6-Minute Core Strength – by Dr. Jonathan Su
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We don’t normally do author biographies here, but in this case it’s worth noting that Dr. Su is a physiotherapist, military rehab expert, and an IAYT yoga therapist. So, these things together certainly do lend weight to his advice.
About the “6-minute” thing: this is in the style of the famous “7-minute workout” and “5 Minutes’ Physical Fitness” etc, and refers to how long each exercise session should take. The baseline is one such session per day, though of course doing more than one set of 6 minutes each time is a bonus if you wish to do so.
The exercises are focused on core strength, but they also include hip and shoulder exercises, since these are after all attached to the core, and hip and shoulder mobility counts for a lot.
A particular strength of the book is in troubleshooting mistakes of the kind that aren’t necessarily visible from photos; in this case, Dr. Su explains what you need to go for in a certain exercise, and how to know if you are doing it correctly. This alone is worth the cost of the book, in this reviewer’s opinion.
Bottom line: if you want core strength and want it simple yet comprehensive, this book can guide you.
Click here to check out 6-Minute Core Strength, and strengthen yours!
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Keep Cellulite At Bay
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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 😎
❝Does anything actually get rid of cellulite? Nothing seems to❞
Let’s get the bad news over with in one go:
Nothing (that the scientific world currently knows of) can get rid of cellulite permanently, nor completely guard against it proactively. Which, given that it affects up to 98% of women to some degree, and often shows up not long after puberty (though it can appear at any time and often increases later in life), any pre-emptive health regime would need to be started as a child in any case.
As with many things that predominantly affect women, the world of medicine isn’t entirely sure what causes it, let alone how to effectively treat it.
Obviously hormones are implicated, namely estrogen.
Obviously adiposity is implicated, because one can’t have dimples in one’s fat if one doesn’t have enough fat to dimple.
Other hypothesized contributory factors include genetics, poor diet, inactivity, unhealthy lifestyle (in ways not previously mentioned, e.g. use of alcohol, tobacco, etc), accumulated toxins, and pregnancy.
Here’s an old paper (from 2004); today’s reviews say pretty much the same thing, but we love how succinctly (albeit, somewhat depressingly) this abstract states how little we know and how little we can do:
Cellulite: a review of its physiology and treatment
However, all is not lost!
There are some things that can affect how much cellulite we get, and there are some things that can reduce it, and even some things that can get rid of it completely—albeit temporarily.
First, a quick refresher on what it actually is, physiologically speaking: cellulite occurs when connective tissue bands pull the skin down in places, where fat tissue has been able to squeeze through. One of the reasons it is hypothesized women get this more than men is because our fat is not merely different in distribution and overall percentage, but also in how the fat cells stack up; we generally have have of a vertical stacking structure going on, while men generally have a more horizontal structure. This means that it can be easier for ours to get moved about differently, causing the connective tissue to pull on the skin unevenly in places.
With that in mind…
Prevention is, as we say, probably impossible if your body is running on estrogen. However, those contributory factors we mentioned above? Most of those are modifiable, including these things that it is hypothesized can reduce it:
Diet: as it seems to be worsened by inflammation (what isn’t?), an anti-inflammatory diet is recommended.
Exercise: there are three things here: 1) exercises to improve circulation and thus the body’s ability to sort things out by itself 2) HIIT exercise to reduce body fat percentage, if one has a high enough starting body fat percentage for that to be a healthy goal 3) mobility exercises, to ensure our connective tissues are the right amount of mobile.
Creams and lotions
These reduce the superficial appearance of cellulite, without actually treating the thing itself. Mostly they are caffeine-based, which when used topically increases blood flow and works as a local diuretic, reducing the water content of the fat cells, diminishing the appearance of the cellulite by making each fat cell physically smaller (while still containing the same amount of fat, and it’ll bounce back in size as soon as the body can restore osmotic balance).
Medical procedures
There are too many of these to discuss them all separately, but they all work on the principle of breaking up the tough bands of connective tissue to eliminate the dimpling of cellulite.
The methods they use vary from ultrasound to cryolipolysis to lasers to “vacuum-assisted precise tissue release”, which involves a suction pump and a multipronged robotic assembly with needles to administer anaesthetic as it goes and small blades to cut the connective tissues under the skin:
Tissue Stabilized–Guided Subcision for the Treatment of Cellulite
That last one definitely sounds like the least fun, but it’s also the only one that doesn’t take months to maybe see results.
Cellulite can and almost certainly will come back after all of these.
Home remedies
Aside from at-home versions of the above (not the robots with vacuum pumps and needles and microblades, hopefully, but for example homemade caffeine creams), and of course diet and exercise which can be considered “home remedies”, there are two more things worth mentioning:
Dry brushing: using a body brush to, as the name suggests, simply brush one’s skin. The “dry” aspect here is simply that it’s not done in the bath or shower; it’s done while dry. It can improve local circulation of blood and lymph, allowing for better detoxification and redistribution of needed bodily resources.
Here’s an example dry brushing body brush on Amazon; this writer has one and hates it, but I’ve also tried with other kinds of brush and hate them too, so it seems to be a me thing rather than a brush thing, and I have desisted in trying, now. Maybe you will like it better; many people do.
Self-massage: or massage by someone else, if that’s an option for you and you prefer. In this case, it works by a different mechanism than dry brushing; this time it’s working by the same principle as the medical techniques described in the previous section; it’s physically breaking down the toughened bits of connective tissue.
Here’s an example wooden massage roller on Amazon; this writer has one and loves it; it’s sooooooo good. I got it as a matter of general maintenance for my fascia, but it’s also very good if I get a muscular pain now and again. As for cellulite, I personally get just a little cellulite sometimes (in the backs of my thighs), and whenever I use this regularly, it goes away for at least a while.
A quick note in closing
Cellulite is normal for women and is not unhealthy. Much like gray hair for example, it’s something that can be increased by poor health, but the thing itself isn’t intrinsically unhealthy, and most of us get it to some degree at some point.
Nevertheless, aesthetic factors can also have a role to play in mental health, and we tend to feel best when we like the way our body looks. If for you that means wanting less/no cellulite, then the above are some ways towards that.
As a bonus, most of the nonmedical options are directly good for the physical health anyway, so doing them is of course good.
In particular that last one (the wooden massage roller), because that connective tissue we talked about? It matters for a lot more than just cellulite, and is heavily implicated in a lot of kinds of chronic pain, so it pays to keep it in good health:
Fascia: Why (And How) You Should Take Care Of Yours
(that article, also written by this same writer by the way, suggests a vibrating foam roller—those are very popular; I just really love my wooden one, and find it more effective)
Take care!
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The GLP-1 Lifestyle – by Dr. Joshua Hackett
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While GLP-1 receptor agonists (i.e. semaglutide drugs such as Ozempic and Wegovy) have enjoyed the spotlight as a miracle cure (with some drawbacks), this book argues very reasonably that we should see them as a tool that we can use (or not) as part of a holistic approach to manage our metabolism.
Unusually, Dr. Hackett doesn’t argue strongly for one way or another, when it comes to using GLP-1 RAs. Rather, he makes the case that they indeed have pros and cons, and we should not only be aware of those pros and cons before making a decision either way, but also, we must understand the process of what goes on.
In contrast to the “inject it and forget it” marketing, he explains how if we actually understand what’s happening in our metabolism, we can improve things for ourselves and, at the very least, avoid sabotaging ourselves. Again, this knowledge is applicable with or without the drugs.
Much of the book is spent covering the physiological underpinnings and how things work for people of various different sizes and metabolic rates, as well as everything you’d expect about dosing, side effects, and whatnot—as well as things you might not have considered closely related, such gut health, and the question of “is there any way to retain the slimmer figure after stopping?”.
The style is methodical and clear, and not at all sensationalized. It’s very much a “read it cover to cover” book rather than a “dip in” book, so be ready for that, though.
Bottom line: if you and/or a loved one are on GLP1-RAs—or on the fence about them—this is a very even-minded and helpfully explanatory book.
Click here to check out The GLP-1 Lifestyle, and transform your metabolism!
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What I Wish People Knew About Dementia – by Dr. Wendy Mitchell
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We hear a lot from doctors who work with dementia patients; sometimes we hear from carers too. In this case, the author spent 20 years working for the NHS, before being diagnosed with young-onset dementia, at the age of 58. Like many health industry workers who got a life-changing diagnosis, she quickly found it wasn’t fun being on the other side of things, and vowed to spend her time researching, and raising awareness about, dementia.
Many people assume that once a person has dementia, they’re basically “gone before they’re gone”, which can rapidly become a self-fulfilling prophecy as that person finds themself isolated and—though this word isn’t usually used—objectified. Talked over, viewed (and treated) more as a problem than a person. Cared for hopefully, but again, often more as a patient than a person. If doctors struggle to find the time for the human side of things with most patients most of the time, this is only accentuated when someone needs more time and patience than average.
Instead, Dr. Mitchell—an honorary doctorate, by the way, awarded for her research—writes about what it’s actually like to be a human with dementia. Everything from her senses, how she eats, the experience of eating in care homes, the process of boiling an egg… To relationships, how care changes them, to the challenges of living alone. And communication, confusion, criticism, the language used by professionals, or how things are misrepresented in popular media. She also talks about the shifting sense of self, and brings it all together with gritty optimism.
The style is deeply personal, yet lucid and clear. While dementia is most strongly associated with memory loss and communication problems, this hasn’t affected her ability to write well (7 years into her diagnosis, in case you were wondering).
Bottom line: if you’d like to read a first-person view of dementia, then this is an excellent opportunity to understand it from the view of, as the subtitle goes, someone who knows.
Click here to check out What I Wish People Knew About Dementia, and then know those things!
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Xylitol vs Erythritol – Which is Healthier?
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Our Verdict
When comparing xylitol to erythritol, we picked the xylitol.
Why?
They’re both sugar alcohols, which so far as the body is concerned are neither sugars nor alcohols in the way those words are commonly understood; it’s just a chemical term. The sugars aren’t processed as such by the body and are passed as dietary fiber, and nor is there any intoxicating effect as one might expect from an alcohol.
In terms of macronutrients, while technically they both have carbs, for all functional purposes they don’t and just have a little fiber.
In terms of micronutrients, they don’t have any.
The one thing that sets them apart is their respective safety profiles. Xylitol is prothrombotic and associated with major adverse cardiac events (CI=95, adjusted hazard ratio=1.57, range=1.12-2.21), while erythritol is also prothrombotic and more strongly associated with major adverse cardiac events (CI=95, adjusted hazard ratio=2.21, range=1.20-4.07).
So, xylitol is bad and erythritol is worse, which means the relatively “healthier” is xylitol. We don’t recommend either, though.
Studies for both:
- Xylitol is prothrombotic and associated with cardiovascular risk
- The artificial sweetener erythritol and cardiovascular event risk
Links for the specific products we compared, in case our assessment hasn’t put you off them:
Want to learn more?
You might like to read:
- The WHO’s New View On Sugar-Free Sweeteners ← the WHO’s advice is “don’t”
- Stevia vs Acesulfame Potassium – Which is Healthier? ← stevia’s pretty much the healthiest artificial sweetener around, though, if you’re going to use one
- The Fascinating Truth About Aspartame, Cancer, & Neurotoxicity ← under the cold light of science, aspartame isn’t actually as bad as it was painted a few decades ago, mostly by a viral hoax letter. Per the WHO’s advice, it’s still good to avoid sweeteners in general, however.
Take care!
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What happens when I stop taking a drug like Ozempic or Mounjaro?
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Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight. But what do we actually know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.
Drugs like Ozempic are very effective at helping most people who take them lose weight. Semaglutide (sold as Wegovy and Ozempic) and tirzepatide (sold as Zepbound and Mounjaro) are the most well known in the class of drugs that mimic hormones to reduce feelings of hunger.
But does weight come back when you stop using it?
The short answer is yes. Stopping tirzepatide and semaglutide will result in weight regain in most people.
So are these medications simply another (expensive) form of yo-yo dieting? Let’s look at what the evidence shows so far.
It’s a long-term treatment, not a short course
If you have a bacterial infection, antibiotics will help your body fight off the germs causing your illness. You take the full course of medication, and the infection is gone.
For obesity, taking tirzepatide or semaglutide can help your body get rid of fat. However it doesn’t fix the reasons you gained weight in the first place because obesity is a chronic, complex condition. When you stop the medications, the weight returns.
Perhaps a more useful comparison is with high blood pressure, also known as hypertension. Treatment for hypertension is lifelong. It’s the same with obesity. Medications work, but only while you are taking them. (Though obesity is more complicated than hypertension, as many different factors both cause and perpetuate it.)
Obesity drugs only work while you’re taking them. KK Stock/Shutterstock Therefore, several concurrent approaches are needed; taking medication can be an important part of effective management but on its own, it’s often insufficient. And in an unwanted knock-on effect, stopping medication can undermine other strategies to lose weight, like eating less.
Why do people stop?
Research trials show anywhere from 6% to 13.5% of participants stop taking these drugs, primarily because of side effects.
But these studies don’t account for those forced to stop because of cost or widespread supply issues. We don’t know how many people have needed to stop this medication over the past few years for these reasons.
Understanding what stopping does to the body is therefore important.
So what happens when you stop?
When you stop using tirzepatide or semaglutide, it takes several days (or even a couple of weeks) to move out of your system. As it does, a number of things happen:
- you start feeling hungry again, because both your brain and your gut no longer have the medication working to make you feel full
When you stop taking it, you feel hungry again. Stock-Asso/Shutterstock - blood sugars increase, because the medication is no longer acting on the pancreas to help control this. If you have diabetes as well as obesity you may need to take other medications to keep these in an acceptable range. Whether you have diabetes or not, you may need to eat foods with a low glycemic index to stabilise your blood sugars
- over the longer term, most people experience a return to their previous blood pressure and cholesterol levels, as the weight comes back
- weight regain will mostly be in the form of fat, because it will be gained faster than skeletal muscle.
While you were on the medication, you will have lost proportionally less skeletal muscle than fat, muscle loss is inevitable when you lose weight, no matter whether you use medications or not. The problem is, when you stop the medication, your body preferentially puts on fat.
Is stopping and starting the medications a problem?
People whose weight fluctuates with tirzepatide or semaglutide may experience some of the downsides of yo-yo dieting.
When you keep going on and off diets, it’s like a rollercoaster ride for your body. Each time you regain weight, your body has to deal with spikes in blood pressure, heart rate, and how your body handles sugars and fats. This can stress your heart and overall cardiovascular system, as it has to respond to greater fluctuations than usual.
Interestingly, the risk to the body from weight fluctuations is greater for people who are not obese. This should be a caution to those who are not obese but still using tirzepatide or semaglutide to try to lose unwanted weight.
How can you avoid gaining weight when you stop?
Fear of regaining weight when stopping these medications is valid, and needs to be addressed directly. As obesity has many causes and perpetuating factors, many evidence-based approaches are needed to reduce weight regain. This might include:
- getting quality sleep
- exercising in a way that builds and maintains muscle. While on the medication, you will likely have lost muscle as well as fat, although this is not inevitable, especially if you exercise regularly while taking it
Prioritise building and maintaining muscle. EvMedvedeva/Shutterstock - addressing emotional and cultural aspects of life that contribute to over-eating and/or eating unhealthy foods, and how you view your body. Stigma and shame around body shape and size is not cured by taking this medication. Even if you have a healthy relationship with food, we live in a culture that is fat-phobic and discriminates against people in larger bodies
- eating in a healthy way, hopefully continuing with habits that were formed while on the medication. Eating meals that have high nutrition and fibre, for example, and lower overall portion sizes.
Many people will stop taking tirzepatide or semaglutide at some point, given it is expensive and in short supply. When you do, it is important to understand what will happen and what you can do to help avoid the consequences. Regular reviews with your GP are also important.
Read the other articles in The Conversation’s Ozempic series here.
Natasha Yates, General Practitioner, PhD Candidate, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Scattered Minds – by Dr. Gabor Maté
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This was not the first book that Dr. Maté sat down to write, by far. But it was the first that he actually completed. Guess why.
Writing from a position of both personal and professional experience and understanding, Dr. Maté explores the inaptly-named Attention Deficit Disorder (if anything, there’s often a surplus of attention, just, to anything and everything rather than necessarily what would be most productive in the moment), its etiology, its presentation, and its management.
This is a more enjoyable book than some others by the same author, as while this condition certainly isn’t without its share of woes (often, for example, a cycle of frustration and shame re “why can’t I just do the things; this is ruining my life and it would be so easy if I could just do the things!”), it’s not nearly so bleak as entire books about trauma, addiction, and so forth (worthy as those books also are).
Dr. Maté frames it specifically as a development disorder, and one whereby with work, we can do the development later that (story of an ADHDer’s life) we should have done earlier but didn’t. In terms of practical advice, he includes a program for effecting this change, including as an adult.
The style is easy-reading, in small chapters, with ADHD’d-up readers in mind, giving a strong sense of speeding pleasantly through the book.
Bottom line: when it’s a book by Dr. Gabor Maté, you know it’s going to be good, and this is no exception. Certainly read it if you, anyone you care about, or even anyone you just spend a lot of time around, has ADHD or similar.
Click here to check out Scattered Minds, and unscatter yours!
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