Why is Diabetes So Serious? - A to Z of the NHS - Dr Gill

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  • Опубликовано: 27 сен 2024

Комментарии • 121

  • @hrplbg
    @hrplbg 3 года назад +42

    It would be nice if you could add "Bookmarks" or "Time Tags" to identify different sections of your video.

    • @laurieinjapan
      @laurieinjapan 3 года назад +2

      Great idea! All you have to do is write the times on individual lines

  • @Heyitsalisa28
    @Heyitsalisa28 3 года назад +21

    I’ve been diagnosed with diabetes since I was 3 years old and at 24 I’m already starting to feel the effects of diabetes due to mismanagement in my teens. It is a serious and terrible disease

    • @DrJamesGill
      @DrJamesGill  3 года назад +4

      I'd hope that your consultant would be able to help reduce the effects

  • @TheASMRMedic
    @TheASMRMedic 3 года назад

    As a third medical student in London with an interest in ASMR (I know this isn’t exactly your main focus), this channel is just the best. I love being able to learn what I need to learn but also to relax. You mannerisms and demeanour as a clinician are great - the patients are always look relaxed and in super safe hands. Great admiration for what you do!

  • @dachickenman
    @dachickenman 3 года назад +23

    I would like a medical video explaining how ASMR works.

    • @DrJamesGill
      @DrJamesGill  3 года назад +14

      Maybe. Have a look at the video by @medlifecrisis he’s recently covered that

    • @sorou
      @sorou 3 года назад +1

      Medlife Crisis’ video on ASMR was great! He talks to James, other people around the medical field who are ASMR-affiliated, as well as current research into why it happens. Very informative!

    • @yunyun5139
      @yunyun5139 3 года назад

      Dr okouromi is the only Doctor who will never prescribe tabs/injections for DIABETES. This is medical miracle.

  • @GuyThatAlex
    @GuyThatAlex 3 года назад +6

    Love the medical news! A nice section to, what is becoming, my favourite Dr. Gill show!

  • @alexn5743
    @alexn5743 3 года назад +1

    "It's our show if we want to work something in we will be!"
    I like this mentality!

  • @sorou
    @sorou 3 года назад +1

    Love the A to Z videos, and they only seem to get better! Been very informative so far, and then once I’ve watched or listened all the way through once, it becomes the perfect sleep aid. Multi-use!

  • @kohinarec6580
    @kohinarec6580 3 года назад

    Very interesting and educational, even for a layman. I meet people with chronic illnesses on a regular basis and knowing about those ailments, treatments and hazards is important. This knowledge guides me and my colleagues in our decisions.
    I do not work in a medical field but we must know about that as well. It really helps.
    Edit.
    This is for laymen and women so... I guess I'm in the right place.

  • @ApatheticMeh
    @ApatheticMeh 3 года назад

    I'm learning so many things this morning, thank you doctors!
    Please never stop and keep educating us.

    • @DrJamesGill
      @DrJamesGill  3 года назад +1

      I genuinely feel that education is a calling, so whilst things are in a balance. We’ll keep going 😊

  • @sriyammohanty4961
    @sriyammohanty4961 3 года назад

    In India , A disease called Black Fungus is Rapidly Growing and Affecting lots of People , And it mainly Affecting diabetic patients , What to do Sir , and Ur work is Phenomenal ❤️ , Lots of Love From India 🙏🏻❤️❤️❤️🔥

  • @will-dt1ui
    @will-dt1ui 3 года назад +1

    Dr Gill, these are getting better and better. Please keep at it.

    • @DrJamesGill
      @DrJamesGill  3 года назад

      Thanks. I think the new editor helped this a lot

  • @busybuddy013
    @busybuddy013 3 года назад

    I didn't think I could like Dr. Gill's explanations any more than I already do, but then we all saw the way he talked about the diabetes drug. And now that I noticed his socks aren't matching. I'm hooked. I just want to show all my friends from med school who used to make fun of me for mismatched socks (or perfectly matched as I'd like to say) that a famous doctor is doing it too!!

    • @DrJamesGill
      @DrJamesGill  3 года назад +1

      🤣🤣 I just don’t see the benefit it taking time to match socks - UNLESS I’m talking about specific activity socks, like hiking or cycling socks

  • @sammie7513
    @sammie7513 3 года назад +3

    I don’t think it’s best idea that the GP said used the word cured when speaking of remission.
    anecdote - My mum long time diabetic, lost a considerable amount of weight, achieved remission and stopped meds for the first time in years, her DN told her she was cured / no longer diabetic
    My mum maintained the weightloss and didn’t think she needed to see her health team after this as she no longer considered herself diabetic, 4 years years later, one morning she woke up with severely blurred vision, went back to the GP her BGs and a1c were very high.
    “cured” can make people believe they don’t have to continue their care, remember weightloss even if maintained isn’t always a permanent fix.

    • @DrJamesGill
      @DrJamesGill  3 года назад +1

      It’s a reasonable point. However in the UK, we would not stop doing yearly bloods for monitoring, which would reduce the chance of such events
      And although we recall the patients, they can still ignore things.
      I think there is a a balance to be had won both sides, and the words we chose are often patient specific

    • @sammie7513
      @sammie7513 3 года назад +2

      @@DrJamesGill She was definitely still invited to her yearly appointments, but she no longer saw them as necessary, it’s like that word “cured” was all she needed to hear to enable her to not go to appointments that she never liked going to in the first place. Some of your patients might take your words in absolute terms leading to “why would I go to dietetic checks when I’m no longer diabetic” attitudes. It’s mostly on them but then some people don’t need much of an excuse.
      I’ve recently, April this year was diagnosed myself after becoming symptomatic in my late 20’s, I figured though my endocrinologist and GP are there as great support, this is mostly on me, so I researched as much as I can to help with my understanding
      I also joined the diabetes Reddit, with tens of thousands of members on there it seemed a good resource, I posted about achieving remission when I don’t want to lose weight to do so, my bmi is 24 and I have been encouraged to lose 10%, so around a stone, I’ll try but I bet I’ll gain it back, 10 stone seems to be my default, so I don’t really want to deal with the inevitable yo-yo dieting personally. What do you do when something maybe good for you physically but not the best for you mentally?
      The general consensus of everybody that commented was remission is rubbish, you’re either diet controlled diabetic or medication controlled, it’s just a term doctors like use when stopping medications but doesn’t mean the root problem is any better itself.
      They all said they got their A1C down, low carbing but shortly after reintroducing moderate carbs they started to see hyperglycaemia.
      I got my A1C from 108 to 32, keto, didn’t lose any weight other than water weight week one, which was expected as I wasn’t in a calorie deficit but I did manage raise my LDL to 3.6 🙄 I’ve added carbs back, I’d missed them and I saw the other night a 18 mmol reading, 2 hours after eating rice and was still on 14 mmol the following morning, that’s after stopping gliclazide, but still treating with trulicity and metformin.
      I was told if my next A1C if low would indicate I was in remission but the root problem hasn’t gotten any better really, despite what my blood test results show.

  • @96MasterOfPuppets96
    @96MasterOfPuppets96 3 года назад +7

    Watches while eating two warmed triple chocolate cookies with whipped cream on top 👁️👄👁️

    • @DrJamesGill
      @DrJamesGill  3 года назад +4

      dent, sounds very nice - need high days and holidays

    • @49ers_red_and_gold2
      @49ers_red_and_gold2 3 года назад +1

      And now your no longer with us 😢

  • @charmingresignation
    @charmingresignation 3 года назад +9

    I just shouted my family from downstairs: “James & Andy have a new one!”
    We watch A-Z of the NHS over supper now; a great way to get my lawyer parents to understand why I love medicine so much. Thank you both so much!!

    • @DrJamesGill
      @DrJamesGill  3 года назад +2

      That’s brilliant to hear 😊 😊 thanks, and hi to the family!

  • @normanjeans2798
    @normanjeans2798 3 года назад +2

    random note because i love etymology, "diabetes" is from greek, but "mellitus" is from latin :)

    • @DrJamesGill
      @DrJamesGill  3 года назад +2

      Ah there we go! Thanks for that! 😊

  • @LoganDC100
    @LoganDC100 3 года назад

    Hopefully (possible) helpful comment? I have Type II diabetes. I started using a continuous blood glucose monitoring system a few years ago. (I won't say which one, since there are several options.) After three months, my A1C dropped from just under 14 to just under 7. I hope this makes sense -- I rather quickly learned that if I eat THAT, it will have THAT impact on my blood glucose levels, and I can a) alter my food choices, or b) adjust my insulin dose in advance to accommodate whatever I've decided to eat. It helps and, honestly? It both lets me, and makes me, interpose conscious thought into the whole process. The feeling of having some degree of control of what happens is perhaps more psychologically helpful than most people may realize. Plus, those A1C numbers weren't too bad, either.

  • @peteperic1783
    @peteperic1783 10 месяцев назад +1

    Hi could you please cover ploymyalgia rheumatic for us all

  • @alejandrocastillo5771
    @alejandrocastillo5771 3 года назад

    Hello from Texas amazing content as always and please leave the part of the medical news greatly appreciate it. From an RN studying to become a FNP thank you for the videos. I often look at your videos both for clinical skills and discussing cases. 👍

    • @DrJamesGill
      @DrJamesGill  3 года назад

      Thanks. That’s great feedback

  • @49ers_red_and_gold2
    @49ers_red_and_gold2 3 года назад +1

    Diabetes run high in my family, this is why I eat clean and watch my weight, trying to stay around 200 pounds at 5'10 💪🏿

    • @DrJamesGill
      @DrJamesGill  3 года назад +3

      Very sensible. Forward looking is the best way 😊

  • @B137-w2c
    @B137-w2c 3 года назад +1

    Great job

    • @DrJamesGill
      @DrJamesGill  3 года назад

      Thanks. I think the edit was a big improvement, but we need to tighten the videos up still

  • @Tdhydfbbjjr
    @Tdhydfbbjjr 3 года назад +1

    Thank you! Great video! Is there anyway you could do a video on mental health?

    • @DrJamesGill
      @DrJamesGill  3 года назад +2

      It is in the pipe line 😊

  • @lewisgardner1660
    @lewisgardner1660 3 года назад

    I have diabetes type two with IBS I am 18 stone I am told to lose weight but it is very hard with the IBS because if my stomach starts to get empty I feel u well so eat to help the IBS pain go away even tho I am not at all hungry, in turn making the sugars rise, my diabetic nurse said I was feeding the insulin but I am feeding the IBS, it’s a battle of circles

  • @ianmurphy9955
    @ianmurphy9955 3 года назад

    I needed to see this, I've not been managing my diabetes for 5 months now, lockdown hasn't made it easy to keeo up weight loss

  • @momtomtse
    @momtomtse 3 года назад

    Excellent information explained so clearly, thank you 😊

  • @Vipertw
    @Vipertw 3 года назад

    waiting on the discussion on the link between Celiac (Coeliac), diabetes and hypothyroidism. ;)

  • @DominikusIII
    @DominikusIII 3 года назад +1

    Very educative material, especially for the "diabetes newbies". One question Dr Gill regarding type 1 diabetes. Is it actually possible to cure it by transplating one's pancreas? I suffer from it myself and still wonder day after day if that's doable. Or somehow by maybe messing with the genes or the immune system?

  • @aksinfinitygaming1148
    @aksinfinitygaming1148 3 года назад

    Hmm... my blood sugar keeps dipping with no answer but yet diabetes is in my family, both types. My A1C is normal, hemoglobin normal within range, but I keep dipping (going dangerously low) and going high at random. I tried diet change and other things. This video is informative and educational. Certainly drew my attention as a biology major with a passion in medicine.

    • @DrJamesGill
      @DrJamesGill  3 года назад +1

      Hypoglycaemia isn’t diabetes, but is often due to the medications there. There can be other conditions which cause hypos however, and it should be investigated

    • @aksinfinitygaming1148
      @aksinfinitygaming1148 3 года назад

      What kind of medications can set off hypoglycemia?

  • @AdiAbdurab
    @AdiAbdurab 3 года назад +2

    Hi Dr. Gill, big fan - this was very informative. As an obese person, this adds ample perspective.
    A quick question, when you do demonstrate medical exams, would it be possible for you to share with us, the viewers, why you are testing specific parts for specific exams? For example, why would you test someone's reflexes during a neuro exam?

    • @DrJamesGill
      @DrJamesGill  3 года назад +1

      If you have a look at the “medicine explained” play list, you’ll find exactly that 😊
      Although they take a LOT more work, and I’m a little behind, but they are being down

    • @AdiAbdurab
      @AdiAbdurab 3 года назад

      @@DrJamesGill thank you very much. I'll do exactly that.

  • @Cindee-Schnitman
    @Cindee-Schnitman 3 года назад

    When you guys get to E’s can you please tell me what you know about epilepsy. I would like to get off medication someday. 😔

  • @piledriver2021
    @piledriver2021 3 года назад

    That is a top quality video! Thank you

    • @DrJamesGill
      @DrJamesGill  3 года назад

      Thanks. I think this is one of the strongest we’ve done 😊

  • @medecinturc
    @medecinturc 3 года назад

    God,protect everyone from this disease. It's awful...

  • @AquilaTheHun
    @AquilaTheHun Год назад +1

    You didn't talk about statin induced diabetes.

    • @DrJamesGill
      @DrJamesGill  Год назад

      Because it is INCREDIBLY rare.
      It’s rarer than a lupus like syndrome which can occur in statins.
      In fact statin induced diabetes is so rare, and see if so infrequently we don’t have any good numbers on how actually how rare it is

    • @AquilaTheHun
      @AquilaTheHun Год назад

      @@DrJamesGill Well, with all due respect, James, not in my personal experience (as a patient with a researcher mind). Also, there are numerous articles about the strong correlation between newly developed T2DM plus of course IR - and statin therapy. Even the leaflet in the meds box calls attention to this. I am really surprised that you said it was extremely rare. Well, I understand that doctors are usually informed by studies of pharmaceutical companies (it IS impossible for a physician to PERSONALLY follow up patients in such a detailed manner, it is impossible to closely monitor their lives 24/7 so where else would they obtain information from...). My fasting glucose level increased by 1 (mmol/l) since I started rosuvastatin and I am only taking low dose of it (2.5 mg /day). It's not yet by definition diabetes but the tendency is worrying. Because I already have IR and IGT (had it before statin). It had happened when I tried statin therapy earlier. When I stopped it, glucose went back down.

  • @hbh7868
    @hbh7868 3 года назад

    Quite enjoyed this

  • @luuucaaas
    @luuucaaas 3 года назад +5

    Just wanted to note about the portion of this video regarding endometriosis - it isn’t only women who can have endometriosis. I’m sure there was no malice intended, but it’s worth pointing out that using gendered language in regards to endometriosis can have a genuine negative impact to those who are not women who suffer with it. Source: I am a man with endometriosis. Definitely interesting to hear about this new drug though, thanks for sharing!

  • @sntslilbosshd8783
    @sntslilbosshd8783 3 года назад

    What happened to Aidan cross ?

  • @deaosatori216
    @deaosatori216 Год назад +1

    Should this vid be titled "type 2" diabetes, instead? Not much talk of type one here

    • @DrJamesGill
      @DrJamesGill  Год назад +1

      True. But both are equally serious, although as you say, it’s only type 2 that a patient can have a huge personal impact in mitiagting

  • @fuzirecon7197
    @fuzirecon7197 3 года назад

    Gettin ready to use this to go to sleep 😅😂

  • @MsTheo1989
    @MsTheo1989 3 года назад +1

    Totally unrelated.... I swear I just want to marry Dr Gill 😭😭 Then he can do ASMR on me for the rest of my life 💖

  • @egolica3060
    @egolica3060 3 года назад

    Dr. Gill is it true that diabetes can be reversed or that is just a myth?

    • @DrJamesGill
      @DrJamesGill  3 года назад

      In some people YES it can be. But unfortunately not everyone

  • @daphnerodriguez9980
    @daphnerodriguez9980 3 года назад

    YES METFORMIN GLIPIZIDE DAPHNE COTTON ALWAYS 💜,

  • @finnenmans5843
    @finnenmans5843 3 года назад

    Lets gooo

  • @AJ_real
    @AJ_real 3 года назад

    Dr, surely you can get out for a haircut now? Haven't things opened up in the UK.

    • @DrJamesGill
      @DrJamesGill  3 года назад

      This was filmed about 6 weeks ago. Not been able to get it sorted before
      I’m ready for my second haircut now!!

  • @MrCharlieCrow
    @MrCharlieCrow 3 года назад

    Subtitles in spanish please :(

    • @DrJamesGill
      @DrJamesGill  3 года назад

      They should auto generate soon

  • @Cindee-Schnitman
    @Cindee-Schnitman 3 года назад

    Brits like their booze. 🤭 what is the correlation between alcohol and diabetes?

  • @XX-gy7ue
    @XX-gy7ue 3 года назад

    DON'T CUT THAT HAIR , AND IF YOU DO , GIVE THE LOCKS TO YOUR FANS !

  • @williamwinder3466
    @williamwinder3466 3 года назад +3

    My Great Grandfather had Diabetes. By the time the doctors told him they had to cut of his last limb he just wanted to die.

    • @DrJamesGill
      @DrJamesGill  3 года назад +2

      I’m so sorry about that. This is one of the worst points of diabetes

  • @BestTroIl
    @BestTroIl 2 года назад +1

    Dr. Gill, I have enjoyed watching your vid's they are both informative and pleasant to listen while I do other things.

    • @DrJamesGill
      @DrJamesGill  2 года назад

      Thank you for that. I’m always grateful when people find a benefit from them 😊

  • @ASMRIrish
    @ASMRIrish 3 года назад +1

    My SO has suffered from endometriosis for many years now. I really hope new treatments or clinical trials become available to Irish citizens soon. I believe the drug they are trialing is DCA; Sodium Dichloroacetate

  • @benisaten
    @benisaten 3 года назад +2

    Another first class video Dr. Gill. 👍 This type of information and education is extremely valuable to the general public. Respects from 🇨🇦.

  • @tonky9572
    @tonky9572 3 года назад +1

    Would like to see endometriosis!!!!!!!

    • @DrJamesGill
      @DrJamesGill  3 года назад +1

      We’re recording that next week 😊
      We’re got the D’s in the bag.

  • @dezzadiggler3693
    @dezzadiggler3693 3 года назад +1

    These presentations are superb! Far better than the rubbish on mainstream TV now; (Reality and other 'celeb' junk!)

    • @DrJamesGill
      @DrJamesGill  3 года назад +1

      Thanks. We’re trying to make them more engaging. Slow, but getting go there 😊

  • @idraote
    @idraote 3 года назад +1

    I am obese and I thought I would have blood tests and a talk with a specialist to make sure.
    That was about february 2020...
    As I'm getting my first vaccine shot in a few days, I'm thinking about rescheduling those tests.

    • @DrJamesGill
      @DrJamesGill  3 года назад +2

      Certainly speak to your GP and get checked in the community.
      As a rough guide, we tend only to refer to the specialists if we can’t handle it in GP land

    • @idraote
      @idraote 3 года назад

      @@DrJamesGill I live in Italy and our GPs usually (and unfortunately) only treat very minor conditions. For everything else, they refer patients to the relevant specialist.
      I think it is a rather sad state of things, but one needs to adapt.
      Thank you for the informative video, it motivated me to take action.

  • @tjardahope
    @tjardahope 3 года назад +1

    would you like to share the link on that article with that drug that may help with endometriosis. would really like to read that. maybe something I can try as an option with my gp.

    • @DrJamesGill
      @DrJamesGill  3 года назад +2

      The medication is still in trial in Edinburgh so I don’t think you’ve get far currently
      The original paper from 2019 is here
      www.pnas.org/content/116/51/25389

    • @tjardahope
      @tjardahope 3 года назад

      only had found this. is still a study
      www.researchgate.net/publication/350026797_Dichloroacetate_as_a_possible_treatment_for_endometriosis-associated_pain_a_single-arm_open-label_exploratory_clinical_trial_EPiC

  • @daphnerodriguez9980
    @daphnerodriguez9980 3 года назад

    THANKS YOU GOODNESS 🌟 YES LOW SUGAR STROKE DAPHNE COTTON ALWAYS 💜,❤️🖤💚🤎 FAMILY,

  • @snookerjam
    @snookerjam 3 года назад

    Damn. Im running 3 adblock systems and still see ads in youtube. Wht??!!!@#$

  • @ben_imaging
    @ben_imaging 3 года назад

    I would watch a review of medical news every week. Could even be a podcast.

  • @zachz699
    @zachz699 3 года назад

    It’s ok I brought the depression
    😁

  • @jayjayb89
    @jayjayb89 3 года назад

    Welcome to PutABitOfPaper News... I'm Dr Gill

  • @gonzaloleyvacantu5865
    @gonzaloleyvacantu5865 3 года назад

    Thank you for this informative video. It helps me understand my condition a lot better.

    • @DrJamesGill
      @DrJamesGill  3 года назад

      Glad you found it helpful 😊

  • @johnathanleonardo912
    @johnathanleonardo912 3 года назад

    So can diabetes lead into amputation? Heard that from somewhere. I could be wrong

    • @DrJamesGill
      @DrJamesGill  3 года назад +1

      Yes. When training I have PERSONALLY done those amputations.
      Diabetes can be horrific

    • @johnathanleonardo912
      @johnathanleonardo912 3 года назад

      I would feel so sorry for that individual. Cutting thru the muscles and bone. And can cause blindness too. It is horrific and BTW you respond fast so thank you. And you probably explained that in the video so I asked a question before watching it. My apologies

  • @Ok-qh7zf
    @Ok-qh7zf 3 года назад

    Top 👏

  • @contouredfife4735
    @contouredfife4735 3 года назад

    I have type 1 diabetes and I can’t stand people who have type 2 diabetes due to weight specifically.
    Its fucking annoying listening to people sook when they can fix it when I don’t have a choice.
    If you have type 2 diabetes and reading this loose weight. Stop making excuses.

    • @DrJamesGill
      @DrJamesGill  3 года назад

      In some cases, even a large percentage weight is a huge factor, but not the only factor.
      I’m going to leave this comment here, to ask that you consider the effects it might have
      On a personal level has my gran, who has a BMI of 21, has had type 2 diabetes since the age of 55
      It is frustrating when people who do have medical issues don’t access or accept help and approaches that would improve their conditions, but each person has to be looked at as an individual, and broad generalisations will only ever result in harm

    • @contouredfife4735
      @contouredfife4735 3 года назад

      That’s why is said “weight specifically” age is the other big factor and obviously that can’t be helped I’m more talking people who are around my age (24ish) with diabetes type 2 who use it as an excuse to not be able to do things when it is entirely their fault (yes sure genetics blah blah) but it makes me incredibly resentful to listen to someone blatantly refuse to exercise or eat healthy and then try and play victim when it suits them when I didn’t get that choice and I work out 5 days a week
      (My HBA1C is 5.5 I take 7 needles a day of insulin and 7-8 blood tests)

    • @DrJamesGill
      @DrJamesGill  3 года назад +1

      But this is my point. We can’t make that sweep.
      I’ll have two patients, but both a BMI of 50, one has diabetes the other doesn’t.
      Weight is certainly a trigger, but not the whole story.
      Unfortunately people are emotional creatures, and react against logic repeatedly. Highlighting weight issues, is the same as pressuring people over smoking, rather than having a positive effect, we more often have paradoxical outcomes (trust me, it drives me crazy when I treat a patient who smokes, and has almost a monthly chest infection DUE to the smoking - BUT as much as I may want, taking a negative or agrees I’ve approach towards their smashing health behaviour will not improve matters)

    • @DrJamesGill
      @DrJamesGill  3 года назад +1

      I do completely sympathise with yourself, with a disease that has such control over your life and is unlikely due to any action yourself.
      The control of type i is so much harder than with type ii.
      Given the differences I have actually had colleagues - and I do agree - that the two diseases really should be separated.
      Perhaps keep Diabetes Mellitus, and have chronic pancreatic failure for the old type I. That simple name change might serve to highlight the differences and that huge differences in impact level

    • @contouredfife4735
      @contouredfife4735 3 года назад

      @@DrJamesGill your right.
      I am just incredibly angry and have an incredibly low tolerance to excuses so it’s probably a good thing your the doctor.
      I appreciate your sympathy
      And 100% yes they need to be separated they are different.

  • @jerkweaselTHEsequel
    @jerkweaselTHEsequel 3 года назад

    Why are you villainizing carbohydrates? You say the problem is linked to excessive fat in the body? If you over eat carbohydrates it will turn to fat. But starving your body of carbohydrates isn't healthy either surely.

    • @DrJamesGill
      @DrJamesGill  3 года назад

      Carbs turn to fat. It’s not actually the food, but how the body responds.
      Carbs cause insulin spikes, which causes resistance, the excess carbs then become fat, causing further resistance
      I’m completely against attacking any particularly food group HOWEVER in the West we have such a poor relationship with food we have to use REALLY big brush strokes to start of with 😊