Reflexology: What The Science Says

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How Does Reflexology Work, Really?

In Wednesday’s newsletter, we asked you for your opinion of reflexology, and got the above-depicted, below-described set of responses:

  • About 63% said “It works by specific nerves connecting the feet and hands to various specific organs, triggering healing remotely”
  • About 26% said “It works by realigning the body’s energies (e.g. qi, ki, prana, etc), removing blockages and improving health“
  • About 11% said “It works by placebo, at best, and has no evidence for any efficacy beyond that”

So, what does the science say?

It works by realigning the body’s energies (e.g. qi, ki, prana, etc), removing blockages and improving health: True or False?

False, or since we can’t prove a negative: there is no reliable scientific evidence for this.

Further, there is no reliable scientific evidence for the existence of qi, ki, prana, soma, mana, or whatever we want to call it.

To save doubling up, we did discuss this in some more detail, exploring the notion of qi as bioelectrical energy, including a look at some unreliable clinical evidence for it (a study that used shoddy methodology, but it’s important to understand what they did wrong, to watch out for such), when we looked at [the legitimately very healthful practice of] qigong, a couple of weeks ago:

Qigong: A Breath Of Fresh Air?

As for reflexology specifically: in terms of blockages of qi causing disease (and thus being a putative therapeutic mechanism of action for attenuating disease), it’s an interesting hypothesis but in terms of scientific merit, it was pre-emptively supplanted by germ theory and other similarly observable-and-measurable phenomena.

We say “pre-emptively”, because despite orientalist marketing, unless we want to count some ancient pictures of people getting a foot massage and say it is reflexology, there is no record of reflexology being a thing before 1913 (and that was in the US, by a laryngologist working with a spiritualist to produce a book that they published in 1917).

It works by specific nerves connecting the feet and hands to various specific organs, triggering healing remotely: True or False?

False, or since we can’t prove a negative: there is no reliable scientific evidence for this.

A very large independent review of available scientific literature found the current medical consensus on reflexology is that:

  • Reflexology is effective for: anxiety (but short lasting), edema, mild insomnia, quality of sleep, and relieving pain (short term: 2–3 hours)
  • Reflexology is not effective for: inflammatory bowel disease, fertility treatment, neuropathy and polyneuropathy, acute low back pain, sub acute low back pain, chronic low back pain, radicular pain syndromes (including sciatica), post-operative low back pain, spinal stenosis, spinal fractures, sacroiliitis, spondylolisthesis, complex regional pain syndrome, trigger points / myofascial pain, chronic persistent pain, chronic low back pain, depression, work related injuries of the hip and pelvis

Source: Reflexology – a scientific literary review compilation

(the above is a fascinating read, by the way, and its 50 pages go into a lot more detail than we have room to here)

Now, those items that they found it effective for, looks suspiciously like a short list of things that placebo is often good for, and/or any relaxing activity.

Another review was not so generous:

❝The best evidence available to date does not demonstrate convincingly that reflexology is an effective treatment for any medical condition❞

~ Dr. Edzard Ernst (MD, PhD, FMedSci)

Source: Is reflexology an effective intervention? A systematic review of randomised controlled trials

In short, from the available scientific literature, we can surmise:

  • Some researchers have found it to have some usefulness against chiefly psychosomatic conditions
  • Other researchers have found the evidence for even that much to be uncompelling

It works by placebo, at best, and has no evidence for any efficacy beyond that: True or False?

Mostly True; of course reflexology runs into similar problems as acupuncture when it comes to testing against placebo:

How Does One Test Acupuncture Against Placebo Anyway?

…but not quite as bad, since it is easier to give a random foot massage while pretending it is a clinical treatment, than to fake putting needles into key locations.

However, as the paper we cited just above (in answer to the previous True/False question) shows, reflexology does not appear to meaningfully outperform placebo—which points to the possibility that it does work by placebo, and is just a placebo treatment on the high end of placebo (because the placebo effect is real, does work, isn’t “nothing”, and some placebos work better than others).

For more on the fascinating science and useful (applicable in daily life!) practicalities of how placebo does work, check out:

How To Leverage Placebo Effect For Yourself

Take care!

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    This book on Rational Emotive Behavior Therapy is a self-help book for people who don’t like self-help books. Highly recommendable for everyone.

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  • What’s the difference between vegan and vegetarian?

    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.

    What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.

    Vegan and vegetarian diets are plant-based diets. Both include plant foods, such as fruits, vegetables, legumes and whole grains.

    But there are important differences, and knowing what you can and can’t eat when it comes to a vegan and vegetarian diet can be confusing.

    So, what’s the main difference?

    Creative Cat Studio/Shutterstock

    What’s a vegan diet?

    A vegan diet is an entirely plant-based diet. It doesn’t include any meat and animal products. So, no meat, poultry, fish, seafood, eggs, dairy or honey.

    What’s a vegetarian diet?

    A vegetarian diet is a plant-based diet that generally excludes meat, poultry, fish and seafood, but can include animal products. So, unlike a vegan diet, a vegetarian diet can include eggs, dairy and honey.

    But you may be wondering why you’ve heard of vegetarians who eat fish, vegetarians who don’t eat eggs, vegetarians who don’t eat dairy, and even vegetarians who eat some meat. Well, it’s because there are variations on a vegetarian diet:

    • a lacto-ovo vegetarian diet excludes meat, poultry, fish and seafood, but includes eggs, dairy and honey
    • an ovo-vegetarian diet excludes meat, poultry, fish, seafood and dairy, but includes eggs and honey
    • a lacto-vegetarian diet excludes meat, poultry, fish, seafood and eggs, but includes dairy and honey
    • a pescatarian diet excludes meat and poultry, but includes eggs, dairy, honey, fish and seafood
    • a flexitarian, or semi-vegetarian diet, includes eggs, dairy and honey and may include small amounts of meat, poultry, fish and seafood.

    Are these diets healthy?

    A 2023 review looked at the health effects of vegetarian and vegan diets from two types of study.

    Observational studies followed people over the years to see how their diets were linked to their health. In these studies, eating a vegetarian diet was associated with a lower risk of developing cardiovascular disease (such as heart disease or a stroke), diabetes, hypertension (high blood pressure), dementia and cancer.

    For example, in a study of 44,561 participants, the risk of heart disease was 32% lower in vegetarians than non-vegetarians after an average follow-up of nearly 12 years.

    Further evidence came from randomised controlled trials. These instruct study participants to eat a specific diet for a specific period of time and monitor their health throughout. These studies showed eating a vegetarian or vegan diet led to reductions in weight, blood pressure, and levels of unhealthy cholesterol.

    For example, one analysis combined data from seven randomised controlled trials. This so-called meta-analysis included data from 311 participants. It showed eating a vegetarian diet was associated with a systolic blood pressure (the first number in your blood pressure reading) an average 5 mmHg lower compared with non-vegetarian diets.

    It seems vegetarian diets are more likely to be healthier, across a number of measures.

    For example, a 2022 meta-analysis combined the results of several observational studies. It concluded a vegetarian diet, rather than vegan diet, was recommended to prevent heart disease.

    There is also evidence vegans are more likely to have bone fractures than vegetarians. This could be partly due to a lower body-mass index and a lower intake of nutrients such as calcium, vitamin D and protein.

    But it can be about more than just food

    Many vegans, where possible, do not use products that directly or indirectly involve using animals.

    So vegans would not wear leather, wool or silk clothing, for example. And they would not use soaps or candles made from beeswax, or use products tested on animals.

    The motivation for following a vegan or vegetarian diet can vary from person to person. Common motivations include health, environmental, ethical, religious or economic reasons.

    And for many people who follow a vegan or vegetarian diet, this forms a central part of their identity.

    Woman wearing and pointing to her t-shirt with 'Go vegan' logo
    More than a diet: veganism can form part of someone’s identity. Shutterstock

    So, should I adopt a vegan or vegetarian diet?

    If you are thinking about a vegan or vegetarian diet, here are some things to consider:

    • eating more plant foods does not automatically mean you are eating a healthier diet. Hot chips, biscuits and soft drinks can all be vegan or vegetarian foods. And many plant-based alternatives, such as plant-based sausages, can be high in added salt
    • meeting the nutrient intake targets for vitamin B12, iron, calcium, and iodine requires more careful planning while on a vegan or vegetarian diet. This is because meat, seafood and animal products are good sources of these vitamins and minerals
    • eating a plant-based diet doesn’t necessarily mean excluding all meat and animal products. A healthy flexitarian diet prioritises eating more whole plant-foods, such as vegetables and beans, and less processed meat, such as bacon and sausages
    • the Australian Dietary Guidelines recommend eating a wide variety of foods from the five food groups (fruit, vegetables, cereals, lean meat and/or their alternatives and reduced-fat dairy products and/or their alternatives). So if you are eating animal products, choose lean, reduced-fat meats and dairy products and limit processed meats.

    Katherine Livingstone, NHMRC Emerging Leadership Fellow and Senior Research Fellow at the Institute for Physical Activity and Nutrition, Deakin University

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

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  • Quit Like a Woman – by Holly Whitaker

    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’ve reviewed “quit drinking” books before, so what makes this one different?

    While others focus on the science of addiction and the tips and tricks of habit breaking/forming, this one is more about environmental factors, and that because of society being as it is, we as women often face different challenges when it comes to drinking (or not). Not necessarily easier or harder than men’s in this case, but different. And that sometimes calls for different methods to deal with them. This book explores those.

    She also looks at such matters as how to quit alcohol when you’ve never stuck to a diet, and other such very down-to-earth topics, in a well-researched and non-preachy fashion.

    Bottom line: if you’ve sometimes tried to quit drinking or even just to cut back, but found the deck stacked against you and things conspire to undermine your efforts, this book will give you a clearer path forward.

    Click here to check out Quite Like A Woman, And Take Care Of Yourself!

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  • Neurotransmitter Cheatsheet

    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.

    Which Neurotransmitter?

    There are a lot of neurotransmitters that are important for good mental health (and, by way of knock-on effects, physical health).

    However, when pop-science headlines refer to them as “feel-good chemicals” (yes but which one?!) or “the love molecule” (yes but which one?!) or other such vague names when referring to a specific neurotransmitter, it’s easy to get them mixed up.

    So today we’re going to do a little disambiguation of some of the main mood-related neurotransmitters (there are many more, but we only have so much room), and what things we can do to help manage them.

    Dopamine

    This one predominantly regulates reward responses, though it’s also necessary for critical path analysis (e.g. planning), language faculties, and motor functions. It makes us feel happy, motivated, and awake.

    To have more:

    • eat foods that are rich in dopamine or its precursors such as tyrosine (bananas and almonds are great)
    • do things that you find rewarding

    Downsides: is instrumental in most addictions, and also too much can result in psychosis. For most people, that level of “too much” isn’t obtainable due to the homeostatic system, however.

    See also: Rebalancing Dopamine (Without “Dopamine Fasting”)

    Serotonin

    This one predominantly helps regulate our circadian rhythm. It also makes us feel happy, calm, and awake.

    To have more:

    • get more sunlight, or if the light must be artificial, then (ideally) full-spectrum light, or (if it’s what’s available) blue light
    • spend time in nature; we are hardwired to feel happy in the environments in which we evolved, which for most of human history was large open grassy expanses with occasional trees (however, for modern purposes, a park or appropriate garden will suffice).

    Downsides: this is what keeps us awake at night if we had too much light before bed, and also too much serotonin can result in (potentially fatal) serotonin syndrome. Most people can’t get that much serotonin due to our homeostatic system, but some drugs can force it upon us.

    See also: Seasonal Affective Disorder Strategies

    Oxytocin

    This one predominantly helps us connect to others on an emotional level. It also makes us feel happy, calm, and relaxed.

    To have more:

    • hug a loved one (or even just think about doing so, if they’re not available)
    • look at pictures/videos of cute puppies, kittens, and the like—this triggers a similar response

    Downsides: negligible. Socially speaking, it can cause us to drop our guard, most for most people most of the time, this is not a problem. It can also reduce sexual desire—it’s in large part responsible for the peaceful lulled state post-orgasm. It’s not responsible for the sleepiness in men though; that’s mostly prolactin.

    See also: Only One Kind Of Relationship Promotes Longevity This Much!

    Adrenaline

    This one predominantly affects our sympathetic nervous system; it elevates heart rate, blood pressure, and other similar functions. It makes us feel alert, ready for action, and energized.

    To have more:

    • listen to a “power anthem” piece of music. What it is can depend on your musical tastes; whatever gets you riled up in an empowering way.
    • engage in something competitive that you feel strongly about while doing it—or by the same mechanism, a solitary activity where the stakes feel high even if it’s actually quite safe (e.g. watching a thriller or a horror movie, if that’s your thing).

    Downsides: its effects are not sustainable, and (in cases of chronic stress) the body will try to sustain them anyway, which has a deleterious effect. Because adrenaline and cortisol are closely linked, chronically high adrenal action will tend to mean chronically high cortisol also.

    See also: Lower Your Cortisol! (Here’s Why & How)

    Some final words

    You’ll notice that in none of the “how to have more” did we mention drugs. That’s because:

    • a drug-free approach is generally the best thing to try first, at the very least
    • there are simply a lot of drugs to affect each one (or more), and talking about them would require talking about each drug in some detail.

    However, the following may be of interest for some readers:

    Antidepressants: Personalization Is Key!

    Take care!

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  • Egg Whites vs Whole Eggs – Which is Healthier?

    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.

    Our Verdict

    When comparing egg whites to whole eggs, we picked the whole eggs.

    Why?

    Egg whites are mostly protein. Egg yolks are mostly fat, with some protein.

    However, fat ≠ bad, and the yolk is also where the choline is stored, which itself (as well as its benefits for your brain) will tend to reduce fat storage in the body.

    Furthermore, the yolk contains an assortment of vitamins, minerals, and essential amino acids. After all, the yolk is there specifically to contain everything needed to turn a cluster of cells into a small bird.

    Read more: Eggs: All Things In Moderation?

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  • Why do I poo in the morning? A gut expert explains

    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.

    No, you’re not imagining it. People really are more likely to poo in the morning, shortly after breakfast. Researchers have actually studied this.

    But why mornings? What if you tend to poo later in the day? And is it worth training yourself to be a morning pooper?

    To understand what makes us poo when we do, we need to consider a range of factors including our body clock, gut muscles and what we have for breakfast.

    Here’s what the science says.

    H_Ko/Shutterstock

    So morning poos are real?

    In a UK study from the early 1990s, researchers asked nearly 2,000 men and women in Bristol about their bowel habits.

    The most common time to poo was in the early morning. The peak time was 7-8am for men and about an hour later for women. The researchers speculated that the earlier time for men was because they woke up earlier for work.

    About a decade later, a Chinese study found a similar pattern. Some 77% of the almost 2,500 participants said they did a poo in the morning.

    But why the morning?

    There are a few reasons. The first involves our circadian rhythm – our 24-hour internal clock that helps regulate bodily processes, such as digestion.

    For healthy people, our internal clock means the muscular contractions in our colon follow a distinct rhythm.

    There’s minimal activity in the night. The deeper and more restful our sleep, the fewer of these muscle contractions we have. It’s one reason why we don’t tend to poo in our sleep.

    Diagram of digestive system including colon and rectum
    Your lower gut is a muscular tube that contracts more strongly at certain times of day. Vectomart/Shutterstock

    But there’s increasing activity during the day. Contractions in our colon are most active in the morning after waking up and after any meal.

    One particular type of colon contraction partly controlled by our internal clock are known as “mass movements”. These are powerful contractions that push poo down to the rectum to prepare for the poo to be expelled from the body, but don’t always result in a bowel movement. In healthy people, these contractions occur a few times a day. They are more frequent in the morning than in the evening, and after meals.

    Breakfast is also a trigger for us to poo. When we eat and drink our stomach stretches, which triggers the “gastrocolic reflex”. This reflex stimulates the colon to forcefully contract and can lead you to push existing poo in the colon out of the body. We know the gastrocolic reflex is strongest in the morning. So that explains why breakfast can be such a powerful trigger for a bowel motion.

    Then there’s our morning coffee. This is a very powerful stimulant of contractions in the sigmoid colon (the last part of the colon before the rectum) and of the rectum itself. This leads to a bowel motion.

    How important are morning poos?

    Large international surveys show the vast majority of people will poo between three times a day and three times a week.

    This still leaves a lot of people who don’t have regular bowel habits, are regular but poo at different frequencies, or who don’t always poo in the morning.

    So if you’re healthy, it’s much more important that your bowel habits are comfortable and regular for you. Bowel motions do not have to occur once a day in the morning.

    Morning poos are also not a good thing for everyone. Some people with irritable bowel syndrome feel the urgent need to poo in the morning – often several times after getting up, during and after breakfast. This can be quite distressing. It appears this early-morning rush to poo is due to overstimulation of colon contractions in the morning.

    Can you train yourself to be regular?

    Yes, for example, to help treat constipation using the gastrocolic reflex. Children and elderly people with constipation can use the toilet immediately after eating breakfast to relieve symptoms. And for adults with constipation, drinking coffee regularly can help stimulate the gut, particularly in the morning.

    A disturbed circadian rhythm can also lead to irregular bowel motions and people more likely to poo in the evenings. So better sleep habits can not only help people get a better night’s sleep, it can help them get into a more regular bowel routine.

    Man preparing Italian style coffee at home, adding coffee to pot
    A regular morning coffee can help relieve constipation. Caterina Trimarchi/Shutterstock

    Regular physical activity and avoiding sitting down a lot are also important in stimulating bowel movements, particularly in people with constipation.

    We know stress can contribute to irregular bowel habits. So minimising stress and focusing on relaxation can help bowel habits become more regular.

    Fibre from fruits and vegetables also helps make bowel motions more regular.

    Finally, ensuring adequate hydration helps minimise the chance of developing constipation, and helps make bowel motions more regular.

    Monitoring your bowel habits

    Most of us consider pooing in the morning to be regular. But there’s a wide variation in normal so don’t be concerned if your poos don’t follow this pattern. It’s more important your poos are comfortable and regular for you.

    If there’s a major change in the regularity of your bowel habits that’s concerning you, see your GP. The reason might be as simple as a change in diet or starting a new medication.

    But sometimes this can signify an important change in the health of your gut. So your GP may need to arrange further investigations, which could include blood tests or imaging.

    Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University

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

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  • Life After Death? (Your Life; A Loved One’s Death)

    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.

    The Show Must Go On

    We’ve previously written about the topics of death and dying. It’s not cheery, but it is important to tackle.

    Sooner is better than later, in the case of:

    Preparations For Managing Your Own Mortality

    And for those who are left behind, of course it is hardest of all:

    What Grief Does To Your Body (And How To Manage It)

    But what about what comes next? For those who are left behind, that is.

    Life goes on

    In cases when the death is that of a close loved one, the early days after death can seem like a surreal blur. How can the world go ticking on as normal when [loved one] is dead?

    But incontrovertibly, it does, so we can only ask again: how?

    And, we get to choose that, to a degree. The above-linked article about grief gives a “101” rundown, but it’s (by necessity, for space) a scant preparation for one of the biggest challenges in life that most of us will ever face.

    For many people, processing grief involves a kind of “saying goodbye”. For others, it doesn’t, as in the following cases of grieving the loss of one’s child—something no parent should ever have to face, but it happens:

    Dr. Ken Druck | The Love That Never Dies

    (with warning, the above article is a little heavy)

    In short: for those who choose not to “say goodbye” in the case of the death of a loved one, it’s more often not a case of cold neglect, but rather the opposite—a holding on. Not in the “denial” sense of holding on, but rather in the sense of “I am not letting go of this feeling of love, no matter how much it might hurt to hold onto; it’s all I have”.

    What about widows, and love after death?

    Note: we’ll use the feminine “widow” here as a) it’s the most common and b) most scientific literature focuses on widows, but there is no reason why most of the same things won’t also apply to widowers.

    We say “most”, as society does tend to treat widows and widowers differently, having different expectations about a respectful mourning period, one’s comportment during same, and so on.

    As an aside: most scientific literature also assumes heterosexuality, which is again statistically reasonable, and for the mostpart the main difference is any extra challenges presented by non-recognition of marriages, and/or homophobic in-laws. But otherwise, grief is grief, and as the saying goes, love is love.

    One last specificity before we get into the meat of this: we are generally assuming marriages to be monogamous here. Polyamorous arrangements will likely sidestep most of these issues completely, but again, they’re not the norm.

    Firstly, there’s a big difference between remarrying (or similar) after being widowed, and remarrying (or similar) after a divorce, and that largely lies in the difference of how they begin. A divorce is (however stressful it may often be) more often seen as a transition into a new period of freedom, whereas bereavement is almost always felt as a terrible loss.

    The science, by the way, shows the stats for this; people are less likely to remarry, and slower to remarry if they do, in instances of bereavement rather than divorce, for example:

    Timing of Remarriage Among Divorced and Widowed Parents

    Love after death: the options

    For widows, then, there seem to be multiple options:

    • Hold on to the feelings for one’s deceased partner; never remarry
    • Grieve, move on, find new love, relegating the old to history
    • Try to balance the two (this is tricky but can be done*)

    *Why is balancing the two tricky, and how can it be done?

    It’s tricky because ultimately there are three people’s wishes at hand:

    • The deceased (“they would want me to be happy” vs “I feel I would be betraying them”—which two feelings can also absolutely come together, by the way)
    • Yourself (whether you actually want to get a new partner, or just remain single—this is your 100% your choice either way, and your decision should be made consciously)
    • The new love (how comfortable are they with your continued feelings for your late love, really?)

    And obviously only two of the above can be polled for opinions, and the latter one might say what they think we want to hear, only to secretly and/or later resent it.

    One piece of solid advice for the happily married: talk with your partner now about how you each would feel about the other potentially remarrying in the event of your death. Do they have your pre-emptive blessing to do whatever, do you ask a respectable mourning period first (how long?), would the thought just plain make you jealous? Be honest, and bid your partner be honest too.

    One piece of solid advice for everyone: make sure you, and your partner(s), as applicable, have a good emotional safety net, if you can. Close friends or family members that you genuinely completely trust to be there through thick and thin, to hold your/their hand through the emotional wreck that will likely follow.

    Because, while depression and social loneliness are expected and looked out for, it’s emotional loneliness that actually hits the hardest, for most people:

    Longitudinal Examination of Emotional Functioning in Older Adults After Spousal Bereavement

    …which means that having even just one close friend or family member with whom one can be at one’s absolute worst, express emotions without censure, not have to put on the socially expected appearance of emotional stability… Having that one person (ideally more, but having at least one is critical) can make a huge difference.

    But what if a person has nobody?

    That’s definitely a hard place to be, but here’s a good starting point:

    How To Beat Loneliness & Isolation

    Take care!

    Don’t Forget…

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