52 Small Changes – by Brett Blumenthal
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We see a lot of books that exhort us to get a six-pack in a month, change our life in 7 days, learn Japanese in 24 hours. The reality is, things take time!
Brett Blumenthal is more realistic while being just as motivational:
The idea is simple… Make one small change per week for 52 weeks, and at the end of the year, you’ll be healthier and happier.
At 10almonds, we’re big fans of small changes that add up (or rather: compound!) to make big differences, so this one’s absolutely our style!
Best of all, she offers us not just “do this” advice, but also “and here’s the information and resources you’ll need to make this change work the best it can for you”
The advices range in topic from nutrition to exercise to sleep to mental wellness to interpersonal stuff and more. The biggest focus is on personal health, though, with small changes to exercise and nutrition making up the lion’s share of the changes.
Bottom line: this is a book you’ll want to grab once a week. Consider setting a reminder on your phone to check in with it each Sunday, for example!
Take the first step and order “52 Small Changes” from Amazon today!
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Brown Rice Protein: Strengths & Weaknesses
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I had a friend mention that recent research showed Brown Rice Protein Powder can be bad for you, possibly impacting your nutrient absorption. Is this true? I’ve been using it given it’s one of the few plant-based proteins with a full essential amino acid profile!❞
Firstly: we couldn’t find anything to corroborate the “brown rice protein powder [adversely] impacts nutrient absorption” idea, but we suspect that the reason for this belief is: brown rice (not brown rice protein powder) contains phytic acid, which is something of an antinutrient, in that it indeed reduces absorption of various other nutrients.
However, two things are important to note here:
- the phytic acid is found in whole grains, not in protein isolates as found in brown rice protein powder. The protein isolates contain protein… Isolated. No phytates!
- even in the case of eating whole grain rice, the phytic acid content is greatly reduced by two things: soaking and heating (especially if those two things are combined) ← doing this the way described results in bioavailability of nutrients that’s even better than if there were just no phytic acid, albeit it requires you having the time to soak, and do so at temperature.
tl;dr = no, it’s not true, unless there truly is some groundbreaking new research we couldn’t find—it was almost certainly a case of an understandable confusion about phytic acid.
Your question does give us one other thing to mention though:
Brown rice indeed technically contains all 9 essential amino acids, but it’s very low in several of them, most notably lysine.
However, if you use our Tasty Versatile Rice Recipe, the chia seeds we added to the rice have 100x the lysine that brown rice does, and the black pepper also boosts nutrient absorption.
Because your brown rice protein powder is a rice protein powder and not simply rice, it’s possible that they’ve tweaked it to overcome rice’s amino acid deficiencies. But, if you’re looking for a plant-based protein powder that is definitely a complete protein, soy is a very good option assuming you’re not allergic to that:
Amino Acid Compositions Of Soy Protein Isolate
If you’re wondering where to get it, you can see examples of them next to each other on Amazon here:
Brown Rice Protein Powder | Soy Protein Isolate Powder
Enjoy!
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The Oh She Glows Cookbook – by Angela Liddon
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Let’s get the criticism out of the way first: notwithstanding the subtitle promising over 100 recipes, there are about 80-odd here, if we discount recipes that are no-brainer things like smoothies, sides such as for example “roasted garlic”, or meta-ingredients such as oat flour (instructions: blend the oats and you get oat flour).
The other criticism is more subjective: if you are like this reviewer, you will want to add more seasonings than recommended to most of the recipes. But that’s easy enough to do.
As for the rest: this is a very healthy cookbook, and quite wide-ranging and versatile, with recipes that are homely, with a lot of emphasis on comfort foods (but still, healthy), though certainly some are perfectly worthy of entertaining too.
A nice bonus of this book is that it offers a lot of available substitutions (much like we do at 10almonds), and also ways of turning the recipe into something else entirely with just a small change. This trait more than makes up for the slight swindle in terms of number of recipes, since some of the recipes have bonus recipes snuck in.
Bottom line: if you’d like to broaden your plant-based cooking range, this book is a fine option for expanding your repertoire.
Click here to check out The Oh She Glows Cookbook, and indeed glow!
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What Are “Adaptogens” Anyway? (And Other Questions Answered)
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I tried to use your calculator for heart health, and was unable to enter in my height or weight. Is there another way to calculate? Why will that field not populate?❞
(this is in reference to yesterday’s main feature “How Are You, Really? And How Old Is Your Heart?“)
How strange! We tested it in several desktop browsers and several mobile browsers, and were unable to find any version that didn’t work. That includes switching between metric and imperial units, per preference; both appear to work fine. Do be aware that it’ll only take numerical imput, though.
Did anyone else have this problem? Let us know! (You can reply to this email, or use the handy feedback widget at the bototm)
❝I may have missed it, but how much black pepper provides benefits?❞
So, for any new subscribers joining us today, this is about two recent main features:
As for a daily dosage of black pepper, it varies depending on the benefit you’re looking for, but:
- 5–20mg of piperine is the dosage range used in most scientific studies we looked at
- 10mg is a very common dosage found in many popular supplements
- That’s the mass of piperine though, so if taking it as actual black pepper rather than as an extract, ½ teaspoon is considered sufficient to enjoy benefits.
❝I loved the health benefits of pepper. I do not like pepper. Where can I get it as a supplement?❞
You can simply buy whole black peppercorns and take a few with water as though they were tablets. Your stomach acid will do the rest. Black pepper is also good for digestion, so taking it with a meal is best.
You can buy piperine (black pepper extract) by itself as a supplement in powder form, but if you don’t like black pepper, you will probably not like this powder either. We couldn’t find it readily in capsule form.
You can buy piperine (black pepper extract) as an adjunct to other supplements, with perhaps the most common/popular being turmeric capsules that also contain 10mg (or more) piperine per capsule. Shop around if you like, but here’s one that has 15mg piperine* per capsule, for example.
*They call it “Bioperine®” but that is literally just piperine. Same goes if you see “Absorbagen™”, it’s still just piperine.
❝What do you mean when you say that something is adaptogenic?❞
Simple version: it means it helps the body adapt to stress, by adjusting the body’s natural responses. Thus, adaptogenic supplements can be contrasted with tranquilizing drugs that mask stress by brute force, for example.
Technical version: adaptogenic activity refers to improving physiological stress resilience, such as by moderating and modulating hypothalamic–pituitary–adrenal axis signaling, and/or by regulating levels of endogenic compounds involved in the cellular stress response.
Read more (technical version):
Read more (simple version):
European Medicines Agency’s Reflection Paper On The Adaptogenic Concept
Enjoy!
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Which Bell Peppers To Pick?
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Bell Peppers: A Spectrum Of Specialties
We were going to do this as part of our ongoing “This Or That?” challenge, but as there are four main types all with many different benefits, we thought this bunch of fruits deserved a main feature.
And yes, they’re botanically fruits, even if culinarily used as vegetables—much like tomatoes, famously!
They’re all the same (but also very much not)
A thing to know is that whether bell peppers be green, yellow, orange, or red, they’re all the same plant, Capiscum anuum. All that differs is how early or late they’re harvested.
Notwithstanding the “Capiscum” genus, they don’t contain capsaicin (as is found in hot peppers). Capsaicin’s a wonderful phytochemical:
Capsaicin For Weight Loss And Against Inflammation
…but today we’re all about the bell peppers.
So, let’s see how they stack up!
💚 Green for lutein
Lutein is especially important for the eyes and [the rest of the] brain, to the point that there’s now an Alzheimer’s test that measures lutein concentration in the eye:
Green peppers have most of this important carotenoid, though the others all have some too. See also:
💛 Yellow for vitamin C
Yellow peppers are technically highest in vitamin C, but all of them contain far more than the daily dose per fruit already, so if there’s any color of pepper that’s nutritionally the most expendable, it’s yellow, since any other color pepper can take its place.
Watch out, though! Cooking destroys vitamin C, so if you want to get your Cs in, you’re going to want to do it raw.
🧡 Orange for zeaxanthin and cryptoxanthins
Similar in their benefits to lutein, these antioxidant carotenoids are found most generously in orange peppers (20x as much as in yellow, 10x as much as in red, and slightly more than in green).
❤️ Red for vitamins A & B6
Red peppers are richest by far in vitamin A, with one fruit giving the daily dose already. The others have about 10% of that, give or take.
Red peppers also have the most vitamin B6, though the others also have nearly as much.
❤️ Red for lycopene
We must do a main feature for lycopene sometime, as unlike a lot of antioxidant carotenoids, lycopene is found in comparatively very few foods (most famously it’s present in tomatoes).
Red is the only color of pepper to have lycopene.
10almonds tip: to get the most out of your lycopene, cook these ones!
Lycopene becomes 4x more bioavailable when cooked:
Lycopene in tomatoes: chemical and physical properties affected by food processing ← this paper is about tomatoes but lycopene is lycopene and this applies to the lycopene in red peppers, too
And the overall winner is…
You! Because you get to eat all four of them
Enjoy!
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The Purple Parsnip’s Bioactive Brain Benefits (& more)
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This Root Might Be A Guardian Angel
Sometimes we go searching for supplements to research; sometimes supplements present themselves for examination! In this case, our attention was grabbed by a headline:
Angelica gigas extract emerges as a potential treatment for vascular disease
Angelica who?
Angelica gigas, also called the purple parsnip (amongst other names), is a flowering plant native to Korea. It has assorted medicinal properties, and in this case, it was its heart-healthy benefits that were making news:
❝Ultimately, this study presents clearly evidence that Angelica gigas extract is a promising natural product-based functional food/herbal medicine candidate for preventing or regulating hyperlipidemic cardiovascular complications❞
But it has a lot more to offer…
The root has various bioactive metabolites, but the compounds that most studies are most interested in are decursin and decursinol, for their neuroprotective and cognitive enhancement effects:
❝[C]rude extracts and isolated components from the root of A. gigas exhibited neuroprotective and cognitive enhancement effects.
Neuronal damage or death is the most important factor for many neurodegenerative diseases.
In addition, recent studies have clearly demonstrated the possible mechanisms behind the neuroprotective action of extracts/compounds from the root of A. gigas.❞
That middle paragraph there? That’s one of the main pathogenic processes of Alzheimer’s, Parkinson’s, Huntington’s, and Multiple Sclerosis.
Angelica gigas attenuates (reduces the force of) that process:
❝The published reports revealed that the extracts and isolated components from the root of A. gigas showed neuroprotective and cognitive enhancement properties through various mechanisms such as anti-apoptosis, antioxidative actions, inhibiting mRNA and protein expressions of inflammatory mediators and regulating a number of signaling pathways.
In conclusion, the A. gigas root can serve as an effective neuroprotective agent by modulating various pathophysiological processes❞
Read more: Neuroprotective and Cognitive Enhancement Potentials of Angelica gigas Nakai Root: A Review
Beyond neuroprotection & cognitive enhancement
…and also beyond its protection against vascular disease, which is what got our attention…
Angelica gigas also has antioxidant properties, anti-cancer properties, and general immune-boosting properties.
We’ve only so much room, so: those links above will take you to example studies for those things, but there are plenty more where they came from, so we’re quite confident in this one.
Of course, what has antioxidant properties is usually anti-inflammatory, anti-cancer, and anti-aging, because these things are reliant on many of the same processes as each other, with a lot of overlap.
Where can we get it?
We don’t sell it, but here’s an example product on Amazon, for your convenience
Enjoy!
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A New $16,000 Postpartum Depression Drug Is Here. How Will Insurers Handle It?
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A much-awaited treatment for postpartum depression, zuranolone, hit the market in December, promising an accessible and fast-acting medication for a debilitating illness. But most private health insurers have yet to publish criteria for when they will cover it, according to a new analysis of insurance policies.
The lack of guidance could limit use of the drug, which is both novel — it targets hormone function to relieve symptoms instead of the brain’s serotonin system, as typical antidepressants do — and expensive, at $15,900 for the 14-day pill regimen.
Lawyers, advocates, and regulators are watching closely to see how insurance companies will shape policies for zuranolone because of how some handled its predecessor, an intravenous form of the same drug called brexanolone, which came on the market in 2019. Many insurers required patients to try other, cheaper medications first — known as the fail-first approach — before they could be approved for brexanolone, which was shown in early trials reviewed by the FDA to provide relief within days. Typical antidepressants take four to six weeks to take effect.
“We’ll have to see if insurers cover this drug and what fail-first requirements they put in” for zuranolone, said Meiram Bendat, a licensed psychotherapist and an attorney who represents patients.
Most health plans have yet to issue any guidelines for zuranolone, and maternal health advocates worry that the few that have are taking a restrictive approach. Some policies require that patients first try and fail a standard antidepressant before the insurer will pay for zuranolone.
In other cases, guidelines require psychiatrists to prescribe it, rather than obstetricians, potentially delaying treatment since OB-GYN practitioners are usually the first medical providers to see signs of postpartum depression.
Advocates are most worried about the lack of coverage guidance.
“If you don’t have a published policy, there is going to be more variation in decision-making that isn’t fair and is less efficient. Transparency is really important,” said Joy Burkhard, executive director of the nonprofit Policy Center for Maternal Mental Health, which commissioned the study.
With brexanolone, which was priced at $34,000 for the three-day infusion, California’s largest insurer, Kaiser Permanente, had such rigorous criteria for prescribing it that experts said the policy amounted to a blanket denial for all patients, according to an NPR investigation in 2021.
KP’s written guidelines required patients to try and fail four medications and electroconvulsive therapy before they would be eligible for brexanolone. Because the drug was approved only for up to six months postpartum, and trials of typical antidepressants take four to six weeks each, the clock would run out before a patient had time to try brexanolone.
An analysis by NPR of a dozen other health plans at the time showed Kaiser Permanente’s policy on brexanolone to be an outlier. Some did require that patients fail one or two other drugs first, but KP was the only one that recommended four.
Miriam McDonald, who developed severe postpartum depression and suicidal ideation after giving birth in late 2019, battled Kaiser Permanente for more than a year to find effective treatment. Her doctors put her on a merry-go-round of medications that didn’t work and often carried unbearable side effects, she said. Her doctors refused to prescribe brexanolone, the only FDA-approved medication specifically for postpartum depression at the time.
“No woman should suffer like I did after having a child,” McDonald said. “The policy was completely unfair. I was in purgatory.”
One month after NPR published its investigation, KP overhauled its criteria to recommend that women try just one medication before becoming eligible for brexanolone.
Then, in March 2023, after the federal Department of Labor launched an investigation into the insurer — citing NPR’s reporting — the insurer revised its brexanolone guidelines again, removing all fail-first recommendations, according to internal documents recently obtained by NPR. Patients need only decline a trial of another medication.
“Since brexanolone was first approved for use, more experience and research have added to information about its efficacy and safety,” the insurer said in a statement. “Kaiser Permanente is committed to ensuring brexanolone is available when physicians and patients determine it is an appropriate treatment.”
“Kaiser basically went from having the most restrictive policy to the most robust,” said Burkhard of the Policy Center for Maternal Mental Health. “It’s now a gold standard for the rest of the industry.”
McDonald is hopeful that her willingness to speak out and the subsequent regulatory actions and policy changes for brexanolone will lead Kaiser Permanente and other health plans to set patient-friendly policies for zuranolone.
“This will prevent other women from having to go through a year of depression to find something that works,” she said.
Clinicians were excited when the FDA approved zuranolone last August, believing the pill form, taken once a day at home over two weeks, will be more accessible to women compared with the three-day hospital stay for the IV infusion. Many perinatal psychiatrists told NPR it is imperative to treat postpartum depression as quickly as possible to avoid negative effects, including cognitive and social problems in the baby, anxiety or depression in the father or partner, or the death of the mother to suicide, which accounts for up to 20% of maternal deaths.
So far, only one of the country’s six largest private insurers, Centene, has set a policy for zuranolone. It is unclear what criteria KP will set for the new pill. California’s Medicaid program, known as Medi-Cal, has not yet established coverage criteria.
Insurers’ policies for zuranolone will be written at a time when the regulatory environment around mental health treatment is shifting. The U.S. Department of Labor is cracking down on violations of the Mental Health Parity and Addiction Equity Act of 2008, which requires insurers to cover psychiatric treatments the same as physical treatments.
Insurers must now comply with stricter reporting and auditing requirements intended to increase patient access to mental health care, which advocates hope will compel health plans to be more careful about the policies they write in the first place.
In California, insurers must also comply with an even broader state mental health parity law from 2021, which requires them to use clinically based, expert-recognized criteria and guidelines in making medical decisions. The law was designed to limit arbitrary or cost-driven denials for mental health treatments and has been hailed as a model for the rest of the country. Much-anticipated regulations for the law are expected to be released this spring and could offer further guidance for insurers in California setting policies for zuranolone.
In the meantime, Burkhard said, patients suffering from postpartum depression should not hold back from asking their doctors about zuranolone. Insurers can still grant access to the drug on a case-by-case basis before they formalize their coverage criteria.
“Providers shouldn’t be deterred from prescribing zuranolone,” Burkhard said.
This article is from a partnership that includes KQED, NPR and KFF Health News.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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