All In Your Head (Which Is Where It’s Supposed To Be)
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Today’s news is all about things above the neck, and mostly in the brain. From beating depression to beating cognitive decline, from mindfulness against pain to dentistry nightmares to avoid:
Transcranial ultrasound stimulation
Transcranial magnetic stimulation is one of those treatments that sounds like it’s out of a 1950s sci-fi novel, and yet, it actually works (it’s very well-evidenced against treatment-resistant depression, amongst other things). However, a weakness of it is that it’s difficult to target precisely, making modulation of most neurological disorders impossible. Using ultrasound instead of a magnetic field allows for much more finesse, with very promising initial results across a range of neurological disorders
Read in full: Transcranial ultrasound stimulation: a new frontier in non-invasive brain therapy
Related: Antidepressants: Personalization Is Key!
This may cause more pain and damage, but at least it’s more expensive too…
While socialized healthcare systems sometimes run into the problem of not wanting to spend money where it actually is needed, private healthcare systems have the opposite problem: there’s a profit incentive to upsell to more expensive treatments. Here’s how that’s played out in dentistry:
Read in full: Dentists are pulling healthy and treatable teeth to profit from implants, experts warn
Related: Tooth Remineralization: How To Heal Your Teeth Naturally
Mindfulness vs placebo, for pain
It can be difficult with some “alternative therapies” to test against placebo, for example “and control group B will merely believe that they are being pierced with needles”, etc. However, in this case, mindfulness meditation was tested as an analgesic vs sham meditation (just deep breathing) and also vs placebo analgesic cream, vs distraction (listening to an audiobook). Mindfulness meditation beat all of the other things:
Read in full: Mindfulness meditation outperforms placebo in reducing pain
Related: No-Frills, Evidence-Based Mindfulness
Getting personal with AI doctors
One of the common reasons that people reject AI doctors is the “lack of a human touch”. However, human and AI doctors may be meeting in the middle nowadays, as humans are pressed to see more patients in less time, and AI is trained to be more personal—not just a friendlier affect, but also, such things as remembering the patient’s previous encounters (again, something with which overworked human doctors sometimes struggle). This makes a big difference to patient satisfaction:
Read in full: Personalization key to patient satisfaction with AI doctors
Related: AI: The Doctor That Never Tires?
Combination brain therapy against cognitive decline
This study found that out of various combinations trialled, the best intervention against cognitive decline was a combination of 1) cognitive remediation (therapeutic interventions designed to improve cognitive functioning, like puzzles and logic problems), and 2) transcranial direct current stimulation (tDCS), a form of non-invasive direct brain stimulation, similar to the magnetic or ultrasound methods we mentioned earlier today. Here’s how it worked:
Read in full: Study reveals effective combination therapy to slow cognitive decline in older adults
Related: How To Reduce Your Alzheimer’s Risk
Take care!
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Green Tea Allergies and Capsules
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Hey Sheila – As always, your articles are superb !! So, I have a topic that I’d love you guys to discuss: green tea. I used to try + drink it years ago but I always got an allergic reaction to it. So the question I’d like answered is: Will I still get the same allergic reaction if I take the capsules ? Also, because it’s caffeinated, will taking it interfere with iron pills, other vitamins + meds ? I read that the health benefits of the decaffeinated tea/capsules are not as great as the caffeinated. Any info would be greatly appreciated !! Thanks much !!❞
Hi! I’m not Sheila, but I’ll answer this one in the first person as I’ve had a similar issue:
I found long ago that taking any kind of tea (not herbal infusions, but true teas, e.g. green tea, black tea, red tea, etc) on an empty stomach made me want to throw up. The feeling would subside within about half an hour, but I learned it was far better to circumvent it by just not taking tea on an empty stomach.
However! I take an l-theanine supplement when I wake up, to complement my morning coffee, and have never had a problem with that. Of course, my physiology is not your physiology, and this “shouldn’t” be happening to either of us in the first place, so it’s not something there’s a lot of scientific literature about, and we just have to figure out what works for us.
This last Monday I wrote (inspired in part by your query) about l-theanine supplementation, and how it doesn’t require caffeine to unlock its benefits after all, by the way. So that’s that part in order.
I can’t speak for interactions with your other supplements or medications without knowing what they are, but I’m not aware of any known issue, beyond that l-theanine will tend to give a gentler curve to the expression of some neurotransmitters. So, if for example you’re talking anything that affects that (e.g. antidepressants, antipsychotics, ADHD meds, sleepy/wakefulness meds, etc) then checking with your doctor is best.
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Managing Your Mortality
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When Planning Is a Matter of Life and Death
Barring medical marvels as yet unrevealed, we are all going to die. We try to keep ourselves and our loved ones in good health, but it’s important to be prepared for the eventuality of death.
While this is not a cheerful topic, considering these things in advance can help us manage a very difficult thing, when the time comes.
We’ve put this under “Psychology Sunday” as it pertains to processing our own mortality, and managing our own experiences and the subsequent grief that our death may invoke in our loved ones.
We’ll also be looking at some of the medical considerations around end-of-life care, though.
Organizational considerations
It’s generally considered good to make preparations in advance. Write (or update) a Will, tie up any loose ends, decide on funerary preferences, perhaps even make arrangements with pre-funding. Life insurance, something difficult to get at a good rate towards the likely end of one’s life, is better sorted out sooner rather than later, too.
Beyond bureaucracy
What’s important to you, to have done before you die? It could be a bucket list, or it could just be to finish writing that book. It could be to heal a family rift, or to tell someone how you feel.
It could be more general, less concrete: perhaps to spend more time with your family, or to engage more with a spiritual practice that’s important to you.
Perhaps you want to do what you can to offset the grief of those you’ll leave behind; to make sure there are happy memories, or to make any requests of how they might remember you.
Lest this latter seem selfish: after a loved one dies, those who are left behind are often given to wonder: what would they have wanted? If you tell them now, they’ll know, and can be comforted and reassured by that.
This could range from “bright colors at my funeral, please” to “you have my blessing to remarry if you want to” to “I will now tell you the secret recipe for my famous bouillabaisse, for you to pass down in turn”.
End-of-life care
Increasingly few people die at home.
- Sometimes it will be a matter of fighting tooth-and-nail to beat a said-to-be-terminal illness, and thus expiring in hospital after a long battle.
- Sometimes it will be a matter of gradually winding down in a nursing home, receiving medical support to the end.
- Sometimes, on the other hand, people will prefer to return home, and do so.
Whatever your preferences, planning for them in advance is sensible—especially as money may be a factor later.
Not to go too much back to bureaucracy, but you might also want to consider a Living Will, to be enacted in the case that cognitive decline means you cannot advocate for yourself later.
Laws vary from place to place, so you’ll want to discuss this with a lawyer, but to give an idea of the kinds of things to consider:
National Institute on Aging: Preparing A Living Will
Palliative care
Palliative care is a subcategory of end-of-life care, and is what occurs when no further attempts are made to extend life, and instead, the only remaining goal is to reduce suffering.
In the case of some diseases including cancer, this may mean coming off treatments that have unpleasant side-effects, and retaining—or commencing—pain-relief treatments that may, as a side-effect, shorten life.
Euthanasia
Legality of euthanasia varies from place to place, and in some times and places, palliative care itself has been considered a form of “passive euthanasia”, that is to say, not taking an active step to end life, but abstaining from a treatment that prolongs it.
Clearer forms of passive euthanasia include stopping taking a medication without which one categorically will die, or turning off a life support machine.
Active euthanasia, taking a positive action to end life, is legal in some places and the means varies, but an overdose of barbiturates is an example; one goes to sleep and does not wake up.
It’s not the only method, though; options include benzodiazepines, and opioids, amongst others:
Efficacy and safety of drugs used for assisted dying
Unspoken euthanasia
An important thing to be aware of (whatever your views on euthanasia) is the principle of double-effect… And how it comes to play in palliative care more often than most people think.
Say a person is dying of cancer. They opt for palliative care; they desist in any further cancer treatments, and take medication for the pain. Morphine is common. Morphine also shortens life.
It’s common for such a patient to have a degree of control over their own medication, however, after a certain point, they will no longer be in sufficient condition to do so.
After this point, it is very common for caregivers (be they medical professionals or family members) to give more morphine—for the purpose of reducing suffering, of course, not to kill them.
In practical terms, this often means that the patient will die quite promptly afterwards. This is one of the reasons why, after sometimes a long-drawn-out period of “this person is dying”, healthcare workers can be very accurate about “it’s going to be in the next couple of days”.
The take-away from this section is: if you would like for this to not happen to you or your loved one, you need to be aware of this practice in advance, because while it’s not the kind of thing that tends to make its way into written hospital/hospice policies, it is very widespread and normalized in the industry on a human level.
Further reading: Goods, causes and intentions: problems with applying the doctrine of double effect to palliative sedation
One last thing…
Planning around our own mortality is never a task that seems pressing, until it’s too late. We recommend doing it anyway, without putting it off, because we can never know what’s around the corner.
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Reasons to Stay Alive – by Matt Haig
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We’ve previously reviewed Matt Haig’s (excellent) The Comfort Book, and now it’s time for his more famous book: Reasons To Stay Alive. So, what’s this one, beyond the obvious?
It narrates the experience of anxiety, depression, and suicidality, and discovering how to find beauty and joy in the world despite it all. It’s not that the author found a magical cure—he still experiences depression and anxiety (cannot speak for suicidality) but he knows now how to manage it, and live his life.
You may be wondering: is this book instructional; is it reproducible, or is it just an autobiography? It’s centered around his own experience and learnings, but it gives a huge sense of not feeling alone, of having hope, and it gives a template for making sense of one’s own experience, even if every person will of course have some points of differences, the commonalities are nonetheless of immense value.
The writing style is similar to The Comfort Book; it’s lots of small chapters, and all very easy-reading. Well, the subject matter is sometimes rather heavy, but the language is easy-reading! In other words, just the thing for when one is feeling easily overwhelmed, or not feeling up to reading a lot.
Bottom line: whether or not you suffer with anxiety and/or depression, whether or not you sometimes feel suicidal, the contents of this book are important, valuable insights for everyone.
Click here to check out Reasons To Stay Alive, and see through the highs and lows of life.
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Is chocolate milk a good recovery drink after a workout? A dietitian reviews the evidence
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Whether you enjoy chocolate milk regularly, as a weekend treat, or as an occasional dose of childhood nostalgia, it probably wouldn’t be the first option you think of for post-workout recovery.
Unless you’re on TikTok, perhaps. According to many people on the social media platform, chocolate milk is not only delicious, but it offers benefits comparable to sports drinks after a workout.
So is there any evidence to support this? Let’s take a look.
eldar nurkovic/Shutterstock Rehydrating after a workout is important
Water accounts for somewhere between 50% and 60% of our body weight. Water has many important functions in the body, including helping to keep our body at the right temperature through sweating.
We lose water naturally from our bodies when we sweat, as well as through our breathing and when we go to the toilet. So it’s important to stay hydrated to replenish the water we lose.
When we don’t, we become dehydrated, which can put a strain on our bodies. Signs and symptoms of dehydration can range from thirst and dizziness to low blood pressure and confusion.
Athletes, because of their higher levels of exertion, lose more water through sweating and from respiration (when their breathing rate gets faster). If they’re training or competing in hot or humid environments they will sweat even more.
Dehydration impacts athletes’ performance and like for all of us, can affect their health.
So finding ways to ensure athletes rehydrate quickly during and after they train or compete is important. Fortunately, sports scientists and dietitians have done research looking at the composition of different fluids to understand which ones rehydrate athletes most effectively.
The beverage hydration index
The best hydrating drinks are those the body retains the most of once they’ve been consumed. By doing studies where they give people different drinks in standardised conditions, scientists have been able to determine how various options stack up.
To this end, they’ve developed something called the beverage hydration index, which measures to what degree different fluids hydrate a person compared to still water.
According to this index beverages with similar fluid retention to still water include sparkling water, sports drinks, cola, diet cola, tea, coffee, and beer below 4% alcohol. That said, alcohol is probably best avoided when recovering from exercise.
Beverages with superior fluid retention to still water include milk (both full-fat and skim), soy milk, orange juice and oral rehydration solutions.
This body of research indicates that when it comes to rehydration after exercise, unflavoured milk (full fat, skim or soy) is better than sports drinks.
But what about chocolate milk?
A small study looked at the effects of chocolate milk compared to plain milk on rehydration and exercise performance in futsal players (futsal is similar to soccer but played on a court indoors). The researchers found no difference in rehydration between the two. There’s no other published research to my knowledge looking at how chocolate milk compares to regular milk for rehydration during or after exercise.
But rehydration isn’t the only thing athletes look for in sports drinks. In the same study, drinking chocolate milk after play (referred to as the recovery period) increased the time it took for the futsal players to become exhausted in further exercise (a shuttle run test) four hours later.
This was also shown in a review of several clinical trials. The analysis found that, compared to different placebos (such as water) or other drinks containing fat, protein and carbohydrates, chocolate milk lengthened the time to exhaustion during exercise.
What’s in chocolate milk?
Milk contains protein, carbohydrates and electrolytes, each of which can affect hydration, performance, or both.
Protein is important for building muscle, which is beneficial for performance. The electrolytes in milk (including sodium and potassium) help to replace electrolytes lost through sweating, so can also be good for performance, and aid hydration.
Compared to regular milk, chocolate milk contains added sugar. This provides extra carbohydrates, which are likewise beneficial for performance. Carbohydrates provide an immediate source of energy for athletes’ working muscles, where they’re stored as glycogen. This might contribute to the edge chocolate milk appears to have over plain milk in terms of athletic endurance.
The added sugar in chocolate milk provides extra carbohydrates. Brent Hofacker/Shutterstock Coffee-flavoured milk has an additional advantage. It contains caffeine, which can improve athletic performance by reducing the perceived effort that goes into exercise.
One study showed that a frappe-type drink prepared with filtered coffee, skim milk and sugar led to better muscle glycogen levels after exercise compared to plain milk with an equivalent amount of sugar added.
So what’s the verdict?
Evidence shows chocolate milk can rehydrate better than water or sports drinks after exercise. But there isn’t evidence to suggest it can rehydrate better than plain milk. Chocolate milk does appear to improve athletic endurance compared to plain milk though.
Ultimately, the best drink for athletes to consume to rehydrate is the one they’re most likely to drink.
While many TikTok trends are not based on evidence, it seems chocolate milk could actually be a good option for recovery from exercise. And it will be cheaper than specialised sports nutrition products. You can buy different brands from the supermarket or make your own at home with a drinking chocolate powder.
This doesn’t mean everyone should look to chocolate milk when they’re feeling thirsty. Chocolate milk does have more calories than plain milk and many other drinks because of the added sugar. For most of us, chocolate milk may be best enjoyed as an occasional treat.
Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Sweet Dreams Are Made Of Cheese (Or Are They?)
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝In order to lose a little weight I have cut out cheese from my diet – and am finding that I am sleeping better. Would be interested in your views on cheese and sleep, and whether some types of cheese are worse for sleep than others. I don’t want to give up cheese entirely!❞
In principle, there’s nothing in cheese that, biochemically, should impair sleep. If anything, its tryptophan content could aid good sleep.
Tryptophan is found in many foods, including cheese, which (of common foods, anyway), for example cheddar cheese ranks second only to pumpkin seeds in tryptophan content.
Tryptophan can be converted by the body into 5-HTP, which you’ve maybe seen sold as a supplement. Its full name is 5-hydroxytryptophan.
5-HTP can, in turn, be used to make melatonin and/or serotonin. Which of those you will get more of, depends on what your body is being cued to do by ambient light/darkness, and other environmental cues.
If you are having cheese and then checking your phone, for instance, or otherwise hanging out where there are white/blue lights, then your body may dutifully convert the tryptophan into serotonin (calm wakefulness) instead of melatonin (drowsiness and sleep).
In short: the cheese will (in terms of this biochemical pathway, anyway) augment some sleep-inducing or wakefulness-inducing cues, depending on which are available.
You may be wondering: what about casein?
Casein is oft-touted as producing deep sleep, or disturbed sleep, or vivid dreams, or bad dreams. There’s no science to back any of this up, though the following research review is fascinating:
Dreams of the Rarebit Fiend: food and diet as instigators of bizarre and disturbing dreams
(it largely supports the null hypothesis of “not a causal factor” but does look at the many more likely alternative explanations, ranging from associated actually casual factors (such as alcohol and caffeine) and placebo/nocebo effect)
Finally, simple digestive issues may be the real thing at hand:
Worth noting that around two thirds of all people, including those who regularly enjoy dairy products, have some degree of lactose intolerance:
Lactose Intolerance in Adults: Biological Mechanism and Dietary Management
So, in terms of what cheese may be better/worse for you in this context, you might try experimenting with lactose-free cheese, which will help you identify whether that was the issue!
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The Daily Stoic – by Ryan Holiday & Stephen Hanselman
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What’s this, a philosophy book in a health and productivity newsletter? Well, look at it this way: Aristotle basically wrote the “How To Win Friends And Influence People” of his day, and Plato before him wrote a book about management.
In this (chiefly modern!) book, we see what the later Stoic philosophers had to say about getting the most out of life—which is also what we’re about, here at 10almonds!
We tend to use the word “stoic” in modern English to refer to a person who is resolute in the face of hardship. The traditional meaning does encompass that, but also means a lot more: a whole, rounded, philosophy of life.
Philosophy in general is not an easy thing into which to “dip one’s toe”. No matter where we try to start, it seems, it turns out there were a thousand other things we needed to read first!
This book really gets around that. The format is:
- There’s a theme for each month
- Each month has one lesson per day
- Each daily lesson starts with some words from a renowned stoic philosopher, and then provides commentary on such
- The commentary provides a jumping-off point and serves as a prompt to actually, genuinely, reflect and apply the ideas.
Unlike a lot of “a year of…” day-by-day books, this is not light reading, by the way, and you are getting a weighty tome for your money.
But, the page-length daily lessons are indeed digestible—which, again, is what we like at 10almonds!
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