# Getting long lasting highs.



## TinaD (Jan 10, 2021)

Been trying to stay on a keto/Michael Mosley style diet for some months. Cannot always do 800 but try to stay under 1000 cals. Carbs restricted to 20 (fail sometimes but mostly close). Lost quite a bit of weight (17kg) and some inches around the tum. However in the past 3 weeks my FBG has been erratic (between 4.2 and 6.9) and regular testing after meals shows that my BG is well outside recommended levels although not a total disaster.  Going up into the low 10s or , rarely, into the 11s. It then rarely drops down to 7 before next meal - using up strips like a maniac trying to establish a pattern without any success. Basically living on chicken, roasted or stir fried, with greens, either as salad or stir fry, or steak and salad. Snacks are almonds but do try to limit them and always count them in . Oil is butter or olive oil. On shopping delivery day may have a Greek yoghurt with almonds (93 cals/3 carbs yog and 62 x 10g almonds) which sadly often produces a similar spike to a full meal. Cannot go walking after a meal to bring BG down as have COPD and palindromic arthritis (oh, also,highish BP and AF for which I take xarelto and losartan). Do drink water or black unsweetened tea to help the kidneys get rid of sugar. Am on reducing dose of steroids, which makes breathing and walking worse, but am down to 17.5mg from 40mg. Sleep is always disturbed by need to P and pain - the latter is mitigated by hot water bottle as am not allowed NSAIDS and find codeine makes me feel nauseous.  Suggestions please about what I am doing wrong. Sadly my diabetic nurse, altho' a nice lass, has absolutely no idea about diet - twice round the gas works once round her, thinks I should "eat more fruit as it is healthy" - so I am looking for help from the ever knowledgeable forum.


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## Inka (Jan 10, 2021)

Hi @TinaD It doesn’t  sound like you’re doing anything wrong. Steroids can push blood sugar up - could this be a factor?


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## TinaD (Jan 10, 2021)

Inka said:


> Hi @TinaD It doesn’t  sound like you’re doing anything wrong. Steroids can push blood sugar up - could this be a factor?


Certainly - they caused the diabetes. However I was doing better 3 months ago whenI was on a much higher dose.


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## Inka (Jan 10, 2021)

Hmm, so it’s unlikely to be the steroids then. It sounds like you’ve done an amazing job with the weight loss 

If this has only started recently, could it be some kind of illness? Pain? Disturbed nights? All of those can affect blood sugar too.


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## TinaD (Jan 10, 2021)

Thanks for the thought Inka. Other than the other conditions listed I do not appear to have any illnesses - certianly not infectious ones - I've been locked down since March 3rd 2020. Pain has been continuous throughout although it has fluctuated in intensity - palindromic arthritis does that - it was a real b***r before I went on the steroids - on a bad day I would struggle to get off the loo and sofa - well forget the sofa and the swearing! Distrurbed nights pre-dated diagnosis so it isn't new. At first I thought the BG was tracking the steroid doses rather than the food intake but that doesn't seem to be reflected in the blood testing. I am failing to spot any change which might have provoked worsening BG post food.


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## Inka (Jan 10, 2021)

TinaD said:


> Thanks for the thought Inka. Other than the other conditions listed I do not appear to have any illnesses - certianly not infectious ones - I've been locked down since March 3rd 2020. Pain has been continuous throughout although it has fluctuated in intensity - palindromic arthritis does that - it was a real b***r before I went on the steroids - on a bad day I would struggle to get off the loo and sofa - well forget the sofa and the swearing! Distrurbed nights pre-dated diagnosis so it isn't new. At first I thought the BG was tracking the steroid doses rather than the food intake but that doesn't seem to be reflected in the blood testing. I am failing to spot any change which might have provoked worsening BG post food.



That is strange then. I’m not sure what else to suggest. I’m Type 1 not Type 2 so I don’t know if this would affect you in the same way, but protein can cause a blood sugar rise too (more slowly than carbs). So if you’re eating lots of protein, that might be a thing to look at? Fat can cause insulin resistance too.

I expect you’ll say that you’re eating the same meals as you did before, but perhaps your body has just stalled a bit with your current diet and foods are pushing you a little higher than they did before? Could you experiment with different meals to see if you can spot the issue (if there is one)?


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## trophywench (Jan 10, 2021)

Well the body can make glucose from protein and fat, so to compare how much where Carb = 100%, Protein = c 40% and Fat = c 10%.  It doesn't actually do it whenever it gets enough carb not to have to bother to do it though, cos it finds it too much work.

It has been doing the latter ever since you drastically cut down on carbs, eating its own stored fat!

I think - but don't know - that Inka's idea might help.  If it doesn't though - I seriously think you need more or different diabetes medication.  That doesn't mark failure by any means - some bodies need more help than others is all it is.


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## TinaD (Jan 10, 2021)

Thanks Inka - I think we are on the same wave length. 
I have been trying a range of proteins (wild duck, farmed duck, Welsh lamb, beef roast or grilled or fried with cream and pepper, fish - baked with egg, cream and cheese, in parcel with butter etc, yoghurt and nuts, curry, chinese, turkey stuffed courgetes, slow cooked pork etc, but I find myself heading back to chicken because of its low calories count. Usually about 100-175g raw weight. As for veggies it tends to be keep the onions low, leeks, garlic, ginger, celerariac (amazingly low given it is a root), courgette, cabbage, broccoli, water cress, spinach, lettuce, rocket, cucumber a few raspberries occsionally if I can fit the carbs. Zero grains. 
I try to restrict added fat if the base protein is fatty (duck/pork/lamb/ribeye etc) to 4 or 5 grams altho' that may go up to 30g if I have a wokfull of veggies - it is only there as a hunger preventative - a limit not a target and, as I have no gall bladder, I see no purpose in adding as if it was a calorie freebie which could overwhelm the system. Cannot see any difference - mostly the BG just  goes up and takes a very long time to decline, quite often rises between 2hr and 3 hr testing and sometimes at 4 hrs (costing a fortune in strips).,.
It was rising between 2 or 3 points post-food now its going 4-5 or even 6 post food - or at least by midmorning/mid afternoon/mid evening if it isn't the food which is doing it. Take my steroids first thing in the morning having done my FBG. The only thing which pushed it up earlier was yoghurt so I hunted about for the one with the lowest carbs (Fage 3g per 100g). Didn't make much difference. I've rather gone off eggs and coffee but other than that and droping spuds, pasta, rice, bread, root veggies, porage, root veggies, my diet is almost as varied as it was pre-diagnosis.  Looking back in my food diary/BG record, there seems to be litle or no change except to the BG. Given thw weight loss I was hopefu to see the results going the other way as my liver and pancreas stopped being silly and started listening to each other.


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## TinaD (Jan 10, 2021)

trophywench said:


> Well the body can make glucose from protein and fat, so to compare how much where Carb = 100%, Protein = c 40% and Fat = c 10%.  It doesn't actually do it whenever it gets enough carb not to have to bother to do it though, cos it finds it too much work.
> 
> It has been doing the latter ever since you drastically cut down on carbs, eating its own stored fat!
> 
> I think - but don't know - that Inka's idea might help.  If it doesn't though - I seriously think you need more or different diabetes medication.  That doesn't mark failure by any means - some bodies need more help than others is all it is.


Well, it may be eating its own stored fat but it doesn't seem as voracious as I would like - or I would now be falling through nicks in the pavement.  I am not on medication - i am diet controlled except that the ccntrol seems to have run into problems  recently. What I am looking to find out is why so that I can make alteration. I was so peeved with my pancreas this afternoon that I sent it a large, fresh, fruit salad to  deal with - the first in 5 months. Expected the swine to have conniptions but instead it returned me a 9.1 at 2 hours - rather lower than it had responded to the modest 2 chicken wings with green leafy veg at the preceding meal. At 4 hours that fruit and cream is behaving just like a meat and leafy greens meal has done recently - it hasn't dropped at all and I suspect it will not do so until 5-7 hours have elapsed. I am completely flummoxed.  Added Monday: It did drop to 7.4 by 22.57 (3mins to 11) - the fruit salad was consumed at 16.40 (20 to 5).


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## everydayupsanddowns (Jan 24, 2021)

Looks like you were diagnosed last year @TinaD?

Just wondering if your weight loss and significant diet changes may be masking some diabetes stuff going on behind the scenes that would have been far more obvious if you were eating regular-western-diet carbs?

Eg if you were LADA not T2. LADA is a slow onset autoimmune diabetes where there can still be enough functioning beta cells at diagnosis to respond to T2 meds and/or major carb reductions, until the ongoing beta-cell destruction by the immune system tips the balance and your body can’t cope any more


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## TinaD (Jan 24, 2021)

everydayupsanddowns said:


> Looks like you were diagnosed last year @TinaD?
> 
> Just wondering if your weight loss and significant diet changes may be masking some diabetes stuff going on behind the scenes that would have been far more obvious if you were eating regular-western-diet carbs?
> 
> Eg if you were LADA not T2. LADA is a slow onset autoimmune diabetes where there can still be enough functioning beta cells at diagnosis to respond to T2 meds and/or major carb reductions, until the ongoing beta-cell destruction by the immune system tips the balance and your body can’t cope any more


Thank you for your response. Yes - diagnosed on 6/8/20. LADA is a nasty thought which has been lurking at the back of my mind - firmly repressed by my determination to get into remission. I have my fingers crossed that it is T2 and that I helped it on its way with a very high carb diet during the first lockdown (meat was hard to access as I was shielding given steroid reduced immune system). Currently, after a poor 10 days when even my FBG rose above its earlier normal (or nearly so) levels I seem to be back on song at the moment - recording a FBG decline over the past 3 days (5.5,5.4.4.9) and better evening results. This a.m. 2 hrs after breakfast 5.4. So another day of pricked fingers to see how lunch/dinner go. Local medical support is not "cuttinge edge" (or indeed available at the moment due to Covid) so I am much obliged for input from the experienced members of this forum.


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## Ljc (Jan 24, 2021)

TinaD said:


> Thank you for your response. Yes - diagnosed on 6/8/20. LADA is a nasty thought which has been lurking at the back of my mind - firmly repressed by my determination to get into remission. I have my fingers crossed that it is T2 and that I helped it on its way with a very high carb diet during the first lockdown (meat was hard to access as I was shielding given steroid reduced immune system). Currently, after a poor 10 days when even my FBG rose above its earlier normal (or nearly so) levels I seem to be back on song at the moment - recording a FBG decline over the past 3 days (5.5,5.4.4.9) and better evening results. This a.m. 2 hrs after breakfast 5.4. So another day of pricked fingers to see how lunch/dinner go. Local medical support is not "cuttinge edge" (or indeed available at the moment due to Covid) so I am much obliged for input from the experienced members of this forum.



I thought you might like to hear from someone who has LADA.
Brief history is in my signature below. As you can see I have only recently been dx with LADA , though I have obviously had it for a few decades. I actually guessed I had LADA back in 2016 after going into insulin .

Please don’t panic about LADA, it is no worse than any other type of diabetes , eventually medication may be needed , it often responds to T2 medications, sometimes for a very long time as it did with me.

If you are worried about  insulin,  I went onto insulin in 2016 , tbh it has made my life much easier in some respects, yes their are a few downsides, though not many, but their are far more benefits .


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## TinaD (Jan 24, 2021)

Ljc said:


> I thought you might like to hear from someone who has LADA.
> Brief history is in my signature below. As you can see I have only recently been dx with LADA , though I have obviously had it for a few decades. I actually guessed I had LADA back in 2016 after going into insulin .
> 
> Please don’t panic about LADA, it is no worse than any other type of diabetes , eventually medication may be needed , it often responds to T2 medications, sometimes for a very long time as it did with me.
> ...


Thank you. I am still struggling with the idea of accepting diabetes of any kind. It just seems all too much to add to the other conditions I have and the wretched pills I have to take for them.  Also I am horrified at the thought of injecting myself- I am still surprised that I can bring myself to use a mini lancet - I can cope with pain but not inflicting it on myself! It was good of you to spell out your experience of developing LADA and your positive response to insulin. If the continued weight loss doesn't fix me I guess I shall have to come around to accepting it and I hope I can do so as gracefully as you and many others on here.


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## trophywench (Jan 24, 2021)

Well damn good news then @TinaD - insulin jabs (approx 99 x out of 100) are utterly painless these days.  Many many times I've had to look to even know the needle's in me!


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## TinaD (Jan 24, 2021)

trophywench said:


> Well damn good news then @TinaD - insulin jabs (approx 99 x out of 100) are utterly painless these days.  Many many times I've had to look to even know the needle's in me!


Whew - that's a comfort!


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## trophywench (Jan 24, 2021)

Usually the first time you know, is when the plastic 'collar' holding the needle itself into the next plastic bit which screws onto the pen, makes contact with the outside of your skin - and furthermore if you shove the needle in too forcefully, that plastic bit does hurt cos you're trying to get that into you too, if you don't reduce the force quick enough, since it's far too big to gain access!  ie User error LOL


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## Ljc (Jan 25, 2021)

Jenny is right, 99 X out if 100 it is utterly painless .
The devices we use (they are called pens) to inject ourselves is nothing like a syringe and needle that we’ve had vaccinations or blood tests with and the needles are very tiny , most of us use 4 or 5 mm ones, you can barely see them , so please don’t worry about insulin. 

Yes it does often seem like it’s one thing after another , some of us on here seem to like (not) collecting other conditions, you are in good company here.
xxx


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## TinaD (Feb 2, 2021)

Spot on Lin - nice to have company! Makes me think of the story by Jerome K, Jerome about reading a medical book and discovering he suffered from everything except Housemaid' Knee. Unable to understand the omission he visited his Dr and received the trenchant advice to eats steak, go for a long walk and not read books he didn't understand. Only I seem to pop in for a quick blood test and come out with something else - as I suspect do you!. 

Jenny - don't joke about willingly making holes in the integument - I am almost the only person I know who has reached her 70s without having her ears pierced (despite various surgeons having carved their nasty way though large tranches). I am gratefult to know it doesn't hurt but I can visualise the lingering horrified hesitation that would accompany my every injection!

Oh well, news not all bad:  after recent wobble, as I was having full blood count for spontaneous bleeding with poor clotting (normal results so they have no idea) I wangled a HbA1c at the same time. Apparently they were going to leave it a year, which seems a tad lackadaisical to me, but I wheedled and pled my vulnerable status for making additional visits...Happy to report that despite my recent wobbles in the BG department it has gone down - now 40 from 43 at 3 months to the day ago. So now to see if I can get it down to 36 and my blasted blood pressure down too. Hold the cake and candles - I am off to eat another duck...


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## trophywench (Feb 2, 2021)

Noooo - having my ears pierced ruddy well hurt!  Best part of 50 years ago and I still remember,  I tell the truth, me.


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## TinaD (Feb 15, 2021)

Has anyone else been reading the PREDICT paper produced by ZOE? Fascinating stuff about the microbiome and its effect on DM. I've pinged off a quick question to Diet Doctor about it as it seems to be pretty firmly against saturated fats, dairy and red meat. As if life hasn't enough miseries without suggesting I abandon sirloin...BG has settled down (mostly normal levels) and BP is also lower.


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## grovesy (Feb 16, 2021)

I have not read that paper but if you mean Dr. Tim Spector, I i have read his book The Diet Myth.


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## TinaD (Feb 16, 2021)

Yes, that is the bloke. He is participating in research into the microbiome under the umbrella of ZOE. It is a bit depressing about saturated fats and meat and their role in causation of disease which, for those of us "doing keto" or similar, raises quite a few questions.


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## AndBreathe (Feb 16, 2021)

@TinaD - if these changes are in the last couple of week, have you started a new pot, or a new batch of test strips in that time?  Occasionally (rarely), I have had the odd batch that is a bit,. erm,... odd and return erratic numbers?  Needless to say that's unhelpful.  Alternatively, have your strips and/or meter been stored in the very cold conditions of late?  I know some unoccupied rooms, even indoors can have got very cold in the recent cold snap.

If you have any other pots of strips, it would be useful to try them out - particularly if they are from a different batch.  The batch numbers are usually on the sides of the pots somewhere, as well as on the packaging.

Just a thought.


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## TinaD (Feb 16, 2021)

AndBreathe said:


> @TinaD - if these changes are in the last couple of week, have you started a new pot, or a new batch of test strips in that time?  Occasionally (rarely), I have had the odd batch that is a bit,. erm,... odd and return erratic numbers?  Needless to say that's unhelpful.  Alternatively, have your strips and/or meter been stored in the very cold conditions of late?  I know some unoccupied rooms, even indoors can have got very cold in the recent cold snap.
> 
> If you have any other pots of strips, it would be useful to try them out - particularly if they are from a different batch.  The batch numbers are usually on the sides of the pots somewhere, as well as on the packaging.
> 
> Just a thought.


An excellent thought. I keep my strips by the PC in the study. At night it probably, during hard frosts, drops to around 10-12c. I get a new batch every 2-3 weeks so, yes, I probably did have a new lot during the recent weird readings - currently my FBG is running between 4.2 and 5.2 and I am only going up between 1 and 3 points 2 hrs after a meal. Sounds as though it might be a good idea to broach a new tub when I have a few of the last lot left and see if there is any marked difference between the batches. Thanks for the suggestion. Down to 10mg of steroids so hopefully I will be one of the lucky ones who reverts to a non diabetic state once I am off them. Meanwhile the great diet continues...I have developed a waist again so hopefully it is "goodbye visceral fat, hello pancreas".


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## grovesy (Feb 16, 2021)

TinaD said:


> Yes, that is the bloke. He is participating in research into the microbiome under the umbrella of ZOE. It is a bit depressing about saturated fats and meat and their role in causation of disease which, for those of us "doing keto" or similar, raises quite a few questions.


I have read his book The Diet Myth and like we find with many on here, there is no on size fits all. He has done alot of research with Twins and even Indentical Twins don't react to the same food and have the same results, as their gut make up are differnt,


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## AndBreathe (Feb 16, 2021)

TinaD said:


> An excellent thought. I keep my strips by the PC in the study. At night it probably, during hard frosts, drops to around 10-12c. I get a new batch every 2-3 weeks so, yes, I probably did have a new lot during the recent weird readings - currently my FBG is running between 4.2 and 5.2 and I am only going up between 1 and 3 points 2 hrs after a meal. Sounds as though it might be a good idea to broach a new tub when I have a few of the last lot left and see if there is any marked difference between the batches. Thanks for the suggestion. Down to 10mg of steroids so hopefully I will be one of the lucky ones who reverts to a non diabetic state once I am off them. Meanwhile the great diet continues...I have developed a waist again so hopefully it is "goodbye visceral fat, hello pancreas".



To be honest, this is a decent first step if we have these befuddling variations.  Of course, it's not the answer to everything - by a long way, but it's a simple thing to tick off.  If it does transpire your strips are a bit adrift on the usual performance, you have the choice of moving onto another batch, or if the rises are pretty consistent, just do a mental calculation (add or subtract whatever you feel the average difference it) to get through what's left.

If you are using insulin or other medications that can drive down your blood sugars significantly, then please take care with the mental arithmetic and trends.

Well done on your progress so far.  This annoying condition throws us some unexpected puzzles sometimes.


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## TinaD (Feb 16, 2021)

grovesy said:


> I have read his book The Diet Myth and like we find with many on here, there is no on size fits all. He has done alot of research with Twins and even Indentical Twins don't react to the same food and have the same results, as their gut make up are differnt,


Yes, the PREDICT trial also uses twins and a very large number of other folk. It is, supposedly, the biggest trial into diet ever conducted. It reaches a number of conclusions, some of which are not comfortable for those doing keto. It also bases its findings on the idea that we are all in post-prandial state most of the time by setting out 3 meals a day plus at least 2 snacks. I doubt that is true of the chubbily challenged DM sufferer, some are OMAD, some 2 meals a day, some eat in a constrained window (IF), most avoid snacking. I could find no suggestion that such people were featured or distinguished in the trials. I quite like Spector (also bought and read  the Myth book) but he/the team seem to be reaching conclusions regarding DM based on a population which do not suffer from it.


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## grovesy (Feb 16, 2021)

Well I read the book and I did not take those things away from it, but I am not a Keto, Ultra  Low Carb, IF,or OMAD.


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## AndBreathe (Feb 16, 2021)

TinaD said:


> Yes, the PREDICT trial also uses twins and a very large number of other folk. It is, supposedly, the biggest trial into diet ever conducted. It reaches a number of conclusions, some of which are not comfortable for those doing keto. It also bases its findings on the idea that we are all in post-prandial state most of the time by setting out 3 meals a day plus at least 2 snacks. I doubt that is true of the chubbily challenged DM sufferer, some are OMAD, some 2 meals a day, some eat in a constrained window (IF), most avoid snacking. I could find no suggestion that such people were featured or distinguished in the trials. I quite like Spector (also bought and read  the Myth book) but he/the team seem to be reaching conclusions regarding DM based on a population which do not suffer from it.



To be clear, I haven't read The Diet Myth, but whatever approach an individual takes, their most important information is their own N1 data.  Obviously, one should research one's own approach, as well as other options, but I'm afraid what works for one may not work for another, whether that be LC, Keto, Paleo, Vegan or the Eatwell Guide.

Edited to add some resources comparing LC diets with some alternatives:  https://phcuk.org/healthy-eating-guidelines-weight-loss-advice-for-the-uk/


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## TinaD (Feb 16, 2021)

AndBreathe said:


> To be clear, I haven't read The Diet Myth, but whatever approach an individual takes, their most important information is their own N1 data.  Obviously, one should research one's own approach, as well as other options, but I'm afraid what works for one may not work for another, whether that be LC, Keto, Paleo, Vegan or the Eatwell Guide.
> 
> Edited to add some resources comparing LC diets with some alternatives:  https://phcuk.org/healthy-eating-guidelines-weight-loss-advice-for-the-uk/


I have to say that I find the phcuk org document full of excellent good sense. It also references papers which I have read relating to saturated fat which is why I was concerned to find the conclusions in Spector's research paper. It made me look harder at the methodology which is where I found the basis for the idea that we are in post-prandial mode for most of the day but nothing suggesting novel investigation of saturated fat. I haven't as yet had time to read the background research papers he prays in aid for his saturated fat view but it does seem to be inconsistent with other recent research.  I quite agree with you about individual solutions nonetheless it does no harm to see what the nutritionists etc are up to!


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