More Mediterranean – by American’s Test Kitchen
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Regular 10almonds readers will know that we talk about the Mediterranean diet often, and with good reason; it’s been for quite a while now the “Gold Standard” when it comes to scientific consensus on what constitutes a good diet for healthy longevity.
However, it’s easy to get stuck in a rut of cooking the same three meals and thinking “I must do something different, but not today, because I have these ingredients and don’t know what to cook” and then when one is grocery-shopping, it’s “I should have researched a new thing to cook, but since I haven’t, I’ll just get the ingredients for what I usually cook, since we need to eat”, and so the cycle continues.
This book will help break you out of that cycle! With (as the subtitle promises) hundreds of recipes, there’s no shortage of good ideas. The recipes are “plant-forward” rather than plant-based per se (i.e. there are some animal products in them), though for the vegetarians and vegans, it’s nothing that’s any challenge to substitute.
Bottom line: if you’re looking for “delicious and nutritious”, this book is sure to put a rainbow on your plate and a smile on your face.
Click here to check out More Mediterranean, and inspire your kitchen!
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The Vagus Nerve (And How You Can Make Use Of It)
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The Vagus Nerve: The Brain-Gut Highway
The longest cranial nerve is the vagus nerve; it runs all the way from your brain to your colon. It’s very important, and (amongst other tasks) it largely regulates your parasympathetic nervous system, and autonomous functions like:
- Breathing
- Heart rate
- Vasodilation & vasoconstriction
- Blood pressure
- Reflex actions (e.g. coughing, sneezing, swallowing, vomiting, hiccuping)
That’s great, but how does knowing about it help us?
Because of vagal maneuvers! This means taking an action to stimulate the vagus nerve, and prompt it to calm down various bodily functions that need calming down. This can take the form of:
- Massage
- Electrostimulation
- Diaphragmatic breathing
Massage is perhaps the simplest; “vagus” means “wandering”, and the nerve is accessible in various places, including behind the ears. That’s the kind of thing that’ easier to show than tell, though, so we’ll include a video at the end.
Electrostimulation is the fanciest, and has been used to treat migraines and cluster headaches. Check out, for example:
Update on noninvasive neuromodulation for migraine treatment-Vagus nerve stimulation
Diaphragmatic breathing means breathing from the diaphragm—the big muscular tissue that sits under your lungs. You might know it as “abdominal breathing”, and refers to breathing “to the abdomen” rather than merely to the chest.
Even though your lungs are obviously in your chest not your abdomen, breathing with a focus on expanding the abdomen (rather than the chest) when breathing in, will result in much deeper breathing as the diaphragm allows the lungs to fill downwards as well as outwards.
Why this helps when it comes to the vagus nerve is simply that the vagus nerve passes by the diaphragm, such that diaphragmatic breathing will massage the vagus nerve deep inside your body.
More than just treating migraines
Vagus nerve stimulation has also been researched and found potentially helpful for managing:
- Depression, inflammation, and heart disease
- Diabetes and glycemic issues in general
- Multiple sclerosis and autoimmune disease in general
- Alzheimer’s disease and dementia in general
- Rheumatoid arthritis (we already mentioned inflammation and autoimmune diseases, but this is an interesting paper so we included it)
All this is particularly important as we get older, because vagal response reduces with age, and vagus nerve stimulation, which improves vagal tone, makes it easier not just to manage the aforementioned maladies, but also simply to relax more easily and more deeply.
See: Influence of age and gender on autonomic regulation of heart
We promised a video for the massage, so here it is:
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Surgery is the default treatment for ACL injuries in Australia. But it’s not the only way
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The anterior cruciate ligament (ACL) is an important ligament in the knee. It runs from the thigh bone (femur) to the shin bone (tibia) and helps stabilise the knee joint.
Injuries to the ACL, often called a “tear” or a “rupture”, are common in sport. While a ruptured ACL has just sidelined another Matildas star, people who play sport recreationally are also at risk of this injury.
For decades, surgical repair of an ACL injury, called a reconstruction, has been the primary treatment in Australia. In fact, Australia has among the highest rates of ACL surgery in the world. Reports indicate 90% of people who rupture their ACL go under the knife.
Although surgery is common – around one million are performed worldwide each year – and seems to be the default treatment for ACL injuries in Australia, it may not be required for everyone.
What does the research say?
We know ACL ruptures can be treated using reconstructive surgery, but research continues to suggest they can also be treated with rehabilitation alone for many people.
Almost 15 years ago a randomised clinical trial published in the New England Journal of Medicine compared early surgery to rehabilitation with the option of delayed surgery in young active adults with an ACL injury. Over half of people in the rehabilitation group did not end up having surgery. After five years, knee function did not differ between treatment groups.
The findings of this initial trial have been supported by more research since. A review of three trials published in 2022 found delaying surgery and trialling rehabilitation leads to similar outcomes to early surgery.
A 2023 study followed up patients who received rehabilitation without surgery. It showed one in three had evidence of ACL healing on an MRI after two years. There was also evidence of improved knee-related quality of life in those with signs of ACL healing compared to those whose ACL did not show signs of healing.
Regardless of treatment choice the rehabilitation process following ACL rupture is lengthy. It usually involves a minimum of nine months of progressive rehabilitation performed a few days per week. The length of time for rehabilitation may be slightly shorter in those not undergoing surgery, but more research is needed in this area.
Rehabilitation starts with a physiotherapist overseeing simple exercises right through to resistance exercises and dynamic movements such as jumping, hopping and agility drills.
A person can start rehabilitation with the option of having surgery later if the knee remains unstable. A common sign of instability is the knee giving way when changing direction while running or playing sports.
To rehab and wait, or to go straight under the knife?
There are a number of reasons patients and clinicians may opt for early surgical reconstruction.
For elite athletes, a key consideration is returning to sport as soon as possible. As surgery is a well established method, athletes (such as Matilda Sam Kerr) often opt for early surgical reconstruction as this gives them a more predictable timeline for recovery.
At the same time, there are risks to consider when rushing back to sport after ACL reconstruction. Re-injury of the ACL is very common. For every month return to sport is delayed until nine months after ACL reconstruction, the rate of knee re-injury is reduced by 51%.
Historically, another reason for having early surgical reconstruction was to reduce the risk of future knee osteoarthritis, which increases following an ACL injury. But a review showed ACL reconstruction doesn’t reduce the risk of knee osteoarthritis in the long term compared with non-surgical treatment.
That said, there’s a need for more high-quality, long-term studies to give us a better understanding of how knee osteoarthritis risk is influenced by different treatments.
Rehab may not be the only non-surgical option
Last year, a study looking at 80 people fitted with a specialised knee brace for 12 weeks found 90% had evidence of ACL healing on their follow-up MRI.
People with more ACL healing on the three-month MRI reported better outcomes at 12 months, including higher rates of returning to their pre-injury level of sport and better knee function. Although promising, we now need comparative research to evaluate whether this method can achieve similar results to surgery.
What to do if you rupture your ACL
First, it’s important to seek a comprehensive medical assessment from either a sports physiotherapist, sports physician or orthopaedic surgeon. ACL injuries can also have associated injuries to surrounding ligaments and cartilage which may influence treatment decisions.
In terms of treatment, discuss with your clinician the pros and cons of management options and whether surgery is necessary. Often, patients don’t know not having surgery is an option.
Surgery appears to be necessary for some people to achieve a stable knee. But it may not be necessary in every case, so many patients may wish to try rehabilitation in the first instance where appropriate.
As always, prevention is key. Research has shown more than half of ACL injuries can be prevented by incorporating prevention strategies. This involves performing specific exercises to strengthen muscles in the legs, and improve movement control and landing technique.
Anthony Nasser, Senior Lecturer in Physiotherapy, University of Technology Sydney; Joshua Pate, Senior Lecturer in Physiotherapy, University of Technology Sydney, and Peter Stubbs, Senior Lecturer in Physiotherapy, University of Technology Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Overcoming Tendonitis – by Dr. Steven Low & Dr. Frank Skretch
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If you assumed tendonitis to be an inflammatory condition, you’re not alone. However, it’s not; the “-itis” nomenclature is a misnomer, and while one can rarely go wrong with reducing chronic/systemic inflammation, it’s not the cure for tendonitis.
What, then, is tendonitis and what does cure it? It’s a non-inflammatory proliferation disorder, meaning, something is growing (or in this case, simply being replaced) in a way it shouldn’t. As to fixing it, that’s more complex.
This book does cover 20 interventions (sorted into “major” and “minor”), ranging from exercise therapies to surgery, with many things between. It also examines popular myths that do not help, such as rest, ice, heat, and analgesics.
The style of this book is hard science, but don’t worry, it explains everything along the way. It does however mean that if you’re not very accustomed to wading through scientific material, you can’t just dip into the middle of the book and be guaranteed to understand what’s going on. Indeed, before even getting to discussing tendonitis/tendinopathy, the first chapter is very reassuringly dedicated to “understanding the levels and classification of evidence in studies”, along with the assorted scales and guidelines of the Center for Evidence-Based Medicine.
The rest, however, is about the etiology, diagnosis, and treatment of tendonitis and tendinopathy more generally. One interesting thing is that, according to the abundant high-quality evidence presented in this book, what works for one body part’s tendonitis does not necessarily work for another body part, so we get quite a part-by-part rundown.
Bottom line: this book has a wealth of useful, applicable information about management of tendonitis, making it indispensable if you or a loved one suffer from such—but settle in, because it’s not a light read.
Click here to check out Overcoming Tendonitis, and overcome tendonitis!
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Caffeine Blues – by Stephen Cherniske
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Caffeine use is an interesting and often-underexamined factor in health. Beyond the most superficial of sleep hygiene advice (à la “if you aren’t sleeping well, consider skipping your triple espresso martini at bedtime”), it’s often considered a “everybody has this” drug.
In this book, Cherniske explores a lot of the lesser-known effects of caffeine, and the book certainly is a litany against caffeine dependence, ultimately arguing strongly against caffeine use itself. The goal is certainly to persuade the reader to desist in caffeine use, and while the book’s selling point is “learn about caffeine” not “how to quit caffeine”, a program for quitting caffeine is nevertheless included.
You may notice the title and cover design are strongly reminiscent of “Sugar Blues”, which came decades before it, and that’s clearly not accidental. The style is similar—very sensationalist, and with a lot of strong claims. In this case, however, there is actually a more robust bibliography, albeit somewhat dated now as science has continued to progress since this book was published.
Bottom line: in this reviewer’s opinion, the book overstates its case a little, and is prone to undue sensationalism, but there is a lot of genuinely very good information in here too, making it definitely worth reading.
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Women take more antidepressants after divorce than men but that doesn’t mean they’re more depressed
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Research out today from Finland suggests women may find it harder to adjust to later-life divorce and break-ups than men.
The study used population data from 229,000 Finns aged 50 to 70 who had undergone divorce, relationship break-up or bereavement and tracked their use of antidepressants before and after their relationship ended.
They found antidepressant use increased in the four years leading to the relationship dissolution in both genders, with women experiencing a more significant increase.
But it’s too simplistic to say women experience poorer mental health or tend to be less happy after divorce than men.
Remind me, how common is divorce?
Just under 50,000 divorces are granted each year in Australia. This has slowly declined since the 1990s.
More couple are choosing to co-habitate, instead of marry, and the majority of couples live together prior to marriage. Divorce statistics don’t include separations of cohabiting couples, even though they are more likely than married couples to separate.
Those who divorce are doing so later in life, often after their children grow up. The median age of divorce increased from 45.9 in 2021 to 46.7 in 2022 for men and from 43.0 to 43.7 for women.
The trend of late divorces also reflects people deciding to marry later in life. The median duration from marriage to divorce in 2022 was around 12.8 years and has remained fairly constant over the past decade.
Why do couples get divorced?
Changes in social attitudes towards marriage and relationships mean divorce is now more accepted. People are opting not to be in unhappy marriages, even if there are children involved.
Instead, they’re turning the focus on marriage quality. This is particularly true for women who have established a career and are financially autonomous.
Similarly, my research shows it’s particularly important for people to feel their relationship expectations can be fulfilled long term. In addition to relationship quality, participants reported needing trust, open communication, safety and acceptance from their partners.
“Grey divorce” (divorce at age 50 and older) is becoming increasingly common in Western countries, particularly among high-income populations. While factors such as an empty nest, retirement, or poor health are commonly cited predictors of later-in-life divorce, research shows older couples divorce for the same reasons as younger couples.
What did the new study find?
The study tracked antidepressant use in Finns aged 50 to 70 for four years before their relationship breakdown and four years after.
They found antidepressant use increased in the four years leading to the relationship break-up in both genders. The proportion of women taking antidepressants in the lead up to divorce increased by 7%, compared with 5% for men. For de facto separation antidepressant use increased by 6% for women and 3.2% for men.
Within a year of the break-up, antidepressant use fell back to the level it was 12 months before the break-up. It subsequently remained at that level among the men.
But it was a different story for women. Their use tailed off only slightly immediately after the relationship breakdown but increased again from the first year onwards.
The researchers also looked at antidepressant use after re-partnering. There was a decline in the use of antidepressants for men and women after starting a new relationship. But this decline was short-lived for women.
But there’s more to the story
Although this data alone suggest women may find it harder to adjust to later-life divorce and break-ups than men, it’s important to note some nuances in the interpretation of this data.
For instance, data suggesting women experience depression more often than men is generally based on the rate of diagnoses and antidepressant use, which does not account for undiagnosed and unmedicated people.
Women are generally more likely to access medical services and thus receive treatment. This is also the case in Australia, where in 2020–2022, 21.6% of women saw a health professional for their mental health, compared with only 12.9% of men.
Why women might struggle more after separating
Nevertheless, relationship dissolution can have a significant impact on people’s mental health. This is particularly the case for women with young children and older women.
So what factors might explain why women might experience greater difficulties after divorce later in life?
Research investigating the financial consequences of grey divorce in men and women showed women experienced a 45% decline in their standard of living (measured by an income-to-needs ratio), whereas men’s dropped by just 21%. These declines persisted over time for men, and only reversed for women following re-partnering.
Another qualitative study investigating the lived experiences of heterosexual couples post-grey divorce identified financial worries as a common theme between female participants.
A female research participant (age 68) said:
[I am most worried about] the money, [and] what I’m going to do when the little bit of money I have runs out […] I have just enough money to live. And, that’s it, [and if] anything happens I’m up a creek. And Medicare is incredibly expensive […] My biggest expense is medicine.
Another factor was loneliness. One male research participant (age 54) described he preferred living with his ex-wife, despite not getting along with her, than being by himself:
It was still [good] knowing that [the] person was there, and now that’s gone.
Other major complications of later-life divorce are possible issues with inheritance rights and next-of-kin relationships for medical decision-making.
Separation can be positive
For some people, divorce or separation can lead to increased happiness and feeling more independent.
And the mental health impact and emotional distress of a relationship dissolution is something that can be counterattacked with resilience. Resilience to dramatic events built from life experience means older adults often do respond better to emotional distress and might be able to adjust better to divorce than their younger counterparts.
Raquel Peel, Adjunct Senior Lecturer, University of Southern Queensland and Senior Lecturer, RMIT University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Buckwheat vs Bulgur Wheat – Which is Healthier?
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Our Verdict
When comparing buckwheat to bulgur, we picked the buckwheat.
Why?
First, some things to know up front:
- Bulgur wheat is a kind of cracked wheat product. As such, it contains wheat, and yes, gluten.
- Buckwheat is not a wheat, nor even a grass, but a flowering plant. Buckwheat is as related to wheat as a lionfish is to a lion. It does not contain gluten.
- Buckwheat can be purchased whole or hulled. We went with whole. If you go with hulled, the percentages of vitamins and minerals will be relatively higher, and/but this will be because you lost the fibrous husk, so they’ll be commensurately lower in fiber. If you were to go with hulled, we’d still pick it over bulgur wheat though, just for a different reason (as in that case, the vitamin and mineral contents would be more overwhelmingly in buckwheat’s favor, even though it’d have less fiber).
Ok, now that those things are covered…
Looking at the macronutrients, there’s not a lot between them, except that buckwheat has the much lower glycemic index (this is only the case if you got whole, not hulled—if you got hulled, the glycemic index would be about the same).
In terms of vitamins, buckwheat has more of vitamins B2, B5, B9, E, K, and choline, while bulgur wheat technically has more vitamin A, but the numbers are tiny; a cup of bulgur wheat will give you 0.12% of the RDA. So, an easy win (functionally: 5:0) for buckwheat.
When it comes to minerals, buckwheat has more copper, magnesium, potassium, and selenium, while bulgur wheat has more calcium and manganese. They’re equal on iron and phosphorus, making this a 4:2 win for buckwheat.
Adding up the categories makes this a clear win for buckwheat!
Want to learn more?
You might like to read:
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