The Great Cholesterol Myth, Revised and Expanded – by Dr. Jonny Bowden and Dr. Stephen Sinatra
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The topic of cholesterol, and saturated fat for that matter, is a complex and often controversial one. How does this book treat it?
With strong opinions, is how—but backed by good science. The authors, a nutritionist and a cardiologist, pull no punches about outdated and/or cherry-picked science, and instead make the case for looking at what, statistically speaking, appear to be the real strongest risk factors.
So, are they advocating for Dave Asprey-style butter-guzzling, or “the carnivore diet”? No, no they are not. Those things remain unhealthy, even if they give some short-term gains (of energy levels, weight loss, etc).
They do advocate, however, for enjoying saturated fats in moderation, and instead of certain polyunsaturated seed oils that do far worse. They also advocate strongly for avoiding sugar, stress, and (for different reasons) statins (in most people’s cases).
They also demystify in clear terms, and often with diagrams and infographics, the various kinds of fats and their components, broken down in far more detail than any other pop-science source this reviewer has seen.
Bottom line: if you want to take a scientific approach to heart health, this book can help you to focus on what will actually make the biggest difference.
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Why do I need to take some medicines with food?
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Have you ever been instructed to take your medicine with food and wondered why? Perhaps you’ve wondered if you really need to?
There are varied reasons, and sometimes complex science and chemistry, behind why you may be advised to take a medicine with food.
To complicate matters, some similar medicines need to be taken differently. The antibiotic amoxicillin with clavulanic acid (sold as Amoxil Duo Forte), for example, is recommended to be taken with food, while amoxicillin alone (sold as Amoxil), can be taken with or without food.
Different brands of the same medicine may also have different recommendations when it comes to taking it with food.
Ron Lach/Pexels Food impacts drug absorption
Food can affect how fast and how much a drug is absorbed into the body in up to 40% of medicines taken orally.
When you have food in your stomach, the makeup of the digestive juices change. This includes things like the fluid volume, thickness, pH (which becomes less acidic with food), surface tension, movement and how much salt is in your bile. These changes can impair or enhance drug absorption.
Eating a meal also delays how fast the contents of the stomach move into the small intestine – this is known as gastric emptying. The small intestine has a large surface area and rich blood supply – and this is the primary site of drug absorption.
Eating a meal with medicine will delay its onset. Farhad/Pexels Eating a larger meal, or one with lots of fibre, delays gastric emptying more than a smaller meal. Sometimes, health professionals will advise you to take a medicine with food, to help your body absorb the drug more slowly.
But if a drug can be taken with or without food – such as paracetamol – and you want it to work faster, take it on an empty stomach.
Food can make medicines more tolerable
Have you ever taken a medicine on an empty stomach and felt nauseated soon after? Some medicines can cause stomach upsets.
Metformin, for example, is a drug that reduces blood glucose and treats type 2 diabetes and polycystic ovary syndrome. It commonly causes gastrointestinal symptoms, with one in four users affected. To combat these side effects, it is generally recommended to be taken with food.
The same advice is given for corticosteroids (such as prednisolone/prednisone) and certain antibiotics (such as doxycycline).
Taking some medicines with food makes them more tolerable and improves the chance you’ll take it for the duration it’s prescribed.
Can food make medicines safer?
Ibuprofen is one of the most widely used over-the-counter medicines, with around one in five Australians reporting use within a two-week period.
While effective for pain and inflammation, ibuprofen can impact the stomach by inhibiting protective prostaglandins, increasing the risk of bleeding, ulceration and perforation with long-term use.
But there isn’t enough research to show taking ibuprofen with food reduces this risk.
Prolonged use may also affect kidney function, particularly in those with pre-existing conditions or dehydration.
The Australian Medicines Handbook, which guides prescribers about medicine usage and dosage, advises taking ibuprofen (sold as Nurofen and Advil) with a glass of water – or with a meal if it upsets your stomach.
If it doesn’t upset your stomach, ibuprofen can be taken with water. Tbel Abuseridze/Unsplash A systematic review published in 2015 found food delays the transit of ibuprofen to the small intestine and absorption, which delays therapeutic effect and the time before pain relief. It also found taking short courses of ibuprofen without food reduced the need for additional doses.
To reduce the risk of ibuprofen causing damage to your stomach or kidneys, use the lowest effective dose for the shortest duration, stay hydrated and avoid taking other non-steroidal anti-inflammatory medicines at the same time.
For people who use ibuprofen for prolonged periods and are at higher risk of gastrointestinal side effects (such as people with a history of ulcers or older adults), your prescriber may start you on a proton pump inhibitor, a medicine that reduces stomach acid and protects the stomach lining.
How much food do you need?
When you need to take a medicine with food, how much is enough?
Sometimes a full glass of milk or a couple of crackers may be enough, for medicines such as prednisone/prednisolone.
However, most head-to-head studies that compare the effects of a medicine “with food” and without, usually use a heavy meal to define “with food”. So, a cracker may not be enough, particularly for those with a sensitive stomach. A more substantial meal that includes a mix of fat, protein and carbohydrates is generally advised.
Your health professional can advise you on which of your medicines need to be taken with food and how they interact with your digestive system.
Mary Bushell, Clinical Associate Professor in Pharmacy, University of Canberra
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Should You Soak Your Nuts?
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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
❝hi. how many almonds should one eat per day? do they need to be soaked? thank you.❞
Within reason, however many you like! Given that protein is an appetite suppressant, you’ll probably find it’s not too many.
Dr. Michael Greger, of “How Not To Die” fame, suggests aiming for 30g of nuts per day. Since almonds typically weigh about 1g each, that means 30 if it’s all almonds.
And if you’re wondering about 10 almonds? The name’s a deliberate reference to an old internet hoax about 10 almonds being the equivalent of an aspirin for treating a headache. It’s a reminder to be open-mindedly skeptical about information circulating wildly, and look into the real, evidence-based, science of things.
- Sometimes, the science validates claims, and we’re excited to share that!
- Sometimes, the science just shoots claims down, and it’s important to acknowledge when that happens too.
On which note, about soaking…
Short version: soaking can improve the absorption of some nutrients, but not much more than simply chewing thoroughly. See:
- A review of the impact of processing on nutrient bioaccessibility and digestion of almonds
- Mastication of almonds: effects of lipid bioaccessibility, appetite, and hormone response
Soaking does reduce certain “antinutrients” (compounds that block absorption of other nutrients), such as phytic acid. However, even a 24-hour soak reduces them only by about 5%:
If you don’t want to take 24-hours to get a 5% benefit, there’s good news! A 12-hour soak can result in 4% less phytic acid in chopped (but not whole) almonds:
The Effect of Soaking Almonds and Hazelnuts on Phytate and Mineral Concentrations
Lest that potentially underwhelming benefit leave a bitter taste in your mouth, one good thing about soaking almonds (if you don’t like bitter tastes, anyway) is that it will reduce their bitterness:
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The Galveston Diet – by Dr. Mary Claire Haver
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We’ve previously reviewed “It’s Not You, It’s Your Hormones” by nutritionist Nikki Williams, and noted at the time that it was very similar to the bestselling “The Galveston Diet”, not just in its content but all the way down its formatting. Some Amazon reviewers have even gone so far as to suggest that “It’s Not You, It’s Your Hormones” (2017) brazenly plagiarized “The Galveston Diet” (2023). However, after carefully examining the publication dates, we feel quite confident that the the earlier book did not plagiarize the later one.
Of course, we would not go so far as to make a counter-accusation of plagiarism the other way around; it was surely just a case of Dr. Haver having the same good ideas 6 years later.
Still, while the original book by Nikki Williams did not get too much international acclaim, the later one by Dr. Mary Claire Haver has had very good marketing and thus received a lot more attention, so let’s review it:
Dr. Haver’s basic principle is (again) that we can manage our hormonal fluctuations, by managing our diet. Specifically, in the same three main ways:
- Intermittent fasting
- Anti-inflammatory diet
- Eating more protein and healthy fats
Why should these things matter to our hormones? The answer is to remember that our hormones aren’t just the sex hormones. We have hormones for hunger and satedness, hormones for stress and relaxation, hormones for blood sugar regulation, hormones for sleep and wakefulness, and more. These many hormones make up our endocrine system, and affecting one part of it will affect the others.
Will these things magically undo the effects of the menopause? Well, some things yes, other things no. No diet can do the job of HRT. But by tweaking endocrine system inputs, we can tweak endocrine system outputs, and that’s what this book is for.
The style is once again very accessible and just as clear, and Dr. Haver also walks us just as skilfully through the changes we may want to make, to avoid the changes we don’t want. The recipes are also very similar, so if you loved the recipes in the other book, you certainly won’t dislike this book’s menu.
In the category of criticism, there is (as with the other book by the other author) some extra support that’s paywalled, in the sense that she wants the reader to buy her personally-branded online plan, and it can feel a bit like she’s holding back in order to upsell to that.
Bottom line: this book is (again) aimed at peri-menopausal and post-menopausal women. It could also (again) definitely help a lot of people with PCOS too, and, when it comes down to it, pretty much anyone with an endocrine system. It’s (still) a well-evidenced, well-established, healthy way of eating regardless of age, sex, or (most) physical conditions.
Click here to check out The Galveston Diet, and enjoy its well-told, well-formatted advice!
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Sweet Dreams Are Made Of Cheese (Or Are They?)
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
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
❝In order to lose a little weight I have cut out cheese from my diet – and am finding that I am sleeping better. Would be interested in your views on cheese and sleep, and whether some types of cheese are worse for sleep than others. I don’t want to give up cheese entirely!❞
In principle, there’s nothing in cheese that, biochemically, should impair sleep. If anything, its tryptophan content could aid good sleep.
Tryptophan is found in many foods, including cheese, which (of common foods, anyway), for example cheddar cheese ranks second only to pumpkin seeds in tryptophan content.
Tryptophan can be converted by the body into 5-HTP, which you’ve maybe seen sold as a supplement. Its full name is 5-hydroxytryptophan.
5-HTP can, in turn, be used to make melatonin and/or serotonin. Which of those you will get more of, depends on what your body is being cued to do by ambient light/darkness, and other environmental cues.
If you are having cheese and then checking your phone, for instance, or otherwise hanging out where there are white/blue lights, then your body may dutifully convert the tryptophan into serotonin (calm wakefulness) instead of melatonin (drowsiness and sleep).
In short: the cheese will (in terms of this biochemical pathway, anyway) augment some sleep-inducing or wakefulness-inducing cues, depending on which are available.
You may be wondering: what about casein?
Casein is oft-touted as producing deep sleep, or disturbed sleep, or vivid dreams, or bad dreams. There’s no science to back any of this up, though the following research review is fascinating:
Dreams of the Rarebit Fiend: food and diet as instigators of bizarre and disturbing dreams
(it largely supports the null hypothesis of “not a causal factor” but does look at the many more likely alternative explanations, ranging from associated actually casual factors (such as alcohol and caffeine) and placebo/nocebo effect)
Finally, simple digestive issues may be the real thing at hand:
Worth noting that around two thirds of all people, including those who regularly enjoy dairy products, have some degree of lactose intolerance:
Lactose Intolerance in Adults: Biological Mechanism and Dietary Management
So, in terms of what cheese may be better/worse for you in this context, you might try experimenting with lactose-free cheese, which will help you identify whether that was the issue!
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What Happens Every Day When You Quit Sugar For 30 Days
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We all know that sugar isn’t exactly a health food, but it can be hard to quit. How long can cravings be expected to last, and when can we expect to see benefits? Today’s video covers the timeline in a realistic yet inspiring fashion:
What to expect on…
Day 1: expect cravings and withdrawal symptoms including headaches, fatigue, mood swings, and irritability—as well as tiredness, without the crutch of sugar.
Days 2 & 3: more of the same, plus likely objections from the gut, since your Candida albicans content will not be enjoying being starved of its main food source.
Days 4–7: reduction of the above symptoms, better energy levels, improved sleep, and likely the gut will be adapting or have adapted.
Days 8–14: beginning of weight loss, clearer skin, improved complexion; taste buds adapt too, making foods taste sweeter. Continued improvement in energy and focus, as well.
Days 15–21: more of the same improvements, plus the immune system will start getting stronger around now. But watch out, because there may still be some cravings from time to time.
Days 22–30: all of the above positive things, few or no cravings now, and enhanced metabolic health as a whole.
For more specificity on each of these stages, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The Not-So-Sweet Science Of Sugar Addiction
Take care!
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Unlimited Memory – by Kevin Horsley
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Premise: there are easily learnable techniques to rapidly (and greatly) improve one’s memory. We’ve touched on some of these methods before at 10almonds, but being a newsletter rather than a book, we’ve not been able to go as deeply into it as Horsley!
Your memory is far, far, far more powerful than you might realize, and this book will help unlock that. To illustrate…
Some of the book is given over to what are for most purposes “party tricks”, such as remembering pi to 10,000 places. Those things are fun, even if not as practical in today’s world of rarely needing to even know the actual digits of a phone number. However, they do also serve as a good example of just how much of “super memory” isn’t a matter of hard work, so much as being better organized about it.
Most of the book is focused on practical methods to improve the useful aspects of memory—including common mistakes!
If the book has any flaw it’s that the first chapter or so is spent persuading the reader of things we presumably already believe, given that we bought the book. For example, that remembering things is a learnable skill and that memory is functionally limitless. However, we still advise to not skip those chapters as they do contain some useful reframes as well.
Bottom line: if you read this book you will be astonished by how much you just learned—because you’ll be able to recall whole sections in detail! And then you can go apply that whatever areas of your life you wanted to when you bought the book.
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