10 Ways To Self-Soothe That Don’t Involve Food Or Drink
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If one is accustomed to comfort-eating or drowning one’s sorrows, what are the alternatives that can actually work? Holistic nutritionist Selin Bilgin has a list:
Self-Care That’s Not Self-Sabotage
You might want to make a note of these 10 things, so they can be a sort of “menu” for you when you need them:
- Give your introversion or extroversion what it needs (e.g. alone time to decompress, or social activities)
- Treat your senses: often we don’t actually need food/drink so much as culinary entertainment. So, we can sate this sensory mood in other ways, for example pleasant candles, flowers, and so forth.
- Bathe/shower nicely: it’s cliché but some personal pampering can go a long way
- Beautify yourself: it’s also cliché, but a makeover evening has its place
- Move! Go for a walk, do some yoga, whatever suits you, but move your body.
- Make movie nights luxurious: instead of making it about food/drink, focus on creating an enjoyable atmosphere
- Physically release tension: at 10almonds we recommend progressive relaxation for this!
- Create something: whether it’s art, craft, baking, or something else, creativity feels good
- Tackle things you’ve been procrastinating: this one doesn’t seem like self-soothing from the front end, but from the back end (i.e., having done it), it makes a big difference!
- Journal: expressing your thoughts and feelings can help a lot—really.
For more on each of these, enjoy:
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Want to learn more?
You might also like to read:
- The Mental Health First-Aid That You’ll Hopefully Never Need
- Rebalancing Dopamine (Without “Dopamine Fasting”)
- Self-Care That’s Not Just Self-Indulgence
Take care!
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HRT: Bioidentical vs Animal
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HRT: A Tale Of Two Approaches
In yesterday’s newsletter, we asked you for your assessment of menopausal hormone replacement therapy (HRT).
- A little over a third said “It can be medically beneficial, but has some minor drawbacks”
- A little under a third said “It helps, but at the cost of increased cancer risk; not worth it”
- Almost as many said “It’s a wondrous cure-all that makes you happier, healthier, and smell nice too”
- Four said “It is a dangerous scam and a sham; “au naturel” is the way to go”
So what does the science say?
Which HRT?
One subscriber who voted for “It’s a wondrous cure-all that makes you healthier, happier, and smell nice too” wrote to add:
❝My answer is based on biodentical hormone replacement therapy. Your survey did not specify.❞
And that’s an important distinction! We did indeed mean bioidentical HRT, because, being completely honest here, this European writer had no idea that Premarin etc were still in such wide circulation in the US.
So to quickly clear up any confusion:
- Bioidentical hormones: these are (as the name suggests) identical on a molecular level to the kind produced by humans.
- Conjugated Equine Estrogens: such as Premarin, come from animals. Indeed, the name “Premarin” comes from “pregnant mare urine”, the substance used to make it.
There are also hormone analogs, such as medroxyprogesterone acetate, which is a progestin and not the same thing as progesterone. Hormone analogs such as the aforementioned MPA are again, a predominantly-American thing—though they did test it first in third-world countries, after testing it on animals and finding it gave them various kinds of cancer (breast, cervical, ovarian, uterine).
A quick jumping-off point if you’re interested in that:
Depot medroxyprogesterone acetate and the risk of breast and gynecologic cancer
this is about its use as a contraceptive (so, much lower doses needed), but it is the same thing sometimes given in the US as part of menopausal HRT. You will note that the date on that research is 1996; DMPA is not exactly cutting-edge and was first widely used in the 1950s.
Similarly, CEEs (like Premarin) have been used since the 1930s, while estradiol (bioidentical estrogen) has been in use since the 1970s.
In short: we recommend being wary of those older kinds and mostly won’t be talking about them here.
Bioidentical hormones are safer: True or False?
True! This is an open-and-shut case:
❝Physiological data and clinical outcomes demonstrate that bioidentical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts.
Until evidence is found to the contrary, bioidentical hormones remain the preferred method of HRT. ❞
Further research since that review has further backed up its findings.
Source: Are Bioidentical Hormones Safer or More Efficacious than Other Commonly Used Versions in HRT?
So simply, if you’re going on HRT (estrogen and/or progesterone), you might want to check it’s the bioidentical kind.
HRT can increase the risk of breast cancer: True or False?
Contingently True, but for most people, there is no significant increase in risk.
First: again, we’re talking bioidentical hormones, and in this case, estradiol. Older animal-derived attempts had much higher risks with much lesser efficaciousness.
There have been so many studies on this (alas, none that have been publicised enough to undo the bad PR in the wake of old-fashioned HRT from before the 70s), but here’s a systematic review that highlights some very important things:
❝Estradiol-only therapy carries no risk for breast cancer, while the breast cancer risk varies according to the type of progestogen.
Estradiol therapy combined with medroxyprogesterone, norethisterone and levonorgestrel related to an increased risk of breast cancer, estradiol therapy combined with dydrogesterone and progesterone carries no risk❞
In fewer words:
- Estradiol by itself: no increased risk of breast cancer
- Estradiol with MDPA or other progestogens that aren’t really progesterone: increased risk of breast cancer
- Estradiol with actual progesterone: back to no increased risk of breast cancer
So again, you might want to make sure you are getting actual bioidentical hormones, and not something else!
However! If you are aware that you already have an increased risk of breast cancer (e.g. family history, you’ve had it before, you know you have certain genes for it, etc), then you should certainly discuss that with your doctor, because your personal circumstances may be different:
❝Tailored HRT may be used without strong evidence of a deleterious effect after ovarian cancer, endometrial cancer, most other gynecological cancers, bowel cancer, melanoma, a family history of breast cancer, benign breast disease, in carriers of BRACA mutations, after breast cancer if adjuvant therapy is not being used, past thromboembolism, varicose veins, fibroids and past endometriosis.
Relative contraindications are existing cardiovascular and cerebrovascular disease and breast cancer being treated with adjuvant therapies❞
Source: HRT in difficult circumstances: are there any absolute contraindications?
HRT makes you happier, healthier, and smell nice too: True or False?
Contingently True, assuming you do want its effects, which generally means the restoration of much of the youthful vitality you enjoyed pre-menopause.
The “and smell nice too” was partly rhetorical, but also partly literal: our scent is largely informed by our hormones, and higher estrogen results in a sweeter scent; lower estrogen results in a more bitter scent. Not generally considered an important health matter, but it’s a thing, so hey.
More often, people take menopausal HRT for more energy, stronger bones (reduced osteoporosis risk), healthier heart (reduced CVD risk), improved sexual health, better mood, healthier skin and hair, and general avoidance of menopause symptoms:
Read more: Skin, hair and beyond: the impact of menopause
We’d need another whole main feature to discuss all the benefits properly; today we’re just mythbusting.
HRT does have some drawbacks: True or False?
True, and/but how serious they are (beyond the aforementioned consideration in the case of an already-increased risk of breast cancer) is a matter of opinion.
For example, it is common to get a reprise of monthly cramps and/or mood swings, depending on how one is taking the HRT and other factors (e.g. your own personal physiology and genetic predispositions). For most people, these will even out over time.
It’s also even common to get a reprise of (much slighter than before) monthly bleeding, unless you have for example had a hysterectomy (no uterus = no bleeding). Again, this will usually settle down in a matter of months.
If you experience anything more alarming than that, then indeed check with your doctor.
HRT is a dangerous scam and sham: True or False?
False, simply. As described above, for most people they’re quite safe. Again, talking bioidentical hormones.
The other kind are in the most neutral sense a sham (i.e. they are literally sham hormones), though they’re not without their merits and for many people they may be better than nothing.
As for being a scam, biodentical hormones are widely prescribed in the many countries that have universal healthcare and/or a single-payer healthcare system, where there would be no profit motive (and considerable cost) in doing so.
They’re prescribed because they are effective and thus reduce healthcare spending in other areas (such as treating osteoporosis or CVD after the fact) and improve Health Related Quality of Life, and by extension, health-adjusted life-years, which is one of the top-used metrics for such systems.
See for example:
Our apologies, gentlemen
We wanted to also talk about testosterone therapy for the andropause, but we’ve run out of room today (because of covering the important distinction of bioidentical vs old-fashioned HRT)!
To make it up to you, we’ll do a full main feature on it (it’s an interesting topic) in the near future, so watch this space
Ladies, we’ll also at some point cover the pros and cons of different means of administration, e.g. pills, transdermal gel, injections, patches, pessaries, etc—which often have big differences.
That’ll be in a while though, because we try to vary our topics, so we can’t talk about menopausal HRT all the time, fascinating and important a topic it is.
Meanwhile… take care, all!
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Slowing the Progression of Cataracts
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Understanding Cataracts
Cataracts are natural and impact everyone.
That’s a bit of a daunting opening line, but as Dr. Michele Lee, a board-certified ophthalmologist, explains, cataracts naturally develop with age, and can be accelerated by factors such as trauma, certain medications, and specific eye conditions.
We know how important your vision is to you (we’ve had great feedback about the book Vision for Life) as well as our articles on how glasses impact your eyesight and the effects of using eye drops.
While complete prevention isn’t possible, steps such as those mentioned below can be taken to slow their progression.
Here is an overview of the video’s first 3 takeaways. You can watch the whole video below.
Protect Your Eyes from Sunlight
Simply put, UV light damages lens proteins, which (significantly) contributes to cataracts. Wearing sunglasses can supposedly prevent up to 20% of cataracts caused by UV exposure.
Moderate Alcohol Consumption
We all, at some level, know that alcohol consumption doesn’t do us any good. Your eye health isn’t an exception to the rule; alcohol has been shown to contribute to cataract development.
If you’re looking at reducing your alcohol use, try reading this guide on lowering, or eradicating, alcohol consumption.
Avoid Smoking
Smokers are 2-3 times more likely to develop cataracts. Additionally, ensure good ventilation while cooking to avoid exposure to harmful indoor smoke.
See all 5 steps in the below video:
How was the video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!
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How Internal Organs Can Be Affected By Spicy Foods (Doctor Explains)
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Capsaicin has an array of health-giving properties in moderation, but consumed in immoderation and/or without building up tolerance first, can cause problems—serious health issues such as heart attacks, brain spasms, torn esophagus, and even death can occur.
Heating up
Capsaicin, the compound that gives peppers their “heat”, is a chemical irritant and neurotoxin that activates pain receptors (TRPV1) tricking the brain into sensing heat, leading to a burning sensation, sweating, and flushing. The pain signal can also trigger the fight-or-flight response, causing a surge of adrenaline. Endorphins are eventually released, creating a pain-relief effect similar to a runner’s high, and ultimately it reduces systemic inflammation, boosts the metabolism, and increases healthy longevity.
However, in cases of extreme consumption and/or lack of preparation, woe can befall, for example:
- A man ruptured his esophagus after vomiting from eating a ghost pepper.
- A participant experienced severe brain blood vessel constriction (reversible cerebral vasoconstriction syndrome) after eating a Carolina reaper.
- A 25-year-old suffered permanent heart damage from cayenne pepper pills due to restricted blood flow.
- A teenager died after the “one chip challenge,” although the cause of death was undetermined.
So, what does moderation and preparation look like?
Moderation can be different to different people, since genetics do play a part—some people have more TRPV1 receptors than other people. However, for all people (unless in case of having an allergy or similar), acclimatization is important, and a much bigger factor than genetics.
Writer’s anecdote: on the other hand, when my son was a toddler I once left the room and came back to find him cheerfully drinking hot sauce straight from the bottle, so it can be suspected that genetics are definitely relevant too, as while I did season his food and he did already enjoy curries and such, he didn’t exactly have a background of entering chili-eating competitions.
Still, regardless of genes (unless you actually have a medical condition that disallows this), a person who regularly eats spicy food will develop an increasing tolerance for spicy food, and will get to enjoy the benefits without the risks, provided they don’t suddenly jump way past their point of tolerance.
On which note, in this video you can also see what happens when Dr. Deshauer goes from biting a jalapeño (relatively low on the Scoville heat scale) to biting a Scotch bonnet pepper (about 10x higher on the Scoville heat scale):
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Want to learn more?
You might also like to read:
Capsaicin For Weight Loss And Against Inflammation
Take care!
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The Other Alzheimer’s Risk Factor
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The usually-listed 7 known risk factors of dementia (in general, not just Alzheimer’s) do not include today’s item. For a recap, those were:
The 7 Known Risk Factors For Dementia
The bonus risk factor
This idea is not completely novel; it’s been known for a while that traumatic brain injury (TBI) can increase the risk of dementia, but it has generally been chalked up to “if you damage an organ, then that organ does not function so well afterwards”.
However, in the case of Alzheimer’s, it seems there’s something deeper at play. Specifically, a study that found…
❝…traumatic brain injury alters the small vessels in the brain, resulting in an accumulation of amyloid beta—a hallmark of Alzheimer’s disease.
The findings suggest that vascular dysfunction could be an early driver in neurodegenerative disorders rather than being caused by neuronal damage.❞
This association held true even in quite young patients!
The study from Sweden looked at brain tissue from TBI patients (who had had to have brain tissue removed for medical reasons due to bleeding and swelling), and found that the (traumatic) changes to the vascular smooth muscle cells were associated with increased aggregation of amyloid-β.
In terms of establishing cause and effect: since it could be safely concluded the amyloid-β had not caused the TBI (which all had external explanations such as “car crash” or such), it can be deduced that almost* certainly the TBI caused the amyloid-β aggregation.
*because little to nothing in science is every truly certain. As in life in general, really; the difference is that scientists admit it!
You may be wondering: what was the control? It would be a very generous group of citizens indeed who would volunteer bits of their brains that hadn’t needed removing. However, the answer is that the control brain bits came from a biobank, and were from uninjured patients with no history of TBI or neurodegenerative disorders, and who had died from systemic, unrelated causes. Having been dead for a matter of hours, and the fixation time for the brain bits from the living people taking long enough that everybody’s brain bits had been out of their respective living bodies for a similar length of time, this was deemed an acceptable, if imperfect, control.
You can read the study in its entirety here; it is fascinating:
The practical take-away
The practical take-away, of course, is: look after your brain
Not just in the sense of eat fiber, get healthy fats, move more, get good sleep, stay intellectually stimulated, etc*, but also in the sense of “keep your brain physically safe”.
Now, you may think that you already try not to get into car crashes, and perhaps you do not compete in contact sports, but do be aware that one of the leading causes of TBI in older people is, ignominiously, falling down.
And if you think “that only happens to older/other people”, then be aware: there’s a first time for everything and you are not immune. With that in mind, do check out:
Fall Special! ← the seasonal title notwithstanding, this is about not falling down in the first place, and being less injurable if you do fall down
*This was a modest and vague list for brevity’s sake, so for much more detail, enjoy:
How To Reduce Your Alzheimer’s Risk ← this is rather more comprehensive
Want to know more?
Here you can read about the largest study of its kind into lifestyle factors and Alzheimer’s disease:
Alzheimer’s Causative Factors To Avoid ← the methods and conclusions of Dr. David Snowdon’s famous “Nun Study”
Take care!
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Semaglutide’s Surprisingly Unexamined Effects
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Semaglutide’s Surprisingly Big Research Gap
GLP-1 receptor agonists like Ozempic, Wegovy, and other semaglutide drugs. are fast becoming a health industry standard go-to tool in the weight loss toolbox. When it comes to recommending that patients lose weight, “Have you considered Ozempic?” is the common refrain.
Sometimes, this may be a mere case of kicking the can down the road with regard to some other treatment that it can be argued (sometimes even truthfully) would go better after some weight loss:
How weight bias in health care can harm patients with obesity: Research
…which we also covered in fewer words in the second-to-last item here:
But GLP-1 agonists work, right?
Yes, albeit there’s a litany of caveats, top of which are usually:
- there are often adverse gastrointestinal side effects
- if you stop taking them, weight regain generally ensues promptly
For more details on these and more, see:
…but now there’s another thing that’s come to light:
The dark side of semaglutide’s weight loss
In academia, “dark” is often used to describe “stuff we don’t have much (or in some cases, any) direct empirical evidence of, but for reasons of surrounding things, we know it’s there”.
Well-known examples include “dark matter” in physics and the Dark Ages in (European) history.
In the case of semaglutide and weight loss, a review by a team of researchers (Drs. Sandra Christenen, Katie Robinson, Sara Thomas, and Dominique Williams) has discovered how little research has been done into a certain aspect of GLP-1 agonist’s weight loss effects, namely…
Dietary changes!
There’s been a lot of popular talk about “people taking semaglutide eat less”, but it’s mostly anecdotal and/or presumed based on parts of the mechanism of action (increasing insulin production, reducing glucagon secretions, modulating dietary cravings).
Where studies have looked at dietary changes, it’s almost exclusively been a matter of looking at caloric intake (which has been found to be a 16–39% reduction), and observations-in-passing that patients reported reduction in cravings for fatty and sweet foods.
This reduction in caloric intake, by the way, is not significantly different to the reduction brought about by counselling alone (head-to-head studies have been done; these are also discussed in the research review).
However! It gets worse. Very few studies of good quality have been done, even fewer (two studies) actually had a registered dietitian nutritionist on the team, and only one of them used the “gold standard” of nutritional research, the 24-hour dietary recall test. Which, in case you’re curious, you can read about what that is here:
Dietary Assessment Methods: What Is A 24-Hour Recall?
Of the four studies that actually looked at the macros (unlike most studies), they found that on average, protein intake decreased by 17.1%. Which is a big deal!
It’s an especially big deal, because while protein’s obviously important for everyone, it’s especially important for anyone trying to lose weight, because muscle mass is a major factor in metabolic base rate—which in turn is much important for fat loss/maintenance than exercise, when it comes to how many calories we burn by simply existing.
A reasonable hypothesis, therefore, is that one of the numerous reasons people who quit GLP-1 agonists immediately put fat back on, is because they probably lost muscle mass in amongst their weight loss, meaning that their metabolic base rate will have decreased, meaning that they end up more disposed to put on fat than before.
And, that’s just a hypothesis and it’s a hypothesis based on very few studies, so it’s not something to necessarily take as any kind of definitive proof of anything, but it is to say—as the researchers of this review do loudly say—more research needs to be done into this, because this has been a major gap in research so far!
Any other bad news?
While we’re talking research gaps, guess how many studies looked into micronutrient intake changes in people taking GLP-1 agonists?
If you guessed zero, you guessed correctly.
You can find the paper itself here:
What’s the main take-away here?
On a broad, scoping level: we need more research!
On a “what this means for individuals who want to lose weight” level: maybe we should be more wary of this still relatively new (less than 10 years old) “wonder drug”. And for most of those 10 years it’s only been for diabetics, with weight loss use really being in just the past few years (2021 onwards).
In other words: not necessarily any need to panic, but caution is probably not a bad idea, and natural weight loss methods remain very reasonable options for most people.
See also: How To Lose Weight (Healthily!)
Take care!
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The Bare-Bones Truth About Osteoporosis
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In yesterday’s issue of 10almonds, we asked you “at what age do you think it’s important to start worrying about osteoporosis?”, and here’s the spread of answers you gave us:
The Bare-bones Truth About Osteoporosis
In yesterday’s issue of 10almonds, we asked you “at what age do you think it’s important to start worrying about osteoporosis?”, and here’s the spread of answers you gave us:
At first glance it may seem shocking that a majority of respondents to a poll in a health-focused newsletter think it’ll never be an issue worth worrying about, but in fact this is partly a statistical quirk, because the vote of the strongest “early prevention” crowd was divided between “as a child” and “as a young adult”.
This poll also gave you the option to add a comment with your vote. Many subscribers chose to do so, explaining your choices… But, interestingly, not one single person who voted for “never” had any additional thoughts to add.
We loved reading your replies, by the way, and wish we had room to include them here, because they were very interesting and thought-provoking.
Let’s get to the myths and facts:
Top myth: “you will never need to worry about it; drink a glass of milk and you’ll be fine!”
The body is constantly repairing itself. Its ability to do that declines with age. Until about 35 on average, we can replace bone mineral as quickly as it is lost. After that, we lose it by up to 1% per year, and that rate climbs after 50, and climbs even more steeply for those who go through (untreated) menopause.
Losing 1% per year might not seem like a lot, but if you want to live to 100, there are some unfortunate implications!
About that menopause, by the way… Because declining estrogen levels late in life contribute significantly to osteoporosis, hormone replacement therapy (HRT) may be of value to many for the sake of bone health, never mind the more obvious and commonly-sought benefits.
On the topic of that glass of milk…
- Milk is a great source of calcium, which is useless to the body if you don’t also have good levels of vitamin D and magnesium.
- People’s vitamin D levels tend to directly correlate to the level of sun where they live, if supplementation isn’t undertaken.
- Plant-based milks are usually fortified with vitamin D (and calcium), by the way.
- Most people are deficient in magnesium, because green leafy things don’t form as big a part of most people’s diets as they should.
See also: An update on magnesium and bone health
Next most common myth: “bone health is all about calcium”
We spoke a little above about the importance of vitamin D and magnesium for being able to properly use that. But potassium is also critical:
Read more: The effects of potassium on bone health
While we’re on the topic…
People think of collagen as being for skin health. And it is important for that, but collagen’s benefits (and the negative effects of its absence) go much deeper, to include bone health. We’ve written about this before, so rather than take more space today, we’ll just drop the link:
We Are Such Stuff As Fish Are Made Of
Want to really maximize your bone health?
You might want to check out this well-sourced LiveStrong article:
Bone Health: Best and Worst Foods
(Teaser: leafy greens are in 2nd place, topped by sardines at #1—where do you think milk ranks?)
Don’t Forget…
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Learn to Age Gracefully
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