Life Lessons From A Brain Surgeon – by Dr. Rahul Jandial
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In the category of surgeons with a “what to put on your table to stay off mine” angle, this book packs an extra punch. As well as being an experienced brain surgeon, Dr. Jandial also does a lot of cutting edge lab research too. What does this mean for us?
This book gives, as the subtitle promises, “practical strategies for peak health and performance”—with a brain-centric bias, of course.
From diet and nootropic supplements, to exercise and brain-training, we get a good science-based view of which ones actually work, and which don’t. The style is also very readable; Dr. Jandial is a great educator, presenting genuine scientific content with very accessible language.
Bottom line: if you’d indeed like to look after your most important organ optimally, this book gives a lot of key pointers, without unnecessary fluff.
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Healing Arthritis – by Dr. Susan Blum
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We previously reviewed another book by this author, her Immune System Recovery Plan, and today it’s more specific: healing arthritis
Of course, not all arthritis is rooted in immune dysfunction, but a) all of it is made worse by immune dysfunction and b) rheumatoid arthritis, which is an autoimmune disease, affects 1% of the population.
This book tackles all kinds of arthritis, by focusing on addressing the underlying causes and treating those, and (whether it was the cause or not) reducing inflammation without medication, because that will always help.
The “3 steps” mentioned in the subtitle are three stages of a plan to improve the gut microbiome in such a way that it not only stops worsening your arthritis, but starts making it better.
The style here is on the hard end of pop-science, so if you want something more conversational/personable, then this won’t be so much for you, but if you just want the information and explanation, then this does it just fine, and it has frequent references to the science to back it up, with a reassuringly extensive bibliography.
Bottom line: if you have arthritis and want a book that will help you to get either symptom-free or as close to that as is possible from your current condition (bearing in mind that arthritis is generally degenerative), then this is a great book for that.
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Can You Get Addicted To MSG, Like With Sugar?
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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 😎
❝Hello, I love your newsletter 🙂 Can I have a question? While browsing through your recepies, I realised many contained MSG. As someone based in Europe, I am not used to using MSG while cooking (of course I know that processed food bought in supermarket containes MSG). There is a stigma, that MSG is not particulary healthy, but rather it should be really bad and cause negative effects like headaches. Is this true? Also, can you get addicted to MSG, just like you get addicted to sugar? Thank you :)❞
Thank you for the kind words, and the interesting questions!
Short answer: no and no 🙂
Longer answer: most of the negative reputation about MSG comes from a single piece of satire written in the US in the 1960s, which the popular press then misrepresented as a genuine concern, and the public then ran with, mostly due to racism/xenophobia/sinophobia specifically, given the US’s historically not fabulous relations with China, and the moniker of “Chinese restaurant syndrome”, notwithstanding that MSG was first isolated in Japan, not China, more than 100 years ago.
The silver lining that comes out of this is that because of the above, MSG has been one of the most-studied food additives in recent decades, with many teams of scientists in many countries trying to determine its risks and not finding any (except insofar as anything in extreme quantities can kill you, including water or oxygen).
You can read more about this and other* myths about MSG, here:
Monosodium Glutamate: Sinless Flavor-Enhancer Or Terrible Health Risk?
*such as pertaining to gluten sensitivity, which in reality MSG has no bearing on whatsoever as it does not contain gluten and is not even made of the same basic stuff; gluten being a protein made of (amongst other things) the amino acid glutamine, not a glutamate salt. Glutamate is as closely related to gluten as cyanocobalamin (vitamin B12) is to cyanide (the famous poison).
PS: if you didn’t click the above link to read that article, then 1) we really do recommend it 2) we did some LD50 calculations there and looked at available research, and found that for someone of this writer’s (very medium) size, eating 1kg of MSG at once is sufficient to cause toxicity, and injecting >250g of MSG may cause heart problems. So we don’t recommend doing that.
However, ½ tsp in a recipe that gives multiple portions is not going to get you anywhere close to the danger zone, unless you consume that entire meal by yourself hundreds of times per day. And if you do, the MSG is probably the least of your concerns.
(2 tsp of cassia cinnamon, however, is enough to cause coumarin toxicity; for this reason we recommend Ceylon (or “True” or “Sweet”) cinnamon in our recipes, as it has almost undetectable levels of coumarin)
With regard to your interesting question about addiction, first of all let’s speak briefly about sugar addiction:
Sugar addiction is, by broad scientific consensus, agreed-upon as an extant thing that does exist, and contemporary research is more looking into the “hows” and “whys” and “whats” rather than the “whether”. It is a somewhat complicated topic, because it’s halfway between what science would usually consider a chemical addiction, and what science would usually consider a behavioral addiction:
The Not-So-Sweet Science Of Sugar Addiction
The reasonable prevailing hypothesis, therefore, is that sugar simply has two moderate mechanisms of addiction, rather than one strong one.
The biochemical side of sugar addiction comes from the body’s metabolism of sugar, so this cannot be a thing for MSG, because there is nothing to metabolize in the same sense of the word (MSG being an inorganic compound with zero calories).
People can crave salt, especially when deficient in it, and MSG does contain sodium (it’s what the “S” stands for), but it contains a little under ⅓ of the sodium that table salt does (sodium chloride in whatever form, be it sea salt, rock salt, or such):
MSG vs. Salt: Sodium Comparison ← we do molecular calculations here!
Sea Salt vs MSG – Which is Healthier? ← this one for a head-to-head
However, even craving salt does not constitute an addiction; nobody is shamefully hiding their rock salt crystals under their bed and getting a fix when they feel low, and nor does withdrawal cause adverse side effects, except insofar as (once again) a person deficient in salt will crave salt.
Finally, the only other way we know of that one might wonder if MSG could be addictive, is about glutamate and glutamate receptors. The glutamate in MSG is the same glutamate (down to the atoms) as the glutamate formed if one consumes tomatoes in the presence of salt, and triggers the same glutamate receptors in the same way. We have the same number of receptors either way, and uptake is exactly the same (because again, it’s exactly the same chemical) so there is a maximum to how strong this effect can be, and that maximum is the same whatever the source of the glutamate was.
In this respect, if MSG is addictive, then so is a tomato salad with a pinch of salt: it’s not—it’s just tasty.
We haven’t cited papers in today’s article, but it’s just because we cited them already in the articles we linked, and so we avoided doubling up. Most of them are in that first link we gave 🙂
One final note
Technically anyone can develop a sensitivity to anything, so in theory someone could develop a sensitivity to MSG, just like they could for any other ingredient. Our usual legal/medical disclaimer applies.
However, it’s certainly not a common trigger, putting it well below common allergens like nuts (or less common allergens like, say, bananas), not even in the same league as common intolerances such as gluten, and less worthy of health risk warnings than, say, spinach (high in oxalates; fine for most people but best avoided if you have kidney problems).
The reason we use it in the recipes we use it in, is simply because it’s a lower-sodium alternative to salt, and while it contains a (very) tiny bit less sodium than low-sodium salt (which itself has about ⅓ the sodium of regular salt), it has more of a flavor-enhancing effect, such that one can use half as much, for a more than sixfold total sodium reduction. Which for most of us in the industrialized world, is beneficial.
Want to try some?
If today’s article has inspired you to give MSG a try, here’s an example product on Amazon 😎
Enjoy!
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Considering taking Wegovy to lose weight? Here are the risks and benefits – and how it differs from Ozempic
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The weight-loss drug Wegovy is now available in Australia.
Wegovy is administered as a once-weekly injection and is approved specifically for weight management. It’s intended to be used in combination with a reduced-energy diet and increased physical activity.
So how does Wegovy work and how much weight can you expect to lose while taking it? And what are the potential risks – and costs – for those who use it?
Let’s look at what the science says.
What is Wegovy?
Wegovy is a brand name for the medication semaglutide. Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better.
Normally when you eat, the body releases the GLP-1 hormone which helps signal to your brain that you are full. Semaglutides enhance this effect, leading to a feeling of fullness, even when you haven’t eaten.
Another role of GLP-1 is to stimulate the body to produce more insulin, a hormone which helps lower the level of glucose (sugar) in the blood. That’s why semaglutides have been used for several years to treat type 2 diabetes.
How does Wegovy differ from Ozempic?
Like Wegovy, Ozempic is a semaglutide. The way Wegovy and Ozempic work in the body are essentially the same. They’re made by the same pharmaceutical company, Novo Nordisk.
But there are two differences:
1) They are approved for two different (but related) reasons.
In Australia (and the United States), Ozempic is approved for use to improve blood glucose levels in adults with type 2 diabetes. By managing blood glucose levels effectively, the medication aims to reduce the risk of major complications, such as heart disease.
Wegovy is approved for use alongside diet and exercise for people with a body mass index (BMI) of 30 or greater, or 27 or greater but with other conditions such as high blood pressure.
Wegovy can also be used in people aged 12 years and older. Like Ozempic, Wegovy aims to reduce the risk of future health complications, including heart disease.
2) They are both injected but come in different strengths.
Ozempic is available in pre-loaded single-dose pens with varying dosages of 0.25 mg, 0.5 mg, 1 mg, or 2 mg per injection. The dose can be slowly increased, up to a maximum of 2 mg per week, if needed.
Wegovy is available in prefilled single-dose pens with doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg. The treatment starts with a dose of 0.25 mg once weekly for four weeks, after which the dose is gradually increased until reaching a maintenance dose of 2.4 mg weekly.
While it’s unknown what the impact of Wegovy’s introduction will be on Ozempic’s availability, Ozempic is still anticipated to be in low supply for the remainder of 2024.
Is Wegovy effective for weight loss?
Given Wegovy is a semaglutide, there is very strong evidence it can help people lose weight and maintain this weight loss.
A recent study found that over four years, participants taking Wevovy as indicated experienced an average weight loss of 10.2% body weight and a reduction in waist circumference of 7.7cm.
For those who stop taking the medication, analyses have shown that about two-thirds of weight lost is regained.
What are the side effects of Wegovy?
The most common side effects are nausea and vomiting.
However, other serious side effects are also possible because of the whole-of-body impact of the medication. Thyroid tumours and cancer have been detected as a risk in animal studies, yet are rarely seen in human scientific literature.
In the four-year Wegovy trial, 16.6% of participants who received Wegovy (1,461 people) experienced an adverse event that led to them permanently discontinuing their use of the medication. This was higher than the 8.2% of participants (718 people) who received the placebo (with no active ingredient).
Side effects included gastrointestinal disorders (including nausea and vomiting), which affected 10% of people who used Wegovy compared to 2% of people who used the placebo.
Gallbladder-related disorders occurred in 2.8% of people who used Wegovy, and 2.3% of people who received the placebo.
Recently, concerns about suicidal thoughts and behaviours have been raised, after a global analysis reviewed more than 36 million reports of adverse events from semaglutide (Ozempic or Wegovy) since 2000.
There were 107 reports of suicidal thoughts and self-harm among people taking semaglutide, sadly including six actual deaths. When people stopped the medication, 62.5% found the thoughts went away. What we don’t know is whether dose, weight loss, or previous mental health status or use of antidepressants had a role to play.
Finally, concerns are growing about the negative effect of semaglutides on our social and emotional connection with food. Anecdotal and scientific evidence suggests people who use semaglutides significantly reduce their daily dietary intake (as anticipated) by skipping meals and avoiding social occasions – not very enjoyable for people and their loved ones.
How can people access Wegovy?
Wegovy is available for purchase at pharmacists with a prescription from a doctor.
But there is a hefty price tag. Wegovy is not currently subsidised through the Pharmaceutical Benefits Scheme, leaving patients to cover the cost. The current cost is estimated at around A$460 per month dose.
If you’re considering Wegovy, make an appointment with your doctor for individual advice.
Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Fasting Without Crashing?
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Intermittent Fasting: What’s the truth?
Before we get to facts and fictions, let’s quickly cover:
What is Intermittent Fasting?
Intermittent Fasting (IF) is an umbrella term for various kinds of time-restricted fasting, based on a schedule. Types include:
Time-restricted IF, for example:
- 16:8—Fast for 16 hours, eat during an 8-hour window
- 18:6–Fast for 18 hours, eat during a 6-hour window
- 20:4—Fast for 20 hours, eat during a 4-hour window
24hr fasting, including:
- Eat Stop Eat—basically, take a day off from eating once a week
- Alternate Day Fasting—a more extreme version of the above; it is what it sounds like; eat one day, fast the next, repeat
Non-fast fasting, e.g:
- 5:2—Eat normally for 5 days, have a very reduced calorie intake (⅓ of normal intake) for the other 2 days
- Fruit Fasting—have a small amount of fruit on “fast” days, but no other food
- The Warrior Diet—as above, but include a small amount of non-starchy vegetables
Why IF?
While IF is perhaps most commonly undertaken as a means of fat loss or fat management (i.e., keeping fat down when it is already low), others cite different reasons, such as short term cognitive performance or long-term longevity.
But… Does it work?
Here we get into the myth-busting bit!
“IF promotes weight loss”
Mix of True and False. It can! But it also doesn’t have to. If you’re a bodybuilder who downs 4,000 calories in your 4hr eating window, you’re probably not going to lose weight! For such people, this is of course “a feature, not a bug” of IF—especially as it has been found that, in an acute study, IF did not adversely impact muscle protein synthesis.
“IF promotes fat loss, without eating less”
Broadly True. IF was found to be potentially equal to, but not necessarily better than, eating less.
“IF provides metabolic benefits for general health”
Broadly True. IF (perhaps counterintuitively) decreases the risk of insulin resistance, and also has anti-inflammatory effects, benefits a healthy gut microbiome, and promotes healthy autophagy (which as we noted in a previous edition of 10almonds, is important against both aging and cancer)
However, results vary according to which protocol you’re observing…
For what it’s worth, 16:8 is perhaps the most-studied protocol. Because such studies tend to have the eating window from midday to 8pm, this means that—going against popular wisdom—part of the advice here is basically “skip breakfast”.
“Unlike caloric restriction, IF is sustainable and healthy as a long-term protocol”
Broadly True. Of course, there’s a slight loophole here in that IF is loosely defined—technically everyone fasts while they’re sleeping, at the very least!
However, for the most commonly-studied IF method (16:8), this is generally very sustainable and healthy and for most people.
On the other hand, a more extreme method such as Alternate Day Fasting, may be trickier to sustain (even if it remains healthy to do so), because it’s been found that hunger does not decrease on fasting days—ie, the body does not “get used to it”.
The American Journal of Clinical Nutrition wrote:
❝Alternate-day fasting was feasible in nonobese subjects, and fat oxidation increased. However, hunger on fasting days did not decrease, perhaps indicating the unlikelihood of continuing this diet for extended periods of time. Adding one small meal on a fasting day may make this approach to dietary restriction more acceptable.❞
“IF improves mood and cognition”
Mix of True and False (plus an honest “We Don’t Know” from researchers).
Many studies have found benefits to both mood and cognition, but in the short-term, fasting can make people “hangry” (or: “experience irritability due to low blood sugar levels”, as the scientists put it), and in the long term, it can worsen symptoms of depression for those who already experience such—although some studies have found it can help alleviate depressive symptoms.
Basically this is one where researchers typically append the words “more research is needed” to their summaries.
“Anyone can do IF”
Definitely False, unless going by the absolute broadest possible interpretation of what constitutes “Intermittent Fasting” to the point of disingenuity.
For example, if you are Type 1 Diabetic, and your blood sugars are hypo, and you wait until tomorrow to correct that, you will stand a good chance of going into a coma instead. So please don’t.
(On the other hand, IF may help achieve remission of type 2 diabetes)
Lastly, IF is broadly not recommend to children and adolescents, anyone pregnant or breastfeeding, and certain underlying health conditions not mentioned above (we’re not going to try to give an exhaustive list here, but basically, if you have a chronic health condition, we recommend you check with your doctor first).
WHICH APP?
Choosing a fasting app
Thinking of giving IF a try and would like a little extra help? We’ve got you covered!
Check out: Livewire’s 7 Best Intermittent Fasting Apps of 2023
Prefer to just trust us with a recommendation?
We like BodyFast—it’s #2 on Lifewire’s list, but it has an array of pre-set plans to choose from (unlike Lifewire’s #1, Zero), and plenty of clear tracking, scheduling help, and motivational features.
Both are available on both iOS and Android:
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A person in Texas caught bird flu after mixing with dairy cattle. Should we be worried?
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The United States’ Centers for Disease Control and Prevention (CDC) has issued a health alert after the first case of H5N1 avian influenza, or bird flu, seemingly spread from a cow to a human.
A farm worker in Texas contracted the virus amid an outbreak in dairy cattle. This is the second human case in the US; a poultry worker tested positive in Colorado in 2022.
The virus strain identified in the Texan farm worker is not readily transmissible between humans and therefore not a pandemic threat. But it’s a significant development nonetheless.
Some background on bird flu
There are two types of avian influenza: highly pathogenic or low pathogenic, based on the level of disease the strain causes in birds. H5N1 is a highly pathogenic avian influenza.
H5N1 first emerged in 1997 in Hong Kong and then China in 2003, spreading through wild bird migration and poultry trading. It has caused periodic epidemics in poultry farms, with occasional human cases.
Influenza A viruses such as H5N1 are further divided into variants, called clades. The unique variant causing the current epidemic is H5N1 clade 2.3.4.4b, which emerged in late 2020 and is now widespread globally, especially in the Americas.
In the past, outbreaks could be controlled by culling of infected birds, and H5N1 would die down for a while. But this has become increasingly difficult due to escalating outbreaks since 2021.
Wild animals are now in the mix
Waterfowl (ducks, swans and geese) are the main global spreaders of avian flu, as they migrate across the world via specific routes that bypass Australia. The main hub for waterfowl to migrate around the world is Quinghai lake in China.
But there’s been an increasing number of infected non-waterfowl birds, such as true thrushes and raptors, which use different flyways. Worryingly, the infection has spread to Antarctica too, which means Australia is now at risk from different bird species which fly here.
H5N1 has escalated in an unprecedented fashion since 2021, and an increasing number of mammals including sea lions, goats, red foxes, coyotes, even domestic dogs and cats have become infected around the world.
Wild animals like red foxes which live in peri-urban areas are a possible new route of spread to farms, domestic pets and humans.
Dairy cows and goats have now become infected with H5N1 in at least 17 farms across seven US states.
What are the symptoms?
Globally, there have been 14 cases of H5N1 clade 2.3.4.4b virus in humans, and 889 H5N1 human cases overall since 2003.
Previous human cases have presented with a severe respiratory illness, but H5N1 2.3.4.4b is causing illness affecting other organs too, like the brain, eyes and liver.
For example, more recent cases have developed neurological complications including seizures, organ failure and stroke. It’s been estimated that around half of people infected with H5N1 will die.
The case in the Texan farm worker appears to be mild. This person presented with conjunctivitis, which is unusual.
Food safety
Contact with sick poultry is a key risk factor for human infection. Likewise, the farm worker in Texas was likely in close contact with the infected cattle.
The CDC advises pasteurised milk and well cooked eggs are safe. However, handling of infected meat or eggs in the process of cooking, or drinking unpasteurised milk, may pose a risk.
Although there’s no H5N1 in Australian poultry or cattle, hygienic food practices are always a good idea, as raw milk or poorly cooked meat, eggs or poultry can be contaminated with microbes such as salmonella and E Coli.
If it’s not a pandemic, why are we worried?
Scientists have feared avian influenza may cause a pandemic since about 2005. Avian flu viruses don’t easily spread in humans. But if an avian virus mutates to spread in humans, it can cause a pandemic.
One concern is if birds were to infect an animal like a pig, this acts as a genetic mixing vessel. In areas where humans and livestock exist in close proximity, for example farms, markets or even in homes with backyard poultry, the probability of bird and human flu strains mixing and mutating to cause a new pandemic strain is higher.
The cows infected in Texas were tested because farmers noticed they were producing less milk. If beef cattle are similarly affected, it may not be as easily identified, and the economic loss to farmers may be a disincentive to test or report infections.
How can we prevent a pandemic?
For now there is no spread of H5N1 between humans, so there’s no immediate risk of a pandemic.
However, we now have unprecedented and persistent infection with H5N1 clade 2.3.4.4b in farms, wild animals and a wider range of wild birds than ever before, creating more chances for H5N1 to mutate and cause a pandemic.
Unlike the previous epidemiology of avian flu, where hot spots were in Asia, the new hot spots (and likely sites of emergence of a pandemic) are in the Americas, Europe or in Africa.
Pandemics grow exponentially, so early warnings for animal and human outbreaks are crucial. We can monitor infections using surveillance tools such as our EPIWATCH platform.
The earlier epidemics can be detected, the better the chance of stamping them out and rapidly developing vaccines.
Although there is a vaccine for birds, it has been largely avoided until recently because it’s only partially effective and can mask outbreaks. But it’s no longer feasible to control an outbreak by culling infected birds, so some countries like France began vaccinating poultry in 2023.
For humans, seasonal flu vaccines may provide a small amount of cross-protection, but for the best protection, vaccines need to be matched exactly to the pandemic strain, and this takes time. The 2009 flu pandemic started in May in Australia, but the vaccines were available in September, after the pandemic peak.
To reduce the risk of a pandemic, we must identify how H5N1 is spreading to so many mammalian species, what new wild bird pathways pose a risk, and monitor for early signs of outbreaks and illness in animals, birds and humans. Economic compensation for farmers is also crucial to ensure we detect all outbreaks and avoid compromising the food supply.
C Raina MacIntyre, Professor of Global Biosecurity, NHMRC L3 Research Fellow, Head, Biosecurity Program, Kirby Institute, UNSW Sydney; Ashley Quigley, Senior Research Associate, Global Biosecurity, UNSW Sydney; Haley Stone, PhD Candidate, Biosecurity Program, Kirby Institute, UNSW Sydney; Matthew Scotch, Associate Dean of Research and Professor of Biomedical Informatics, College of Health Solutions, Arizona State University, and Rebecca Dawson, Research Associate, The Kirby Institute, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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In the Realm of Hungry Ghosts – by Dr. Gabor Maté
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We’ve reviewed books by Dr. Maté before, and this one’s about addiction. We’ve reviewed books about addiction before too, so what makes this one different?
Wow, is this one so different. Most books about addiction are about “beating” it. Stop drinking, quit sugar, etc. And, that’s all well and good. It is definitely good to do those things. But this one’s about understanding it, deeply. Because, as Dr. Maté makes very clear, “there, but for the grace of epigenetics and environmental factors, go we”.
Indeed, most of us will have addictions; they’re (happily) just not too problematic for most of us, being either substances that are not too harmful (e.g. coffee), or behavioral addictions that aren’t terribly impacting our lives (e.g. Dr. Maté’s compulsion to keep buying more classical music, which he then tries to hide from his wife).
The book does also cover a lot of much more serious addictions, the kind that have ruined lives, and the kind that definitely didn’t need to, if people had been given the right kind of help—instead of, all too often, they got the opposite.
Perhaps the greatest value of this book is that; understanding what creates addiction in the first place, what maintains it, and what help people actually need.
Bottom line: if you’d like more insight into the human aspect of addiction without getting remotely wishy-washy, this book is probably the best one out there.
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