Somewhat off-topic but, given our continuing questions about doctor training, this might be relevant and interesting for some. Am still listening...
The Medical Field: Why student doctors are getting out on farms
The Food Programme
Sheila Dillon joins a group of medical students on a farm visit, to discuss whether an education in food production could help them offer better nutritional support to patients.
Link is to the program's website - not yet available for listen again but should be very soon.
Sheila Dillon joins a group of medical students on a farm visit, to discuss whether an education in food production could help them offer better nutritional support to patients.
I would never trust a group of people on nutrition who are convinced that nutrient levels are only of importance and relevance to health if they are below range.
Thanks for the notice. Doubt it will make any difference to an entrenched way of teaching medical students. Just a few hours about education on healthy nutrition etc. will not be enough to educate them… When I see so many doctors and nurses grossly overweight, frankly obese, I wonder what they know about healthy nutrition… and what they actually eat! Yet, such doctors have the cheek to tell some patients that they are overweight/obese and need to lose weight! The irony of it. It would be quite hilarious if this wasn’t so important! The way doctors are taught needs to be reframed… but it won’t happen.
I don't think we ought to assume that just because people are over-weight - be they doctors or others - that they over-eat/eat the wrong things. That's what doctors do to us, and we don't like it, do we!
Of course, there are genuine reasons why one is overweight. However, I see many more people grossly overweight, obese in fact… everywhere… Young people: this must be due to the fact they don’t eat healthy foodstuff. Before the lockdown I used to see people’s trolleys in supermarkets full of unhealthy food: huge bags of crisps, frozen French fries, pizza galore, loads of biscuits, bottles of soda, coca-cola… need I carry on? The children are not fed properly and in turn will not feed their children properly because they weren’t taught what healthy food is! No excuse for that. Plus kids don’t walk anymore, driven by car everywhere.. perhaps some not doing any kind of physical activities.. playing games on their laptops etc,I find it worrying when going into hospital to see most nurses, including very young ones, are obese… that’s not because they’re all ill, surely… Same with some doctors… The NHS should crack on that… after all, they should lead by example.
I agree with you that there do seem to be many more obese people around than there used to be. But, there is also an epidemic of hypothyroidism - and how many of them are undiagnosed? And just because they're doctors or nurses doesn't mean that they're more likely to get diagnosed because the NHS is in denial about the whole thyroid thing. And, I know plenty of people thin as a rake who live on unhealthy diets. So, I still maintain that we ought to give people the benefit of the doubt and not make assumptions.
I get your point. However, all that unhealthy food people buy is not helping! People eating bad food all the time will put on weight and become ill, very ill. Diabetes is raging in the UK… too much sugar/bad carbohydrates… less physical activity… People need to take responsibility for themselves because they won’t get help from doctors.
I think they ought to go back to giving lessons in nutrition and cookery classes in schools. I think that's when the rot set in, when they stopped all that.
Very good point. People have also taken the habit of getting takeaways.. the odd one is ok but it’s too often now. Plus all those unhealthy food places like McDonald , chicken fry etc…. People need to rethink about the way they treat food.
I beg to disagree. They’re full of salt, bad fat, additives etc and probably not the best quality meat if not eating vegetarian… Cool at home you can choose good healthy products and reduce the salt and no additives added by buying good Asian products (a bit more expensive). Of course it’s lovely not to have to cook from time to time as long it’s not a regular habit I suppose. I stopped eating such takeaways a long time ago because I had problems digesting them and felt quite unwell after eating them.
Haven’t eaten in a restaurant for well over a year… thanks to Covid, shielding and lockdown. I am very choosy where I go into a restaurant… I used to go quite often but careful of what I ate. Wasn’t so choosy before I became so ill, but still cautious. Never go into McDonald etc… they’re not restaurants but fast food outlets serving unhealthy food. It’s a choice we have to make.
I did say 'restaurant', not McDonald's. I do know the difference. I don't suppose many of us have been to a restaurant in the past 18 months or so, but if you get your takeaway from a restaurant you would be happy to eat in, I can't see the problem.
But, we'll just have to agree to disagree, because we're obviously not going to come to any agreement on this.
I understand you meant restaurant, but there again there’s restaurant and restaurant… Unfortunately too many people use fast food outlets … No restaurant where I live deliver decent food. I tried to order from so called “chefs” locally, having read recommendations on the local community website… wow! What a disappointment… it showed that most people nowadays don’t really know what good food is! Yes, compared to food outlets and Chinese and Indian takeaways it was probably better. I never ordered again. The trouble is if one is very careful with food while still making it enjoyable then the standards change. There was an excellent hotel and restaurant not far from where I live, I used to go there every week, good food, not cheap but not too expensive either, unfortunately they’ve had to close down since Covid. Well, we can agree to disagree as you say. Take care. 😀
No, it’s not judging people because they are overweight or obese because of certain health issues. It’s to do with all the people who use that excuse while being undisciplined and do not make the effort to look after their health/weight. Not taking any responsibility for the way they behave, then expecting miracles to change their weight, attitude. I do not discriminate against people who are so unfortunately overweight because of genuine health problems. I have put on weight because I have been on steroids for so long and am losing my mobility, so I can’t exercise as I used too, can’t enjoy gardening, going for long walks, practicing tai chi as I used to, going to the gym regularly… that’s gone because of my declining health, but I do my very best in trying not to put more unnecessary weight on. Not hugely overweight but I am small and for me it’s too much, was never that way… so I take responsibility by being as careful as I can in selecting the food I eat and the way I cook it. I do hope this explains why I feel the way I do. It’s not easy at all… far from it and I so miss the time I could eat anything without having to worry. I need to maintain what little health I have left. Each person needs to be responsible. I think I have exhausted this conversation now. 😊
I've had to cut salt right down as I have high blood pressure. I am slowly getting used to it. I think its one of those things that once you've cut it out for a while.....you find you don't like it any more, and there's a lot in things like bread.
Of course a gf beer and a packet of crisps on a hot day is always an excellent idea.
The myth that salt caused high blood pressure was debunked a long time ago. I had high blood pressure for most of my adult life. Until I was optimally medicated for my thyroid. No change in my salt intake.
Don't forget that your body needs salt. Low salt diets cause low stomach acid and constipation. The adrenals need salt. The body needs salt for all sorts of things. If your salt consumption is too low, it will kill you.
It is sensible to watch your salt intake, especially if you have blood pressure. A little salt is ok as you say. Especially as we grow older our systems do not work as well to help our body function well. Caution is always a good thing.
This is an extremely new paper - the full paper is under embargo to "free" access until almost Christmas this year.
Note the last sentence of the conclusion!
Eur Heart J. 2021 Jun 1;42(21):2103-2112.
doi: 10.1093/eurheartj/ehaa947.
Sodium intake, life expectancy, and all-cause mortality
Franz H Messerli 1 2 3 , Louis Hofstetter 1 , Lamprini Syrogiannouli 4 , Emrush Rexhaj 1 , George C M Siontis 1 , Christian Seiler 1 , Sripal Bangalore 5
Affiliations
• PMID: 33351135
• PMCID: PMC8169157 (available on 2021-12-20)
• DOI: 10.1093/eurheartj/ehaa947
Abstract
Aims :
Since dietary sodium intake has been identified as a risk factor for cardiovascular disease and premature death, a high sodium intake can be expected to curtail life span. We tested this hypothesis by analysing the relationship between sodium intake and life expectancy as well as survival in 181 countries worldwide.
Methods and results :
We correlated age-standardized estimates of country-specific average sodium consumption with healthy life expectancy at birth and at age of 60 years, death due to non-communicable diseases and all-cause mortality for the year of 2010, after adjusting for potential confounders such as gross domestic product per capita and body mass index. We considered global health estimates as provided by World Health Organization. Among the 181 countries included in this analysis, we found a positive correlation between sodium intake and healthy life expectancy at birth (β = 2.6 years/g of daily sodium intake, R2 = 0.66, P < 0.001), as well as healthy life expectancy at age 60 (β = 0.3 years/g of daily sodium intake, R2 = 0.60, P = 0.048) but not for death due to non-communicable diseases (β = 17 events/g of daily sodium intake, R2 = 0.43, P = 0.100). Conversely, all-cause mortality correlated inversely with sodium intake (β = -131 events/g of daily sodium intake, R2 = 0.60, P < 0.001). In a sensitivity analysis restricted to 46 countries in the highest income class, sodium intake continued to correlate positively with healthy life expectancy at birth (β = 3.4 years/g of daily sodium intake, R2 = 0.53, P < 0.001) and inversely with all-cause mortality (β = -168 events/g of daily sodium intake, R2 = 0.50, P < 0.001).
Conclusion :
Our observation of sodium intake correlating positively with life expectancy and inversely with all-cause mortality worldwide and in high-income countries argues against dietary sodium intake being a culprit of curtailing life span or a risk factor for premature death. These data are observational and should not be used as a base for nutritional interventions.
That is interesting. It has to be said "I'm going to take that with a pinch of salt" sorry, sorry, sorry. If I didn't have high bp I would probably think differently, but I think its worth reducing and see where I am in 3 months. We all react so individually. .....Patience, and trial and error.
The way I look at it is that it might be worth trying things, but the idea that the entire population should, indeed must, reduce their salt intake appears questionable.
Thank you for thinking of me GG. There is a surprising amount of info debunking the 'salt problem'.
Although I've cut down a bit, I'm not on a low sodium diet. The only changes I've made are unsalted butter, and putting a bit less on my food. I doubt this will help my bp, but you never know.
I was prescribed a thiazide diuretic for bp in Feb this year (I don't have fluid retention at all) and that leeched everything. I think it was the sudden drop in sodium that sent me to A&E though. 3 days after starting the drug I woke up very, very confused. It was like there was a wall up blocking information, and I couldn't get round it. Apparently I looked like a deer in the head-lights. Really, really bad headache too.
It’s interesting that before I was diagnosed I could not abide even one grain of salt in anything I didn’t touch it as an additive (no doubt it was in things I ate) for decades. Once I was diagnosed and treated I began to crave it. I still like some salt on my food nowadays. I did wonder if it had anything to do with iodine. I use sea salt but presume it must have some iodine in it. I tend to follow my inclination with it.
There is next to no iodine in sea salt. I doubt that has anything to do with it. Craving salt is an indication that adrenals are struggling.
Don't get me wrong, I don't cover my food in masses of salt. In fact, the only time I add salt to my plate is when I'm having chips. What I object to is the suggestion that it should be left out of the cooking! As it says in that article: “The rigid low-sodium diet is insipid, unappetising, monotonous, unacceptable, and intolerable. To stay on it requires the asceticism of a religious zealot.”
Nature knows what it's doing. If it make salt a flavour enhancer, it's for a reason: we need salt. Whether you sprinkle a little on your chips, or add it to the cooking water, salt adds colour to life - and flavour to veggies that would otherwise taste like something out of a horse's nosebag. We need the salt and we need the veggies. Put them together and somethig magical happens: we eat them! lol
‘Roman soldiers were paid in salt’ may be the simplest form of the myth, but it’s also a secondary form. […] that seems to indicate that people first started writing about the idea around the 1860s (here, for example).
The older, primary form of the myth is that soldiers were given ‘salt money’, that is, a monetary allowance for buying salt. This, too, is a modern invention.
May be it’s because they have to work such long hours to make ends meet that they struggle to do home cooking on top, plus take a ways are so readily available.
That’s probably a possibility. However, it would be healthier to buy (or bring = cheaper) fresh fruits or low fat unsweetened yogurt…When I mentioned seeing NHS staff in Costa in hospital it’s mid- morning break or lunch break or mid-afternoon break… quite expensive too if you don’t earn much…
One questions how these PRIVATE companies selling 💩 invaded the NHS, where proving healthy nutritious food to staff ought to be central to the service.
Quite. Both Tesco and Waitrose do a 10% fat Greek yogurt which is delicious. We had a herd of Guernsey cows which yielded really rich milk which we drank unpasteurised. When we took some cream off it was cream-coloured, not white. I cannot understand why anyone would drink skimmed milk, it is like chalk and water.
Guernsey Milk Facts
Omega 3: Guernsey milk contains 3 times as much omega 3 as other milks.
Beta casein A2: When tested in the UK, Guernsey milk had more than 95% A2, compared with 40% A2 in Jersey milk and 15% in 'ordinary milk'.
Beta carotene: This is not digested by Guernsey cows so it passes into the milk and produces the wonderful golden colour. Beta carotene is found in green vegetable matter (i.e., grass) and is thought to give protection against certain cancers. It is known that the consumption of vegetables is good for you. Therefore drinking Guernsey milk should provide the same health advantages.
Other benefits: Guernsey milk contains 12% more protein, 30% more cream, 33% more vitamin D, 25% more vitamin A and 15% more calcium than other milks. On average it contains 4.65% butterfat and 3.55% protein. The fat and protein content of Guernsey milk is higher than that of 'ordinary' milk, meaning it has a better balance then Jersey milk and is therefore 95% fat-free.
I read a news article a couple of days ago. A new scheme..... GP's being paid £11.50 for obese patients, and giving Fitbits (or something like) to anybody with a BMI over 30.
Crazy world where you can buy 8 bounty's in the supermarket for less than the price of a few decent oranges/apples.
The world has gone mad! Paying GPs extra money for each obese patient is really immortal! They’re paid enough as it is… I see obese GPs all the time… why don’t they take the lead in dealing with obesity? It’s a money racket. What sort of society are we moving in… most concerning.
I went to see an NHS dietician with my daughter (type 1 diabetic) years ago, and a young woman opened the door, and she must have been at least UK dress size 26..........not what you'd expect at all. I wondered if she'd become a dietician to try and help herself, and probably had some underlying illness making her quite so big. I think it was very brave of her, and I hope that she succeeded.
My one-time bank manager - a huge woman - felt the need to confide in me that it was due to her adrenal disease. I returned the compliment. So sad that we feel the need to explain who we are in order not to be judged.
It is difficult to understand why so many people working for the NHS are so overweight, obese… why SO MANY? I could understand the odd ones having serious health issues but THAT many? It’s to do with a lack of discipline and control regarding food. When it was safe to go to a Costa , after an hospital appointment I always saw large NHS workers buying large pieces of cake! Surely that’s not too clever nor responsible. I noticed often very overweight people will always find an excuse. Well, it’s their lives, their choice but not a good example.
They are, or certainly were, the biggest employer in NW Europe so it could just be a reflection of the variety of body sizes in society. I think are only second to US for obesity as a country.
I understand that the UK has the highest rate of obesity in Europe and is second in the world after the USA as you have said! Nothing to be proud of. It is a known fact that the UK looks to the USA in doing things and therefore adapting very bad US eating habits. However, I believe obesity is on the rise throughout Europe too, it’s all because of fast food establishments opening up everywhere and people perhaps not cooking meals from scratch… I don’t know. Hardly progress….
Sorry but who are the biggest employers in NW Europe? You’ve lost me here.
Not sure how reliable, but this site suggests the UK is 29th for obesity in adult males. And 60th in adult females. It is based on 2016. And some of the countries which are higher are quite small.
I did read that somewhere, yes. Can't remember where. And how true it is, I really don't know. But it could just be that with modern testing - if you can get it! - more people are being diagnosed.
Could be all sorts of reasons why. More endocrine-disruptors in circulation, perhaps. Or, my favourite theory, more soy used in just about everything! It's almost impossible to get a loaf of bread witout soy flour in the UK these days.
Yes soy is in almost everything your right, I wonder have you had more people asking for help and guidance on here with hypo? Would you say it’s doubled? I think it’s important somehow to try find an answer that’s all
I'm not much good on statistics, but helvella would know about the increase in members. The forum has certainly greatly increased since I first joined.
That’s what I was thinking too that’s it’s a environmental issue that so many are getting sick. I’ve noticed that over the last 4 years my thyroid packed up I’m bumping into people that tell me they have thyroid issues that they never had before, also noticed they are all quite young. My own son is now diagnosed with autoimmune thyroid disease. Thank you for replying
You're right in that doctors - if the patient is consulting with them is 'bloated' or appears overweight - the doctors put all the emphasis of this onto the patient and blame them for 'overeating' and that it's the patient's fault.
The real fact is that many, many hypothyroid patients do gain weight but it is usually due to not being on an optimum dose of hypothyroid hormones to raise their metabolism sufficiently.
I think it would do no harm for doctors/endocrinologists to test both Free T4 and Free T3 more often. This is from TUK:-
Thanks Shaws… Of course it’s always the patients’ fault… Doctors do all they can in avoiding taking responsibility for anything and are experts in denying necessary investigations, referrals to consultants and appropriate treatments. It looks to me that the role of doctors nowadays is not to help patients but of being an administrator reissuing usual prescriptions. Sit at a desk in front of a computer, tick boxes - all the same for everyone… job done plus good salary. I fear it will get worse…
Well, my mature doctor (I suppose due for retirement soon) phoned to tell me that my 'TSH is too low' "T3 too high" -"T4 too low".
Me -"yes doctor, that's correct. My TSH is low because I take T3 only My T4 is low because I take none. My T3 is higher because that's what I take. He then responds:-
"But T3 converts to T4". No doctor it's the other way around, i.e. T4 is supposed to convert to T3.
I know!! These so-called doctors don’t have a clue… frightening we are in their hands. I have often thought that surviving a health problem is due not so much to medical knowledge (except in rare exceptions) but to luck and because we take responsibility for our health issues. Should not have to do so had we real able doctors.
I think the fact is that doctors have lost a 'talent' that our old-fashioned doctors had in diagnosing people who had dysfunctional thyroid glands witout blood tests.
I am assuming it's like the 'old wives tales' that used to cure or fix people who were unwell with the knowledge that the 'old wives' used to have.
Our old-fashioned doctors, before the introduction of blood tests or levothyroxine, diagnosed upon our clinical symptoms alone and given a trial of NDT. If we felt an improvement we stayed upon this with small gradual increases.
My GP couldn't diagnose me when TSH was 100 and he actually phoned to tell me there was nothing wrong. I was feeling extremely unwell.
If you want to read the rest of this click on my name as I've put some information on it.
Two of our last 'old-fashioned trained doctors - Dr Gordon Skinner and Dr Peatfield were pursued as if they were criminals towards the end of their careers as they had been taught how to diagnose those who had dysfunctional thyroid glands without blood tests.
These doctors were loved and respected by their staff and their patients who travelled the length and breadth of the UK for a consultation. Both doctors restored health and wellbeing.
Doctors have lost their talent in diagnosis of symptoms in ALL fields of medicine, not just in thyroid problems. I have multiple problems and I am faced with the same poor medical help… Great doctors were destroyed by all the other incompetent doctors, obviously they didn’t want to be put in a situation whereby they would have to make much more of an effort in carrying investigations further… they prefer the easy way out.
I had precisely the same conversation with my endo… almost word for word!!! What are they teaching these people and why are they allowed to call themselves ‘consultants’ with salaries to match? They couldn’t ‘consult’ their way out of a wet paper bag!!! 🤬
Looking at this from a different point of view! I used to work with students in my working life and particularly medical students in their second and third years, technically in their first two years as one earlier year most are exempted as they have done the right A levels. I’m just surprised that they have the time to visit the countryside! The students I worked with had half a day off to do sport, not that there would be many facilities but there wouldn’t be room to fit that in for various reasons. Yes I could agree to farm produce may be put into one of their lectures but visiting a farm sounds a far fetched idea but not practical. Most medical schools are also in large cities as they have more in patients for them to interact with but time is also at a premium to fit in lectures, clinical demonstrations etc each week. It’s a very long, intensive study and some do not attend everything they should.
Farmers spend a lot of time and money getting the diet right for their animals, checking protein and vitamin levels and supplimenting if needed. If the trainee docs learn from this, it can only be a good thing.
A friend who is training to be a fitness bod asked me to keep a food diary, which he then fed through some pooter programme. Apparently I was good for everything (I grow most of it) but low in salt. This was while I was married, my husband had to have a low salt diet, and I just kept cooking without salt after the divorce. How I wish I had fed him salt!
Not all farmers, serenfach. Some supplements are given to improve and speed up weight gain and for milk production, not for the health of the animal. Crops are sprayed with chemicals to improve yields, not the food quality of the crop.
Penny, your comment is way off topic for a thyroid forum. However, if you are going to make such an assertion, please provide link/s to bona fide evidence that this is true here in the UK.
Please remember this is a thyroid forum and the relevance of this post was to the training of doctors. General discussion about agricultural and animal husbandry practices is really off-topic and further posts will be removed and the thread closed.
Also, you failed to reply to the response from serenfach - just to the original post.
The problem is that you are replying using the box at the end of the thread - which is, effectively, a reply to the original post.
In order to reply to a specific existing response, you need to click on the blue [Reply] button on the response you want to reply to.
You will see that your recent responses are all at the top level - not indented. Whereas, for example, RedApple and my replies to your response are indented another level. This also means that the person to whom you are meaning to respond does not get an alert!
I was with my husband in the doctor's surgery once, and the doctor was under stress, short of time, and very frazzled. She decided to take my husband's BP and put the cuff on his arm, upside down, squint and very loose. The tube should come out of the cuff pointing down the arm, but his was on pointing towards his shoulder. I know where the tube should be, since my BP monitor was the same make as the doctor's.
When his blood pressure was measured it was sky-high - something like 180+ over 100+.
At home with the cuff put on properly his blood pressure is really good - around optimal according to current standards.
And more recently... I got my BP done by a junior doctor about 10 days ago. My BP isn't that great, but it isn't yet at a level where I would agree to take BP drugs. The doctor put on the cuff very loosely - although at least it was the right way up. Since I have my own BP monitor (which is well looked after) I have experimented with it so I know that having the cuff loose will raise any result from my own BP. The doctor's BP monitor looked like it had been kicked around the surgery every morning for the last 5 years.
So, there's me with this loose cuff around my upper arm and the doctor presses the switch. It takes a while for it to actually be vaguely "snug" and the monitor is raising the numbers all the way through the process of it getting snug. But the damn thing didn't turn off - it's still pumping air into the cuff. I complained it hurt about three times but the doctor just ignored me. It's still pumping away and my lower arm started to swell up like a Michelin man and it was also very bright red. My BP result was much, much higher than it is in real life and the doctor commented on it and suggested I should be investigated for hypertension.
The result of both these incidents is that my BP and my husband's BP have been recorded in our respective medical records as being much, much higher than they are in real life. It really doesn't help that I have white coat syndrome - doctors raise my BP whenever I get within quarter of a mile of one, and for that reason I would never rely on a doctor for a BP measurement.
So, if a doctor ever takes your BP, you could try putting the cuff on yourself if you know how to do it and the doctor will let you. Having it much too loose might raise your result and could cause you (briefly) quite eye-watering levels of pain.
They cannot legally change the notes, but they can add a comment. In this case all they have to do is add the words "invalid reading" to the notes. Write to the Practice Manager and explain the situation and ask for the GP to add a comment.
I saw that, I listen to something about when they were still students and trying to improve the nutrition training so it's good to see how they have progressed and kept at it
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