Comfortable with Uncertainty – by Pema Chödrön
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This book is exactly what the subtitle claims it to be: 108 teachings on cultivating fearlessness and compassion. They are short extracts, entire of themselves, taken from Chödrön’s wider work and arranged to offer her insights and advices on this one topic, in one place.
It is worth noting, by the way, that the author is a Buddhist nun, and as such, the principles and practices are Buddhist in origin. If that’s a problem for you, then this book will not be for you. It does not, however, require that the reader be Buddhist to benefit, simply that one has a will to be calm in the face of chaos, and yet not indifferent—rather, to take on the challenges of life with a whole heart.
And about that compassion? This is about alleviating suffering; your own, and the suffering in the world as a whole, increasingly uncertain as this world is. And being brave enough to do that, in a world that is not always gentle.
The style is idiosyncratic, and you will likely love it or hate it. If you love it, then you will find this book at once both soothing and empowering; if not, you will put the book down and pick up a book on CBT or something instead.
Bottom line: this book absolutely does deliver on its title/subtitle promises—provided you, dear reader, internalize it and practise it.
Click here to check out Comfortable with Uncertainty, and get comfortable with uncertainty!
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People with dementia aren’t currently eligible for voluntary assisted dying. Should they be?
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Dementia is the second leading cause of death for Australians aged over 65. More than 421,000 Australians currently live with dementia and this figure is expected to almost double in the next 30 years.
There is ongoing public discussion about whether dementia should be a qualifying illness under Australian voluntary assisted dying laws. Voluntary assisted dying is now lawful in all six states, but is not available for a person living with dementia.
The Australian Capital Territory has begun debating its voluntary assisted dying bill in parliament but the government has ruled out access for dementia. Its view is that a person should retain decision-making capacity throughout the process. But the bill includes a requirement to revisit the issue in three years.
The Northern Territory is also considering reform and has invited views on access to voluntary assisted dying for dementia.
Several public figures have also entered the debate. Most recently, former Australian Chief Scientist, Ian Chubb, called for the law to be widened to allow access.
Others argue permitting voluntary assisted dying for dementia would present unacceptable risks to this vulnerable group.
Inside Creative House/Shutterstock Australian laws exclude access for dementia
Current Australian voluntary assisted dying laws exclude access for people who seek to qualify because they have dementia.
In New South Wales, the law specifically states this.
In the other states, this occurs through a combination of the eligibility criteria: a person whose dementia is so advanced that they are likely to die within the 12 month timeframe would be highly unlikely to retain the necessary decision-making capacity to request voluntary assisted dying.
This does not mean people who have dementia cannot access voluntary assisted dying if they also have a terminal illness. For example, a person who retains decision-making capacity in the early stages of Alzheimer’s disease with terminal cancer may access voluntary assisted dying.
What happens internationally?
Voluntary assisted dying laws in some other countries allow access for people living with dementia.
One mechanism, used in the Netherlands, is through advance directives or advance requests. This means a person can specify in advance the conditions under which they would want to have voluntary assisted dying when they no longer have decision-making capacity. This approach depends on the person’s family identifying when those conditions have been satisfied, generally in consultation with the person’s doctor.
Another approach to accessing voluntary assisted dying is to allow a person with dementia to choose to access it while they still have capacity. This involves regularly assessing capacity so that just before the person is predicted to lose the ability to make a decision about voluntary assisted dying, they can seek assistance to die. In Canada, this has been referred to as the “ten minutes to midnight” approach.
But these approaches have challenges
International experience reveals these approaches have limitations. For advance directives, it can be difficult to specify the conditions for activating the advance directive accurately. It also requires a family member to initiate this with the doctor. Evidence also shows doctors are reluctant to act on advance directives.
Particularly challenging are scenarios where a person with dementia who requested voluntary assisted dying in an advance directive later appears happy and content, or no longer expresses a desire to access voluntary assisted dying.
What if the person changes their mind? Jokiewalker/Shutterstock Allowing access for people with dementia who retain decision-making capacity also has practical problems. Despite regular assessments, a person may lose capacity in between them, meaning they miss the window before midnight to choose voluntary assisted dying. These capacity assessments can also be very complex.
Also, under this approach, a person is required to make such a decision at an early stage in their illness and may lose years of otherwise enjoyable life.
Some also argue that regardless of the approach taken, allowing access to voluntary assisted dying would involve unacceptable risks to a vulnerable group.
More thought is needed before changing our laws
There is public demand to allow access to voluntary assisted dying for dementia in Australia. The mandatory reviews of voluntary assisted dying legislation present an opportunity to consider such reform. These reviews generally happen after three to five years, and in some states they will occur regularly.
The scope of these reviews can vary and sometimes governments may not wish to consider changes to the legislation. But the Queensland review “must include a review of the eligibility criteria”. And the ACT bill requires the review to consider “advanced care planning”.
Both reviews would require consideration of who is able to access voluntary assisted dying, which opens the door for people living with dementia. This is particularly so for the ACT review, as advance care planning means allowing people to request voluntary assisted dying in the future when they have lost capacity.
The legislation undergoes a mandatory review. Jenny Sturm/Shutterstock This is a complex issue, and more thinking is needed about whether this public desire for voluntary assisted dying for dementia should be implemented. And, if so, how the practice could occur safely, and in a way that is acceptable to the health professionals who will be asked to provide it.
This will require a careful review of existing international models and their practical implementation as well as what would be feasible and appropriate in Australia.
Any future law reform should be evidence-based and draw on the views of people living with dementia, their family caregivers, and the health professionals who would be relied on to support these decisions.
Ben White, Professor of End-of-Life Law and Regulation, Australian Centre for Health Law Research, Queensland University of Technology; Casey Haining, Research Fellow, Australian Centre for Health Law Research, Queensland University of Technology; Lindy Willmott, Professor of Law, Australian Centre for Health Law Research, Queensland University of Technology, Queensland University of Technology, and Rachel Feeney, Postdoctoral research fellow, Queensland University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Hummus vs Guacamole – Which is Healthier?
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Our Verdict
When comparing hummus to guacamole, we picked the guacamole.
Why?
First up, let’s assume that the standards are comparable, for example that both have been made with simple whole foods. The hummus is mostly chickpeas with tahini and a little olive oil and some seasoning; the guacamole is mostly avocado with a little lime juice and some seasoning.
In terms of macronutrients, hummus has slightly more protein and fiber, 2x the carbohydrates (but they are healthy carbs), and usually slightly less fat (but the fats are healthy in both cases).
In terms of micronutrients, the hummus is rich in iron and B vitamins, and the guacamole is rich in potassium, magnesium, vitamins C, E, and K.
So far, it’s pretty much tied. What else is there to consider?
We picked the guacamole because some of its nutrients (especially the potassium, magnesium, and vitamin K) are more common deficiencies in most people’s diets than iron and B vitamins. So, on average, it’s probably the one with the nutrients that you need more of at any given time.
So, it was very very close, and it came down to the above as the deciding factor.
However!
- If you like one and not the other? Eat that one; it’s good.
- If you like both but feel like eating one of them in particular? Eat that one; your body is probably needing those nutrients more right now.
- If you are catering for a group of people? Serve both!
- If you are catering for just yourself and would enjoy both? Serve both! There’s nobody to stop you!
Want to read more?
You might like: Avocado Oil vs Olive Oil – Which is Healthier?
Enjoy!
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Eat to Live – by Dr. Joel Fuhrman
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It sure would be great if we could eat all that we wanted, and remain healthy without putting on weight.
That’s the main intent of Dr. Joel Fuhrman’s book, with some caveats:
- His diet plan gives unlimited amounts of some foods, while restricting others
- With a focus on nutrient density, he puts beans and legumes into the “eat as much as you want” category, and grains (including whole grains) into the “restrict” category
This latter is understandable for a weight-loss diet (as the book’s subtitle promises). The question then is: will it be sustainable?
Current scientific consensus holds for “whole grains are good and an important part of diet”. It does seem fair that beans and legumes should be able to replace grains, for grains’ carbohydrates and fiber.
However, now comes the double-edged aspect: beans and legumes contain more protein than grains. So, we’ll feel fuller sooner, and stay fuller for longer. This means we’ll probably lose weight, and keep losing weight. Or at least: losing fat. Muscle mass will stay or go depending on what you’re doing with your muscles.
If you want to keep your body fat percentage at a certain level and not go below it, you may well need to reintroduce grains to your diet, which isn’t something that Dr. Fuhrman covers in this book.
Bottom line: this is a good, science-based approach for healthily losing weight (specifically, fat) and keeping it off. It might be a little too good at this for some people though.
Click here to check out Eat To Live and decide what point you want to stop losing weight at!
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‘Sleep tourism’ promises the trip of your dreams. Beyond the hype plus 5 tips for a holiday at home
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Imagine arriving at your hotel after a long flight and being greeted by your own personal sleep butler. They present you with a pillow menu and invite you to a sleep meditation session later that day.
You unpack in a room kitted with an AI-powered smart bed, blackout shades, blue light-blocking glasses and weighted blankets.
Holidays are traditionally for activities or sightseeing – eating Parisian pastry under the Eiffel tower, ice skating at New York City’s Rockefeller Centre, lying by the pool in Bali or sipping limoncello in Sicily. But “sleep tourism” offers vacations for the sole purpose of getting good sleep.
The emerging trend extends out of the global wellness tourism industry – reportedly worth more than US$800 billion globally (A$1.2 trillion) and expected to boom.
Luxurious sleep retreats and sleep suites at hotels are popping up all over the world for tourists to get some much-needed rest, relaxation and recovery. But do you really need to leave home for some shuteye?
RossHelen/Shutterstock Not getting enough
The rise of sleep tourism may be a sign of just how chronically sleep deprived we all are.
In Australia more than one-third of adults are not achieving the recommended 7–9 hours of sleep per night, and the estimated cost of this inadequate sleep is A$45 billion each year.
Inadequate sleep is linked to long-term health problems including poor mental health, heart disease, metabolic disease and deaths from any cause.
Can a fancy hotel give you a better sleep?
Many of the sleep services available in the sleep tourism industry aim to optimise the bedroom for sleep. This is a core component of sleep hygiene – a series of healthy sleep practices that facilitate good sleep including sleeping in a comfortable bedroom with a good mattress and pillow, sleeping in a quiet environment and relaxing before bed.
The more people follow sleep hygiene practices, the better their sleep quality and quantity.
When we are staying in a hotel we are also likely away from any stressors we encounter in everyday life (such as work pressure or caring responsibilities). And we’re away from potential nighttime disruptions to sleep we might experience at home (the construction work next door, restless pets, unsettled children). So regardless of the sleep features hotels offer, it is likely we will experience improved sleep when we are away.
Being away from home also means being away from domestic disruptions. Makistock/Shutterstock What the science says about catching up on sleep
In the short-term, we can catch up on sleep. This can happen, for example, after a short night of sleep when our brain accumulates “sleep pressure”. This term describes how strong the biological drive for sleep is. More sleep pressure makes it easier to sleep the next night and to sleep for longer.
But while a longer sleep the next night can relieve the sleep pressure, it does not reverse the effects of the short sleep on our brain and body. Every night’s sleep is important for our body to recover and for our brain to process the events of that day. Spending a holiday “catching up” on sleep could help you feel more rested, but it is not a substitute for prioritising regular healthy sleep at home.
All good things, including holidays, must come to an end. Unfortunately the perks of sleep tourism may end too.
Our bodies do not like variability in the time of day that we sleep. The most common example of this is called “social jet lag”, where weekday sleep (getting up early to get to work or school) is vastly different to weekend sleep (late nights and sleep ins). This can result in a sleepy, grouchy start to the week on Monday. Sleep tourism may be similar, if you do not come back home with the intention to prioritise sleep.
So we should be mindful that as well as sleeping well on holiday, it is important to optimise conditions at home to get consistent, adequate sleep every night.
Good sleep hygiene doesn’t require a passport. Maridav/Shutterstock 5 tips for having a sleep holiday at home
An AI-powered mattress and a sleep butler at home might be the dream. But these features are not the only way we can optimise our sleep environment and give ourselves the best chance to get a good night’s sleep. Here are five ideas to start the night right:
1. avoid bright artificial light in the evening (such as bright overhead lights, phones, laptops)
2. make your bed as comfortable as possible with fresh pillows and a supportive mattress
3. use black-out window coverings and maintain a cool room temperature for the ideal sleeping environment
4. establish an evening wind-down routine, such as a warm shower and reading a book before bed or even a “sleepy girl mocktail”
5. use consistency as the key to a good sleep routine. Aim for a similar bedtime and wake time – even on weekends.
Charlotte Gupta, Senior postdoctoral research fellow, Appleton Institute, HealthWise research group, CQUniversity Australia and Dean J. Miller, Adjunct Research Fellow, Appleton Institute of Behavioural Science, CQUniversity Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Diabetes Drugs That Can Cut Asthma Attacks By 70%
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Asthma, obesity, and type 2 diabetes are closely linked, with the latter two greatly increasing asthma attack risk.
While bronchodilators / corticosteroids can have immediate adverse effects due to sympathetic nervous system activation, and lasting adverse effects due to the damage it does to metabolic health, diabetes drugs, on the other hand, can improve things with (for most people) fewer unwanted side effects.
Great! Which drugs?
Metformin, and glucagon-like peptide-1 receptor agonists (GLP-1RAs).
Specifically, researchers have found:
- Metformin is associated with a 30% reduction in asthma attacks
- GLP-1RAs are associated with a 40% reduction in asthma attacks
…and yes, they stack, making for a 70% reduction in the case of people taking both. Furthermore, the results are independent of weight, glycemic control, or asthma phenotype.
In terms of what was counted, the primary outcome was asthma attacks at 12-month follow-up, defined by oral corticosteroid use, emergency visits, hospitalizations, or death.
The effect of metformin on asthma attacks was not affected by BMI, HbA1c levels, eosinophil count, asthma severity, or sex.
Of the various extra antidiabetic drugs trialled in this study, only GLP-1 receptor agonists showed a further and sustained reduction in asthma attacks.
Here’s the study itself, hot off the press, published on Monday:
JAMA Int. Med. | Antidiabetic Medication and Asthma Attacks
“But what if I’m not diabetic?”
Good news:
More than half of all US adults are eligible for semaglutide therapy ← this is because they’ve expanded the things that semaglutide (the widely-used GLP-1 receptor agonist drug) can be prescribed for, now going beyond just diabetes and/or weight loss 😎
And metformin, of course, is more readily available than semaglutide, so by all means speak with your doctor/pharmacist about that, if it’s of interest to you.
Take care!
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How To Reduce Chronic Stress
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Sunday Stress-Buster
First, an important distinction:
- Acute stress (for example, when stepping out of your comfort zone, engaging in competition, or otherwise focusing on something that requires your full attention for best performance) is generally a good thing. It helps you do you your best. It’s sometimes been called “eustress”, “good stress”.
- Chronic stress (for example, when snowed under at work and you do not love it, when dealing with a serious illness, and/or faced with financial problems) is unequivocally a bad thing. Our body is simply not made to handle that much cortisol (the stress hormone) all the time.
Know the dangers of too much cortisol
We covered this as a main feature last month: Lower Your Cortisol! (Here’s Why & How)
…but it bears mentioning again and for those who’ve joined us since then:
A little spike of cortisol now and again can be helpful. Having it spiking all the time, or even a perpetual background low-to-moderate level, can be ruinous to the health in so many ways.
The good news is, the physiological impact of stress on the body (which ranges from face-and-stomach fat deposits, to rapid aging), can be reversed—even the biological aging!
Read: Biological age is increased by stress and restored upon recovery ← this study is so hot-of-the-press that it was published literally two days ago
Focus on what you can control
A lot of things that cause you stress may be outside of your control. Focus on what is within your control. Oftentimes, we are so preoccupied with the stress, that we employ coping strategies that don’t actually deal with the problem.
That’s a maladaptive response to an evolutionary quirk—our bodies haven’t caught up with modern life, and on an evolutionary scale, are still priming us to deal with sabre-toothed tigers, not financial disputes, for example.
But, how to deal with the body’s “wrong” response?
First, deal with the tiger. There isn’t one, but your body doesn’t know that. Do some vigorous exercise, or if that’s not your thing, tense up your muscles strongly for a few seconds and then relax them, doing each part of your body. This is called progressive relaxation, and how it works is basically tricking your body into thinking you successfully fled the tiger, or fought the tiger and won.
Next, examine what the actual problem is, that’s causing you stress. You’re probably heavily emotionally attached to the problem, or else it wouldn’t be stressing you. So, imagine what advice you would give to help a friend deal with the same problem, and then do that.
Better yet: enlist an actual friend (or partner, family member, etc) to help you. We are evolved to live in a community, engaged in mutual support. That’s how we do well; that’s how we thrive best.
By dealing with the problem—or sometimes even just having support and/or something like a plan—your stress will evaporate soon enough.
The power of “…and then what?”
Sometimes, things are entirely out of your control. Sometimes, bad things are entirely possible; perhaps even probable. Sometimes, they’re so bad, that it’s difficult to avoid stressing about the possible outcomes.
If something seems entirely out of your control and/or inevitable, ask yourself:
“…and then what?”
Writer’s storytime: when I was a teenager, sometimes I would go out without a coat, and my mother would ask, pointedly, “But what will you do if it rains?!”
I’d reply “I’ll get wet, of course”
This attitude can go just the same for much more serious outcomes, up to and including death.
So when you find yourself stressing about some possible bad outcome, ask yourself, “…and then what?”.
- What if this is cancer? Well, it might be. And then what? You might seek cancer treatment.
- What if I can’t get treatment, or it doesn’t work? Well, you might die. And then what?
In Dialectic Behavior Therapy (DBT), this is called “radical acceptance” and acknowledges bad possible/probable/known outcomes, allows one to explore the feelings, and come up with a plan for managing the situation, or even just coming to terms with the fact that sometimes, suffering is inevitable and is part of the human condition.
It’ll still be bad—but you won’t have added extra suffering in the form of stress.
Breathe.
Don’t underestimate the power of relaxed deep breathing to calm the rest of your body, including your brain.
Also: we’ve shared this before, a few months ago, but this 8 minute soundscape was developed by sound technicians working with a team of psychologists and neurologists. It’s been clinically tested, and found to have a much more relaxing effect(in objective measures of lowering heart rate and lowering cortisol levels, as well as in subjective self-reports) than merely “relaxing music”.
Try it and see for yourself:
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