It can get better

I haven't posted yet in 2023 and wanted to remedy that. It has been a very busy year, mostly with running! I have discussed my running before but this year it has gone to another level. A Ledderhose patient that had to use a walking stick and weighed at least 19 stone at one point (probably more) is now one of the better runners in his area. I will try and make sure I post about my running elsewhere.

I am sure this won't mean much to people on here but I have broken my records for 10k, 5k and the half marathon with a sub 38, sub 18 and 1:25 (on a tough course) during this year. I have come 1st!!! at parkrun 4 times this year and when racing it (it is a run not a race but that doesn't stop us) have not been outside the top 10. 

My proudest achievement this year is running 2500 miles, a few years ago I attempted to run 2191 miles to raise money and awareness of the British Dupuytren's Society but I failed due to injury. This year I have surpassed 2700 miles and just had an amazing year. I won't rave about my running any more, I will post about that elsewhere but needless to say that if you are currently in pain with Ledderhose there can be a light at the end of the tunnel and people similar to yourselves have found a way out. 

My low carb diet

After my recent post on my thoughts on diets and their potential impact on the pathways that impact Dupuytren's and Ledderhose I had a few questions about what diet I am on exactly. The answer is a low-carb high fat diet. We do not follow any particular rules or book but have made up our own way of doing things that work for us and even I differ from what my wife has. The main difference between the 2 of us is that I avoid sweetener more than she does e.g. diet coke and low carb chocolate but I probably have a bit more fat e.g. in cream or leaving the fat on the bacon. 

Now I don't want to make this into a low carb blog but if there is any particular interest in this or in any of the recipes below and I think it will be beneficial then I might add some more but I think it is unlikely, after all this is the Ledderhose disease blog. 

To be honest most of the below is actually a case of making an alternative, different bread, ground almonds rather than flour, almond yogurt instead of normal and certainly never get low fat options for anything, cauliflower mash / rice rather than the normal. Breakfast is the most different as can have a fry up every day and we did for the first year that we were on the diet. 

Breakfasts: 

Low carb bacon sandwich - The bread is from Tom Kerridge book Dopamine diet and is mainly ground almond and flax seed based. 

Bacon, egg, leek and mushroom. 

Fruit, almond yogurt and nut butter 

Pizza Omelette

Lunch: (can use some of these breakfast)

Chicken salad

Tuna Mayo 

Bacon, chicken and mayo sandwich (same bread as above can be used to make lots of different sandwiches) 

Dinner:

Curry with cauliflower rice

Cottage pie (cauliflower mash) and packed with lots of veg e.g. cabbage, leek, mushroom, celery, radish, kale, spinach etc. 

Chilli 

Lasagna - lots of alternatives for pasta there is one that uses psyllium (sp?) husk or you can use leek or white radish. 

I have created a few Chinese dishes including chicken and cashew nuts, sweet and sour, egg fried cauliflower rice, chicken balls etc and you can have crispy duck. 

Puddings: We try to only use natural sweetened (by fruit)

Jelly and ice cream 

Fruit and yogurt 

Pear and raspberry low carb pie (pastry made with ground almonds and custard with no sugar)

Some thoughts on diets

I was actually thinking of doing a long well structured and scientific blog post on this as it is something I have been thinking about for some time and just wanted to see what everyone's thoughts were.

Of course I am not a doctor and I am not saying that doing a certain diet should be considered a treatment nor that you should start a diet or life-style change without giving it proper thought etc. Please do not see the below as me giving medical advice, as with everyone on this blog, it is just some research I have noticed and wanted to share.

We know from the various publications and research out there that insulin / diabetes and IGFs have an impact on DD (I have posted about this before see links below) and also that TNF is currently being looked into for clinical trials (https://ridd.octru.ox.ac.uk/). Would also say that with the later age of onset there is a higher chance that patients will have diabetes or at least early stage metabolic syndrome, it is also my understanding that TNF increases with age as well.

http://ledderhose.blogspot.co.uk/2012/02/igf-2-and-its-relationship-to.html

http://ledderhose.blogspot.co.uk/2014/09/calorie-restriction-to-help-dupuytrens.html (pictures seem to be gone!)

http://ledderhose.blogspot.co.uk/2012/04/is-there-really-link-between-diabetes.html

It is now fairly well established that a low carbohydrate diet can be used to control type II diabetes and actually, in some cases, can keep it under control without the need for insulin (should be monitored by a doctor). Low carb diets are also low GI as all high GI food would defeat the point of the life-style. Low GI diets have been shown to decrease TNF e.g.  https://www.ncbi.nlm.nih.gov/pubmed/21525252 and I have seen articles suggesting that many tumours rely on glucose and that a low carb diet is being tested as an assisted therapy to be used alongside other cancer treatments. Note that it is not as a treatment in its own right but rather to see if other treatments can be more successful when the patients diet is changed.

Given the above is it reasonable to suggest that a low carb, low GI diet could be used to try to delay the progression of DD/LD or as an adjunctive therapy with other treatments? Who knows as the study pool is limited enough already and finding patients willing to alter their diet may not be easy. I have also not, yet at least, researched this extensively.

I have also had quite a few comments from various people that undertaking a LC and or LGI diet has helped their condition. I am not suggesting for 1 second that a) it would work for everyone (potentially anyone) b) that a low carb diet itself is for everyone c) that everyone should go to the same level of carb intake as me and I also understand that I am probably biased but I personally do think that a low carb diet could increase the quality of life of many patients.

Maybe, depending on how this is received, I think it would perhaps be interesting to do a small survey on the patient community to see whether patients have noticed any impact of diet on their conditions. Again if results are good perhaps I could try and conduct a larger scale survey and get in touch some experts in various fields to gauge their interest.

Ultimately it is up to you to get all the information you can to find out what is the right treatment for you, of course this information should be gained from medical professionals and publications.

That Sugar Film

Some people may question the relevance of a post on a documentary about sugar on a blog about a rare foot condition however our health is all linked together and I have noticed a marked improvement in my overall well-being since removing sugar from my diet. 

The thing that annoys me however is the criticism I get for being on a low sugar, high fat diet. The science, despite what others may say, is firmly on my side and the theory it is all about calories in against calories out is wrong and the type of calories matter. A lot of my problems with sugar, with calories, with cholesterol and the modern take on these things are very well illustrated in That Sugar Film. 

Personally I recommend that anyone and everyone watch it, the problem is that those that most need to watch it will probably ignore it. The problem is that people think that fat people are just weak of mind when in fact their bodies are less able to process carbohydrates and this causes a host of problems many of which are on the insides of those that are not fat externally.

This post is hopefully going to be the start of me making a stand against sugar. I am fed up of people questioning my way of eating without looking at the evidence. I am proud to say that I am low-carb, healthier and fitter than ever and out of everyone I know I can honestly say I have the healthiest diet of everyone. Ask yourself this.. When did you last eat any of the following, cake, sweets, sugary drinks, fruit juice, bread (yes it is not healthy), beer etc. I can say I have not eaten them, at least in the conventional sugar filled sense, in 20 months and not wanted them for the best part of 18 months.   

In terms of the relevance to these conditions.. It is not known how the conditions are triggered other than the probably genetic element. It is highly likely, due to the reported link to diabetes and thyroid conditions etc, that there is also a hormonal element so I have to question whether I am myself to blame for the development of this painful condition in my foot. Did my sugar levels and poor eating trigger an epigenetic event that caused the onset of the condition. On top of this it was 100% sugar, or at least my inability to a) process it and b) control my eating of it that caused me to be overweight, well obese and certainly being overweight could have been a contributing factor towards the trauma that may have caused the beginnings of this condition. 

Of course the above is conjecture but That Sugar Film is a great way of getting a non-scientific audience to understand the issues at hand. Sugar is addictive and it is not healthy. I urge everyone to please watch this film, it is fairly cheap and I am sure it will be a real eye opening for most.  

UK - That Sugar Film

US - That Sugar Film

Ketogenic diet keeps cancer at bay?

I have probably mentioned this subject before, there is evidence that ketogenic or low carb diet may help to keep cancer at bay. I don't think anyone is suggesting it is a cure but rates of cancer have increased as a carbohydrate rich diet has become popular. Of course it is one of a multitude of factors including smoking, pollution, ageing etc and so you can not even begin to suggest that its involvement is a fact, it is purely speculation. Right from the start I am going to say that I am a massive advocate of a low-carb, high fat diet and feel that not many people are going to suffer from being on it and that many will suffer from not being on it. (I mean suffer in general not cancer).

Today I came across the following link

http://www.npr.org/sections/health-shots/2016/03/05/468285545/fighting-cancer-by-putting-tumor-cells-on-a-diet

I found this really interesting. Having previously worked in cancer research I do not agree with the mutations are not required as there is such a strong link between DNA damage, mutations and cancer. Nevertheless I do find the metabolic aspect of the report very interesting. The article states "the potential of dietary approaches to contain the disease."

Diet is being used to complement traditional approaches and this is a good idea. As I said the idea is that in order to sustain themselves the cancer cells need glucose, they need sugar otherwise they cannot sustain themselves. The thing with cancer cells is that they are growing out of control, they can't very easily (I am not qualified to say they can't at all) stop themselves from trying to replicate so they run out of energy and boom they struggle more than a normal cell would which can switch to using fat as its primary energy source and be happy. 

As is also stated in the article the problem is money. There is money in creating a drug that battles cancer there is no money in creating a diet, even if it is good for the patients. I think the same thing applies to diets in general as there is money in getting people hooked on sugar and there are so many companies that rely on this that a shift to a low carb diet by the masses would ruin them. Hence the reason there are many (failed? as there are not many publications) studies on high carb diets and not so many on high fat diets. 

Anyway I noticed after I started low carb that many things changed and one of these was the slight pain that still came from my foot. You could argue that it was the weight loss by the pain stopped well before I had lost significant amounts of weight, I strongly believe that Ledderhose is another of the many small (it is only a small issue for me since RT) medical issues that going low-carb has helped heal. 

There are actually pilot studies that show that patients have improved their situation using a low-carb diet: 

http://authoritynutrition.com/ketogenic-diets-and-cancer/ - Good review

I think there is room to see whether Dupuytren's and Ledderhose patients could see improvements under this way of eating. After all the conditions

• Involved tumours
• Are often progressive and painful so can be tracked by the patient
• Are not life threatening - so giving a diet a go is not going to hurt? 
• There is no cure - Currently there is no cure, there is no way to really stop the condition so giving this a try. 

I am not saying that patients should give it a try but I am saying based on the evidence it could be worth a go and perhaps they should track it so we can see the improvement. For me it was an unexpected side effect of trying to lose weight. 

Of course you should see your doctor and if you and they think radiotherapy (for example) is a better treatment option and you can afford it then don't put it off because you want to see if a diet could work. After all I don't think it could be a cure I just think it could help. 

Any thoughts? 

I have also found the following references: 

A low-carb diet kills tumor cells with a mutant p53 tumor suppressor gene

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3610718/

Dietary downregulation of mutant p53 levels via glucose restriction

Mechanisms and implications for tumor therapy

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3552926/