Holistic Approach To Resculpting A Face Affected By Hypothyroidism, PCOS, Or Menopause

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Mila Magnani has PCOS and hypothyroidism, but the principles are the same for menopause because both menopause and PCOS are a case of a hormone imbalance resulting in androgenic effects, so there’s a large amount of overlap.

Obviously, a portion of the difference in the thumbnail is a matter of angle and make-up, but as you can see in the video itself, there’s also a lot of genuine change underneath, too:

Stress-free method

Firstly, she bids us get lab tests and work with a knowledgeable doctor to address potential thyroid, hormonal, or nutrient imbalances. Perhaps we already know at least part of what is causing our problems, but even if so, it doesn’t hurt to take steps to rule the others out. Imagine spending ages unsuccessfully battling PCOS or menopause, only to discover it was a thyroid issue, and you were fighting the wrong battle!

Magnani used a natural route to manage her PCOS and hypothyroidism, while acknowledging that medication is fine too; it’s usually cheaper and more convenient—and there’s a lot more standardization for medications than there is for supplements, which makes it a lot easier to navigate, find what works, and keep getting the exact same thing once it does work.

Other things she recommends include:

  • Lymphatic drainage: addressing the lymphatic system to reduce puffiness. Techniques include lymphatic drainage massage, stretching, rebounding (trampoline), and dry brushing. She emphasizes that for facial de-puffing, it’s important to treat the whole upper body, not just the face.
  • Low-impact exercise: she switched from high-intensity workouts to low-impact exercises like nature walking and gentle stretching to reduce stress and improve health.
  • Nervous system regulation: she worked on nervous system regulation by means of journaling, breathwork, and stimulating the vagus nerve, which improved sleep and reduced stress and anxiety. These things, of course, have knock-on benefits for almost every part of health.
  • Diet: she adopted a low-glycemic diet, reduced salt intake, and cooked at home to avoid water retention caused by high sodium in restaurant meals.
  • Natural diuretics: she uses teas like hibiscus and chamomile to reduce puffiness after consuming high-sodium foods.
  • Sauna and sweating: consider a sauna mat or hot baths to detox and reduce swelling; that’s what she uses in lieu of a convenient sauna.

You may be wondering how quickly you can expect results: it took 3–6 months of daily effort to see significant changes, and she now maintains the routine less frequently (every 2–3 days, instead of daily).

For more on all this, enjoy:

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  • Why You’re Tired & How To Fix It

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    This is Sadia Badiei. A dietician by academic and professional background, she’s nowadays hung up her lab coat for a chef’s jacket, and is best known for her “Pick Up Limes” brand. Today, we’ll be taking her advice on managing energy levels with what’s on our plates!

    Quick note: our usual medical/legal disclaimer applies, and this article cannot diagnose you from afar, and thus neither can it make any certain prescription; this is for educational purposes, and aimed at being applicable to most of our readers.

    There are many possible things that can cause chronic fatigue, and not all of them can be fixed by diet. Your doctor will have access to tests and such that we, being a humble health science publication, do not.

    You may recognize her; we’ve featured her videos occasionally, mostly recently:

    Pick Up A Zest For Life: 10 Lessons For A Healthy Mind & Body

    But, what does she want us to know about living life with more energy?

    It starts with balance

    Badiei makes the case that we should strive for a nutritionally-balanced diet; that may not come as much of a revelation, but what does that look like for a vegan (Badiei advocates for plant-based eating)?

    She recommends that our diet consist of:

    • About 50% fruits and vegetables
    • About 25% grains and starches
    • About 25% proteins
    • Modest amounts of fats
    • A little of well-chosen dairy substitutions
    • Finally, a few judicious supplements to top it off

    That does add up to more than 100%, but 1) we did say “About n%” and 2) this is not a bad thing to note, actually, since Badiei advocates (as we do) for focussing more on what we add into our diet, rather than what we take out.

    Breaking it down a little further, she recommends making sure to get “the foundational seven”, which is a little like “Dr. Greger’s Daily Dozen”, but in this case it’s counted on a per-food-type basis.

    Thus, she recommends:

    1. Dark green leafy vegetables
    2. Assorted other non-starchy vegetables (your choice what kind)
    3. Fruit, of any kinds (unlike Dr. Greger separating berries)
    4. Grains and starches (so for example, potatoes are lumped in with rice here, botanically very different, but often fulfil a similar culinary role)
    5. Nuts and seeds
    6. Legumes
    7. Fortified dairy alternatives

    For full details including how much of each, and “what counts”, etc, see:

    Pick Up Limes | The Nourish Method

    Time your carbs

    Slow-release carbohydrates, those with the most fiber, are best most of the time, giving us more sustained fuel, keeping us energized for longer after meals—even if we would rather sleep:

    She cites: Fiber and Saturated Fat Are Associated with Sleep Arousals and Slow Wave Sleep

    Quick-release carbohydrates, those with what’s generally considered a less favorable carb:fiber ratio, are best if we’re going to eat nearer to bedtime. We know, eating before bed is often considered a bit of a no-no, but Badiei bids us indulge if we so desire, as the quicker-absorbed carbohydrates support tryptophan reaching our brain more efficiently, and thus promote sleep onset.

    See also: Should You Go Light Or Heavy On Carbs?

    About that fat

    We mentioned (or rather, Badiei’s citation mentioned) saturated fat. It is indeed linked with difficulty falling asleep, and/but omega-3 fatty acids, on the other hand, promote better sleep.

    She cites: The relationship between sleep duration, sleep quality and dietary intake in adults

    While you’re enjoying those nuts and seeds (for the omega-3 fatty acids), you might also note that several also star in Badiei’s list of plant-based foods that are rich in tryptophan, such as soy, cashews, pumpkin seeds, sunflower seeds, beans, green vegetables, and mushrooms.

    Micronutrients

    Badiei’s focus here is on B-vitamins, iron, magnesium, selenium, and zinc. We imagine most of our readers here are taking steps to ensure to get a full daily coverage of vitamins and minerals anyway, but you might want to read what she has to say about iron on a plant-based diet, because the numbers may be different than you think.

    The reason for this is that while animal products contain mostly heme iron, which is easier to absorb but associated with a risk increase in some diseases, plant-based foods usually* contain only non-heme iron, which is healthier but not as bioavailable, so if eating only plants, we need more of it:

    Pick Up Limes | Iron on a Plant-Based Diet

    *If you eat a carnivorous plant, guess what, it’ll have heme iron in it, tangling that food web.

    “What if I know I have chronic fatigue for non-dietary reasons?”

    Well, that sucks, and we’re not going to pretend the above will magically fix it. However, there are still things that can at least relatively improve your experience:

    Eat To Beat Chronic Fatigue! Yes, Even When Fatigued Chronically

    (it’s a good guide to being able to consistently eat healthily when your energy levels are consistently at minimal, meaning that a lot of common advice becomes unusable)

    Take care!

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  • Zuranolone: What to know about the pill for postpartum depression

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    In the year after giving birth, about one in eight people who give birth in the U.S. experience the debilitating symptoms of postpartum depression (PPD), including lack of energy and feeling sad, anxious, hopeless, and overwhelmed. 

    Postpartum depression is a serious, potentially life-threatening condition that can affect a person’s bond with their baby. Although it’s frequently confused with the so-called “baby blues,” it’s not the same. 

    The baby blues include similar, temporary symptoms that affect up to 80 percent of people who have recently given birth and usually go away within the first few weeks. PPD usually begins within the first month after giving birth and can last for months and interfere with a person’s daily life if left untreated. Thankfully, PPD is treatable and there is help available

    On August 4, the FDA approved zuranolone, branded as Zurzuvae, the first-ever oral medication to treat PPD. Until now, besides other common antidepressants, the only medication available to treat PPD specifically was the IV injection brexanolone, which is difficult to access and expensive and can only be administered in a hospital or health care setting. 

    Read on to find out more about zuranolone: what it is, how it works, how much it costs, and more. 

    What is zuranolone?

    Zurzuvae is the brand name for zuranolone, an oral medication to treat postpartum depression. Developed by Sage Therapeutics in partnership with Biogen, it’s now available in the U.S. Zurzuvae is typically prescribed as two 25 mg capsules a day for 14 days. In clinical trials, the medication showed to be fast-acting, improving PPD symptoms in just three days

    How does zuranolone work? 

    Zuranolone is a neuroactive steroid, a type of medication that helps the neurotransmitter GABA’s receptors, which affect how the body reacts to anxiety, stress, and fear, function better.

    “Zuranolone can be thought of as a synthetic version of [the neuroactive steroid] allopregnanolone,” says Dr. Katrina Furey, a reproductive psychiatrist, clinical instructor at Yale University, and co-host of the Analyze Scripts podcast. “Women with PPD have lower levels of allopregnenolone compared to women without PPD.”

    How is it different from other antidepressants?

    “What differentiates zuranolone from other previously available oral antidepressants is that it has a much more rapid response and a shorter course of treatment,” says Dr. Asima Ahmad, an OB-GYN, reproductive endocrinologist, and founder of Carrot Fertility

    “It can take effect as early as on day three of treatment, versus other oral antidepressants that can take up to six to 12 weeks to take full effect.” 

    What are Zurzuvae’s side effects? 

    According to the FDA, the most common side effects of Zurzuvae include dizziness, drowsiness, diarrhea, fatigue, the common cold, and urinary tract infection. Similar to other antidepressants, the medication may increase the risk of suicidal thoughts and actions in people 24 and younger. However, NPR noted that this type of labeling is required for all antidepressants, and researchers didn’t see any reports of suicidal thoughts in their trials.

    “Drug trials also noted that the side effects for zuranolone were not as severe,” says Ahmad. “[There was] no sudden loss of consciousness as seen with brexanolone or weight gain and sexual dysfunction, which can be seen with other oral antidepressants.”

    She adds: “Given the lower incidence of side effects and more rapid-acting onset, zuranolone could be a viable option for many,” including those looking for a treatment that offers faster symptom relief. 

    Can someone breastfeed while taking zuranolone?

    It’s complicated. In clinical trials, participants were asked to stop breastfeeding (which, according to Furey, is common in early clinical trials). 

    A small study of people who were nursing while taking zuranolone found that 0.3 percent of the medication dose was passed on to breast milk, which, Furey says, is a pretty low amount of exposure for the baby. Ahmad says that “though some data suggests that the risk of harm to the baby may be low, there is still overall limited data.”

    Overall, people should talk to their health care provider about the risks and benefits of breastfeeding while on the medication. 

    “A lot of factors will need to be weighed, such as overall health of the infant, age of the infant, etc., when making this decision,” Furey says. 

    How much does Zurzuvae cost? 

    Zurzuvae’s price before insurance coverage is $15,900 for the 14-day treatment. However, the Policy Center for Maternal Mental Health says insurance companies and Medicaid are expected to cover it because it’s the only drug of its kind. 

    Less than 1 percent of U.S. insurers have issued coverage guidelines so far, so it’s still unknown how much it will cost patients after insurance. Some insurers require patients to try another antidepressant first (like the more common SSRIs) before covering Zurzuvae. For uninsured and underinsured people, Sage Therapeutics said it will offer copay assistance

    The hefty price tag and potential issues with coverage may widen existing health disparities, says Ahmad. “We need to ensure that we are seeking out solutions to enable wide-scale access to all PPD treatments so that people have access to whatever treatment may work best for them.”

    If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.

    For more information, talk to your health care provider.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • To tackle gendered violence, we also need to look at drugs, trauma and mental health

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    After several highly publicised alleged murders of women in Australia, the Albanese government this week pledged more than A$925 million over five years to address men’s violence towards women. This includes up to $5,000 to support those escaping violent relationships.

    However, to reduce and prevent gender-based and intimate partner violence we also need to address the root causes and contributors. These include alcohol and other drugs, trauma and mental health issues.

    Why is this crucial?

    The World Health Organization estimates 30% of women globally have experienced intimate partner violence, gender-based violence or both. In Australia, 27% of women have experienced intimate partner violence by a co-habiting partner; almost 40% of Australian children are exposed to domestic violence.

    By gender-based violence we mean violence or intentionally harmful behaviour directed at someone due to their gender. But intimate partner violence specifically refers to violence and abuse occurring between current (or former) romantic partners. Domestic violence can extend beyond intimate partners, to include other family members.

    These statistics highlight the urgent need to address not just the aftermath of such violence, but also its roots, including the experiences and behaviours of perpetrators.

    What’s the link with mental health, trauma and drugs?

    The relationships between mental illness, drug use, traumatic experiences and violence are complex.

    When we look specifically at the link between mental illness and violence, most people with mental illness will not become violent. But there is evidence people with serious mental illness can be more likely to become violent.

    The use of alcohol and other drugs also increases the risk of domestic violence, including intimate partner violence.

    About one in three intimate partner violence incidents involve alcohol. These are more likely to result in physical injury and hospitalisation. The risk of perpetrating violence is even higher for people with mental ill health who are also using alcohol or other drugs.

    It’s also important to consider traumatic experiences. Most people who experience trauma do not commit violent acts, but there are high rates of trauma among people who become violent.

    For example, experiences of childhood trauma (such as witnessing physical abuse) can increase the risk of perpetrating domestic violence as an adult.

    Small boy standing outside, eyes down, hands over ears
    Childhood trauma can leave its mark on adults years later. Roman Yanushevsky/Shutterstock

    Early traumatic experiences can affect the brain and body’s stress response, leading to heightened fear and perception of threat, and difficulty regulating emotions. This can result in aggressive responses when faced with conflict or stress.

    This response to stress increases the risk of alcohol and drug problems, developing PTSD (post-traumatic stress disorder), and increases the risk of perpetrating intimate partner violence.

    How can we address these overlapping issues?

    We can reduce intimate partner violence by addressing these overlapping issues and tackling the root causes and contributors.

    The early intervention and treatment of mental illness, trauma (including PTSD), and alcohol and other drug use, could help reduce violence. So extra investment for these are needed. We also need more investment to prevent mental health issues, and preventing alcohol and drug use disorders from developing in the first place.

    Female psychologist or counsellor talking with male patient
    Early intervention and treatment of mental illness, trauma and drug use is important. Okrasiuk/Shutterstock

    Preventing trauma from occuring and supporting those exposed is crucial to end what can often become a vicious cycle of intergenerational trauma and violence. Safe and supportive environments and relationships can protect children against mental health problems or further violence as they grow up and engage in their own intimate relationships.

    We also need to acknowledge the widespread impact of trauma and its effects on mental health, drug use and violence. This needs to be integrated into policies and practices to reduce re-traumatising individuals.

    How about programs for perpetrators?

    Most existing standard intervention programs for perpetrators do not consider the links between trauma, mental health and perpetrating intimate partner violence. Such programs tend to have little or mixed effects on the behaviour of perpetrators.

    But we could improve these programs with a coordinated approach including treating mental illness, drug use and trauma at the same time.

    Such “multicomponent” programs show promise in meaningfully reducing violent behaviour. However, we need more rigorous and large-scale evaluations of how well they work.

    What needs to happen next?

    Supporting victim-survivors and improving interventions for perpetrators are both needed. However, intervening once violence has occurred is arguably too late.

    We need to direct our efforts towards broader, holistic approaches to prevent and reduce intimate partner violence, including addressing the underlying contributors to violence we’ve outlined.

    We also need to look more widely at preventing intimate partner violence and gendered violence.

    We need developmentally appropriate education and skills-based programs for adolescents to prevent the emergence of unhealthy relationship patterns before they become established.

    We also need to address the social determinants of health that contribute to violence. This includes improving access to affordable housing, employment opportunities and accessible health-care support and treatment options.

    All these will be critical if we are to break the cycle of intimate partner violence and improve outcomes for victim-survivors.

    The National Sexual Assault, Family and Domestic Violence Counselling Line – 1800 RESPECT (1800 737 732) – is available 24 hours a day, seven days a week for any Australian who has experienced, or is at risk of, family and domestic violence and/or sexual assault.

    If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14. In an emergency, call 000.

    Siobhan O’Dean, Postdoctoral Research Associate, The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney; Lucinda Grummitt, Postdoctoral Research Fellow, The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, and Steph Kershaw, Research Fellow, The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney

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

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  • Low-Dose Aspirin & Anemia

    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 recently wrote about…

    How To Survive A Heart Attack When You’re Alone

    …and one of the items was “if you have aspirin readily available, then after calling an ambulance is the time to take it—but don’t exert yourself trying to find some”.

    But what of aspirin as a preventative?

    Many people take low-dose aspirin daily as a way to reduce the risk of atherothrombosis specifically (and thus, indirectly, they hope to reduce the risk of heart attacks).

    The science of how helpful this is both clear and complicated—that is to say, the stats are not ambiguous*, but there are complicating factors of which many people are unaware.

    *it will reduce the overall risk of cardiovascular events, but will not affect CVD mortality; in other words, it may improve your recovery from minor cardiac events, but is not likely to save you from major ones.

    And also, it has unwanted side effects that can constitute a more relevant threat for many people. We’ll share more on that at the end of today’s article, but first…

    A newly identified threat from daily aspirin use

    A large (n=313,508) study of older adults (median age 73) were sorted into those who used low-dose aspirin as a preventative, and those who did not.

    The primary outcome was incidence of anemia sufficient to require treatment, and the secondary outcome was major bleeding. And, at least 1 in 5 of those who experienced anemia also experienced bleeding.

    The bleeding issue was not “newly identified” and will not surprise many people; after all, the very reason that aspirin is taken as a CVD preventative is for its anti-clotting property of allowing blood to flow more freely.

    The anemia, however, has been getting increasing scientific scrutiny lately, after long going unnoticed in the wild. Given that anemia also gives the symptom “dizziness”, this is also a significant threat for increasing the incidence of falls in the older population, too, which can of course lead to serious complications and ultimately death.

    Here’s the paper itself:

    Low-Dose Aspirin and Risk of Anaemia in Older Adults: Insights from a Danish Register-based Cohort Study

    Want to know more?

    As promised, here’s what we wrote previously about some of aspirin’s other risks:

    Aspirin, CVD Risk, & Potential Counter-Risks

    Take care!

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  • New News From The Centenarian Blue Zones

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    From Blue To Green…

    We sometimes write about supercentenarians, which word is usually used in academia to refer to people who are not merely over 100 years of age, but over 110 years. These people can be found in many countries, but places where they have been found to be most populous (as a percentage of the local population) have earned the moniker “Blue Zones”—of which Okinawa and Sardinia are probably the most famous, but there are others too.

    This is in contrast to, for example “Red Zones”, a term often used for areas where a particular disease is endemic, or areas where a disease is “merely” epidemic, but particularly rife at present.

    In any case, back to the Blue Zones, where people live the longest and healthiest—because the latter part is important too! See also:

    • Lifespan: how long we live
    • Healthspan: how long we stay healthy (portmanteau of “healthy lifespan”)

    Most of our readers don’t live in a Blue Zone (in fact, many live in a COVID Red Zone, a diabetes Red Zone, and a heart disease Red Zone), but that doesn’t mean we can’t all take tips from the Blue Zones and apply them, for example:

    You may be wondering… How much good will this do me? And, we do have an answer for that:

    When All’s Said And Done, How Likely Are You To Live To 100?

    Now that we’re all caught-up…

    The news from the Blues

    A team of researchers did a big review of observational studies of centenarians and near-centenarians (aged 95+). Why include the near-centenarians, you ask? Well, most of the studies are also longitudinal, and if we’re doing an observational study of the impact of lifestyle factors on a 100-year-old, it’s helpful to know what they’ve been doing recently. Hence nudging the younger-end cutoff a little lower, so as to not begin each study with fresh-faced 100-year-olds whom we know nothing about.

    Looking at thousands of centenarians (and near-centenarians, but also including some supercentenarians, up the age of 118), the researchers got a lot of very valuable data, far more than we have room to go into here (do check out the paper at the bottom of this article, if you have time; it’s a treasure trove of data), but one of the key summary findings was a short list of four factors they found contributed the most to extreme longevity:

    1. A diverse diet with low salt intake: in particular, a wide variety of plant diversity, including protein-rich legumes, though fish featured prominently also. On average they got 57% and 65% of their energy intake from carbohydrates, 12% to 32% from protein, and 27% to 31% from fat. As for salt, they averaged 1.6g of sodium per day, which is well within the WHO’s recommendation of averaging under 2g of sodium per day. As a matter of interest, centenarians in Okinawa itself averaged 1.1g of sodium per day.
    2. Low medication use: obviously there may be a degree of non-causal association here, i.e. the same people who just happened to be healthier and therefore lived longer, correspondingly took fewer medications—they took fewer medications because they were healthier; they weren’t necessarily healthier because they took fewer medications. That said, overmedication can be a big problem, especially in places with a profit motive like the US, and can increase the risk of harmful drug interactions, and side effects that then need more medications to treat the side effects, as well as direct iatrogenic damage (i.e. this drug treats your condition, but as the cost of harming you in some other way). Naturally, sometimes we really do need meds, but it’s a good reminder to do a meds review with one’s doctor once in a while, and see if everything’s still of benefit.
    3. Getting good sleep: not shocking, and this one’s not exactly news. But what may be shocking is that 68% of centenarians reported consistently getting enough good-quality sleep. To put that into perspective, only 35% of 10almonds readers reported regularly getting sleep in the 7–9 hours range.
    4. Rural living environment: more than 75% of the centenarians and near-centenarians lived in rural areas. This is not usually something touted as a Blue Zones thing on lists of Blue zones things, but this review strongly highlighted it as very relevant. In the category of things that are more obvious once it’s pointed out, though, this isn’t necessarily such a difference between “country folk” and “city folk”, so much as the ability to regularly be in green spaces has well-established health benefits physically, mentally, and both combined (such as: neurologically).

    See: The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes

    And showing that yes, even parks in cities make a significant difference:

    The association of green space, tree canopy and parks with life expectancy in neighborhoods of Los Angeles

    Want to know more?

    You can read the study in full here:

    A systematic review of diet and medication use among centenarians and near-centenarians worldwide

    Take care!

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  • Nudge – by Richard Thaler & Cass Sunstein

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    How often in life do we make a suboptimal decision that ends up plaguing us for a long time afterwards? Sometimes, a single good or bad decision can even directly change the rest of our life.

    So, it really is important that we try to optimize the decisions we do make.

    Professors Richard Thaler and Cass Sunstein look at all kinds of decision-making in this book. Their goal, as per the subtitle, is “improving decisions about health, wealth, and happiness”.

    For the most part, the book concentrates on “nudges”. Small factors that influence our decisions one way or another.

    Most importantly: that some of them are very good reasons to be nudged; others, very bad ones. And they often look similar.

    Where this book excels is in highlighting the many ways we make decisions without even thinking about it… or we think about it, but only down a prescribed, foreseen track, to an externally expected conclusion (for example, an insurance company offering three packages, but two of them exist only to direct you to the “correct” choice).

    A weakness of the book is that in some aspects it’s a little inconsistent. The authors describe their economic philosophy as “libertarian paternalism”, and as libertarians they’re against mandates, except when as paternalists they’re for them. But, if we take away their labels, this boils down to “some mandates can be good and some can be bad”, which would not be so inconsistent after all.

    Bottom line: if you’d like to better understand your own decision-making processes through the eyes of policy-setting economists (especially Sunstein, who worked for the White House Office of Information & Regulatory Affairs) whose job it is to make sure you make the “right” decisions, then this is a very enlightening book.

    Click here to check out Nudge and improve your decision-making clarity!

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    Learn to Age Gracefully

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