Head Over Hips

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We’ve written before about managing osteoarthritis (or ideally: avoiding it, but that’s not always an option on the table, of course), so here’s a primer/refresher before we get into the meat of today’s article:

Avoiding/Managing Osteoarthritis

When the head gets in the way

Research shows that the problem with recovery in cases of osteoarthritis of the hip is in fact often not the hip itself, but rather, the head:

❝In fact, the stronger your muscles are, the more protected your joint is, and the less pain you will experience.

Our research has shown that people with hip osteoarthritis were unable to activate their muscles as efficiently, irrespective of strength.

Basically, people with hip arthritis are unable to activate their muscles properly because the brain is actively putting on the brake to stop them from using the muscle.❞

~ Dr. Myles Murphy

See: People with hip osteoarthritis have reduced quadriceps voluntary activation and altered motor cortex function

This is a case of a short-term protective response being unhelpful in the long-term. If you injure yourself, your brain will try to inhibit you from exacerbating that injury, such as by (for example) disobliging you from putting weight on an injured joint.

This is great if you merely twisted an ankle and just need to sit back and relax while your body works its healing magic, but it’s counterproductive if it’s a chronic issue like osteoarthritis. In such (i.e. chronic) cases, avoidance of use of the joint will simply cause atrophy of the surrounding muscle and other tissues, leading to more of the very wear-and-tear that led to the osteoarthritis in the first place.

So… How to deal with that?

You probably can exercise

It’s easy to get caught between the dichotomy of “exercise and inflame your joints” vs “rest and your joints seize up”, which is not pleasant.

However, the trick lies in how you exercise, per joint type:

When Bad Joints Stop You From Exercising (5 Things To Change)

…which to be clear, isn’t a case of “avoid using the joint that’s bad”, but is rather “use it in this specific way, so that it gets stronger without doing it more damage in the process”.

Which is exactly what is needed!

Further resources

For those who like learning from short videos, here’s a trio of helpers (along with our own text-based overview for each):

And for those who prefer just reading, here’s a book we reviewed on the topic:

11 Minutes to Pain-Free Hips – by Melinda Wright

Take care!

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  • Egg Noodles vs Rice Noodles – 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 noodles to rice noodles, we picked the egg noodles.

    Why?

    It was close—these are both quite mediocre foods. They’re neither amazing for the health nor appalling for the health (in moderation). They are both relatively low in nutrients, but they are also low in anti-nutrients, i.e. things that have a negative effect on the health.

    Their mineral profiles are similar; both are a source of selenium, manganese, phosphorus, copper, and iron. Not as good as many sources, but not devoid of nutrients either.

    Their vitamin profiles are both pitiful; rice noodles have trace amounts of various vitamins, and egg noodles have only slightly more. While eggs themselves are nutritious, the processing has robbed them of much of their value.

    In terms of macros, egg noodles have a little more fat (but the fats are healthier) and rice noodles have a lot more carbs, so this is the main differentiator, and is the main reason we chose the egg noodles over the rice noodles. Both have a comparable (small) amount of protein.

    In short:

    • They’re comparable on minerals, and vitamins here are barely worth speaking about (though egg noodles do have marginally more)
    • Egg noodles have a little more fat (but the fats are healthier)
    • Rice noodles have a lot more carbs (with a moderately high glycemic index, which is relatively worse—if you eat them with vegetables and fats, then that’ll offset this, but we’re judging the two items on merit, not your meal)

    Learn more

    You might like this previous main feature of ours:

    Should You Go Light Or Heavy On Carbs?

    Take care!

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  • What are the most common symptoms of menopause? And which can hormone therapy treat?

    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.

    Despite decades of research, navigating menopause seems to have become harder – with conflicting information on the internet, in the media, and from health care providers and researchers.

    Adding to the uncertainty, a recent series in the Lancet medical journal challenged some beliefs about the symptoms of menopause and which ones menopausal hormone therapy (also known as hormone replacement therapy) can realistically alleviate.

    So what symptoms reliably indicate the start of perimenopause or menopause? And which symptoms can menopause hormone therapy help with? Here’s what the evidence says.

    Remind me, what exactly is menopause?

    Menopause, simply put, is complete loss of female fertility.

    Menopause is traditionally defined as the final menstrual period of a woman (or person female at birth) who previously menstruated. Menopause is diagnosed after 12 months of no further bleeding (unless you’ve had your ovaries removed, which is surgically induced menopause).

    Perimenopause starts when menstrual cycles first vary in length by seven or more days, and ends when there has been no bleeding for 12 months.

    Both perimenopause and menopause are hard to identify if a person has had a hysterectomy but their ovaries remain, or if natural menstruation is suppressed by a treatment (such as hormonal contraception) or a health condition (such as an eating disorder).

    What are the most common symptoms of menopause?

    Our study of the highest quality menopause-care guidelines found the internationally recognised symptoms of the perimenopause and menopause are:

    • hot flushes and night sweats (known as vasomotor symptoms)
    • disturbed sleep
    • musculoskeletal pain
    • decreased sexual function or desire
    • vaginal dryness and irritation
    • mood disturbance (low mood, mood changes or depressive symptoms) but not clinical depression.

    However, none of these symptoms are menopause-specific, meaning they could have other causes.

    In our study of Australian women, 38% of pre-menopausal women, 67% of perimenopausal women and 74% of post-menopausal women aged under 55 experienced hot flushes and/or night sweats.

    But the severity of these symptoms varies greatly. Only 2.8% of pre-menopausal women reported moderate to severely bothersome hot flushes and night sweats symptoms, compared with 17.1% of perimenopausal women and 28.5% of post-menopausal women aged under 55.

    So bothersome hot flushes and night sweats appear a reliable indicator of perimenopause and menopause – but they’re not the only symptoms. Nor are hot flushes and night sweats a western society phenomenon, as has been suggested. Women in Asian countries are similarly affected.

    Woman sits on chair, looking deflated
    You don’t need to have night sweats or hot flushes to be menopausal.
    Maridav/Shutterstock

    Depressive symptoms and anxiety are also often linked to menopause but they’re less menopause-specific than hot flushes and night sweats, as they’re common across the entire adult life span.

    The most robust guidelines do not stipulate women must have hot flushes or night sweats to be considered as having perimenopausal or post-menopausal symptoms. They acknowledge that new mood disturbances may be a primary manifestation of menopausal hormonal changes.

    The extent to which menopausal hormone changes impact memory, concentration and problem solving (frequently talked about as “brain fog”) is uncertain. Some studies suggest perimenopause may impair verbal memory and resolve as women transition through menopause. But strategic thinking and planning (executive brain function) have not been shown to change.

    Who might benefit from hormone therapy?

    The Lancet papers suggest menopause hormone therapy alleviates hot flushes and night sweats, but the likelihood of it improving sleep, mood or “brain fog” is limited to those bothered by vasomotor symptoms (hot flushes and night sweats).

    In contrast, the highest quality clinical guidelines consistently identify both vasomotor symptoms and mood disturbances associated with menopause as reasons for menopause hormone therapy. In other words, you don’t need to have hot flushes or night sweats to be prescribed menopause hormone therapy.

    Often, menopause hormone therapy is prescribed alongside a topical vaginal oestrogen to treat vaginal symptoms (dryness, irritation or urinary frequency).

    Doctor talks to woman
    You don’t need to experience hot flushes and night sweats to take hormone therapy.
    Monkey Business Images/Shutterstock

    However, none of these guidelines recommend menopause hormone therapy for cognitive symptoms often talked about as “brain fog”.

    Despite musculoskeletal pain being the most common menopausal symptom in some populations, the effectiveness of menopause hormone therapy for this specific symptoms still needs to be studied.

    Some guidelines, such as an Australian endorsed guideline, support menopause hormone therapy for the prevention of osteoporosis and fracture, but not for the prevention of any other disease.

    What are the risks?

    The greatest concerns about menopause hormone therapy have been about breast cancer and an increased risk of a deep vein clot which might cause a lung clot.

    Oestrogen-only menopause hormone therapy is consistently considered to cause little or no change in breast cancer risk.

    Oestrogen taken with a progestogen, which is required for women who have not had a hysterectomy, has been associated with a small increase in the risk of breast cancer, although any risk appears to vary according to the type of therapy used, the dose and duration of use.

    Oestrogen taken orally has also been associated with an increased risk of a deep vein clot, although the risk varies according to the formulation used. This risk is avoided by using estrogen patches or gels prescribed at standard doses

    What if I don’t want hormone therapy?

    If you can’t or don’t want to take menopause hormone therapy, there are also effective non-hormonal prescription therapies available for troublesome hot flushes and night sweats.

    In Australia, most of these options are “off-label”, although the new medication fezolinetant has just been approved in Australia for postmenopausal hot flushes and night sweats, and is expected to be available by mid-year. Fezolinetant, taken as a tablet, acts in the brain to stop the chemical neurokinin 3 triggering an inappropriate body heat response (flush and/or sweat).

    Unfortunately, most over-the-counter treatments promoted for menopause are either ineffective or unproven. However, cognitive behaviour therapy and hypnosis may provide symptom relief.

    The Australasian Menopause Society has useful menopause fact sheets and a find-a-doctor page. The Practitioner Toolkit for Managing Menopause is also freely available.The Conversation

    Susan Davis, Chair of Women’s Health, Monash University

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

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  • Antihistamines’ Generation Gap

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    Are You Ready For Allergy Season?

    For those of us in the Northern Hemisphere, fall will be upon us soon, and we have a few weeks to be ready for it. A common seasonal ailment is of course seasonal allergies—it’s not serious for most of us, but it can be very annoying, and can disrupt a lot of our normal activities.

    Suddenly, a thing that notionally does us no real harm, is making driving dangerous, cooking take three times as long, sex laughable if not off-the-table (so to speak), and the lightest tasks exhausting.

    So, what to do about it?

    Antihistamines: first generation

    Ye olde antihistamines such as diphenhydramine and chlorpheniramine are probably not what to do about it.

    They are small molecules that cross the blood-brain barrier and affect histamine receptors in the central nervous system. This will generally get the job done, but there’s a fair bit of neurological friendly-fire going on, and while they will produce drowsiness, the sleep will usually be of poor quality. They also tax the liver rather.

    If you are using them and not experiencing unwanted side effects, then don’t let us stop you, but do be aware of the risks.

    See also: Long-term use of diphenhydramine ← this is the active ingredient in Benadryl in the US and Canada, but safety regulations in many other countries mean that Benadryl has different, safer active ingredients elsewhere.

    Antihistamines: later generations

    We’re going to aggregate 2nd gen, 3rd gen, and 4th gen antihistamines here, because otherwise we’ll be writing a history article and we don’t have room for that. But suffice it to say, later generations of antihistamines do not come with the same problems.

    Instead of going in all-guns-blazing to the CNS like first-gens, they are more specific in their receptor-targetting, resulting in negligible collateral damage:

    CSACI position statement: Newer generation H1-antihistamines are safer than first-generation H1-antihistamines and should be the first-line antihistamines for the treatment of allergic rhinitis and urticaria

    Special shout-out to cetirizine and loratadine, which are the drugs behind half the brand names you’ll see on pharmacy shelves around most of the world these days (including many in the US and Canada).

    Note that these two are very often discussed in the same sentence, sit next to each other on the shelf, and often have identical price and near-identical packaging. Their effectiveness (usually: moderate) and side effects (usually: low) are similar and comparable, but they are genuinely different drugs that just happen to do more or less the same thing.

    This is relevant because if one of them isn’t working for you (and/or is creating an unwanted side effect), you might want to try the other one.

    Another honorable mention goes to fexofenadine, for which pretty much all the same as the above goes, though it gets talked about less (and when it does get mentioned, it’s usually by its most popular brand name, Allegra).

    Finally, one that’s a little different and also deserving of a special mention is azelastine. It was recently (ish, 2021) moved from being prescription-only to being non-prescription (OTC), and it’s a nasal spray.

    It can cause drowsiness, but it’s considered safe and effective for most people. Its main benefit is not really the difference in drug, so much as the difference in the route of administration (nasal rather than oral). Because the drug is in liquid spray form, it can be absorbed through the mucus lining of the nose and get straight to work on blocking the symptoms—in contrast, oral antihistamines usually have to go into your stomach and take their chances there (we say “usually”, because there are some sublingual antihistamines that dissolve under the tongue, but they are less common.)

    Better than antihistamines?

    Writer’s note: at this point, I was given to wonder: “wait, what was I squirting up my nose last time anyway?”—because, dear readers, at the time I got it I just bought one of every different drug on the shelf, desperate to find something that worked. What worked for me, like magic, when nothing else had, was beclometasone dipropionate, which a) smelled delightfully of flowers, which might just be the brand I got, b) needs replacing now because I got it in March 2023 and it expired July 2024, and c) is not an antihistamine at all.

    But, that brings us to the final chapter for today: systemic corticosteroids

    They’re not ok for everyone (check with your doctor if unsure), and definitely should not be taken if immunocompromised and/or currently suffering from an infection (including colds, flu, COVID, etc) unless your doctor tells you otherwise (and even then, honestly, double-check).

    But! They can work like magic when other things don’t. Unlike antihistamines, which only block the symptoms, systemic corticosteroids tackle the underlying inflammation, which can stop the whole thing in its tracks.

    Here’s how they measure up against antihistamines:

    ❝The results of this systematic review, together with data on safety and cost effectiveness, support the use of intranasal corticosteroids over oral antihistamines as first line treatment for allergic rhinitis.❞

    ~ Dr. Robert Puy et al.

    Read in full: Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: systematic review of randomised controlled trials

    Take care!

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  • Peach vs Papaya – 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 peach to papaya, we picked the peach.

    Why?

    It was close!

    In terms of macros, there’s not much between them; they are close to identical on protein, carbs, and fiber. Technically peach has slightly more protein (+0.4g/100g) and papaya has slightly more carbs and fiber (+1.28g/100g carbs, +0.2g/100g fiber), but since the differences are so tiny, we’re calling this section a tie—bearing in mind, these numbers are based on averages, which means that when they’re very close, they’re meaningless—one could easily, for example, pick up a peach that has more fiber than a papaya, because that 0.2g/100g is well within the margin of variation. So, as we say: a tie.

    When it comes to vitamins, things are also close; peaches have more of vitamins B1, B2, B3, and E, while papaya has more of vitamins A, B6, B9, and C. This is a 4:4 tie, but since the most notable margin of difference is vitamin C (of which papayas have 9x more) while the others are much closer, we’ll call this a tie-breaker win for papaya.

    The category of minerals sets things apart more: peaches have more copper, iron, manganese, phosphorus, potassium, and zinc, while papaya has more calcium, magnesium, and selenium. That’s already a 6:3 win for peaches, before we take into account that the numbers for papaya’s calcium and selenium are tiny, so adding this to the already 6:3 win for peaches makes for a clear and easy win for peaches in this category.

    Adding up the sections is 1W/1D/1L for both fruits, but looking at the win/loss for each, it’s clear which won/lost on a tiebreaker, and which won/lost by a large margin, so peaches get the victory here.

    Of course, enjoy either or both, though! And see below for a bonus feature of peaches:

    Want to learn more?

    You might like to read:

    Top 8 Fruits That Prevent & Kill Cancer ← peaches are high on this list! They kill cancer cells while sparing healthy ones 🙂

    Take care!

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  • How to Permanently Loosen a Tight Psoas

    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 Is Your Psoas?

    Your psoas is a deep muscle in your lower back and hip area that connects your spine to your thigh bone. It helps you bend your hips and spine, making it a hip flexor.

    In today’s video, Your Wellness Nerd (the YouTube channel behind the video below) has revealed some great tips on loosening said tight hip flexors!

    How to loosen them

    First off, the big reveal…your tight psoas is likely stemming from an overlooked cause: your lower back! The video kicks off with a simple technique to loosen up that stiff area in your lower back. All you need is a foam roller.

    But, before diving into the exercises, it’s essential to gauge your current flexibility. A basic hip flexor stretch serves as a pre-test.

    Note: the goal here isn’t to stretch, but rather to feel how tight you are.

    After testing, it’s time to roll…literally. Working through the lower back, use your roller or tennis ball to any find stiff spots and loosen them out; those spots are likely increasing the tension on your psoas.

    After some rolling, retest with the hip flexor stretch. Chances are, you’ll feel more mobility and less tightness right away.

    Note: this video focuses on chronic psoas issues. If you have sore psoas from a muscular workout, you may want to read our piece on speeding up muscle recovery.

    Is That All?

    But wait, there’s more! The video also covers two more exercises specifically targeting the psoas. This one’s hard to describe, so we recommend watching the video. However, to provide an overview, you’re doing the “classic couch stretch”, but with a few alterations.

    Next, the tennis ball technique zeroes in on specific tight spots in the psoas. By lying on the ball and adjusting its position around the hip area, you can likely release some deeply held tension.

    Additionally, some of our readers advocate for acupuncture for psoas relief – we’ve done an acupuncture myth-busting article here for reference.

    Other Sources

    If you’re looking for some more in-depth guides on stretching your psoas, and your body in general, we’ve made a range of 1-minute summaries of books that specifically target stretching:

    The final takeaway? If you’re constantly battling tight psoas muscles despite trying different exercises and stretches, it might be time to look at your lower back and your daily habits. This video isn’t just a band-aid fix; it’s about addressing the root cause for long-term relief:

    How did you find that video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!

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  • Apples vs Figs – 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 apples to figs, we picked the figs.

    Why?

    These two fruits are both known for being quite rich in sugar (but also rich in fiber, which offsets it metabolically), and indeed their macros are quite similar. That said, figs have slightly more protein, fiber, and carbs. Both are considered low glycemic index foods. We can consider this category a tie, or perhaps a nominal win for apples, whose glycemic index is the lower of the two. But since figs’ GI is also low, it’s really not a deciding factor.

    In terms of vitamins, apples have more of vitamins C and E, while figs have more of vitamins A, B1, B2, B3, B5, B6, B9, and choline, with noteworthy margins of difference. A clear for figs here.

    When it comes to minerals, apples are not higher in any minerals, while figs are several times higher in calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. An overwhelming win for figs.

    Of course, enjoy either or both, but if you want nutritional density, apples simply cannot compete with figs.

    Want to learn more?

    You might like to read:

    Which Sugars Are Healthier, And Which Are Just The Same?

    Take care!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

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