How the NHS failed me and mine.
What it did, to the most important person
in my life and how it could happen to you unless
we do something about it!

Thursday, 24 November 2011

Chocolate and Paracetamol.

No, it's not a new recipe for pain relief, although thinking about it may have some merit.

Chocolate has been investigated for it's efficacy as a medicine, primarily as an anti-hypertensive, but also for it's possible use in many cardiometabolic disorders. This is especially good news, for those who desire chocolate almost, if not more than sex, as a number of women have told me (although that may be a reflection of my lack of personal attraction). Hey-Ho. But yes, there is at least some statistically significant evidence that even the obese can benefit. It is important that it is dark chocolate and in my interpretation, that with the highest cocoa mass would be the one to go for, although above 85%, it does tend to be somewhat bitter, although as cocoa mass increases, sugar decreases. Always remember as sucrose intake increases, so does plasma glucose and insulin.

85% cocoa mass chocolate yields (per 100grammes);-
Protein - 9.70 g
Carbohydrates - 17.00 g
(of which sugar is 5.80 g)
Fat - 51.40 g
(of which monounsaturates is 17.90 g)

Putting aside the sugar content, for the non-diabetic that is quite small and provided consumption is kept to 25 or 50 grammes per day is unlikely to yield much harm whilst at the same time providing a healthy fat intake and of course the flavanoids that produce the improved endothelial function. The study published in the BMJ seems quite convincing although as a meta-analysis and largely observational study, it does have confounding factors and the cohorts had little heterogeneity. Nonetheless for the relatively healthy it's a somewhat better 'medicine' than most of the drugs peddled by 'Pharma' and I have myself, despite my indifference to chocolate (what you say!) started to consume 25 g per day, some time ago.

In the responses there are some detractors, mainly those who are frightened of 'fat' despite the fact that high cocoa mass fats largely comprise monounsaturates with a small polyunsaturates content which the 'mainstream' generally view as healthy. I'd prefer mine with lard to be honest, but I'll leave that for frying my egg yolks and bacon, oh and my 97% meat content, organic sausages. I'll eat my chocolate with a glass of good red wine instead.

Paracetamol (acetaminophen) was in the news recently although if you blinked you may have missed it. This is largely because even in doses that are often prescribed by Doctors in Hospitals (yes really) they can be somewhat dangerous. It does have a cumulative effect especially if taken at maximum dosage for a number of days and in some cases for weeks. The effect on the liver is quite toxic and can often be fatal, especially in those with reduced function in that organ, such as those with even mild alcoholic or non-alcoholic fatty liver disease. Even mild overdose due to timing of intake can be hazardous, and the study in the British Journal of Clinical Pharmacology warned that prolonged usage presented more problems in treatment, and risk of death than did single overdoses. It is easy to forget that no more than 4 doses (of 2x500mg) in 24 hours should be taken, when those doses are taken at 4 hour intervals.

The data is not exactly new and the phenomena well known for some time,  but most was for single excessive doses, a number of which were intentional, although I could think of better ways to end it all than the multi organ failure that often is the outcome. The important lesson, which was not very well reported, is that this is an easy trap in which to fall into. You do not have to be much outside the 'normal' dose parameters to cause fatal consequences, and that is for healthy people. The elderly, children, and underweight and malnourished recipients are particularly vulnerable and it is so easy for people to view this over the counter analgesic, as eminently benign. It isn't, it is potentially fatal at quite low levels. The antidote, N-acetylcysteine, (NAC) another OTC supplement used in some cough medicines, has to be administered pretty rapidly to save lives, although for this problem intravenously by rapid infusion. The window for saving lives is tight, generally eight hours.

Personally, I never take paracetamol, well not any more, as I have known of its dangers for many years. If I'm in any serious pain, which is usually due to arthritis, I use a topical NSAID, such as Ibuprofen gel and even then rarely. The lesson is plain. Over the counter paracetamol and its combination forms (aspirin, ibuprofen and codeine) can be lethal, just as lethal as some potent drugs.

Monday, 21 November 2011

The English Diet and Other Drivel.

Not been too well of late, so I'm having to catch up with a few things. Quite debilitating back pain was the problem; something I've had for some years due to a 'hard life' but which responds to physiotherapy relatively quickly. My thanks once more to Robin McKenzie again for his excellent protocols, they have stood me in good stead, when my back succumbs to the disc problems I am plagued with from time to time.

Posture corrected then, I can (hopefully) satisfy those who waited with breathless eager anticipation for my latest post, filled with my rapier like wit and surgical dissection of the sensible from the profoundly stupid, and there's been a lot of that recently.

The 'English Diet' came in for praise, on the back of a 'study' from Oxford University, and it's pretty much 'wibble'. Based upon the 'Dietron Model' a sort of Monte Carlo simulation (more wibble). It hypothesises, that data gleaned from self reported information from people, (that no doubt told many lies about what they ate), could be in any way be useful to a scientist in his/her pronouncements about that which might make a difference to the health of each of the nations that make up the United Kingdom. House of cards built upon quicksand is the only conclusion that I can come to. It's a corruption of a meta-analysis, that's purely self-reported and observational with a huge array of confounding factors that are ignored. Why anyone takes this sort of rubbish seriously when most, if not all of the conclusions have been proven by good scientific studies, to be untrue really makes me cringe.

It is suggested that saturated fat is taxed and that fruit and vegetables be subsidised and of course salt is restricted. All in the name of better health for the nations that border England. It continues the myth that if we all eat 'healthy food' like (highly volatile) seed oils, rice, pasta, whole grains (brown food), fruit and vegetables (full of starch and sugar) we will possibly live forever! This is of course the advice we've been given for about thirty years with no appreciable benefit thus far other than an increase in the profits of the food cartels and supermarkets, and an inexorable rise in the output of 'Big Pharma' to counteract the consequences of this blatant rubbish. I have debunked most of this before and written extensively about the dogma that masquerades as science, but so long as these 'faux' studies are given air time and media coverage without challenge, ever will it be so.

Moving swiftly on, I note that illustrious body the British Medical Association (BMA), the Doctors Union has pronounced on smoking in cars, especially with children in them. The eminent Dr. No has done a first class 'hatchet job' on the evidence, so I don't need to, except to say that the BMA would be better expending its time and its members funds on other pursuits such as protecting patients, and their membership from attacks by the GMC than involving itself in this sort of support for the Neoliberal agenda to curb personal freedom. This attempt by Vivienne Nathanson to once more proselytise, using the 'child harm' card is typical of most of the 'politicised' class of Doctor, invoking the hysteria that allows the actual evidence to be forgotten, in the face of the dogma. This is the ethos of medical ethics 'at the top'; ignore the vast harms that are perpetrated every day in health care in favour of a distraction to grab a cheap headline in the Sun or the Daily Fail Mail.

Salt, specifically sea and rock salt, is in the news and has been shown to be little different to 'normal' salt. Except of course for the additives, which they obviously didn't include in the analysis. Pretty much the same the conclusion arrived at when organic food was debunked in the media as being no different than say McDonalds'. Of course if one blasts things in a bomb calorimeter all you are doing is analysing the basic constituents and ignoring micro nutrients, which are an important constituent of the human diet that are generally lost in processed food. The same of course is true in salt.

Sea salt, is generally lower in iodine and richer in magnesium than is table salt, but the main thing is that it's natural product used by man for eons, both as preservative, condiment and ingredient, even as a means of payment ( 'sal' means salary). Iodised table salt, whilst having some advantages for thyroid function is also full of additives to make it 'free-running', and anti-caking agents so it doesn't 'stick'. My personal view is that sea or rock salt is better (rock salt is 'old' sea salt), and like many natural products you use less. As for 'low sodium' salt, well, we just put more on our food because you can't taste it! In fact the evidence still shows that sodium reduction has virtually no effect and can even be counterproductive for overall mortality.

And GlaxoSmithKline is having to dig deep to settle its dispute with the US Federal Drugs Administration (FDA). The largest payout in 'Pharma's' history. Even bigger than Pfizer's payout in 2009. It's unlikely to dent the drug giants A+ credit rating. Well there's a surprise then!

And finally  from my new friends, over at the Low Carb Diabetic; this is priceless. They have suffered greatly of late from the sort of complaints that beset bloggers and had their blog removed/blocked on occasions and had a lot of grief from the mainstream idiots aligned with, well you know who they are.