Hormones & Health, Beyond The Obvious

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Wholesome Health

This is Dr. Sara Gottfried, who some decades ago got her MD from Harvard and specialized as an OB/GYN at MIT. She’s since then spent the more recent part of her career educating people (mostly: women) about hormonal health, precision, functional, & integrative medicine, and the importance of lifestyle medicine in general.

What does she want us to know?

Beyond “bikini zone health”

Dr. Gottfried urges us to pay attention to our whole health, in context.

“Women’s health” is often thought of as what lies beneath a bikini, and if it’s not in those places, then we can basically treat a woman like a man.

And that’s often not actually true—because hormones affect every living cell in our body, and as a result, while prepubescent girls and postmenopausal women (specifically, those who are not on HRT) may share a few more similarities with boys and men of similar respective ages, for most people at most ages, men and women are by default quite different metabolically—which is what counts for a lot of diseases! And note, that difference is not just “faster” or “slower””, but is often very different in manner also.

That’s why, even in cases where incidence of disease is approximately similar in men and women when other factors are controlled for (age, lifestyle, medical history, etc), the disease course and response to treatment may vary considerable. For a strong example of this, see for example:

  • The well-known: Heart Attack: His & Hers ← most people know these differences exist, but it’s always good to brush up on what they actually are
  • The less-known: Statins: His & Hers ← most people don’t know these differences exist, and it pays to know, especially if you are a woman or care about one

Nor are brains exempt from his…

The female brain (kinda)

While the notion of an anatomically different brain for men and women has long since been thrown out as unscientific phrenology, and the idea of a genetically different brain is… Well, it’s an unreliable indicator, because technically the cells will have DNA and that DNA will usually (but not always; there are other options) have XX or XY chromosomes, which will usually (but again, not always) match apparent sex (in about 1/2000 cases there’s a mismatch, which is more common than, say, red hair; sometimes people find out about a chromosomal mismatch only later in life when getting a DNA test for some unrelated reason), and in any case, even for most of us, the chromosomal differences don’t count for much outside of antenatal development (telling the default genital materials which genitals to develop into, though this too can get diverted, per many intersex possibilities, which is also a lot more common than people think) or chromosome-specific conditions like colorblindness…

The notion of a hormonally different brain is, in contrast to all of the above, a reliable and easily verifiable thing.

See for example:

Alzheimer’s Sex Differences May Not Be What They Appear

Dr. Gottfried urges us to take the above seriously!

Because, if women get Alzheimer’s much more commonly than men, and the disease progresses much more quickly in women than men, but that’s based on postmenopausal women not on HRT, then that’s saying “Women, without women’s usual hormones, don’t do so well as men with men’s usual hormones”.

She does, by the way, advocate for bioidentical HRT for menopausal women, unless contraindicated for some important reason that your doctor/endocrinologist knows about. See also:

Menopausal HRT: A Tale Of Two Approaches (Bioidentical vs Animal)

The other very relevant hormone

…that Dr. Gottfried wants us to pay attention to is insulin.

Or rather, its scrubbing enzyme, the prosaically-named “insulin-degrading enzyme”, but it doesn’t only scrub insulin. It also scrubs amyloid beta—yes, the same that produces the amyloid beta plaques in the brain associated with Alzheimer’s. And, there’s only so much insulin-degrading enzyme to go around, and if it’s all busy breaking down excess insulin, there’s not enough left to do the other job too, and thus can’t break down amyloid beta.

In other words: to fight neurodegeneration, keep your blood sugars healthy.

This may actually work by multiple mechanisms besides the amyloid hypothesis, by the way:

The Surprising Link Between Type 2 Diabetes & Alzheimer’s

Want more from Dr. Gottfried?

You might like this interview with Dr. Gottfried by Dr. Benson at the IMCJ:

Integrative Medicine: A Clinician’s Journal | Conversations with Sara Gottfried, MD

…in which she discusses some of the things we talked about today, and also about her shift from a pharmaceutical-heavy approach to a predominantly lifestyle medicine approach.

Enjoy!

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  • Just One Thing – by Dr. Michael Mosley

    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.

    This is a collection of easy-to-implement changes that have good science behind them to show how they can benefit us. Some things are obvious (e.g: drink water); others, less so (e.g: sing, to reduce inflammation).

    The book is divided thematically into times of the day, though in many cases it’s not a hard rule that a thing needs to be done at a certain time. Others are, like a cold shower in the morning and hot bath before bed—you might not want to switch those around!

    The style is very pop-science, and does not have in-line citations for claims, but it does have a bibliography in the bag organized by each “one thing”, e.g. it might say “get some houseplants” and then list a number of references supporting that, with links to the studies showing how that helps. For those with the paper version, don’t worry, you can copy the URL from the book into your browser and see it that way. In any case, there are 2–6 scientific references for each claim, which is very respectable for a pop-sci book.

    Bottom line: if you’re looking for evidence-based “one little thing” changes that can make a big difference, this book has lots!

    Click here to check out Just One Thing, and improve your life!

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  • Dietary Changes for Artery 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.

    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝How does your diet change clean out your arteries of the bad cholesterol?❞

    There’s good news and bad news here, and they can both be delivered with a one-word reply:

    Slowly.

    Or rather: what’s being cleaned out is mostly not the LDL (bad) cholesterol, but rather, the result of that.

    When our diet is bad for cardiovascular health, our arteries get fatty deposits on their walls. Cholesterol gets stuck here too, but that’s not the main physical problem.

    Our body’s natural defenses come into action and try to clean it up, but they (for example macrophages, a kind of white blood cell that consumes invaders and then dies, before being recycled by the next part of the system) often get stuck and become part of the buildup (called atheroma), which can lead to atherosclerosis and (if calcium levels are high) hardening of the arteries, which is the worst end of this.

    This can then require medical attention, precisely because the body can’t remove it very well—especially if you are still maintaining a heart-unhealthy diet, thus continuing to add to the mess.

    However, if it is not too bad yet, yes, a dietary change alone will reverse this process. Without new material being added to the arterial walls, the body’s continual process of rejuvenation will eventually fix it, given time (free from things making it worse) and resources.

    In fact, your arteries can be one of the quickest places for your body to make something better or worse, because the blood is the means by which the body moves most things (good or bad) around the body.

    All the more reason to take extra care of it, since everything else depends on it!

    You might also like our previous main feature:

    All Things Heart Health

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  • Stay off My Operating Table – by Dr. Philip Ovadia

    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.

    With heart disease as the #1 killer worldwide, and 88% of adults being metabolically unhealthy (leading cause of heart disease), this is serious!

    Rather than taking a “quick fix” advise-and-go approach, Dr. Ovadia puts the knowledge and tools in our hands to do better in the long term.

    As a heart surgeon himself, his motto here is:

    ❝What foods to put on your table so you don’t end up on mine❞

    There’s a lot more to this book than the simple “eat the Mediterranean diet”:

    • While the Mediterranean diet is generally considered the top choice for heart health, he also advises on how to eat healthily on all manner of diets… Carnivore, Keto, Paleo, Atkins, Gluten-Free, Vegan, you-name-it.
    • A lot of the book is given to clearing up common misconceptions, things that sounded plausible but are just plain dangerous. This information alone is worth the price of the book, we think.
    • There’s also a section given over to explaining the markers of metabolic health, so you can monitor yourself effectively
    • Rather than one-size-fits-all, he also talks about common health conditions and medications that may change what you need to be doing
    • He also offers advice about navigating the health system to get what you need—including dealing with unhelpful doctors!

    Bottom line: A very comprehensive (yet readable!) manual of heart health.

    Get your copy of Stay Off My Operating Table from Amazon today!

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  • The S.T.E.P.S. To A Healthier Heart
  • Why is toddler milk so popular? Follow the money

    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.

    Toddler milk is popular and becoming more so. Just over a third of Australian toddlers drink it. Parents spend hundreds of millions of dollars on it globally. Around the world, toddler milk makes up nearly half of total formula milk sales, with a 200% growth since 2005. Growth is expected to continue.

    We’re concerned about the growing popularity of toddler milk – about its nutritional content, cost, how it’s marketed, and about the impact on the health and feeding of young children. Some of us voiced our concerns on the ABC’s 7.30 program recently.

    But what’s in toddler milk? How does it compare to cow’s milk? How did it become so popular?

    What is toddler milk? Is it healthy?

    Toddler milk is marketed as appropriate for children aged one to three years. This ultra-processed food contains:

    • skim milk powder (cow, soy or goat)
    • vegetable oil
    • sugars (including added sugars)
    • emulsifiers (to help bind the ingredients and improve the texture)
    • added vitamins and minerals.

    Toddler milk is usually lower in calcium and protein, and higher in sugar and calories than regular cow’s milk. Depending on the brand, a serve of toddler milk can contain as much sugar as a soft drink.

    Even though toddler milks have added vitamins and minerals, these are found in and better absorbed from regular foods and breastmilk. Toddlers do not need the level of nutrients found in these products if they are eating a varied diet.

    Global health authorities, including the World Health Organization (WHO), and Australia’s National Health and Medical Research Council, do not recommend toddler milk for healthy toddlers.

    Some children with specific metabolic or dietary medical problems might need tailored alternatives to cow’s milk. However, these products generally are not toddler milks and would be a specific product prescribed by a health-care provider.

    Toddler milk is also up to four to five times more expensive than regular cow’s milk. “Premium” toddler milk (the same product, with higher levels of vitamins and minerals) is more expensive.

    With the cost-of-living crisis, this means families might choose to go without other essentials to afford toddler milk.

    Woman holding blue plastic spoon of formula powder over open tin of formula, milk bottle in background
    Toddler milk is more expensive than cow’s milk and contains more sugar.
    Dragana Gordic/Shutterstock

    How toddler milk was invented

    Toddler milk was created so infant formula companies could get around rules preventing them from advertising their infant formula.

    When manufacturers claim benefits of their toddler milk, many parents assume these claimed benefits apply to infant formula (known as cross-promotion). In other words, marketing toddler milks also boosts interest in their infant formula.

    Manufacturers also create brand loyalty and recognition by making the labels of their toddler milk look similar to their infant formula. For parents who used infant formula, toddler milk is positioned as the next stage in feeding.

    How toddler milk became so popular

    Toddler milk is heavily marketed. Parents are told toddler milk is healthy and provides extra nutrition. Marketing tells parents it will benefit their child’s growth and development, their brain function and their immune system.

    Toddler milk is also presented as a solution to fussy eating, which is common in toddlers.

    However, regularly drinking toddler milk could increase the risk of fussiness as it reduces opportunities for toddlers to try new foods. It’s also sweet, needs no chewing, and essentially displaces energy and nutrients that whole foods provide.

    Toddler wearing bib with food smeared on face
    Toddler milk is said to help fussy eating, but it may make things worse.
    zlikovec/Shutterstock

    Growing concern

    The WHO, along with public health academics, has been raising concerns about the marketing of toddler milk for years.

    In Australia, moves to curb how toddler milk is promoted have gone nowhere. Toddler milk is in a category of foods that are allowed to be fortified (to have vitamins and minerals added), with no marketing restrictions. The Australian Competition & Consumer Commission also has concerns about the rise of toddler milk marketing. Despite this, there is no change in how it’s regulated.

    This is in contrast to voluntary marketing restrictions in Australia for infant formula.

    What needs to happen?

    There is enough evidence to show the marketing of commercial milk formula, including toddler milk, influences parents and undermines child health.

    So governments need to act to protect parents from this marketing, and to put child health over profits.

    Public health authorities and advocates, including us, are calling for the restriction of marketing (not selling) of all formula products for infants and toddlers from birth through to age three years.

    Ideally, this would be mandatory, government-enforced marketing restrictions as opposed to industry self-regulation in place currently for infant formulas.

    We musn’t blame parents

    Toddlers are eating more processed foods (including toddler milk) than ever because time-poor parents are seeking a convenient option to ensure their child is getting adequate nutrition.

    Formula manufacturers have used this information, and created a demand for an unnecessary product.

    Parents want to do the best for their toddlers, but they need to know the marketing behind toddler milks is misleading.

    Toddler milk is an unnecessary, unhealthy, expensive product. Toddlers just need whole foods and breastmilk, and/or cow’s milk or a non-dairy, milk alternative.

    If parents are worried about their child’s eating, they should see a health-care professional.

    Anthea Rhodes, a paediatrician from Royal Children’s Hospital Melbourne and a lecturer at the University of Melbourne, co-authored this article.The Conversation

    Jennifer McCann, Lecturer Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University; Karleen Gribble, Adjunct Associate Professor, School of Nursing and Midwifery, Western Sydney University, and Naomi Hull, PhD candidate, University of Sydney

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

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  • The Science-Backed Anti-Inflammatory Diet for Beginners – by Dr. Yasmine Elamir & Dr. William Grist

    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.

    We have written about how to eat to beat inflammation, but what we didn’t do is include 75 recipes and a plan for building up one’s culinary repertoire around those core dishes!

    That’s what this book does. It covers briefly the science of inflammation and anti-inflammatory diet, discusses experimental elimination diets (e.g. you eliminate likely culprits of triggering your inflammation, then reintroduce them one by one to see which it was), and ingredients likely to increase or decrease inflammation.

    The 75 recipes are good, and/but a caveat is “yes, one of the recipes is ketchup and another is sour cream” so it’s not exactly 75 mains.

    However! Where this book excels is in producing anti-inflammatory versions of commonly inflammatory dishes. That ketchup? Not sugary. The sour cream? Vegan. And so forth. We also see crispy roast potatoes, an array of desserts, and sections for popular holiday dishes too, so you will not need to be suddenly inflamed into the next dimension when it comes to festive eating.

    The recipes are what the title claims them to be, “science-backed anti-inflammatory”, and that is clearly the main criterion for their inclusion. They are not by default vegan, vegetarian, dairy-free, nut-free, gluten-free, etc. For this reason, all recipes are marked with such tags as “V, VG, DF, GF, EF, NF” etc as applicable.

    Bottom line: we’d consider this book more of a jumping-off point than a complete repertoire, but it’s a very good jumping-off point, and will definitely get you “up and running” (there’s a 21-day meal plan, for example).

    Click here to check out The Science-Back Anti-Inflammatory Diet for Beginners, and dial down the inflammation!

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  • How To Avoid Slipping Into (Bad) Old Habits

    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.

    Treating Bad Habits Like Addictions

    How often have you started a healthy new habit (including if it’s a “quit this previous thing” new habit), only to find that you slip back into your old ways?

    We’ve written plenty on habit-forming before, so here’s a quick recap before we continue:

    How To Really Pick Up (And Keep!) Those Habits

    …and even how to give them a boost:

    How To Keep On Keeping On… Long Term!

    But how to avoid the relapses that are most likely to snowball?

    Borrowing from the psychology of addiction recovery

    It’s well known that someone recovering from substance addiction should not have even a small amount of the thing they were addicted to. Not one sip of champagne at a wedding, not one drag of a cigarette, and so forth.

    This can go for other bad habits too; make one exception, and suddenly you have a whole string of “exceptions”, and before you know it, it’s not the exception anymore; it’s the new rule—again.

    Three things that can help guard against this are:

    1. Absolutely refuse to romanticize the bad habit. Do not fall for its marketing! And yes, everything has marketing even if not advertising; for example, consider the Platonic ideal of a junk-food-eating couch-potato who is humble, unassuming, agreeable, the almost-holy idea of homely comfort, and why shouldn’t we be comfortable after all, haven’t we earned our chosen hedonism, and so on. It’s seductive, and we need to make the choice to not be seduced by it. In this case for example, yes pleasure is great, but being sick tired and destroying our bodies is not, in fact, pleasurable in the long run. Which brings us to…
    2. Absolutely refuse to forget why you dropped that behavior in the first place. Remember what it did to you, remember you at your worst. Remember what you feared might become of you if you continued like that. This is something where journaling helps, by the way; remembering our low points helps us to avoid finding ourselves in the same situation again.
    3. Absolutely refuse to let your guard down due to an overabundance of self-confidence in your future self. We all can easily feel that tomorrow is a mystical land in which all productivity is stored, and also where we are strong, energized, iron-willed, and totally able to avoid making the very mistakes that we are right now in the progress of making. Instead, be that strong person now, for the benefit of tomorrow’s you. Because after all, if it’s going to be easy tomorrow, it’s easy now, right?

    The above is a very simple, hopefully practical, set of rules to follow. If you like hard science more though, Yale’s Dr. Steven Melemis offers five rules (aimed more directly at addiction recovery, so this may be a big “heavy guns” for some milder habits):

    1. change your life
    2. be completely honest
    3. ask for help
    4. practice self-care
    5. don’t bend the rules

    You can read his full paper and the studies it’s based on, here:

    Relapse Prevention and the Five Rules of Recovery

    “What if I already screwed up?”

    Draw a line under it, now, and move forwards in the direction you actually want to go.

    Here’s a good article, that saves us taking up more space here; it’s very well-written so we do recommend it:

    The Abstinence Violation Effect and Overcoming It

    this article gives specific, practical advices, including CBT tools to use

    Take care!

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