Before You Reach For That Tylenol…
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First, on names: we’ve titled this with “Tylenol” because that’s a well-known brand name, but the drug name is paracetamol or acetaminophen:
- paracetamol is the drug name used by the World Health Organization, and thus also most countries.
- acetaminophen is the drug name used in Canada, Colombia, Iran, Japan, US, and Venezuela.
They are absolutely the same drug.
Firstly, obviously, do avoid overdose
The safe dosage described on the packet is generally accurate (usually around 4g/day, spaced out at 1g per 4 hours), and the dose required for toxicity is generally about 10g, or 200mg/kg body weight, whichever is lower. Since a single dose usually contains 2x 500mg = 1g, that makes overdose all too easy.
The amount required for toxicity can be misleading too, because that’s assuming…
- a healthy liver
- no other health problems
- no other medications that interact or add to the toxicity
- no medications that strain the liver (as with many pro-drugs, and drugs in general that are metabolized by the liver, which is lots).
Which is a lot of assumptions! Especially given that the liver can only process so much at once, meaning that if your liver has a lot of things to do, it can get a backlog, and you think “I’m not taking anything with this painkiller that I shouldn’t” but your liver is still metabolizing the last of last night’s glass of wine and one of your regular medications from this morning, because previously it was still metabolizing things from the day before yesterday, and so on.
See also: How To Regenerate Your Liver ← the liver is an incredible organ that does an amazing job, but it can’t do that if you don’t do this
Please don’t overdose deliberately either. Intentional overdoses make up a very large portion of acetaminophen overdoses (exact figures vary from year to year and place to place, but it’s always high), and what a lot of people doing that don’t realize is:
- it’s a very unpleasant way to die. You’ll take it, you might get some initial symptoms within the first hours or you might not, then you’ll probably feel better, and then the next day or so, you’ll enter the organs-shutting-down stage that usually will take most of a week to kill you slowly and painfully. Often your kidneys will go first but it’ll usually be liver necrosis that deals the final blow.
- it’s very difficult to treat. Stomach-pumping might work if you get it within 1 hour of overdose, and activated charcoal might help if you get it within 2 hours. Acetylcysteine may reduce the toxicity if you get it within the 8–48 hour window (depending on the speed of gastric emptying), but whether or not that will help depends on the severity of the overdose and other factors, so this is not something to bet on. After 48 hours, a liver transplant is the last resort, without which, mortality is around 95%.
Unfortunately, this means that a lot of people who do not intend to die horribly, and hoped to either die peacefully or else be saved, die horribly instead.
Ok, that was not a cheerful topic but it is important, before moving on, we’ll just put this here for anyone it may benefit:
How To Stay Alive (When You Really Don’t Want To) ← this is about suicidality, in yourself or others
Secondly, that dosage is for occasional use only
The problem often starts like this:
❝Due to its perceived safety, paracetamol has long been recommended as the first line drug treatment for osteoarthritis by many treatment guidelines, especially in older people who are at higher risk of drug-related complications❞
People with chronic pain, whether high or low on the pain level of that chronic pain, can very easily get into a habit of “I’ll just take this to take the edge off”, for example when getting up in the morning (often a trigger for pain starting) or going to bed at night (one needs to sleep and the pain is a barrier to that).
But… Those events, getting up and going to bed, it means that taking the drug also becomes part of one’s morning/evening routine—with many people even metering the doses out into pill organizers for the week, with this in mind.
A large (n=582,961) study looked at two groups of people, all aged 65+:
- 180,483 people who had been prescribed paracetamol repeatedly (≥2 prescriptions within six months)
- 402,478 people of the same age who had never been prescribed paracetamol repeatedly
The findings? Bearing in mind that “≥2 prescriptions within six months” is not something generally considered excessive…
❝Acetaminophen use was associated with an increased risk of peptic ulcer bleeding (aHR 1.24; 95% CI 1.16, 1.34), uncomplicated peptic-ulcers (aHR 1.20; 95% CI 1.10, 1.31), lower gastrointestinal-bleeding (aHR 1.36; 95% CI 1.29, 1.46), heart-failure (aHR 1.09; 95% CI 1.06, 1.13), hypertension (aHR 1.07; 95% CI 1.04, 1.11), and chronic kidney disease (aHR 1.19; 95% CI 1.13, 1.24).❞
The researchers concluded:
❝Despite its perceived safety, acetaminophen is associated with several serious complications. Given its minimal analgesic effectiveness, the use of acetaminophen as the first-line oral analgesic for long-term conditions in older people requires careful reconsideration.❞
You can see the study itself here: Incidence of side effects associated with acetaminophen in people aged 65 years or more: a prospective cohort study using data from the Clinical Practice Research Datalink
What to use instead?
It’s been established that taking aspirin regularly isn’t great either:
See: Low-Dose Aspirin & Anemia and Aspirin, CVD Risk, & Potential Counter-Risks
And as for ibuprofen, we don’t have an article about that yet, but it’s gut-unhealthy (harms your microbiome), and besides, anything it can do, ginger can do as well or better (in head-to-head trials; we’re not speaking hyperbolically here):
Ginger Does A Lot More Than You Think ← in fact, it was even found as effective as the combination of acetaminophen, ibuprofen, and caffeine
There are other options though, and as pain is complicated and there’s no one-size-fits-all solution, we’ve compiled the following:
- Dial Down Your Pain
- Stop Pain Spreading
- Managing Chronic Pain (Realistically!)
- The 7 Approaches To Pain Management
- Science-Based Alternative Pain Relief ← when painkillers aren’t helping, these things might
Take care!
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Escape Self-Sabotage
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Stop Making The Same Mistakes
It’s easy to think that a self-destructive cycle is easy to avoid if you have no special will to self-destruction. However, the cycle is sneaky.
It’s sneaky because it can be passive, and/or omissions rather than actions, procrastinations rather than obvious acts of impulse, and so forth.
So, they’re often things that specifically aren’t there to see.
How to catch them
How often do you think “I wish I had [done xyz]” or “I wish I had [done yxz] sooner”?
Now, how often have you thought that about the same thing more than once? For example, “I should have kept up my exercise”.
For things like this, habit-trackers are a great way to, well, keep track of habits. If for example you planned to do a 10-minute exercise session daily but you’ve been postponing it since you got distracted on January the 2nd, then it’ll highlight that. See also:
How To Really Pick Up (And Keep!) Those Habits
Speaking of habits, this goes for other forms of procrastination, too. For example, if you are always slow to get medical check-ups, or renew your prescriptions, or get ready for some regularly-occurring thing in your schedule, then set a reminder in your preferred way (phone app, calendar on the wall, whatever) and when the appointed time arrives (to book the check-up, renew the prescription, do your taxes, whatever), do it on the day you set your reminder for, as a personal rule for you that you keep to, barring extreme calamity.
By “extreme calamity” we mean less “running late today” and more “house burned down”.
Digital traps
Bad habits can be insidious in other ways too, like getting sucked into social media scrolling (it is literally designed to do that to you; you are not immune modern programming hijacking evolutionary dopamine responses).
Setting a screentime limit (you can specify “just these apps” if you like) will help with this. On most devices, this feature includes a sticky notification in the notification bar, that’ll remind you “27 out of 30 minutes remaining” or whatever you set it for. That’ll remind you to do what you went there to do, instead of getting caught in the endless scroll (and if you went there to just browse, to do so briefly).
Here’s how to set that:
Instructions for iOS devices | Instructions for Android devices
Oh, and on the topic of social media? If you find yourself getting caught up in unproductive arguments on the Internet, try the three-response rule:
- You reply; they reply (no progress made)
- You reply; they reply (still no progress made)
- You reply; they reply (still yet no progress made)
You reply just one more time: “I have a personal rule that if I’m arguing on the Internet and no progress has been made after three replies, I don’t reply further—I find this is helpful to avoid a lot of time lost to pointless arguing that isn’t going anywhere. Best wishes.”
(and then stick to it, no matter how they try to provoke you; best is to just not look until at least the next day)
When “swept up in love” gets to one of those little whirlpools…
The same works in personal relationships, by the way. If for example you are arguing with a loved one and not making progress, it can be good if you both have a pre-arranged agreement that either of you can, up to once on any given day, invoke a “time-out” (e.g. 30 minutes, but you agree the time between you when you first make this standing policy) during which you will both keep out of the other’s way, and come back with a more productive head on (remembering that things go best when it’s you both vs the problem, rather than vs each other).
See also:
Seriously Useful Communication Skills: Conflict Resolution
What if the self-sabotaging cycle is active and apparent?
Well, that is less sneaky, but certainly no less serious, and sometimes moreso. An obvious example is drinking too much; this is often cyclical in nature. We wrote about this one previously:
That article’s alcohol-specific, but the same advices go for other harmful activities, including other substance abuse (which in turn includes binge-eating), as well psychological addictions (such as gambling, for example).
Finally…
If your destructive cycle is more of a rut you’ve got stuck in, a common advice is to change something, anything, to get out of the rut.
That can be very bad advice! Because sometimes the change you go for is absolutely not the change that was needed, and is rather just cracking under pressure and doing something impulsive.
Here’s one way to actively get out of a slump:
Behavioral Activation Against Depression & Anxiety
Note: you do not have to be depressed or anxious to do this. But the point is, it’s a tool you can use even if you are depressed and/or anxious, so it’s a good thing to try for getting out of most kinds of slumps.
And really finally, here’s a resource for, well, the title speaks for itself:
When You Know What You “Should” Do (But Knowing Isn’t The Problem)
Take care!
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Chai-Spiced Rice Pudding
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Sweet enough for dessert, and healthy enough for breakfast! Yes, “chai tea” is “tea tea”, just as “naan bread” is “bread bread”. But today, we’re going to be using the “tea tea” spices to make this already delicious and healthy dish more delicious and more healthy:
You will need
- 1 cup wholegrain rice (a medium-length grain is best for the optimal amount of starch to make this creamy but not sticky)
- 1½ cups milk (we recommend almond milk, but any milk will work)
- 1 cup full fat coconut milk
- 1 cup water
- 4 Medjool dates, soaked in hot water for 5 minutes, drained, and chopped
- 2 tbsp almond butter
- 1 tbsp maple syrup (omit if you prefer less sweetness)
- 1 tbsp chia seeds
- 2 tsp ground sweet cinnamon
- 1 tsp ground ginger
- 1 tsp vanilla extract
- ½ tsp ground cardamom
- ½ tsp ground nutmeg
- ½ ground cloves
- Optional garnish: berries (your preference what kind)
Method
(we suggest you read everything at least once before doing anything)
1) Add all of the ingredients except the berries into the cooking vessel* you’re going to use, and stir thoroughly.
*There are several options here and they will take different durations:
- Pressure cooker: 10 minutes at high pressure (we recommend, if available)
- Rice cooker: 25 minutes or thereabouts (we recommend only if the above or below aren’t viable options for you)
- Slow cooker: 3 hours or thereabouts, but you can leave it for 4 if you’re busy (we recommend if you want to “set it and forget it” and have the time; it’s very hard to mess this one up unless you go to extremes)
Options that we don’t recommend:
- Saucepan: highly variable and you’re going to have to watch and stir it (we don’t recommend this unless the other options aren’t available)
- Oven: highly variable and you’re going to have to check it frequently (we don’t recommend this unless the other options aren’t available)
2) Cook, using the method you selected from the list.
3) Get ready to serve. Depending on the method, they may be some extra liquid at the top; this can just be stirred into the rest and it will take on the same consistency.
4) Serve in bowls, with a berry garnish if desired:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Grains: Bread Of Life, Or Cereal Killer?
- Which Plant Milk?
- If You’re Not Taking Chia, You’re Missing Out
- Our Top 5 Spices: How Much Is Enough For Benefits?
- Sweet Cinnamon vs Regular Cinnamon – Which is Healthier?
Take care!
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Intermittent Fasting In Women
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
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
❝Does intermittent fasting differ for women, and if so, how?❞
For the sake of layout, we’ve put a shortened version of this question here, but the actual wording was as below, and merits sharing in full for context
Went down a rabbit hole on your site and now can’t remember how I got to the “Fasting Without Crashing” article on intermittent fasting so responding to this email lol, but was curious what you find/know about fasting for women specifically? It’s tough for me to sift through and find legitimate studies done on the results of fasting in women, knowing that our bodies are significantly different from men. This came up when discussing with my sister about how I’ve been enjoying fasting 1-2 days/week. She said she wanted more reliable sources of info that that’s good, since she’s read more about how temporary starvation can lead to long-term weight gain due to our bodies feeling the need to store fat. I’ve also read about that, but also that fasting enables more focused autophagy in our bodies, which helps with long-term staving off of diseases/ailments. Curious to know what you all think!
~ 10almonds subscriber
So, first of all, great question! Thanks for asking it
Next up, isn’t it strange? Books come in the format:
- [title]
- [title, for women]
You would not think women are a little over half of the world’s population!
Anyway, there has been some research done on the difference of intermittent fasting in women, but not much.
For example, here’s a study that looked at 1–2 days/week IF, in other words, exactly what you’ve been doing. And, they did have an equal number of men and women in the study… And then didn’t write down whether this made a difference or not! They recorded a lot of data, but neglected to note down who got what per sex:
Here’s a more helpful study, that looked at just women, and concluded:
❝In conclusion, intermittent fasting could be a nutritional strategy to decrease fat mass and increase jumping performance.
However, longer duration programs would be necessary to determine whether other parameters of muscle performance could be positively affected by IF. ❞
~ Dr. Martínez-Rodríguez et al.
Those were “active women”; another study looked at just women who were overweight or obese (we realize that “active women” and “obese or overweight women” is a Venn diagram with some overlap, but still, the different focus is interesting), and concluded:
❝IER is as effective as CER with regard to weight loss, insulin sensitivity and other health biomarkers, and may be offered as an alternative equivalent to CER for weight loss and reducing disease risk.❞
As for your sister’s specific concern about yo-yoing, we couldn’t find studies for this yet, but anecdotally and based on books on Intermittent Fasting, this is not usually an issue people find with IF. This is assumed to be for exactly the reason you mention, the increased cellular apoptosis and autophagy—increasing cellular turnover is very much the opposite of storing fat!
You might, by the way, like Dr. Mindy Pelz’s “Fast Like A Girl”, which we reviewed previously
Take care!
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Ras El-Hanout
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This is a spice blend, and its name (رأس الحانوت) means “head of the shop”. It’s popular throughout Morocco, Algeria, and Tunisia, but can often be found elsewhere. The exact blend will vary a little from place to place and even from maker to maker, but the general idea is the same. The one we provide here today is very representative (and for an example of its use, see our Marrakesh Sorghum Salad recipe!).
Note: we’re giving all the quantities in whole tsp today, to make multiplying/dividing easier if you want to make more/less ras el-hanout.
You will need
- 6 tsp ground ginger
- 6 tsp ground coriander seeds
- 4 tsp ground turmeric
- 4 tsp ground sweet cinnamon
- 4 tsp ground cumin
- 2 tsp ground allspice ← not a spice mix! This is the name of a spice!
- 2 tsp ground cardamom
- 2 tsp ground anise
- 2 tsp ground black pepper
- 1 tsp ground cayenne pepper
- 1 tsp ground cloves
Note: you may notice that garlic and salt are conspicuous by their absence. The reason for this is that they are usually added separately per dish, if desired.
Method
1) Mix them thoroughly
That’s it! Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Our Top 5 Spices: How Much Is Enough For Benefits?
- A Tale Of Two Cinnamons ← this is important, to understand why it’s critical to use sweet cinnamon specifically
- Sweet Cinnamon vs Regular Cinnamon – Which is Healthier? ← not even exaggerating; one is health-giving and the other contains a compound that is toxic at 01.mg/kg; guess which one is easier to find in the US and Canada?
Take care!
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Time Smart – by Dr. Ashley Whillans
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First, what this is not: it’s not a productivity book.
What is rather: a book of better wellbeing.
There is a little overlap, insofar as getting “time smart” in the ways that Dr. Whillans recommends will give you more ability to also be more productive—if that’s what you want.
She talks us through time traps and the “time poverty epidemic”, as well as steps to finding time and funding time. Perhaps most critical idea-wise is the chapter on building a “time-affluence habit”, making decisions that prioritize your time-freedom where you can—which in turn will allow you to build yet more. Kind of like compound interest really, but for time.
The writing style is a conversational tone, but peppered with bullet-point lists and charts and the like from time to time, and often with citations to back up claims. It makes for a very readable book, and yet one that’s also inspiring of the confidence that it’s more than just one person’s opinion.
Bottom line: if you sometimes feel like you could do everything you want to if you could just find the time, this book can help you get there.
Click here to check out Time Smart, and live your most satisfying life!
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Unlock Your Air-Fryer’s Potential!
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Unlock Your Air-Fryer’s Potential!
You know what they say:
“you get out of it what you put in”
…and in the case of an air-fryer, that’s very true!
More seriously:
A lot of people buy an air fryer for its health benefits and convenience, make fries a couple of times, and then mostly let it gather dust. But for those who want to unlock its potential, there’s plenty more it can do!
Let’s go over the basics first…
Isn’t it just a tiny convection oven?
Mechanically, yes. But the reason that it can be used to “air-fry” food rather than merely bake or roast the food is because of its tiny size allowing for much more rapid cooking at high temperatures.
On which note… If you’re shopping for an air-fryer:
- First of all, congratulations! You’re going to love it.
- Secondly: bigger is not better. If you go over more than about 4 liters capacity, then you don’t have an air-fryer; you have a convection oven. Which is great and all, but probably not what you wanted.
Are there health benefits beyond using less oil?
It also creates much less acrylamide than deep-frying starchy foods does. The jury is out on the health risks of acrylamide, but we can say with confidence: it’s not exactly a health food.
I tried it, but the food doesn’t cook or just burns!
The usual reason for this is either over-packing the fryer compartment (air needs to be able to circulate!), or not coating the contents in oil. The oil only needs to be a super-thin layer, but it does need to be there, or else again, you’re just baking things.
Two ways to get a super thin layer of oil on your food:
- (works for anything you can air-fry) spray the food with oil. You can buy spray-on oils at the grocery store (Fry-light and similar brands are great), or put oil in little spray bottle (of the kind that you might buy for haircare) yourself.
- (works with anything that can be shaken vigorously without harming it, e.g. root vegetables) chop the food, and put it in a tub (or a pan with a lid) with about a tablespoon of olive oil. Don’t worry if that looks like it’s not nearly enough—it will be! Now’s a great time to add your seasonings* too, by the way. Put the lid on, and holding the lid firmly in place, shake the tub/pan/whatever vigorously. Open it, and you’ll find the oil has now distributed itself into a very thin layer all over the food.
*About those seasonings…
Obviously not everything will go with everything, but some very healthful seasonings to consider adding are:
- Garlic minced/granules/powder (great for the heart and immune health)
- Black pepper (boosts absorption of other nutrients, and provides more benefits of its own than we can list here)
- Turmeric (slows aging and has anti-cancer properties)
- Cinnamon (great for the heart and has anti-inflammatory properties)
Garlic and black pepper can go with almost anything (and in this writer’s house, they usually do!)
Turmeric has a sweet nutty taste, and will add its color anything it touches. So if you want beautiful golden fries, perfect! If you don’t want yellow eggplant, maybe skip it.
Cinnamon is, of course, great as part of breakfast and dessert dishes
On which note, things most people don’t think of air-frying:
- Breakfast frittata—the healthy way!
- Omelets—no more accidental scrambled egg and you don’t have to babysit it! Just take out the tray that things normally sit on, and build it directly onto the (spray-oiled) bottom of the air-fryer pan. If you’re worried it’ll burn: a) it won’t, because the heat is coming from above, not below b) you can always use greaseproof paper or even a small heatproof plate
- French toast—again with no cooking skills required
- Fish cakes—make the patties as normal, spray-oil and lightly bread them
- Cauliflower bites—spray oil or do the pan-jiggle we described; for seasonings, we recommend adding smoked paprika and, if you like heat, your preferred kind of hot pepper! These are delicious, and an amazing healthy snack that feels like junk food.
- Falafel—make the balls as usual, spray-oil (do not jiggle violently; they won’t have the structural integrity for that) and air-fry!
- Calamari (vegan option: onion rings!)—cut the squid (or onions) into rings, and lightly coat in batter and refrigerate for about an hour before air-frying at the highest heat your fryer does. This is critical, because air-fryers don’t like wet things, and if you don’t refrigerate it and then use a high heat, the batter will just drip, and you don’t want that. But with those two tips, it’ll work just great.
Want more ideas?
Check out EatingWell’s 65+ Healthy Air-Fryer Recipes ← the recipes are right there, no need to fight one’s way to them in any fashion!
Don’t Forget…
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Learn to Age Gracefully
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