
A Statin-Free Life – by Dr. Aseem Malhotra
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Here at 10almonds, we’ve written before about the complexities of statins, and their different levels of risk/benefit for men and women, respectively. It’s a fascinating topic, and merits more than an article of the size we write here!
So, in the spirit of giving pointers of where to find a lot more information, this book is a fine choice.
Dr. Malhotra, a consultant cardiologist and professor of evidence-based medicine, talks genes and lifestyle, drugs and blood. He takes us on a tour of the very many risk factors for heart disease, and how cholesterol levels may be at best an indicator, but less likely a cause, of heart disease, especially for women. Further and even better, he discusses various more reliable indicators and potential causes, too.
Rather than be all doom and gloom, he does offer guidance on how to reduce each of one’s personal risk factors and—which is important—keep on top of the various relevant measures of heart health (including some less commonly tested ones, like the coronary calcium score).
The style is light reading andyet with a lot of reference to hard science, so it’s really the best of both worlds in that regard.
Bottom line: if you’re considering statins, or are on statins and are reconsidering that choice, then this book will (notwithstanding its own bias in its conclusion) help you make a more-informed decision.
Click here to check out A Statin-Free Life, and make the best choice for you!
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Death by Food Pyramid – by Denise Minger
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This one is less about “here’s the perfect way of eating” or even “these specific foods are ontologically evil”, but more about teaching science literacy.
The author explores various health trends from the 70s until time of writing (the book was published in 2014), what rationales originally prompted them, and what social phenomena either helped them to persist, or caused them to get dropped quite quickly.
Of course, even in the case of fads that are societally dropped quite quickly, on an individual level there will always be someone just learning about it for the first time, reading some older material, and thinking “that sounds like just the miracle life-changer I need!”
What she teaches the reader to do is largely what we do a lot of here at 10almonds—examine the claims, go to the actual source material (studies! Not just books about studies!), and see whether the study conclusions actually support the claim, to start with, and then further examine to see if there’s some way (or sometimes, a plurality of ways) in which the study itself is methodologically flawed.
Which does happen sometimes, do actually watch out for that!
The style is quite personal and entertaining for the most part, and yet even moving sometimes (the title is not hyperbole; deaths will be discussed). As one might expect of a book teaching science literacy, it’s very easy to read, with copious footnotes (well, actually they are at the back of the book doubling up as a bibliography, but they are linked-to throughout) for those who wish to delve deeper—something the author, of course, encourages.
Bottom line: if you’d like to be able to sort the real science from the hype yourself, then this book can set you on the right track!
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Why do I need to take some medicines with food?
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Have you ever been instructed to take your medicine with food and wondered why? Perhaps you’ve wondered if you really need to?
There are varied reasons, and sometimes complex science and chemistry, behind why you may be advised to take a medicine with food.
To complicate matters, some similar medicines need to be taken differently. The antibiotic amoxicillin with clavulanic acid (sold as Amoxil Duo Forte), for example, is recommended to be taken with food, while amoxicillin alone (sold as Amoxil), can be taken with or without food.
Different brands of the same medicine may also have different recommendations when it comes to taking it with food.
Ron Lach/Pexels Food impacts drug absorption
Food can affect how fast and how much a drug is absorbed into the body in up to 40% of medicines taken orally.
When you have food in your stomach, the makeup of the digestive juices change. This includes things like the fluid volume, thickness, pH (which becomes less acidic with food), surface tension, movement and how much salt is in your bile. These changes can impair or enhance drug absorption.
Eating a meal also delays how fast the contents of the stomach move into the small intestine – this is known as gastric emptying. The small intestine has a large surface area and rich blood supply – and this is the primary site of drug absorption.
Eating a meal with medicine will delay its onset. Farhad/Pexels Eating a larger meal, or one with lots of fibre, delays gastric emptying more than a smaller meal. Sometimes, health professionals will advise you to take a medicine with food, to help your body absorb the drug more slowly.
But if a drug can be taken with or without food – such as paracetamol – and you want it to work faster, take it on an empty stomach.
Food can make medicines more tolerable
Have you ever taken a medicine on an empty stomach and felt nauseated soon after? Some medicines can cause stomach upsets.
Metformin, for example, is a drug that reduces blood glucose and treats type 2 diabetes and polycystic ovary syndrome. It commonly causes gastrointestinal symptoms, with one in four users affected. To combat these side effects, it is generally recommended to be taken with food.
The same advice is given for corticosteroids (such as prednisolone/prednisone) and certain antibiotics (such as doxycycline).
Taking some medicines with food makes them more tolerable and improves the chance you’ll take it for the duration it’s prescribed.
Can food make medicines safer?
Ibuprofen is one of the most widely used over-the-counter medicines, with around one in five Australians reporting use within a two-week period.
While effective for pain and inflammation, ibuprofen can impact the stomach by inhibiting protective prostaglandins, increasing the risk of bleeding, ulceration and perforation with long-term use.
But there isn’t enough research to show taking ibuprofen with food reduces this risk.
Prolonged use may also affect kidney function, particularly in those with pre-existing conditions or dehydration.
The Australian Medicines Handbook, which guides prescribers about medicine usage and dosage, advises taking ibuprofen (sold as Nurofen and Advil) with a glass of water – or with a meal if it upsets your stomach.
If it doesn’t upset your stomach, ibuprofen can be taken with water. Tbel Abuseridze/Unsplash A systematic review published in 2015 found food delays the transit of ibuprofen to the small intestine and absorption, which delays therapeutic effect and the time before pain relief. It also found taking short courses of ibuprofen without food reduced the need for additional doses.
To reduce the risk of ibuprofen causing damage to your stomach or kidneys, use the lowest effective dose for the shortest duration, stay hydrated and avoid taking other non-steroidal anti-inflammatory medicines at the same time.
For people who use ibuprofen for prolonged periods and are at higher risk of gastrointestinal side effects (such as people with a history of ulcers or older adults), your prescriber may start you on a proton pump inhibitor, a medicine that reduces stomach acid and protects the stomach lining.
How much food do you need?
When you need to take a medicine with food, how much is enough?
Sometimes a full glass of milk or a couple of crackers may be enough, for medicines such as prednisone/prednisolone.
However, most head-to-head studies that compare the effects of a medicine “with food” and without, usually use a heavy meal to define “with food”. So, a cracker may not be enough, particularly for those with a sensitive stomach. A more substantial meal that includes a mix of fat, protein and carbohydrates is generally advised.
Your health professional can advise you on which of your medicines need to be taken with food and how they interact with your digestive system.
Mary Bushell, Clinical Associate Professor in Pharmacy, University of Canberra
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Support For Long COVID & Chronic Fatigue
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Long COVID and Chronic Fatigue
Getting COVID-19 can be very physically draining, so it’s no surprise that getting Long COVID can (and usually does) result in chronic fatigue.
But, what does this mean and what can we do about it?
What makes Long COVID “long”
Long COVID is generally defined as COVID-19 whose symptoms last longer than 28 days, but in reality the symptoms not only tend to last for much longer than that, but also, they can be quite distinct.
Here’s a large (3,762 participants) study of Long COVID, which looked at 203 symptoms:
Characterizing long COVID in an international cohort: 7 months of symptoms and their impact
Three symptoms stood at out as most prevalent:
- Chronic fatigue (CFS)
- Cognitive dysfunction
- Post-exertional malaise (PEM)
The latter means “the symptoms get worse following physical or mental exertion”.
CFS, Chronic Fatigue Syndrome, is also called Myalgic Encephalomyelitis (ME).
What can be done about it?
The main “thing that people do about it” is to reduce their workload to what they can do, but this is not viable for everyone. Note that work doesn’t just mean “one’s profession”, but anything that requires physical or mental energy, including:
- Childcare
- Housework
- Errand-running
- Personal hygiene/maintenance
For many, this means having to get someone else to do the things—either with support of family and friends, or by hiring help. For many who don’t have those safety nets available, this means things simply not getting done.
That seems bleak; isn’t there anything more we can do?
Doctors’ recommendations are chiefly “wait it out and hope for the best”, which is not encouraging. Some people do recover from Long COVID; for others, it so far appears it might be lifelong. We just don’t know yet.
Doctors also recommend to journal, not for the usual mental health benefits, but because that is data collection. Patients who journal about their symptoms and then discuss those symptoms with their doctors, are contributing to the “big picture” of what Long COVID and its associated ME/CFS look like.
You may notice that that’s not so much saying what doctors can do for you, so much as what you can do for doctors (and in the big picture, eventually help them help people, which might include you).
So, is there any support for individuals with Long COVID ME/CFS?
Medically, no. Not that we could find.
However! Socially, there are grassroots support networks, that may be able to offer direct assistance, or at least point individuals to useful local resources.
Grassroots initiatives include Long COVID SOS and the Patient-Led Research Collaborative.
The patient-led organization Body Politic also used to have such a group, until it shut down due to lack of funding, but they do still have a good resource list:
Click here to check out the Body Politic resource list (it has eight more specific resources)
Stay strong!
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An unbroken night’s sleep is a myth. Here’s what good sleep looks like
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What do you imagine a good night’s sleep to be?
Often when people come into our sleep clinic seeking treatment, they share ideas about healthy sleep.
Many think when their head hits the pillow, they should fall into a deep and restorative sleep, and emerge after about eight hours feeling refreshed. They’re in good company – many Australians hold the same belief.
In reality, healthy sleep is cyclic across the night, as you move in and out of the different stages of sleep, often waking up several times. Some people remember one or more of these awakenings, others do not. Let’s consider what a healthy night’s sleep looks like.
Bricolage/Shutterstock Sleep cycles are a roller-coaster
As an adult, our sleep moves through different cycles and brief awakenings during the night. Sleep cycles last roughly 90 minutes each.
We typically start the night with lighter sleep, before moving into deeper sleep stages, and rising again into rapid eye movement (REM) sleep – the stage of sleep often linked to vivid dreaming.
If sleeping well, we get most of our deep sleep in the first half of the night, with REM sleep more common in the second half of the night.
Deepest sleep usually happens during the first half of the night. Verin/Shutterstock Adults usually move through five or six sleep cycles in a night, and it is entirely normal to wake up briefly at the end of each one. That means we might be waking up five times during the night. This can increase with older age and still be healthy. If you’re not remembering these awakenings that’s OK – they can be quite brief.
What does getting a ‘good’ sleep actually mean?
You’ll often hear that adults need between seven and nine hours of sleep per night. But good sleep is about more than the number of hours – it’s also about the quality.
For most people, sleeping well means being able to fall asleep soon after getting into bed (within around 30 minutes), sleeping without waking up for long periods, and waking feeling rested and ready for the day.
You shouldn’t be feeling excessively sleepy during the day, especially if you’re regularly getting at least seven hours of refreshing sleep a night (this is a rough rule of thumb).
But are you noticing you’re feeling physically tired, needing to nap regularly and still not feeling refreshed? It may be worthwhile touching base with your general practitioner, as there a range of possible reasons.
Common issues
Sleep disorders are common. Up to 25% of adults have insomnia, a sleep disorder where it may be hard to fall or stay asleep, or you may wake earlier in the morning than you’d like.
Rates of common sleep disorders such as insomnia and sleep apnoea – where your breathing can partially or completely stop many times during the night – also increase with age, affecting 20% of early adults and 40% of people in middle age. There are effective treatments, so asking for help is important.
Beyond sleep disorders, our sleep can also be disrupted by chronic health conditions – such as pain – and by certain medications.
There can also be other reasons we’re not sleeping well. Some of us are woken by children, pets or traffic noise during the night. These “forced awakenings” mean we may find it harder to get up in the morning, take longer to leave bed and feel less satisfied with our sleep. For some people, night awakenings may have no clear cause.
A good way to tell if these awakenings are a problem for you is by thinking about how they affect you. When they cause feelings of frustration or worry, or are impacting how we feel and function during the day, it might be a sign to seek some help.
If waking up in the night is interfering with your normal day-to-day activities, it may indicate a problem. BearFotos/Shutterstock We also may struggle to get up in the morning. This could be for a range of reasons, including not sleeping long enough, going to bed or waking up at irregular times – or even your own internal clock, which can influence the time your body prefers to sleep.
If you’re regularly struggling to get up for work or family needs, it can be an indication you may need to seek help. Some of these factors can be explored with a sleep psychologist if they are causing concern.
Can my smart watch help?
It is important to remember sleep-tracking devices can vary in accuracy for looking at the different sleep stages. While they can give a rough estimate, they are not a perfect measure.
In-laboratory polysomnography, or PSG, is the best standard measure to examine your sleep stages. A PSG examines breathing, oxygen saturation, brain waves and heart rate during sleep.
Rather than closely examining nightly data (including sleep stages) from a sleep tracker, it may be more helpful to look at the patterns of your sleep (bed and wake times) over time.
Understanding your sleep patterns may help identify and adjust behaviours that negatively impact your sleep, such as your bedtime routine and sleeping environment.
And if you find viewing your sleep data is making you feel worried about your sleep, this may not be useful for you. Most importantly, if you are concerned it is important to discuss it with your GP who can refer you to the appropriate specialist sleep health provider.
Amy Reynolds, Associate Professor in Clinical Sleep Health, Flinders University; Claire Dunbar, Research Associate, Sleep Health, Flinders University; Gorica Micic, Postdoctoral Research Fellow, Clinical Psychologist, Flinders University; Hannah Scott, Research Fellow in Sleep Health, Flinders University, and Nicole Lovato, Associate Professor, Adelaide Institute for Sleep Health, Flinders University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Medicinal Chef – by Dale Pinnock
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The philosophy here is very much like our own—to borrow from Hippocrates: “let food be thy medicine”. Obviously please do also let medicine be thy medicine if you need it, but the point is that food is a very good starting place for combatting a lot of disease.
To this end, instead of labelling the recipes with such things as “V”, “Ve”, “GF” and suchlike, it assumes we can tell those things from the ingredients lists, and instead labels things per what they are especially good for:
- S: skin
- J: joints & bones
- R: respiratory system
- I: immune system
- M: metabolic health
- N: nervous system and mental health
- H: heart and circulation
- D: digestive system
- U: reproductive & urinary systems
As for the recipes themselves… They’re a lot like the recipes we share here at 10almonds in their healthiness, skill level, and balance of easy-to-find ingredients with the occasional “order it online” items that punch above their weight. In fact, we’ll probably modify some of the recipes for sharing here.
Bottom line: if you’re looking for genuinely healthy recipes that are neither too basic nor too arcane, this book has about 80 of them.
Click here to check out The Medicinal Chef: Healthy Every Day, and be healthy every day!
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How To Manage Your Mood With Food (8 Ways)
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It is hard to be mentally healthy for long without good diet. Food can not only affect our mood directly, but also indirectly because of how our brain works (or doesn’t, if we don’t have the right nutrients, or it is being sabotaged in some other dietary fashion).
Selecting the food for setting the mood
Mind, the mental health charity, have these advices to share (with some bonus notes of our own):
- Eat regularly: blood sugar peaks and troughs can heighten feelings of tiredness, irritability, or depression. Instead, enjoy foods that are high in energy but low in glycemic index, such as nuts, seeds, and oats—that way you’ll have plenty of energy, that lasts longer.
- Choose the right fats: omega-3 fatty acids are essential for the brain. So are omega-6 fatty acids, but it is rare to have a deficiency in omega-6, and indeed, many people have the ratio of omega-3 to omega-6 far too imbalanced in omega-6’s favor. So, focussing on getting more omega-3 fatty acids is important. Nuts and seeds are again great, as are avocados, eggs, and oily fish.
- Get a healthy amount of protein: and importantly, with a good mix of amino acids—so a variety of sources of protein is best. In particular, if you are vegan, paying attention to ensure you get a full spread of amino acids is critical, as not many plants have all the ones we need (soy does, though). The reason this is important for mood is because many of those amino acids double up as the building blocks of neurotransmitters, so they’re not entirely interchangeable.
- Stay hydrated: our bodies are famously made of mostly water, and our brain will not work well if it’s dehydrated. The human body can squeeze water out of almost anything that has water in it, but water from food (such as fruit, or soups) is best. If enjoying actual drinks, then herbal teas are excellent for hydration.
- Eat a rainbow of fruits and vegetables: these have many nutrients that are important for brain health, and the point of the colors is that most of those pigments are themselves nutrients. Additionally, the fiber content of fruits and vegetables is of topmost important for your heart, and as you’ll remember (we say it often, because it’s true): what’s good for your heart is good for your brain.
- Limit caffeine intake: for many people, excess caffeine can lead to feelings of anxiety, disrupt your sleep, and for everyone who has developed an addiction to it, it will cause withdrawal symptoms if stopped abruptly. Cutting back on caffeine, or even eliminating it, may improve your mood and sleep quality. Note, however, that if you have ADHD, then your brain’s physiological relationship with caffeine is a little different, and stimulants will be more beneficial (and less deleterious) for you than for most people. If unsure, speak with your doctor about this one.
- Support your gut health: because of the gut-brain axis (via the vagal nerve), and also because nearly all of our endogenous serotonin is made in the gut (along with other neurotransmitters/hormones), getting plenty of fiber is important, and probiotics can help too.
- Consider food intolerances: if you know you have one, then keep that in mind and tailor your diet accordingly. If you suspect you have one, seek a nutritionist’s help to find out for sure. These can affect many aspects of health, including mood, so should not be dismissed as a triviality.
For more on all of this, enjoy:
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Want to learn more?
You might also like to read:
The 6 Pillars Of Nutritional Psychiatry
Take care!
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