Immunity – by Dr. William Paul
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This book gives a very person-centric (i.e., focuses on the contributions of named individuals) overview of advances in the field of immunology—up to its publication date in 2015. So, it’s not cutting edge, but it is very good at laying the groundwork for understanding more recent advances that occur as time goes by. After all, immunology is a field that never stands still.
We get a good grounding in how our immune system works (and how it doesn’t), the constant arms race between pathogens and immune responses, and the complexities of autoimmune disorders and—which is functionally in an overlapping category of disease—cancer. And, what advances we can expect soon to address those things.
Given the book was published 8 years ago, how did it measure up? Did we get those advances? Well, for the mostpart yes, we have! Some are still works in progress. But, we’ve also had obvious extra immunological threats in years since, which have also resulted in other advances along the way!
If the book has a downside, it’s that sometimes the author can be a little too person-centric. It’s engaging to focus on human characters, and helps us bring information to life; name-dropping to excess, along with awards won, can sometimes feel a little like the book was co-authored by Tahani Al-Jamil.
Nevertheless, it certainly does keep the book from getting too dry!
Bottom line: this book is a great overview of immunology and immunological research, for anyone who wants to understand these things better.
Click here to check out Immunity, and boost your knowledge of yours!
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Statins: Study Insights
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It’s Q&A Day at 10almonds!
Q: Can you let us know about more studies that have been done on statins? Are they really worth taking?
That is a great question! We imagine it might have been our recent book recommendation that prompted it? It’s quite a broad question though, so we’ll do that as a main feature in the near future!
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Grains: Bread Of Life, Or Cereal Killer?
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Going Against The Grain?
In Wednesday’s newsletter, we asked you for your health-related opinion of grains (aside from any gluten-specific concerns), and got the above-depicted, below-described, set of responses:
- About 69% said “They are an important cornerstone of a healthy balanced diet”
- About 22% said “They can be enjoyed in moderation, but watch out”
- About 8% said “They are terrible health-drainers that will kill us”
So, what does the science say?
They are terrible health-drainers that will kill us: True or False?
True or False depending on the manner of their consumption!
There is a big difference between the average pizza base and a bowl of oats, for instance. Or rather, there are a lot of differences, but what’s most critical here?
The key is: refined and ultraprocessed grains are so inferior to whole grains as to be actively negative for health in most cases for most people most of the time.
But! It’s not because processing is ontologically evil (in reality: some processed foods are healthy, and some unprocessed foods are poisonous). although it is a very good general rule of thumb.
So, we need to understand the “why” behind the “key” that we just gave above, and that’s mostly about the resultant glycemic index and associated metrics (glycemic load, insulin index, etc).
In the case of refined and ultraprocessed grains, our body gains sugar faster than it can process it, and stores it wherever and however it can, like someone who has just realised that they will be entertaining a houseguest in 10 minutes and must tidy up super-rapidly by hiding things wherever they’ll fit.
And when the body tries to do this with sugar from refined grains, the result is very bad for multiple organs (most notably the liver, but the pancreas takes quite a hit too) which in turn causes damage elsewhere in the body, not to mention that we now have urgently-produced fat stored in unfortunate places like our liver and abdominal cavity when it should have gone to subcutaneous fat stores instead.
In contrast, whole grains come with fiber that slows down the absorption of the sugars, such that the body can deal with them in an ideal fashion, which usually means:
- using them immediately, or
- storing them as muscle glycogen, or
- storing them as subcutaneous fat
👆 that’s an oversimplification, but we only have so much room here.
For more on this, see:
Glycemic Index vs Glycemic Load vs Insulin Index
And for why this matters, see:
Which Sugars Are Healthier, And Which Are Just The Same?
And for fixing it, see:
They can be enjoyed in moderation, but watch out: True or False?
Technically True but functionally False:
- Technically true: “in moderation” is doing a lot of heavy lifting here. One person’s “moderation” may be another person’s “abstemiousness” or “gluttony”.
- Functionally false: while of course extreme consumption of pretty much anything is going to be bad, unless you are Cereals Georg eating 10,000 cereals each day and being a statistical outlier, the issue is not the quantity so much as the quality.
Quality, we discussed above—and that is, as we say, paramount. As for quantity however, you might want to know a baseline for “getting enough”, so…
They are an important cornerstone of a healthy balanced diet: True or False?
True! This one’s quite straightforward.
3 servings (each being 90g, or about ½ cup) of whole grains per day is associated with a 22% reduction in risk of heart disease, 5% reduction in all-cause mortality, and a lot of benefits across a lot of disease risks:
❝This meta-analysis provides further evidence that whole grain intake is associated with a reduced risk of coronary heart disease, cardiovascular disease, and total cancer, and mortality from all causes, respiratory diseases, infectious diseases, diabetes, and all non-cardiovascular, non-cancer causes.
These findings support dietary guidelines that recommend increased intake of whole grain to reduce the risk of chronic diseases and premature mortality.❞
~ Dr. Dagfinn Aune et al.
We’d like to give a lot more sources for the same findings, as well as papers for all the individual claims, but frankly, there are so many that there isn’t room. Suffice it to say, this is neither controversial nor uncertain; these benefits are well-established.
Here’s a very informative pop-science article, that also covers some of the things we discussed earlier (it shows what happens during refinement of grains) before getting on to recommendations and more citations for claims than we can fit here:
Harvard School Of Public Health | Whole Grains
“That’s all great, but what if I am concerned about gluten?”
There certainly are reasons you might be, be it because of a sensitivity, allergy, or just because perhaps you’d like to know more.
Let’s first mention: not all grains contain gluten, so it’s perfectly possible to enjoy naturally gluten-free grains (such as oats and rice) as well as gluten-free pseudocereals, which are not actually grains but do the same job in culinary and nutritional terms (such as quinoa and buckwheat, despite the latter’s name).
Finally, if you’d like to know more about gluten’s health considerations, then check out our previous mythbusting special:
Enjoy!
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Can a drug like Ozempic help treat addictions to alcohol, opioids or other substances?
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Semaglutide (sold as Ozempic, Wegovy and Rybelsus) was initially developed to treat diabetes. It works by stimulating the production of insulin to keep blood sugar levels in check.
This type of drug is increasingly being prescribed for weight loss, despite the fact it was initially approved for another purpose. Recently, there has been growing interest in another possible use: to treat addiction.
Anecdotal reports from patients taking semaglutide for weight loss suggest it reduces their appetite and craving for food, but surprisingly, it also may reduce their desire to drink alcohol, smoke cigarettes or take other drugs.
But does the research evidence back this up?
Animal studies show positive results
Semaglutide works on glucagon-like peptide-1 receptors and is known as a “GLP-1 agonist”.
Animal studies in rodents and monkeys have been overwhelmingly positive. Studies suggest GLP-1 agonists can reduce drug consumption and the rewarding value of drugs, including alcohol, nicotine, cocaine and opioids.
Out team has reviewed the evidence and found more than 30 different pre-clinical studies have been conducted. The majority show positive results in reducing drug and alcohol consumption or cravings. More than half of these studies focus specifically on alcohol use.
However, translating research evidence from animal models to people living with addiction is challenging. Although these results are promising, it’s still too early to tell if it will be safe and effective in humans with alcohol use disorder, nicotine addiction or another drug dependence.
What about research in humans?
Research findings are mixed in human studies.
Only one large randomised controlled trial has been conducted so far on alcohol. This study of 127 people found no difference between exenatide (a GLP-1 agonist) and placebo (a sham treatment) in reducing alcohol use or heavy drinking over 26 weeks.
In fact, everyone in the study reduced their drinking, both people on active medication and in the placebo group.
However, the authors conducted further analyses to examine changes in drinking in relation to weight. They found there was a reduction in drinking for people who had both alcohol use problems and obesity.
For people who started at a normal weight (BMI less than 30), despite initial reductions in drinking, they observed a rebound increase in levels of heavy drinking after four weeks of medication, with an overall increase in heavy drinking days relative to those who took the placebo.
There were no differences between groups for other measures of drinking, such as cravings.
Some studies show a rebound increase in levels of heavy drinking. Deman/Shutterstock In another 12-week trial, researchers found the GLP-1 agonist dulaglutide did not help to reduce smoking.
However, people receiving GLP-1 agonist dulaglutide drank 29% less alcohol than those on the placebo. Over 90% of people in this study also had obesity.
Smaller studies have looked at GLP-1 agonists short-term for cocaine and opioids, with mixed results.
There are currently many other clinical studies of GLP-1 agonists and alcohol and other addictive disorders underway.
While we await findings from bigger studies, it’s difficult to interpret the conflicting results. These differences in treatment response may come from individual differences that affect addiction, including physical and mental health problems.
Larger studies in broader populations of people will tell us more about whether GLP-1 agonists will work for addiction, and if so, for whom.
How might these drugs work for addiction?
The exact way GLP-1 agonists act are not yet well understood, however in addition to reducing consumption (of food or drugs), they also may reduce cravings.
Animal studies show GLP-1 agonists reduce craving for cocaine and opioids.
This may involve a key are of the brain reward circuit, the ventral striatum, with experimenters showing if they directly administer GLP-1 agonists into this region, rats show reduced “craving” for oxycodone or cocaine, possibly through reducing drug-induced dopamine release.
Using human brain imaging, experimenters can elicit craving by showing images (cues) associated with alcohol. The GLP-1 agonist exenatide reduced brain activity in response to an alcohol cue. Researchers saw reduced brain activity in the ventral striatum and septal areas of the brain, which connect to regions that regulate emotion, like the amygdala.
In studies in humans, it remains unclear whether GLP-1 agonists act directly to reduce cravings for alcohol or other drugs. This needs to be directly assessed in future research, alongside any reductions in use.
Are these drugs safe to use for addiction?
Overall, GLP-1 agonists have been shown to be relatively safe in healthy adults, and in people with diabetes or obesity. However side effects do include nausea, digestive troubles and headaches.
And while some people are OK with losing weight as a side effect, others aren’t. If someone is already underweight, for example, this drug might not be suitable for them.
In addition, very few studies have been conducted in people with addictive disorders. Yet some side effects may be more of an issue in people with addiction. Recent research, for instance, points to a rare risk of pancreatitis associated with GLP-1 agonists, and people with alcohol use problems already have a higher risk of this disorder.
Other drugs treatments are currently available
Although emerging research on GLP-1 agonists for addiction is an exciting development, much more research needs to be done to know the risks and benefits of these GLP-1 agonists for people living with addiction.
In the meantime, existing effective medications for addiction remain under-prescribed. Only about 3% of Australians with alcohol dependence, for example, are prescribed medication treatments such as like naltrexone, acamprosate or disulfiram. We need to ensure current medication treatments are accessible and health providers know how to prescribe them.
Continued innovation in addiction treatment is also essential. Our team is leading research towards other individualised and effective medications for alcohol dependence, while others are investigating treatments for nicotine addiction and other drug dependence.
Read the other articles in The Conversation’s Ozempic series here.
Shalini Arunogiri, Addiction Psychiatrist, Associate Professor, Monash University; Leigh Walker, , Florey Institute of Neuroscience and Mental Health, and Roberta Anversa, , The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Tuna vs Catfish – Which is Healthier?
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Our Verdict
When comparing tuna to catfish, we picked the tuna.
Why?
Today in “that which is more expensive and/or harder to get is not necessarily healthier”…
Looking at their macros, tuna has more protein and less fat (and overall, less saturated fat, and also less cholesterol).
In the category of vitamins, both are good but tuna distinguishes itself: tuna has more of vitamins A, B1, B2, B3, B6, and D, while catfish has more of vitamins B5, B9, B12, E, and K. They are both approximately equal in choline, and as an extra note in tuna’s favor (already winning 6:5), tuna is a very good source of vitamin D, while catfish barely contains any. All in all: a moderate, but convincing, win for tuna.
When it comes to minerals, things are clearer still: tuna has more copper, iron, magnesium, phosphorus, potassium, and selenium, while catfish has more calcium, manganese, and zinc. Oh, and catfish is also higher in one other mineral: sodium, which most people in industrialized countries need less of, on average. So, a 6:3 win for tuna, before we even take into account the sodium content (which makes the win for tuna even stronger).
In short: tuna wins the day in every category!
Want to learn more?
You might like to read:
Farmed Fish vs Wild Caught (It Makes Quite A Difference)
Take care!
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Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer – by Dr. Patrick Walsh & Janet Farrar Worthington
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Prostate cancer is not glamorous or fun, and neither is this book.
Nevertheless, it’s a disease that affects 12% of men in general, and 60% of men aged 60+, with that percentage climbing every year after that.
So, if you have a prostate or love someone who has one, this book is worthwhile reading—yes, even as a preventative.
Like many cancers, prostate cancer is easy to treat if caught very early, becomes harder to treat as it goes, and almost impossible to cure if it gets as far as metastasis (i.e., it spread). Like all cancers, it’s better off avoided entirely if possible.
This book covers all the stages:
- How to avoid it
- How to check for it
- How to “nip it in the bud”
- Why some might want to delay treatment (!)
- What options are available afterwards
This latter is quite extensive, and covers not just surgery, but radiation, thermo- or cryoablation, and hormone therapy.
And as for surgery, not just “remove the tumor”, but other options like radical prostatectomy, and even orchiectomy. Not many men will choose to have their testicles removed to stop them from feeding the prostate, but the point is that this book is comprehensive.
It’s asking whenever possible “is there another option?” and exploring all options, with information and without judgment, at each stage.
The writing style (likely co-author Worthington’s influence; she is an award-winning science-writer) is very “for the layman”, and that’s really helpful in demystifying a lot of what can be quite opaque in the field of oncology.
Bottom line: absolutely not an enjoyable read, but a potentially lifesaving one, especially given the odds we mentioned up top.
Click here to check out Dr. Patrick Walsh’s Guide To Surviving Prostate Cancer, and be prepared!
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We’re the ‘allergy capital of the world’. But we don’t know why food allergies are so common in Australian children
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Australia has often been called the “allergy capital of the world”.
An estimated one in ten Australian children develop a food allergy in their first 12 months of life. Research has previously suggested food allergies are more common in infants in Australia than infants living in Europe, the United States or Asia.
So why are food allergies so common in Australia? We don’t know exactly – but local researchers are making progress in understanding childhood allergies all the time.
Miljan Zivkovic/Shutterstock What causes food allergies?
There are many different types of reactions to foods. When we refer to food allergies in this article, we’re talking about something called IgE-mediated food allergy. This type of allergy is caused by an immune response to a particular food.
Reactions can occur within minutes of eating the food and may include swelling of the face, lips or eyes, “hives” or welts on the skin, and vomiting. Signs of a severe allergic reaction (anaphylaxis) include difficulty breathing, swelling of the tongue, swelling in the throat, wheeze or persistent cough, difficulty talking or a hoarse voice, and persistent dizziness or collapse.
Recent results from Australia’s large, long-running food allergy study, HealthNuts, show one in ten one-year-olds have a food allergy, while around six in 100 children have a food allergy at age ten.
A food allergy can present with skin reactions. comzeal images/Shutterstock In Australia, the most common allergy-causing foods include eggs, peanuts, cow’s milk, shellfish (for example, prawn and lobster), fish, tree nuts (for example, walnuts and cashews), soybeans and wheat.
Allergies to foods like eggs, peanuts and cow’s milk often present for the first time in infancy, while allergies to fish and shellfish may be more common later in life. While most children will outgrow their allergies to eggs and milk, allergy to peanuts is more likely to be lifelong.
Findings from HealthNuts showed around three in ten children grew out of their peanut allergy by age six, compared to nine in ten children with an allergy to egg.
Are food allergies becoming more common?
Food allergies seem to have become more common in many countries around the world over recent decades. The exact timing of this increase is not clear, because in most countries food allergies were not well measured 40 or 50 years ago.
We don’t know exactly why food allergies are so common in Australia, or why we’re seeing a rise around the world, despite extensive research.
But possible reasons for rising allergies around the world include changes in the diets of mothers and infants and increasing sanitisation, leading to fewer infections as well as less exposure to “good” bacteria. In Australia, factors such as increasing vitamin D deficiency among infants and high levels of migration to the country could play a role.
In several Australian studies, children born in Australia to parents who were born in Asia have higher rates of food allergies compared to non-Asian children. On the other hand, children who were born in Asia and later migrated to Australia appear to have a lower risk of nut allergies.
Meanwhile, studies have shown that having pet dogs and siblings as a young child may reduce the risk of food allergies. This might be because having pet dogs and siblings increases contact with a range of bacteria and other organisms.
This evidence suggests that both genetics and environment play a role in the development of food allergies.
We also know that infants with eczema are more likely to develop a food allergy, and trials are underway to see whether this link can be broken.
Can I do anything to prevent food allergies in my kids?
One of the questions we are asked most often by parents is “can we do anything to prevent food allergies?”.
We now know introducing peanuts and eggs from around six months of age makes it less likely that an infant will develop an allergy to these foods. The Australasian Society of Clinical Immunology and Allergy introduced guidelines recommending giving common allergy-causing foods including peanut and egg in the first year of life in 2016.
Our research has shown this advice had excellent uptake and may have slowed the rise in food allergies in Australia. There was no increase in peanut allergies between 2007–11 to 2018–19.
Introducing other common allergy-causing foods in the first year of life may also be helpful, although the evidence for this is not as strong compared with peanuts and eggs.
Giving kids peanuts early can reduce the risk of a peanut allergy. Madame-Moustache/Shutterstock What next?
Unfortunately, some infants will develop food allergies even when the relevant foods are introduced in the first year of life. Managing food allergies can be a significant burden for children and families.
Several Australian trials are currently underway testing new strategies to prevent food allergies. A large trial, soon to be completed, is testing whether vitamin D supplements in infants reduce the risk of food allergies.
Another trial is testing whether the amount of eggs and peanuts a mother eats during pregnancy and breastfeeding has an influence on whether or not her baby will develop food allergies.
For most people with food allergies, avoidance of their known allergens remains the standard of care. Oral immunotherapy, which involves gradually increasing amounts of food allergen given under medical supervision, is beginning to be offered in some facilities around Australia. However, current oral immunotherapy methods have potential side effects (including allergic reactions), can involve high time commitment and cost, and don’t cure food allergies.
There is hope on the horizon for new food allergy treatments. Multiple clinical trials are underway around Australia aiming to develop safer and more effective treatments for people with food allergies.
Jennifer Koplin, Group Leader, Childhood Allergy & Epidemiology, The University of Queensland and Desalegn Markos Shifti, Postdoctoral Research Fellow, Child Health Research Centre, Faculty of Medicine, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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