Best morning routine?

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You’ve Got Questions? We’ve Got Answers!

Q: Best morning routine?

A: The best morning routine is whatever makes you feel most ready to take on your day!

This one’s going to vary a lot—one person’s morning run could be another person’s morning coffee and newspaper, for example.

In a nutshell, though, ask yourself these questions:

  • How long does it take me to fully wake up in the morning, and what helps or hinders that?
  • When I get out of bed, what do I really need before I can take on my day?
  • If I could have the perfect morning, what would it look like?
  • What can evening me do, to look after morning me’s best interests? (Semi-prepare breakfast ready? Lay out clothes ready? Running shoes? To-Do list?)

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  • Beat Cancer Kitchen – by Chris Wark & Micah Wark

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    When we eat, many things can increase our cancer risk. Some we might remember to avoid, like ultra-processed foods and red meat. Others might be more neutral when it comes to cancer, neither good nor bad.

    But! Some foods also have cancer-fighting properties. Which means reducing cancer risk, and/or having an anti-proliferative effect (i.e., shrinks or at least slows growth of tumors), in the event of already having cancer.

    That’s what Chris & Micah Wark are offering here; a cookbook built around anti-cancer foods—after the former beat his own cancer with the help of the latter. He had surgery, but skipped chemo, preferring to look to nutrition to keep cancer-free. Now 18 years later, and so far, so good.

    The dietary advice here is entirely consistent with what we’d offer at 10almonds; it’s plant-based, and high in anti-cancer phytonutrients.

    The recipes themselves (of which there are about 70-ish) are as delicious and simple as the title suggests, and/but you might want to know:

    • On the one hand, many recipes are things like sauces, condiments, or dressings, which in a recipe book can sometimes feel like underdelivering on the promise of recipes when we expect full meals
    • On the other hand, those things if you just purchase them ready-made are usually the things with the most ultra-processed products, thus, having anticancer homemade versions instead here can actually make a very big difference
    • On the third hand, there areplenty of starters/mains/desserts too!

    Bottom line: if you’re looking for an anti-cancer cookbook, this is a very good one whose ingredients aren’t obscure (which can otherwise be a problem for some books of this kind)

    Click here to check out Beat Cancer Kitchen, and take good care of yourself and your loved ones!

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  • Get The Right Help For Your Pain

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    How Much Does It Hurt?

    Sometimes, a medical professional will ask us to “rate your pain on a scale of 1–10”.

    It can be tempting to avoid rating one’s pain too highly, because if we say “10” then where can we go from there? There is always a way to make pain worse, after all.

    But that kind of thinking, however logical, is folly—from a practical point of view. Instead of risking having to give an 11 later, you have now understated your level-10 pain as a “7” and the doctor thinks “ok, I’ll give Tylenol instead of morphine”.

    A more useful scale

    First, know this:

    Zero is not “this is the lowest level of pain I get to”.

    Zero is “no pain”.

    As for the rest…

    1. My pain is hardly noticeable.
    2. I have a low level of pain; I am aware of my pain only when I pay attention to it.
    3. My pain bothers me, but I can ignore it most of the time.
    4. I am constantly aware of my pain, but can continue most activities.
    5. I think about my pain most of the time; I cannot do some of the activities I need to do each day because of the pain.
    6. I think about my pain all of the time; I give up many activities because of my pain.
    7. I am in pain all of the time; It keeps me from doing most activities.
    8. My pain is so severe that it is difficult to think of anything else. Talking and listening are difficult.
    9. My pain is all that I can think about; I can barely move or talk because of my pain.
    10. I am in bed and I can’t move due to my pain; I need someone to take me to the emergency room because of my pain.

    10almonds tip: are you reading this on your phone? Screenshot the above, and keep it for when you need it!

    One extra thing to bear in mind…

    Medical staff will be more likely to believe a pain is being overstated, on a like-for-like basis, if you are a woman, or not white, or both.

    There are some efforts to compensate for this:

    A new government inquiry will examine women’s pain and treatment. How and why is it different?

    Some other resources of ours:

    Take care!

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  • CBD Against Diabetes!

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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

    ❝CBD for diabetes! I’ve taken CBD for body pain. Did no good. Didn’t pay attention as to diabetes. I’m type 1 for 62 years. Any ideas?❞

    Thanks for asking! First up, for reference, here’s our previous main feature on the topic of CBD:

    CBD Oil: What Does The Science Say?

    There, we touched on CBD’s effects re diabetes:

    in mice / in vitro / in humans

    In summary, according to the above studies, it…

    • lowered incidence of diabetes in non-obese diabetic mice. By this they mean that pancreatic function improved (reduced insulitis and reduced inflammatory Th1-associated cytokine production). Obviously this has strong implications for Type 1 Diabetes in humans—but so far, just that, implications (because you are not a mouse).
    • attenuated high glucose-induced endothelial cell inflammatory response and barrier disruption. Again, this is promising, but it was an in vitro study in very controlled lab conditions, and sometimes “what happens in the Petri dish, stays in the Petri dish”—in order words, these results may or may not translate to actual living humans.
    • Improved insulin response ← is the main take-away that we got from reading through their numerical results, since there was no convenient conclusion given. Superficially, this may be of more interest to those with type 2 diabetes, but then again, if you have T1D and then acquire insulin resistance on top of that, you stand a good chance of dying on account of your exogenous insulin no longer working. In the case of T2D, “the pancreas will provide” (more or less), T1D, not so much.

    So, what else is there out there?

    The American Diabetes Association does not give a glowing review:

    ❝There’s a lot of hype surrounding CBD oil and diabetes. There is no noticeable effect on blood glucose (blood sugar) or insulin levels in people with type 2 diabetes. Researchers continue to study the effects of CBD on diabetes in animal studies. ❞

    ~ American Diabetes Association

    Source: ADA | CBD & Diabetes

    Of course, that’s type 2, but most research out there is for type 2, or else have been in vitro or rodent studies (and not many of those, at that).

    Here’s a relatively more recent study that echoes the results of the previous mouse study we mentioned; it found:

    ❝CBD-treated non-obese diabetic mice developed T1D later and showed significantly reduced leukocyte activation and increased FCD in the pancreatic microcirculation.

    Conclusions: Experimental CBD treatment reduced markers of inflammation in the microcirculation of the pancreas studied by intravital microscopy. ❞

    ~ Dr. Christian Lehmann et al.

    Read more: Experimental cannabidiol treatment reduces early pancreatic inflammation in type 1 diabetes

    …and here’s a 2020 study (so, more recent again) that was this time rats, and/but still more promising, insofar as it was with rats that had full-blown T1D already:

    Read in full: Two-weeks treatment with cannabidiol improves biophysical and behavioral deficits associated with experimental type-1 diabetes

    Finally, a paper in July 2023 (so, since our previous article about CBD), looked at the benefits of CBD against diabetes-related complications (so, applicable to most people with any kind of diabetes), and concluded:

    ❝CBDis of great value in the treatment of diabetes and its complications. CBD can improve pancreatic islet function, reduce pancreatic inflammation and improve insulin resistance. For diabetic complications, CBD not only has a preventive effect but also has a therapeutic value for existing diabetic complications and improves the function of target organs

    ~ Dr. Jin Zhang et al.

    …before continuing:

    ❝However, the safety and effectiveness of CBD are still needed to prove. It should be acknowledged that the clinical application of CBD in the treatment of diabetes and its complications has a long way to go.

    The dissecting of the pharmacology and therapeutic role of CBD in diabetes would guide the future development of CBD-based therapeutics for treating diabetes and diabetic complications❞

    ~ Ibid.

    Now, the first part of that is standard ass-covering, and the second part of that is standard “please fund more studies please”. Nevertheless, we must also not fail to take heed—little is guaranteed, especially when it comes to an area of research where the science is still very young.

    In summary…

    It seems well worth a try, and with ostensibly nothing to lose except the financial cost of the CBD.

    If you do, you might want to keep careful track of a) your usual diabetes metrics (blood sugar levels before and after meals, insulin taken), and b) when you took CBD, what dose, etc, so you can do some citizen science here.

    Lastly: please remember our standard disclaimer; we are not doctors, let alone your doctors, so please do check with your endocrinologist before undertaking any such changes!

    Want to read more?

    You might like our previous main feature:

    How To Prevent And Reverse Type 2 Diabetes ← obviously this will not prevent or reverse Type 1 Diabetes, but avoiding insulin resistance is good in any case!

    If you’re not diabetic and you’ve perhaps been confused throughout this article, then firstly thank you for your patience, and secondly you might like this quick primer:

    The Sweet Truth About Diabetes: Debunking Diabetes Myths! ← this gives a simplified but fair overview of types 1 & 2

    (for space, we didn’t cover the much less common types 3 & 4; perhaps another time we will)

    Meanwhile, take care!

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  • 4 things ancient Greeks and Romans got right about mental health

    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.

    According to the World Health Organization, about 280 million people worldwide have depression and about one billion have a mental health problem of any kind.

    People living in the ancient world also had mental health problems. So, how did they deal with them?

    As we’ll see, some of their insights about mental health are still relevant today, even though we might question some of their methods.

    Jr Morty/Shutterstock

    1. Our mental state is important

    Mental health problems such as depression were familiar to people in the ancient world. Homer, the poet famous for the Iliad and Odyssey who lived around the eighth century BC, apparently died after wasting away from depression.

    Already in the late fifth century BC, ancient Greek doctors recognised that our health partly depends on the state of our thoughts.

    In the Epidemics, a medical text written in around 400BC, an anonymous doctor wrote that our habits about our thinking (as well as our lifestyle, clothing and housing, physical activity and sex) are the main determinants of our health.

    Bronze statue of Homer on Greek island of IOS
    Homer, the ancient Greek poet, had depression. Thirasia/Shutterstock

    2. Mental health problems can make us ill

    Also writing in the Epidemics, an anonymous doctor described one of his patients, Parmeniscus, whose mental state became so bad he grew delirious, and eventually could not speak. He stayed in bed for 14 days before he was cured. We’re not told how.

    Later, the famous doctor Galen of Pergamum (129-216AD) observed that people often become sick because of a bad mental state:

    It may be that under certain circumstances ‘thinking’ is one of the causes that bring about health or disease because people who get angry about everything and become confused, distressed and frightened for the slightest reason often fall ill for this reason and have a hard time getting over these illnesses.

    Galen also described some of his patients who suffered with their mental health, including some who became seriously ill and died. One man had lost money:

    He developed a fever that stayed with him for a long time. In his sleep he scolded himself for his loss, regretted it and was agitated until he woke up. While he was awake he continued to waste away from grief. He then became delirious and developed brain fever. He finally fell into a delirium that was obvious from what he said, and he remained in this state until he died.

    3. Mental illness can be prevented and treated

    In the ancient world, people had many different ways to prevent or treat mental illness.

    The philosopher Aristippus, who lived in the fifth century BC, used to advise people to focus on the present to avoid mental disturbance:

    concentrate one’s mind on the day, and indeed on that part of the day in which one is acting or thinking. Only the present belongs to us, not the past nor what is anticipated. The former has ceased to exist, and it is uncertain if the latter will exist.

    The philosopher Clinias, who lived in the fourth century BC, said that whenever he realised he was becoming angry, he would go and play music on his lyre to calm himself.

    Doctors had their own approaches to dealing with mental health problems. Many recommended patients change their lifestyles to adjust their mental states. They advised people to take up a new regime of exercise, adopt a different diet, go travelling by sea, listen to the lectures of philosophers, play games (such as draughts/checkers), and do mental exercises equivalent to the modern crossword or sudoku.

    Galen, the physician
    Galen, a famous doctor, believed mental problems were caused by some idea that had taken hold of the mind. Pierre Roche Vigneron/Wikimedia

    For instance, the physician Caelius Aurelianus (fifth century AD) thought patients suffering from insanity could benefit from a varied diet including fruit and mild wine.

    Doctors also advised people to take plant-based medications. For example, the herb hellebore was given to people suffering from paranoia. However, ancient doctors recognised that hellebore could be dangerous as it sometimes induced toxic spasms, killing patients.

    Other doctors, such as Galen, had a slightly different view. He believed mental problems were caused by some idea that had taken hold of the mind. He believed mental problems could be cured if this idea was removed from the mind and wrote:

    a person whose illness is caused by thinking is only cured by taking care of the false idea that has taken over his mind, not by foods, drinks, [clothing, housing], baths, walking and other such (measures).

    Galen thought it was best to deflect his patients’ thoughts away from these false ideas by putting new ideas and emotions in their minds:

    I put fear of losing money, political intrigue, drinking poison or other such things in the hearts of others to deflect their thoughts to these things […] In others one should arouse indignation about an injustice, love of rivalry, and the desire to beat others depending on each person’s interest.

    4. Addressing mental health needs effort

    Generally speaking, the ancients believed keeping our mental state healthy required effort. If we were anxious or angry or despondent, then we needed to do something that brought us the opposite of those emotions.

    De Morbis acutis et Chronicis by Caelius Aurelianus
    Watch some comedy, said physician Caelius Aurelianus. VCU Tompkins-McCaw Library/Flickr, CC BY-NC-SA

    This can be achieved, they thought, by doing some activity that directly countered the emotions we are experiencing.

    For example, Caelius Aurelianus said people suffering from depression should do activities that caused them to laugh and be happy, such as going to see a comedy at the theatre.

    However, the ancients did not believe any single activity was enough to make our mental state become healthy. The important thing was to make a wholesale change to one’s way of living and thinking.

    When it comes to experiencing mental health problems, we clearly have a lot in common with our ancient ancestors. Much of what they said seems as relevant now as it did 2,000 years ago, even if we use different methods and medicines today.


    If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

    Konstantine Panegyres, McKenzie Postdoctoral Fellow, researching Greco-Roman antiquity, The University of Melbourne

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Mindfulness – by Olivia Telford

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    Olivia Telford takes us on a tour of mindfulness, meditation, mindfulness meditation, and how each of these things impacts stress, anxiety, and depression—as well as less obvious things too, like productivity and relationships.

    In the category of how much this is a “how-to-” guide… It’s quite a “how-to” guide. We’re taught how to meditate, we’re taught assorted mindfulness exercises, and we’re taught specific mindfulness interventions such as beating various life traps (e.g. procrastination, executive dysfunction, etc) with mindfulness.

    The writing style is simple and to the point, explanatory and very readable. References are made to pop-science and hard science alike, and all in all, is not too far from the kind of writing you might expect to find here at 10almonds.

    Bottom line: if you’d like to practice mindfulness meditation and want an easy “in”, or perhaps you’re curious and wonder what mindfulness could tangibly do for you and how, then this book is a great choice for that.

    Click here to check out Mindfulness, and enjoy being more present in life!

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  • Metformin For Weight-Loss & More

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    Metformin Without Diabetes?

    Metformin is a diabetes drug; it works by:

    • decreasing glucose absorption from the gut
    • decreasing glucose production in the liver
    • increasing glucose sensitivity

    It doesn’t change how much insulin is secreted, and is unlikely to cause hypoglycemia, making it relatively safe as diabetes drugs go.

    It’s a biguanide drug, and/but so far as science knows (so far), its mechanism of action is unique (i.e. no other drug works the same way that metformin does).

    Today we’ll examine its off-label uses and see what the science says!

    A note on terms: “off-label” = when a drug is prescribed to treat something other than the main purpose(s) for which the drug was approved.

    Other examples include modafinil against depression, and beta-blockers against anxiety.

    Why take it if not diabetic?

    There are many reasons people take it, including just general health and life extension:

    One of the cheapest diabetes drugs on the market can also slow aging and extend your life span. Here’s how

    However, its use was originally expanded (still “off-label”, but widely prescribed) past “just for diabetes” when it showed efficacy in treating pre-diabetes. Here for example is a longitudinal study that found metformin use performed similarly to lifestyle interventions (e.g. diet, exercise, etc). In their words:

    ❝ Lifestyle intervention or metformin significantly reduced diabetes development over 15 years. There were no overall differences in the aggregate microvascular outcome between treatment groups❞

    Source: Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up

    But, it seems it does more, as this more recent review found:

    Long-term weight loss was also seen in both [metformin and intensive lifestyle intervention] groups, with better maintenance under metformin.

    Subgroup analyses from the DPP/DPPOS have shed important light on the actions of metformin, including a greater effect in women with prior gestational diabetes, and a reduction in coronary artery calcium in men that might suggest a cardioprotective effect.

    Long-term diabetes prevention with metformin is feasible and is supported in influential guidelines for selected groups of subjects.❞

    Source: Metformin for diabetes prevention: update of the evidence base

    We were wondering about that cardioprotective effect, so…

    Cardioprotective effect

    In short, another review (published a few months after the above one) confirmed the previous findings, and also added:

    ❝Patients with BMI > 35 showed an association between metformin use and lower incidence of CVD, including African Americans older than age 65. The data suggest that morbidly obese patients with prediabetes may benefit from the use of metformin as recommended by the ADA.❞

    Real World Data: Off-Label Metformin in Patients with Prediabetes is Associated with Improved Cardiovascular Outcomes

    We wondered about the weight loss implications of this, and…

    For weight loss

    The short version is, it works:

    …and many many more where those came from. As a point of interest, it has also been compared and contrasted to GLP-1 agonists.

    Compared/contrasted with GLP-1 agonists

    It’s not quite as effective for weight loss, and/but it’s a lot cheaper, is tablets rather than injections, has fewer side effects (for most people), and doesn’t result in dramatic yoyo-ing if there’s an interruption to taking it:

    Comparison of Beinaglutide Versus Metformin for Weight Loss in Overweight and Obese Non-diabetic Patients

    Or if you prefer a reader-friendly pop-science version:

    Ozempic vs Metformin: Comparing The Two Diabetes Medications

    Is it safe?

    For most people yes, but there are a stack of contraindications, so it’s best to speak with your doctor. However, particular things to be aware of include:

    • Usually contraindicated if you have kidney problems of any kind
    • Usually contraindicated if you have liver problems of any kind
    • May be contraindicated if you have issues with B12 levels

    See also: Metformin: Is it a drug for all reasons and diseases?

    Where can I get it?

    As it’s a prescription-controlled drug, we can’t give you a handy Amazon link for this one.

    However, many physicians are willing to prescribe it for off-label use (i.e., for reasons other than diabetes), so speak with yours (telehealth options may also be available).

    If you do plan to speak with your doctor and you’re not sure they’ll be agreeable, you might want to get this paper and print it to take it with you:

    Off-label indications of Metformin – Review of Literature

    Take care!

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