Being Mortal – by Dr. Atul Gawande

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Maybe you want to “live forever or die trying”, and that’s an understandable goal… But are you prepared for “or die trying” being the outcome?

This is not a cheerful book, if you’re anything like this reviewer, you will need a little towel or something to mop up the tears while you read. But it’s worth it.

Dying is one thing; fighting for life is even generally considered a noble endeavor. Suffering alone isn’t fun, losing independence can feel humiliating, and seeing someone who was always a tower of strength, now a frail shadow of their former self, reduced to begging for something that they’re “not allowed”, can be worse.

Do we want that for ourselves? For our loved ones? Can there be a happy medium between that, and the alternative to indeed “go gentle into that good night”?

Dr. Gawande, a surgeon well-acquainted with death and dying, thinks so. But it involves work on our part, and being prepared for hard decisions.

  • What is most important to us, and what tradeoffs are we willing to make for it?
  • What, even, is actually an option to us with the resources available?
  • Can we make peace with a potentially bad lot? And… Should we?
  • When is fighting important, and when is it self-destructive?

These (and others) are all difficult questions posed by Dr. Gawande, but critical ones.

We don’t usually quote other people’s reviews when reviewing books here, but let’s consider the following words from the end of a long review on Amazon:

❝If “dying as we lived” is some kind of standard for how we should go, then maybe alone and medicalized makes some sense right now after all.❞

~ Pamela J. H.

Bottom line: we all deserve better than that. And if we don’t take the time to think about what’s most important, then time will take it from us. This very insightful book may not have all the answers, but it has the questions, and it can help a lot in exploring them and deciding what matters most to us in the end, really.

Click here to check out Being Mortal, and make every day count—because nothing matters more than that.

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  • The Power of When – by Dr. Michael Breus
    Dive into the depths of your circadian rhythm with “The Power of When.” Learn to sync activities with your biological clock for optimal performance and health.

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  • What does lion’s mane mushroom actually do, anyway?

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    You may know it as an ingredient in nootropic supplements. You may have heard of lion’s mane mushroom coffee. You may know it as the big shaggy white mushroom that grows in nature and can look very impressive.

    What’s special about it?

    The lion’s mane mushroom, or ​​Hericium erinaceus (we mention, as studies we’ll cite often use the botanical name) is an adaptogenic agent that has an established ability to promote nerve regeneration through nerve growth factor neurotrophic activity. In other words, it helps (re)grow neurons.

    In a 2023 study, researchers wondered if its abilities (well-established in the peripheral nervous system) would work in the central nervous system too, namely the brain, specifically the hippocampus (responsible for memory).

    To boil what they found down to a single line, they concluded:

    ❝[Lion’s mane extract] therefore acts through a novel pan-neurotrophic signaling pathway, leading to improved cognitive performance.❞

    You can read the full study for yourself (with pictures!) here:

    Hericerin derivatives activates a pan-neurotrophic pathway in central hippocampal neurons converging to ERK1/2 signaling enhancing spatial memory

    Limitations of the study

    It’s worth noting that the above study was performed on mice brains, not those of humans. As there is a shortage of human volunteers willing to have their brains sliced and examined under microscopes, we do not expect this study to be repeated with humans any time soon.

    So, are there human studies that have been done?

    There are! Particularly promising was this 2020 study of people with Alzheimer’s disease, wherein supplementation with 1g of lion’s mane mushroom daily for 49 weeks significantly increased cognitive test scores compared with a placebo; you can read about it here:

    Prevention of Early Alzheimer’s Disease by Erinacine A-Enriched Hericium erinaceus Mycelia Pilot Double-Blind Placebo-Controlled Study

    Additionally, this 2019 study showed that taking 1.2g daily for eight weeks helped relieve depression, anxiety, and sleep disorders in overweight or obese patiences:

    Hericium erinaceus Improves Mood and Sleep Disorders in Patients Affected by Overweight or Obesity: Could Circulating Pro-BDNF and BDNF Be Potential Biomarkers?

    Are there other health benefits?

    It seems so! Unfortunately, most of its other health claims are only supported by animal studies so far, aside from one small study funded by a supplement company for their supplement that contained mostly Agaricus blazei (a different mushroom) with 14% lion’s mane.

    However, in animal studies, lion’s mane has also shown promise:

    Where can I get it?

    We don’t sell it (or anything else, for that matter) but if you’d like to try it, here’s an example product for your convenience:

    Lion’s Mane Organic Mushroom Powder, for Memory Support, Focus, Clarity, Nerve Health, Creativity and Mood

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  • A short history of sunscreen, from basting like a chook to preventing skin cancer

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Australians have used commercial creams, lotions or gels to manage our skin’s sun exposure for nearly a century.

    But why we do it, the preparations themselves, and whether they work, has changed over time.

    In this short history of sunscreen in Australia, we look at how we’ve slathered, slopped and spritzed our skin for sometimes surprising reasons.

    At first, suncreams helped you ‘tan with ease’

    Advertisement for Hamilton's Sunburn Vanishing Cream
    This early sunscreen claimed you could ‘tan with ease’.
    Trove/NLA

    Sunscreens have been available in Australia since the 30s. Chemist Milton Blake made one of the first.

    He used a kerosene heater to cook batches of “sunburn vanishing cream”, scented with French perfume.

    His backyard business became H.A. Milton (Hamilton) Laboratories, which still makes sunscreens today.

    Hamilton’s first cream claimed you could “
    Sunbathe in Comfort and TAN with ease”. According to modern standards, it would have had an SPF (or sun protection factor) of 2.

    The mirage of ‘safe tanning’

    A tan was considered a “modern complexion” and for most of the 20th century, you might put something on your skin to help gain one. That’s when “safe tanning” (without burning) was thought possible.

    Coppertone advertisement showing tanned woman in bikini
    This 1967 Coppertone advertisement urged you to ‘tan, not burn’.
    SenseiAlan/Flickr, CC BY-SA

    Sunburn was known to be caused by the UVB component of ultraviolet (UV) light. UVA, however, was thought not to be involved in burning; it was just thought to darken the skin pigment melanin. So, medical authorities advised that by using a sunscreen that filtered out UVB, you could “safely tan” without burning.

    But that was wrong.

    From the 70s, medical research suggested UVA penetrated damagingly deep into the skin, causing ageing effects such as sunspots and wrinkles. And both UVA and UVB could cause skin cancer.

    Sunscreens from the 80s sought to be “broad spectrum” – they filtered both UVB and UVA.

    Researchers consequently recommended sunscreens for all skin tones, including for preventing sun damage in people with dark skin.

    Delaying burning … or encouraging it?

    Up to the 80s, sun preparations ranged from something that claimed to delay burning, to preparations that actively encouraged it to get that desirable tan – think, baby oil or coconut oil. Sun-worshippers even raided the kitchen cabinet, slicking olive oil on their skin.

    One manufacturer’s “sun lotion” might effectively filter UVB; another’s merely basted you like a roast chicken.

    Since labelling laws before the 80s didn’t require manufacturers to list the ingredients, it was often hard for consumers to tell which was which.

    At last, SPF arrives to guide consumers

    In the 70s, two Queensland researchers, Gordon Groves and Don Robertson, developed tests for sunscreens – sometimes experimenting on students or colleagues. They printed their ranking in the newspaper, which the public could use to choose a product.

    An Australian sunscreen manufacturer then asked the federal health department to regulate the industry. The company wanted standard definitions to market their products, backed up by consistent lab testing methods.

    In 1986, after years of consultation with manufacturers, researchers and consumers, Australian Standard AS2604 gave a specified a testing method, based on the Queensland researchers’ work. We also had a way of expressing how well sunscreens worked – the sun protection factor or SPF.

    This is the ratio of how long it takes a fair-skinned person to burn using the product compared with how long it takes to burn without it. So a cream that protects the skin sufficiently so it takes 40 minutes to burn instead of 20 minutes has an SPF of 2.

    Manufacturers liked SPF because businesses that invested in clever chemistry could distinguish themselves in marketing. Consumers liked SPF because it was easy to understand – the higher the number, the better the protection.

    Australians, encouraged from 1981 by the Slip! Slop! Slap! nationwide skin cancer campaign, could now “slop” on a sunscreen knowing the degree of protection it offered.

    How about skin cancer?

    It wasn’t until 1999 that research proved that using sunscreen prevents skin cancer. Again, we have Queensland to thank, specifically the residents of Nambour. They took part in a trial for nearly five years, carried out by a research team led by Adele Green of the Queensland Institute of Medical Research. Using sunscreen daily over that time reduced rates of squamous cell carcinoma (a common form of skin cancer) by about 60%.

    Follow-up studies in 2011 and 2013 showed regular sunscreen use almost halved the rate of melanoma and slowed skin ageing. But there was no impact on rates of basal cell carcinoma, another common skin cancer.

    By then, researchers had shown sunscreen stopped sunburn, and stopping sunburn would prevent at least some types of skin cancer.

    What’s in sunscreen today?

    An effective sunscreen uses one or more active ingredients in a cream, lotion or gel. The active ingredient either works:

    • “chemically” by absorbing UV and converting it to heat. Examples include PABA (para-aminobenzoic acid) and benzyl salicylate, or

    • “physically” by blocking the UV, such as zinc oxide or titanium dioxide.

    Physical blockers at first had limited cosmetic appeal because they were opaque pastes. (Think cricketers with zinc smeared on their noses.)

    With microfine particle technology from the 90s, sunscreen manufacturers could then use a combination of chemical absorbers and physical blockers to achieve high degrees of sun protection in a cosmetically acceptable formulation.

    Where now?

    Australians have embraced sunscreen, but they still don’t apply enough or reapply often enough.

    Although some people are concerned sunscreen will block the skin’s ability to make vitamin D this is unlikely. That’s because even SPF50 sunscreen doesn’t filter out all UVB.

    There’s also concern about the active ingredients in sunscreen getting into the environment and whether their absorption by our bodies is a problem.

    Sunscreens have evolved from something that at best offered mild protection to effective, easy-to-use products that stave off the harmful effects of UV. They’ve evolved from something only people with fair skin used to a product for anyone.

    Remember, slopping on sunscreen is just one part of sun protection. Don’t forget to also slip (protective clothing), slap (hat), seek (shade) and slide (sunglasses).The Conversation

    Laura Dawes, Research Fellow in Medico-Legal History, Australian National University

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

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  • 4 ways to cut down on meat when dining out – and still make healthy choices

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Many of us are looking for ways to eat a healthier and more sustainable diet. And one way to do this is by reducing the amount of meat we eat.

    That doesn’t mean you need to become a vegan or vegetarian. Our recent research shows even small changes to cut down on meat consumption could help improve health and wellbeing.

    But not all plant-based options are created equal and some are ultra-processed. Navigating what’s available when eating out – including options like tofu and fake meats – can be a challenge.

    So what are your best options at a cafe or restaurant? Here are some guiding principles to keep in mind when cutting down on meat.

    Mikhaylovskiy/Shutterstock

    Health benefits to cutting down

    Small amounts of lean meat can be part of a healthy, balanced diet. But the majority of Australians still eat more meat than recommended.

    Only a small percentage of Australians (10%) are vegetarian or vegan. But an increasing number opt for a flexitarian diet. Flexitarians eat a diet rich in fruits and vegetables, while still enjoying small amounts of meat, dairy, eggs and fish.

    Our recent research looked at whether the average Australian diet would improve if we swapped meat and dairy for plant-based alternatives, and the results were promising.

    The study found health benefits when people halved the amount of meat and dairy they ate and replaced them with healthy plant-based foods, like tofu or legumes. On average, their dietary fibre intake – which helps with feeling fuller for longer and digestive health – went up. Saturated fats – which increase our blood cholesterol levels, a risk factor for heart disease – went down.

    Including more fibre and less saturated fat helps reduce the risk of heart disease.

    Achieving these health benefits may be as simple as swapping ham for baked beans in a toastie for lunch, or substituting half of the mince in your bolognese for lentils at dinner.

    A hand holding a plate filled with vegetables and pita bread.
    Filling your plate with fibre-rich foods can help lower cholesterol. Wally Pruss/Shutterstock

    How it’s made matters

    For a long time we’ve known processed meats – such as ham, bacon and sausages – are bad for your health. Eating high amounts of these foods is associated with poor heart health and some forms of cancer.

    But the same can be true of many processed meat alternatives.

    Plant-based alternatives designed to mimic meat, such as sausages and burgers, have become readily available in supermarkets, cafes and restaurants. These products are ultra-processed and can be high in salt and saturated fat.

    Our study found when people replaced meat and dairy with ultra-processed meat alternatives – such as plant-based burgers or sausages – they ate more salt and less calcium, compared to eating meat or healthy plant-based options.

    So if you’re cutting down on meat for health reasons, it’s important to think about what you’re replacing it with. The Australian Dietary Guidelines recommend eggs, legumes/beans, tofu, nuts and seeds.

    Tofu can be a great option. But we recommend flavouring plain tofu with herbs and spices yourself, as pre-marinated products are often ultra-processed and can be high in salt.

    What about when dining out?

    When you’re making your own food, it’s easier to adapt recipes or reduce the amount of meat. But when faced with a menu, it can be difficult to work out what is the best option.

    Two people eat noodles from takeaway bowls.
    Eating a range of colours is one way to ensure variety. Mikhail Nilov/Pexels

    Here are our four ways to make healthy choices when you eat out:

    1. Fill half your plate with vegetables

    When cutting down on meat, aim for half your plate to be vegetables. Try to also eat a variety of colours, such as leafy green spinach, red capsicum and pumpkin.

    When you’re out, this might look like choosing a vegetable-based entree, a stir-fry or ordering a side salad to have with your meal.

    2. Avoid the deep fryer

    The Australian Dietary Guidelines recommend limiting deep fried foods to once a week or less. When dining out, choose plant-based options that are sautéed, grilled, baked, steamed, boiled or poached – instead of those that are crumbed or battered before deep frying.

    This could mean choosing vegetarian dumplings that are steamed not fried, or poached eggs at brunch instead of fried. Ordering a side of roast vegetables instead of hot chips is also a great option.

    3. Pick wholegrains

    Scan the menu for wholegrain options such as brown rice, wholemeal pizza or pasta, barley, quinoa or wholemeal burger buns. Not only are they good sources of protein, but they also provide more dietary fibre than refined grains, which help keep you fuller for longer.

    4. If you do pick meat – choose less processed kinds

    You may not always want, or be able, to make a vegetarian choice when eating out and with other people. If you do opt for meat, it’s better to steer clear of processed options like bacon or sausages.

    If sharing dishes with other people, you could try adding unprocessed plant-based options into the mix. For example, a curry with lentils or chickpeas, or a vegetable-based pizza instead of one with ham or salami. If that’s not an option, try choose meat that’s a lean cut, such as chicken breast, or options which are grilled rather than fried.

    Laura Marchese, PhD candidate at the Institute for Physical Activity and Nutrition, Deakin University and Katherine Livingstone, NHMRC Emerging Leadership Fellow and Senior Research Fellow at the Institute for Physical Activity and Nutrition, Deakin University

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

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Related Posts

  • How to Read a Book – by Mortimer J. Adler and Charles Van Doren
  • If You’re Not Flexible, These Are The Only 3 Stretches You Need, To Fix That

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    If you can’t put your leg behind your head while standing, try doing the splits against a wall first, and progress from there! ← text version of an item from a “if you can’t do this yet, try this first” picture set this writer saw on Instagram once upon a time

    So, what if you’re more at the point of not quite being able to touch your toes yet?

    From zero to…

    Liv, of LivInLeggings fame, has these three starter-stretches that are actually starter-stretches:

    Stretch 1: Reverse Tabletop with Foot Tuck Variation

    1. Sit on the floor, feet slightly wider than your hips, lean back onto your hands (fingertips pointing outward).
    2. Lift your hips towards a reverse tabletop, engage your glutes, and flatten the front of your hips.
    3. Add a foot tuck variation by stepping one foot back and pressing your weight forward.

    Benefits:

    • Stretches multiple muscles, including the soles of the feet.
    • Improves foot arches, balance, and stability.
    • Loosens fascia, enhancing flexibility in subsequent stretches.

    Stretch 2: Squat to Forward Fold

    1. Start in a low squat (feet wider than your hips, toes mostly forward).
    2. Alternate between a low squat and a forward fold, keeping your hands on the floor or your toes.

    Benefits:

    • Stretches hamstrings, glutes, and lower back.
    • Maintains good form and avoids overstraining.

    Stretch 3: Side Lunge with Side Body Reach

    1. Begin in a tall kneeling position, step one foot out to the side (toes pointing outward).
    2. Lunge your hips towards your front ankle, keeping your tailbone tucked.
    3. Add a side body reach by resting your forearm on your thigh and reaching the other arm overhead.
    4. For a deeper stretch, cradle the back of your head with your hand, pressing lightly for a tricep stretch.

    Benefits:

    • Stretches inner thighs, lats, and triceps.
    • Improves posture, shoulder mobility, and low squat ability.

    For more on each of these plus visual demonstrations, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Test For Whether You Will Be Able To Achieve The Splits

    Take care!

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  • Fasting Without Crashing?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Intermittent Fasting: What’s the truth?

    Before we get to facts and fictions, let’s quickly cover:

    What is Intermittent Fasting?

    Intermittent Fasting (IF) is an umbrella term for various kinds of time-restricted fasting, based on a schedule. Types include:

    Time-restricted IF, for example:

    • 16:8—Fast for 16 hours, eat during an 8-hour window
    • 18:6–Fast for 18 hours, eat during a 6-hour window
    • 20:4—Fast for 20 hours, eat during a 4-hour window

    24hr fasting, including:

    • Eat Stop Eat—basically, take a day off from eating once a week
    • Alternate Day Fasting—a more extreme version of the above; it is what it sounds like; eat one day, fast the next, repeat

    Non-fast fasting, e.g:

    • 5:2—Eat normally for 5 days, have a very reduced calorie intake (⅓ of normal intake) for the other 2 days
    • Fruit Fasting—have a small amount of fruit on “fast” days, but no other food
    • The Warrior Diet—as above, but include a small amount of non-starchy vegetables

    Why IF?

    While IF is perhaps most commonly undertaken as a means of fat loss or fat management (i.e., keeping fat down when it is already low), others cite different reasons, such as short term cognitive performance or long-term longevity.

    But… Does it work?

    Here we get into the myth-busting bit!

    “IF promotes weight loss”

    Mix of True and False. It can! But it also doesn’t have to. If you’re a bodybuilder who downs 4,000 calories in your 4hr eating window, you’re probably not going to lose weight! For such people, this is of course “a feature, not a bug” of IF—especially as it has been found that, in an acute study, IF did not adversely impact muscle protein synthesis.

    “IF promotes fat loss, without eating less”

    Broadly True. IF was found to be potentially equal to, but not necessarily better than, eating less.

    “IF provides metabolic benefits for general health”

    Broadly True. IF (perhaps counterintuitively) decreases the risk of insulin resistance, and also has anti-inflammatory effects, benefits a healthy gut microbiome, and promotes healthy autophagy (which as we noted in a previous edition of 10almonds, is important against both aging and cancer)

    However, results vary according to which protocol you’re observing…

    For what it’s worth, 16:8 is perhaps the most-studied protocol. Because such studies tend to have the eating window from midday to 8pm, this means that—going against popular wisdom—part of the advice here is basically “skip breakfast”.

    “Unlike caloric restriction, IF is sustainable and healthy as a long-term protocol”

    Broadly True. Of course, there’s a slight loophole here in that IF is loosely defined—technically everyone fasts while they’re sleeping, at the very least!

    However, for the most commonly-studied IF method (16:8), this is generally very sustainable and healthy and for most people.

    On the other hand, a more extreme method such as Alternate Day Fasting, may be trickier to sustain (even if it remains healthy to do so), because it’s been found that hunger does not decrease on fasting days—ie, the body does not “get used to it”.

    The American Journal of Clinical Nutrition wrote:

    ❝Alternate-day fasting was feasible in nonobese subjects, and fat oxidation increased. However, hunger on fasting days did not decrease, perhaps indicating the unlikelihood of continuing this diet for extended periods of time. Adding one small meal on a fasting day may make this approach to dietary restriction more acceptable.❞

    American Journal of Clinical Nutrition

    “IF improves mood and cognition”

    Mix of True and False (plus an honest “We Don’t Know” from researchers).

    Many studies have found benefits to both mood and cognition, but in the short-term, fasting can make people “hangry” (or: “experience irritability due to low blood sugar levels”, as the scientists put it), and in the long term, it can worsen symptoms of depression for those who already experience such—although some studies have found it can help alleviate depressive symptoms.

    Basically this is one where researchers typically append the words “more research is needed” to their summaries.

    “Anyone can do IF”

    Definitely False, unless going by the absolute broadest possible interpretation of what constitutes “Intermittent Fasting” to the point of disingenuity.

    For example, if you are Type 1 Diabetic, and your blood sugars are hypo, and you wait until tomorrow to correct that, you will stand a good chance of going into a coma instead. So please don’t.

    (On the other hand, IF may help achieve remission of type 2 diabetes)

    Lastly, IF is broadly not recommend to children and adolescents, anyone pregnant or breastfeeding, and certain underlying health conditions not mentioned above (we’re not going to try to give an exhaustive list here, but basically, if you have a chronic health condition, we recommend you check with your doctor first).

    WHICH APP?

    Choosing a fasting app

    Thinking of giving IF a try and would like a little extra help? We’ve got you covered!

    Check out: Livewire’s 7 Best Intermittent Fasting Apps of 2023

    Prefer to just trust us with a recommendation?

    We like BodyFast—it’s #2 on Lifewire’s list, but it has an array of pre-set plans to choose from (unlike Lifewire’s #1, Zero), and plenty of clear tracking, scheduling help, and motivational features.

    Both are available on both iOS and Android:

    See the BodyFast App / See the Zero App

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  • Exercise with Type 1 Diabetes – by Ginger Vieira

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    If you or a loved one has Type 1 Diabetes, you’ll know that exercise can be especially frustrating…

    • If you don’t do it, you risk weight gain and eventual insulin resistance.
    • If you do it, you risk dangerous hypos, or perhaps hypers if you took off your pump or skipped a bolus.

    Unfortunately, the popular medical advice is “well, just do your best”.

    Ginger Vieira is Type 1 Diabetic, and writes with 20+ experience of managing her diabetes while being a keen exerciser. As T1D folks out there will also know, comorbidities are very common; in her case, fibromyalgia was the biggest additional blow to her ability to exercise, along with an underactive thyroid. So when it comes to dealing with the practical nuts and bolts of things, she (while herself observing she’s not a doctor, let alone your doctor) has a lot more practical knowledge than an endocrinologist (without diabetes) behind a desk.

    Speaking of nuts and bolts, this book isn’t a pep talk.

    It has a bit of that in, but most of it is really practical information, e.g: using fasted exercise (4 hours from last meal+bolus) to prevent hypos, counterintuitive as that may seemthe key is that timing a workout for when you have the least amount of fast-acting insulin in your body means your body can’t easily use your blood sugars for energy, and draws from your fat reserves instead… Win/Win!

    That’s just one quick tip because this is a 1-minute review, but Vieira gives:

    • whole chapters, with example datasets (real numbers)
    • tech-specific advice, e.g. pump, injection, etc
    • insulin-specific advice, e.g. fast vs slow, and adjustments to each in the context of exercise
    • timing advice re meal/bolus/exercise for different insulins and techs
    • blood-sugar management advice for different exercise types (aerobic/anaerobic, sprint/endurance, etc)

    …and lots more that we don’t have room to mention here

    Basically… If you or a loved one has T1D, we really recommend this book!

    Order a copy of “Exercise with Type 1 Diabetes” from Amazon today!

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