined effect switches on addiction. Wobbly blood sugar levels are highly damaging because of their hormonal effects. These hormonal effects I suspect relate to the rate at which levels of sugar rise and fall in the bloodstream. As we lose control of our blood sugar, then eating a high-carbohydrate snack or meal will cause blood sugar levels to spike, and as blood sugar levels make this rapid rise there is an outpouring of insulin in order to protect the body from this dangerous (but addictive) sugar spike. Insulin brings the blood sugar level down by shunting it into fat. However, if this occurs quickly, then blood sugar levels fall precipitously and that results in an outpouring of adrenaline. Adrenaline is responsible for all the symptoms that we call ‘hypoglycaemia’.

Hypoglycaemia comes from the Greek words ‘hypo’ meaning low, ‘gly’ meaning sugar and ‘aemia’ meaning blood, and hence has a literal meaning of ‘low sugar blood’.

However, the term hypoglycaemia I suspect is a misnomer that relates to at least two issues. Firstly, adrenaline is released in response to poor fuel delivery (lack of sugar and/or ketones in the bloodstream). This means that, in the keto-adapted, the adrenaline symptoms do not arise because these people can switch into fat burning mode. Secondly, in those who cannot make this switch, it is not just the absolute level of blood sugar that causes the symptoms but also the rate of change; this means that often people who complain of hypoglycaemia wil d their blood sugar level is normal from a ‘snapshot’ blood-sugar test result. What they need is a ‘video’ of their blood sugar level changing over time to make the diagnosis. Consequences of the rollercoaster spikes in insulin and adrenaline include the following:

a.) High levels of insulin put us into a metabolic state of laying down fat, and prevent fat burning – this is the major problem of
metabolic inflexibility. It is almost impossible to lose weight when insulin levels are high. Furthermore this effect can be sustained for hours.

b.) High levels of adrenaline make us anxious, irritable and sleepless. This adrenaline release is a major cause of high blood pressure. Indeed, it astonishes me that doctors appear completely unaware of this link so that hypertension is described as ‘essential’ (of unknown cause) or ‘idiopathic’ (again, of unknown cause). They may accurately describe it as due to ‘stress’, but fail to realise the cause of this stress is actually nutritional stress due to loss of control of blood sugar levels.

Sugar has immediate effects on the brain, by various mechanisms, and this is partly responsible for why sugar is so addictive. For people who have lost control of their blood sugar, in the very short term, a carbohydrate rush, or ‘hit’, will have a calming effect which allows them to concentrate. Inspector Morse used the carbohydrate hit of a pint of beer to solve his murder mysteries – but ended up diabetic and died prematurely. Falstaff too found that alcohol had an inspirational effect.

‘It ascends me into the brain, dries me there all the foolish and dull and crudy vapours which environ it, makes it apprehensive, quick, forgetive, full of nimble, fiery, and delectable shapes, which delivered o’er to the voice, the tongue, which is the birth, becomes excellent wit.’  Act IV scene iii of Henry IV, Part 2 William Shakespeare (1564–1616)

Any parent will report how their child’s behaviour changes abruptly with a sugar hit and, much more noticeably, when blood sugar dives and they become irritable and moody. My daughters were often tired and irritable when they came in from school – it was not until supper that their normal good humour and energy were restored.

Problems with sugar – hyperglycaemia

Symptoms of blood sugar rising rapidly (due to the sugar hit and insulin) Diseases of blood sugar rising rapidly (due to the sugar hit and insulin)
Brain function improves – better concentration, feel calm, relief from depression.
Satiety
Triglycerides in the blood are high as insulin shunts excessive sugar into fat. 
Obesity and Inability to lose weight. (It is important to recognise that obesity is not the cause of diabetes but may be a symptom of metabolic syndrome – indeed, many people with normal weight have metabolic syndrome and diabetes.)

Problems with sugar – the rollercoaster

Symptoms of blood sugar falling rapidly (due to adrenaline release) Diseases of blood sugar falling rapidly (due to adrenaline release)
Acute anxiety and low mood.
Panic attacks.
Insomnia.
Shaking.
Palpitations.
Fearfulness.
Hunger and intense desire to eat.
Weakness.
High blood pressure.
 
Chronic high blood pressure.
Premenstrual tension.
Chronic anxiety.
Depression.
Eating disorders (anorexia and bulimia). Obsessive compulsive disorders.
Increased tendency to addiction – caffeine, chocolate, nicotine, cannabis, ‘social highs’, gambling, sexual perversions, exercise.

You will again see the similarities between the mood changes here and those noted by Barry Ritholtz in his financial writings on the rollercoaster ride experienced by investors in risky stocks.

This extract was taken from Prevent and Cure Diabetes: Delicious Diets, Not Dangerous Drugs by Dr Sarah Myhill.

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The reasons behind Male Anorexia

The reasons behind male anorexia

Although the risk of anorexia nervosa is higher in females, boys and men are not immune. Interestingly, atypical eating disorders, such as ‘selective eating’ (very limited food choices) are more common in boys than girls before puberty. These are often related to developmental disorders, such as autism spectrum disorders, or to severe anxiety. However, very few of these eating problems develop into anorexia nervosa after puberty.

About 10% of people with anorexia known to health services are male. On the other hand, large community-based epidemiological studies have recently shown that as many as 30% of participants reporting a lifetime history of anorexia were male, but only a minority sought treatment. Eating disorders are associated with women and this may be an impediment to seeking treatment for men. John Prescott’s disclosure of his bulimia could be a typical example of this situation.

However, even if as many as 30% of sufferers were male, the imbalance towards the female sex is most extreme amongst psychiatric disorders. Interestingly, there is some evidence that homosexuality/bisexuality is a specific risk factor for eating disorders (particularly bulimia) in males. According to a recent study, attending a gay recreational group is significantly related to eating disorder prevalence in gay and bisexual men. The reason for the higher prevalence in non-heterosexual males is unknown at present. In some cases, the drive for weight loss may be an expression of the rejection of male sexuality, such as in men with gender identity disorders.

The motivation for initial weight loss is usually different for men than for women. Preoccupation with a muscular but ‘fat-free’ body is more common, sometimes resulting in excessive exercise and steroid abuse. This is consistent with male sexual attractiveness, but paradoxically, these strategies damage normal sexual functioning. Biologically, abnormally low weight does not allow muscle building, not just because of lack of nutrients, but also because testosterone levels fall during starvation. The low testosterone does not just affect libido and sexual performance, but also the body’s ability to build muscles. Steroids illicitly used for muscle building also interfere with normal sex hormone production, and can be harmful in the long run.

Illicit substance misuse has also been associated with anorexia in males, for a number of reasons. Firstly, amphetamines, heroin and cocaine all reduce appetite. Secondly, some underlying personality traits may present a risk for both conditions.

Research on anorexia in boys and men is limited. This is mainly because only a small proportion of clinic populations are male, so it is very difficult to recruit sufficient numbers of male participants into studies. Furthermore, the majority of research studies concerning anorexia nervosa exclude male patients from recruitment or the analysis in an attempt to keep the methodology simple. The Minnesota Semi-Starvation study, which will be discussed later, included only male participants. Hence, this study has provided invaluable information about the consequences of self-induced starvation in males.

Medical complications are more common in men than women during starvation. However, a recent study in Sweden showed that the long-term recovery rate of men hospitalised for anorexia was good. The same research group has also shown that the outcome of eating disorders in females has improved in Sweden (in contrast to many other countries). These findings may be true only for the Swedish populations, due to the effective screening programmes and early intervention in this country’s highly developed and equitable healthcare system. Finnish researchers also found better outcome for males in terms of weight restoration, but additional psychological problems were common.

 

This extract was taken from Anorexia Nervosa by Dr Agnes Ayton.

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Psoriasis: Natural Remedies

Natural remedies for Psoriasis

Psoriasis is a chronic skin disorder that affects 1% to 3% of the world’s population. It is characterised by periodic flare-ups of well-defined red patches covered by a silvery, flaky scale on the skin and the scalp. There are several variations of psoriasis, but the most common type is chronic plaque psoriasis. The exact cause is unknown, but it is believed that a combination of several factors contributes to the development of this disease. In a normally functioning immune system, white blood cells produce antibodies to foreign invaders such as bacteria and viruses. These white blood cells also produce chemicals that aid in healing and fighting infective agents. With psoriasis, though, special white blood cells called T-cells become overactive; they attack the skin and set off a cascade of events that make the skin cells multiply so fast they start to stack up on the surface of the skin. Normal skin cells form, mature and then are sloughed off every 30 days, but in plaque psoriasis the skin goes through this whole process in three to six days.

DAMAGE
Sometimes an injury to the skin can cause the formation of a psoriasis patch. This is known as the Koebner phenomenon, and it can occur in other skin diseases, such as eczema and lichen planus. It can take two to six weeks for a psoriasis lesion to develop after an injury. Types of damage that can trigger a flare include: abrasion – even mild abrasions; increased friction from clothing or skin rubbing against skin in folds, such as armpits or under breasts; sunburn; viral rashes; drug rashes and weather damage.

DIET
Alcohol, sugar, coffee, fatty meats, refined processed foods, additives and deficiencies in minerals and phytonutrients can induce attacks of psoriasis.

DRUGS THAT CAN INDUCE OR WORSEN PSORIASIS

  • Chloroquine – used to treat or prevent malaria.
  • ACE inhibitors – angiotens in converting enzyme inhibitors, used to treat high blood pressure. Examples include fosinopril, captopril, and lisinopril.
  • Beta-blockers – used to treat high blood pressure. Examples include metoprolol tartrate (Lopressor) and atenolol (Tenormin).
  • Lithium – used to treat bipolar disorder.
  • Indocin – an anti-inflammatory medication used to treat a variety of conditions, including gout and arthritis.

INFECTIONS
Infections caused by bacteria or viruses can cause a psoriasis flare. Streptococcal infections that cause tonsillitis, or strep throat, tooth abscesses, cellulitis, and impetigo, can cause a flare of guttate psoriasis in children. The human immunodeficiency virus (HIV) does not increase the frequency of psoriasis, but it does increase the severity of the disease.

PSYCHOLOGICAL STRESS
This has long been understood as a trigger for psoriasis flares, but scientists are still unclear about exactly how this occurs. Studies do show that not only can a sudden, stressful event trigger a rash to worsen; the daily struggles of life can also trigger a flare. In addition, one study showed that people who were categorised as ‘high worriers’ were almost two times less likely to respond to treatment compared to ‘low worriers’.

WEATHER
Weather is a strong factor in triggering psoriasis. Exposure to direct sunlight, which usually occurs in the warmer months, often improves the rash. On the other hand, cold, short days seen in the winter months can trigger the rash to worsen.

NATURE CURES FOR PSORIASIS
Raw juice therapy can effectively improve psoriasis. The best organic natural foods to juice are: apricot, beetroot, carrot, celery, cucumber, grapes, lemon, spinach and tomato.

EXTERNAL REMEDIES FOR PSORIASIS
The following can be used as external remedies for psoriasis: burdock root, Chinese rhubarb root, egg white (beaten to fluffy stage), mango, oats, parsley, pine needle tea bath and tamanu oil.

 

This extract was taken from Nature Cures by Nat Hawes. Check out her website at http://www.naturecures.co.uk/about.html

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How to cope with IBD at work

How to cope with IBD at work

Sometimes it seems that living with IBD is a full-time job (albeit one with zero pay or benefits!). Time spent at the hospital, recovering from flares and trying to live a healthy life can all add up. Unfortunately, most of us are not millionaires and work is a necessity, and for lots of us a fulfilling part of our lives. Working with IBD isn’t always easy but for the vast majority of us it is possible. However, you may need to talk to your employer and have adaptions made.

 

Be honest

It is very important that you are honest with your employer about your condition and what it involves. IBD, like any chronic illness, is covered under the 2010 Equality Act since it is a physical and long-term impairment (definition of disability under the Equality Act 2010, 2015). This means employers must make necessary adaptions to help you in your role. This could include flexible working hours, access to a disabled toilet or a fridge to store your medicine in. Most employers are accommodating if you talk to them and explain what your condition actually entails (and if this is disclosed at interview, employers cannot discriminate against you in the recruitment process).

 

Be realistic

Many people with inflammatory bowel disease have really high expectations of themselves, which is also reflected in their careers. However, it is important to reflect on your career path and whether it is adaptable to life with IBD. Does it involve lots of travel? Is it stressful? Are you often on the go? Having IBD doesn’t mean giving up on your career dreams but just making sure the job is right for you.

 

Be informed

Reading the paperwork and the terms and conditions that comes with a job is more important than ever with IBD. Here are some things you need to find out:

  • What is the sick pay entitlement?
  • What is the policy for long-term periods of sickness?
  • How flexible are the working hours?
  • If you are working abroad, is medical insurance included and does this include pre-existing conditions?
  • Will you get regular breaks? (This can be easy for office workers; not so easy for those in retail.)
  • Is there the possibility of reduced hours or going part-time further down the line?

Keep records

It may be worth having a notebook to keep a list of any time you have had to take off work for IBD and the corresponding symptoms and hospital trips.

 

My experience of working with IBD

I am a teacher by trade and have taught both in the UK and abroad. In every job, I’ve been honest about my conditions from day one and luckily all my employers have been great. When I was on infliximab, my employers were great at giving me time off to go to hospital appointments and in my previous role I had surgery and the school arranged for me to come back on a phased return. It can be really hard teaching with IBD – I have had days where I felt like I wanted to faint in front of a class – but luckily most of the time I’m fine. In some ways doing a demanding job means I often forget about my symptoms, but I have had to dash out of class on a few occasions. I think this is why talking with colleagues about your condition is so important – it has meant they have been able to quickly step in if needed. Yet over the years, I think I’ve also become more realistic about my teaching career and this year I’ve reduced my workload to three days a week, aiming to spend more time on my health and my writing. I don’t see this as a step down but a necessary adaption to help me live as balanced a life as possible; hopefully I can combine the security of a teaching job with my other passions in life – writing and nutrition.

This blog is taken from Managing IBD: A balanced guide to inflammatory bowel disease by Jenna Farmer.

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CFS/ME: Are you sleeping too much?

CFS/ME: Are you sleeping too much

Difficulty with sleep is common for people with CFS/ME. Some people find they are sleeping too much, while others find they are not sleeping enough. If you experience problems with sleep there are several things you can do to help yourself.

There is no such thing as an ideal amount of sleep. For example, some people need 10 hours, while others only need five. An average night’s sleep is around eight hours. When the amount of sleep someone is getting is causing an increase in fatigue that is when it becomes a problem.

When people first have CFS/ME they often over sleep. People who have had CFS/ME for a longer period of time often go from over sleeping to not being able to sleep enough, despite high fatigue levels. Continue reading CFS/ME: Are you sleeping too much?

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Books on Prescription: Reading Well for Long Term Conditions

We are delighted to announce that Fighting Fatigue and Irritable Bowel Syndrome: Navigating Your Way to Recovery have been placed on the Reading Well scheme for long term conditions.

If the pen is mightier than the sword, perhaps the book is mightier than the drug.

These stirring words from Professor Martin Marshall at the 2017 Reading Well launch really summed up the miraculous effect that books have on us.

Bibliotherapy –  the use of books and reading to facilitate management of and recovery from illness – is not a new concept, but it has found increased recognition in recent years thanks in part to the Reading Well scheme. Continue reading Books on Prescription: Reading Well for Long Term Conditions