How I Cured My Silent Reflux – by Don Daniels
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Acid reflux, in its various forms (not all of which include heartburn as a symptom!), affects around 1 in 8 people. Often it takes the form of coughing or excess mucus after eating, and it can trigger ostensibly random sweats, for example.
Don Daniels does an excellent job of demystifying the various kinds of acid reflux, explaining clearly and simply the mechanics of what is going on for each of them and why.
Further, he talks about the medications that can make things worse (and how and why), and supplements that can make it better (and supplements that can make it worse, too!), and a multiphase plan (diet on, meds weaned off, supplements on, supplements weaned off when asymptomatic, diet adjust to a new normal) to get free from acid reflux.
The writing style is simple, clear, and jargon-free, while referencing plenty of scientific literature, often quoting from it and providing sources, much like we often do at 10almonds. There are 50+ such references in all, for a 105-page book.
So, do also note that yes, it’s quite a short book for the price, but the content is of value and wouldn’t have benefitted from padding of the kind that many authors do just to make the book longer.
Bottom line: if you have, or suspect you may have, an acid reflux condition of any kind, then this book can guide you through fixing that.
Click here to check out How I Cured My Silent Reflux, and put up with it no longer!
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Alpha, beta, theta: what are brain states and brain waves? And can we control them?
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There’s no shortage of apps and technology that claim to shift the brain into a “theta” state – said to help with relaxation, inward focus and sleep.
But what exactly does it mean to change one’s “mental state”? And is that even possible? For now, the evidence remains murky. But our understanding of the brain is growing exponentially as our methods of investigation improve.
Brain-measuring tech is evolving
Currently, no single approach to imaging or measuring brain activity gives us the whole picture. What we “see” in the brain depends on which tool we use to “look”. There are myriad ways to do this, but each one comes with trade-offs.
We learnt a lot about brain activity in the 1980s thanks to the advent of magnetic resonance imaging (MRI).
Eventually we invented “functional MRI”, which allows us to link brain activity with certain functions or behaviours in real time by measuring the brain’s use of oxygenated blood during a task.
We can also measure electrical activity using EEG (electroencephalography). This can accurately measure the timing of brain waves as they occur, but isn’t very accurate at identifying which specific areas of the brain they occur in.
Alternatively, we can measure the brain’s response to magnetic stimulation. This is very accurate in terms of area and timing, but only as long as it’s close to the surface.
What are brain states?
All of our simple and complex behaviours, as well as our cognition (thoughts) have a foundation in brain activity, or “neural activity”. Neurons – the brain’s nerve cells – communicate by a sequence of electrical impulses and chemical signals called “neurotransmitters”.
Neurons are very greedy for fuel from the blood and require a lot of support from companion cells. Hence, a lot of measurement of the site, amount and timing of brain activity is done via measuring electrical activity, neurotransmitter levels or blood flow.
We can consider this activity at three levels. The first is a single-cell level, wherein individual neurons communicate. But measurement at this level is difficult (laboratory-based) and provides a limited picture.
As such, we rely more on measurements done on a network level, where a series of neurons or networks are activated. Or, we measure whole-of-brain activity patterns which can incorporate one or more so-called “brain states”.
According to a recent definition, brain states are “recurring activity patterns distributed across the brain that emerge from physiological or cognitive processes”. These states are functionally relevant, which means they are related to behaviour.
Brain states involve the synchronisation of different brain regions, something that’s been most readily observed in animal models, usually rodents. Only now are we starting to see some evidence in human studies.
Various kinds of states
The most commonly-studied brain states in both rodents and humans are states of “arousal” and “resting”. You can picture these as various levels of alertness.
Studies show environmental factors and activity influence our brain states. Activities or environments with high cognitive demands drive “attentional” brain states (so-called task-induced brain states) with increased connectivity. Examples of task-induced brain states include complex behaviours such as reward anticipation, mood, hunger and so on.
In contrast, a brain state such as “mind-wandering” seems to be divorced from one’s environment and tasks. Dropping into daydreaming is, by definition, without connection to the real world.
We can’t currently disentangle multiple “states” that exist in the brain at any given time and place. As mentioned earlier, this is because of the trade-offs that come with recording spatial (brain region) versus temporal (timing) brain activity.
Brain states vs brain waves
Brain state work can be couched in terms such as alpha, delta and so forth. However, this is actually referring to brain waves which specifically come from measuring brain activity using EEG.
EEG picks up on changing electrical activity in the brain, which can be sorted into different frequencies (based on wavelength). Classically, these frequencies have had specific associations:
- gamma is linked with states or tasks that require more focused concentration
- beta is linked with higher anxiety and more active states, with attention often directed externally
- alpha is linked with being very relaxed, and passive attention (such as listening quietly but not engaging)
- theta is linked with deep relaxation and inward focus
- and delta is linked with deep sleep.
Brain wave patterns are used a lot to monitor sleep stages. When we fall asleep we go from drowsy, light attention that’s easily roused (alpha), to being relaxed and no longer alert (theta), to being deeply asleep (delta).
Can we control our brain states?
The question on many people’s minds is: can we judiciously and intentionally influence our brain states?
For now, it’s likely too simplistic to suggest we can do this, as the actual mechanisms that influence brain states remain hard to detangle. Nonetheless, researchers are investigating everything from the use of drugs, to environmental cues, to practising mindfulness, meditation and sensory manipulation.
Controversially, brain wave patterns are used in something called “neurofeedback” therapy. In these treatments, people are given feedback (such as visual or auditory) based on their brain wave activity and are then tasked with trying to maintain or change it. To stay in a required state they may be encouraged to control their thoughts, relax, or breathe in certain ways.
The applications of this work are predominantly around mental health, including for individuals who have experienced trauma, or who have difficulty self-regulating – which may manifest as poor attention or emotional turbulence.
However, although these techniques have intuitive appeal, they don’t account for the issue of multiple brain states being present at any given time. Overall, clinical studies have been largely inconclusive, and proponents of neurofeedback therapy remain frustrated by a lack of orthodox support.
Other forms of neurofeedback are delivered by MRI-generated data. Participants engaging in mental tasks are given signals based on their neural activity, which they use to try and “up-regulate” (activate) regions of the brain involved in positive emotions. This could, for instance, be useful for helping people with depression.
Another potential method claimed to purportedly change brain states involves different sensory inputs. Binaural beats are perhaps the most popular example, wherein two different wavelengths of sound are played in each ear. But the evidence for such techniques is similarly mixed.
Treatments such as neurofeedback therapy are often very costly, and their success likely relies as much on the therapeutic relationship than the actual therapy.
On the bright side, there’s no evidence these treatment do any harm – other than potentially delaying treatments which have been proven to be beneficial.
Susan Hillier, Professor: Neuroscience and Rehabilitation, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Resistance Is Useful! (Especially As We Get Older)
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Resistance Is Useful!
At 10almonds we talk a lot about the importance of regular moderate exercise (e.g. walking, gardening, housework, etc), and with good reason: getting in those minutes (at least 150 minutes per week, so, a little over 20 minutes per day, or 25 minutes per day with one day off) is the exericise most consistently linked to better general health outcomes and reduced mortality risk.
We also often come back to mobility, because at the end of the day, being able to reach for something from a kitchen cabinet without doing oneself an injury is generally more important in life than being able to leg-press a car.
Today though, we’re going to talk about resistance training.
What is resistance training?
It can be weight-lifting, or it can be bodyweight exercises. In those cases, what you’re resisting is gravity. It can also be exercises with resistance bands or machines. In all cases, it’s about building and/or maintaining strength.
Why does it matter?
Let’s say you’re not an athlete, soldier, or laborer, and the heaviest thing you have to pick up is a bag of groceries. Strength still matters, for two main reasons:
- Muscle strength correlates to bone strength. You can’t build (or maintain) strong muscles on weak bones, so if you take care of your muscles, then your body will keep your bones strong too.
- That’s assuming you have a good diet as well—but today’s not about that. If you’d like to know more about eating for bone health though, do check out this previous article about that!
- Muscle strength correlates to balance and stability. You can’t keep yourself from falling over if you are physically frail.
Both of those things matter, because falls and fractures often have terrible health outcomes (e.g., slower recovery and more complications) the older we get. So, we want to:
- Ideally, not fall in the first place
- If we do fall, have robust bones
See also: Effects of Resistance Exercise on Bone Health
How much should we do?
Let’s go to the Journal of Strength and Conditioning Research on this one:
❝There is strong evidence to support the benefits of resistance exercise for countering many age-related processes of sarcopenia, muscle weakness, mobility loss, chronic disease, disability, and even premature mortality.
In addition, this Position Statement provides specific evidence-based practice recommendations to aid in the implementation of resistance exercise programs for healthy older adults and those with special considerations.
While there are instances where low-intensity, low-volume programs are appropriate (i.e., beginning programs for individuals with frailty or CVDs), the greatest benefits are possible with progression to moderate to higher intensity programs.❞
~ Fragala et al
Read the statement in full:
There’s a lot of science there and it’s well worth reading if you have the time. It’s particularly good at delineating how much is not enough vs how much is too much, and the extent to which we should (or shouldn’t) train to exhaustion.
If you don’t fancy that, though, and/or just want to start with something accessible and work your way up, the below is a very good (and also evidence-based) start-up plan:
Healthline’s Exercise Plan For Seniors—For Strength, Balance, & Flexibility
(it has a weekly planner, step-by-step guides to the exercises, and very clear illustrative animations of each)
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- Muscle strength correlates to bone strength. You can’t build (or maintain) strong muscles on weak bones, so if you take care of your muscles, then your body will keep your bones strong too.
Marrakesh Sorghum Salad
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As the name suggests, it’s a Maghreb dish today! Using sorghum, a naturally gluten-free whole grain with a stack of vitamins and minerals. This salad also comes with fruit and nuts (apricots and almonds; a heavenly combination for both taste and nutrients) as well as greens, herbs, and spices.
Note: to keep things simple today, we’ve listed ras el-hanout as one ingredient. If you’re unfamiliar, it’s a spice blend; you can probably buy a version locally, but you might as well know how to make it yourself—so here’s our recipe for that!
You will need
- 1½ cups sorghum, soaked overnight in water (if you can’t find it locally, you can order it online (here’s an example product on Amazon), or substitute quinoa) and if you have time, soaked overnight and then kept in a jar with just a little moisture for a few days until they begin to sprout—this will be best of all. But if you don’t have time, don’t worry about it; overnight soaking is sufficient already.
- 1 carrot, grated
- ½ cup chopped parsley
- 1 tbsp apple cider vinegar
- ½ tbsp chopped chives
- 2 tbsp ras el-hanout
- 3 cloves garlic, crushed
- 2 tbsp almond butter
- 1 tbsp lemon juice
- 1 tsp white miso paste
- ½ cup sliced almonds
- 4 fresh apricots, pitted and cut into wedges
- 1 cup mint leaves, chopped
- To serve: your choice of salad greens; we suggest chopped romaine lettuce and rocket
Method
(we suggest you read everything at least once before doing anything)
1) Cook the sorghum, which means boiling it for about 45 minutes, or 30 in a pressure cooker. If unsure, err on the side of cooking longer—even up to an hour will be totally fine. You have a lot of wiggle room, and will soon get used to how long it takes with your device/setup. Drain the cooked sorghum, and set it aside to cool. If you’re entertaining, we recommend doing this part the day before and keeping it in the fridge.
2) When it’s cool, add the carrot, the parsley, the chives, the vinegar, and 1 tbsp of the ras el-hanout. Toss gently but thoroughly to combine.
3) Make the dressing, which means putting ¼ cup water into a blender with the other 1 tbsp of the ras el-hanout, the garlic, the almond butter, the lemon juice, and the miso paste. Blend until smooth.
4) Assemble the salad, which means adding the dressing to sorghum-and-ingredients bowl, along with the almonds, apricots, and mint leaves. Toss gently, but sufficiently that everything is coated.
5) Serve on a bed of salad greens.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Four Ways To Upgrade The Mediterranean Diet ← including an anti-inflammatory version, which is functionally what we’re doing today. As an aside when people hear “Mediterranean” they often think “Italy and Greece”. Which, sure, but N. Africa (and thus Maghreb cuisine) is also very much Mediterranean, and it shows!
- Our Top 5 Spices: How Much Is Enough For Benefits?
- Why You Should Diversify Your Nuts!
- Brain Food? The Eyes Have It!
Take care!
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Super-Nutritious Shchi
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Today we have a recipe we’ve mentioned before, but now we have standalone recipe pages for recipes, so here we go. The dish of the day is shchi—which is Russian cabbage soup, which sounds terrible, and looks as bad as it sounds. But it tastes delicious, is an incredible comfort food, and is famous (in Russia, at least) for being something one can eat for many days in a row without getting sick of it.
It’s also got an amazing nutritional profile, with vitamins A, B, C, D, as well as lots of calcium, magnesium, and iron (amongst other minerals), and a healthy blend of carbohydrates, proteins, and fats, plus an array of anti-inflammatory phytochemicals, and of course, water.
You will need
- 1 large white cabbage, shredded
- 1 cup red lentils
- ½ lb tomatoes, cut into eighths (as in: halve them, halve the halves, and halve the quarters)
- ½ lb mushrooms sliced (or halved, if they are baby button mushrooms)
- 1 large onion, chopped finely
- 1 tbsp rosemary, chopped finely
- 1 tbsp thyme, chopped finely
- 1 tbsp black pepper, coarse ground
- 1 tsp cumin, ground
- 1 tsp yeast extract
- 1 tsp MSG, or 2 tsp low-sodium salt
- A little parsley for garnishing
- A little fat for cooking; this one’s a tricky and personal decision. Butter is traditional, but would make this recipe impossible to cook without going over the recommended limit for saturated fat. Avocado oil is healthy, relatively neutral in taste, and has a high smoke point for caramelizing the onions. Extra virgin olive oil is also a healthy choice, but not as neutral in flavor and does have a lower smoke point. Coconut oil has far too strong a taste and a low smoke point. Seed oils are very heart-unhealthy. All in all, avocado oil is a respectable choice from all angles except tradition.
Note: with regard to the seasonings, the above is a basic starting guide; feel free to add more per your preference—however, we do not recommend adding more cumin (it’ll overpower it) or more salt (there’s enough sodium in here already).
Method
(we suggest you read everything at least once before doing anything)
1) Cook the lentils until soft (a rice cooker is great for this, but a saucepan is fine); be generous with the water; we are making a soup, after all. Set them aside without draining.
2) Sauté the cabbage, and put it in a big stock pot or similar large pan (not yet on the heat)
3) Fry the mushrooms, and add them to the big pot (still not yet on the heat)
4) Use a stick blender to blend the lentils in the water you cooked them in, and then add to the big pot too.
5) Turn the heat on low, and if necessary, add more water to make it into a rich soup
6) Add the seasonings (rosemary, thyme, cumin, black pepper, yeast extract, MSG-or-salt) and stir well. Keep the temperature on low; you can just let it simmer now because the next step is going to take a while:
7) Caramelize the onion (keep an eye on the big pot, stirring occasionally) and set it aside
8) Fry the tomatoes quickly (we want them cooked, but just barely) and add them to the big pot
9) Serve! The caramelized onion is a garnish, so put a little on top of each bowl of shchi. Add a little parsley too.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- The Magic Of Mushrooms: “The Longevity Vitamin” (That’s Not A Vitamin)
- Easily Digestible Vegetarian Protein Sources
- The Bare-Bones Truth About Osteoporosis
- Some Surprising Truths About Hunger And Satiety
Take care!
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Miss Diagnosis: Anxiety, ADHD, & Women
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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
❝Why is ADHD so often misdiagnosed as anxiety in women?❞
A great question! A short and slightly flippant answer could be “it’s the medical misogyny”:
Women and Minorities Bear the Brunt of Medical Misdiagnosis
…and if you’d like to learn more in-depth about this, we recommend this excellent book:
Unwell Women: Misdiagnosis and Myth in a Man-Made World – by Dr. Elinor Cleghorn ← you can read our review here
However, in this case there is more going on too!
Part of this is because ADHD is, like many psychiatric issues, a collection of symptoms that may or may not all always be present. Since clinical definitions are decided by clinicians, rather than some special natural law of the universe, sometimes this results in “several small conditions in a trenchcoat”, and if one symptom is or isn’t present, it can make things look quite different:
What’s The Difference Between ADD and ADHD?
There are two things at hand here: as in the above example, there’s the presence or absence of hyperactivity, but also, that “attention deficit”?
It’s often not really a deficit of attention, so much as the attention is going somewhere else—an example of naming psychiatric disorders for how they affect other people, rather than the person in question.
Sidenote: personality disorders really get the worst of this!
“You have a deep insecurity about never being good enough, and you constantly mess up in your attempt to overcompensate? You may have Evil Bastard Disorder!”
“You have a crippling fear of abandonment and that you are fundamentally unloveable, so you do all you can to try to keep people close? You must have Manipulative Bitch Disorder!”
etc
In the case of ADHD and anxiety and women, a lot of this comes down to how the redirection of focus is perceived:
❝For some time, it has been held that women with ADHD are more likely to internalize symptoms and become anxious and depressed and to suffer emotional dysregulation❞
This internalization of symptoms, vs the externalization more generally perceived in boys and men, is more likely to be seen as anxiety.
Double standards also abound for social reasons, e.g:
- He is someone who thinks ten steps ahead and covers all bases
- She is anxious and indecisive and unable to settle on one outcome
Here’s a very good overview of how this double-standard makes its way into diagnostic processes, along with other built-in biases:
Miss. Diagnosis: A Systematic Review of ADHD in Adult Women
Want to learn more?
We’ve reviewed quite a few books about ADHD, but if we had to pick one to spotlight, we’d recommend this one:
The Silent Struggle: Taking Charge of ADHD in Adults – by L. William Ross-Child, MLC
Enjoy! And while we have your attention… Would you like this section to be bigger? If so, send us more questions!
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The Polyvagal Theory – by Dr. Stephen Porges
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Do you ever find that your feelings (or occasionally: lack thereof) sometimes can seem mismatched with the observed facts of your situation? This book unravels that mystery—or rather, that stack of mysteries.
Dr. Porges’ work on this topic is, by the way, the culmination of 40 years of research. While he’s not exactly a household name to the layperson, he’s very respected in his field, and this book is his magnum opus.
Here he explains the disparate roles of the two branches of the vagus nerve (hence: polyvagal theory). At least, the two branches that we mammals have; non-mammalian vertebrates have only one. This makes a big difference, because of the cascade of inhibitions that this allows.
The answer to the very general question “What stops you from…?” is usually found somewhere down this line of cascade of inhibitions.
These range from “what stops you from quitting your job/relationship/etc” to “what stops you from freaking out” to “what stops you from relaxing” to “what stops you from reacting quickly” to “what stop you from giving up” to “what stops you from gnawing your arm off” and many many more.
And because sometimes we wish we could do something that we can’t, or wish we wouldn’t do something that we do, understanding this process can be something of a cheat code to life.
A quick note on style: the book is quite dense and can be quite technical, but should be comprehensible to any layperson who is content to take their time, because everything is explained as we go along.
Bottom line: if you’d like to better understand the mysteries of how you feel vs how you actually are, and what that means for what you can or cannot wilfully do, this is a top-tier book
Click here to check out Polyvagal Theory, and take control of your responses!
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