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.❞
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.
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Artichoke vs Brussels Sprouts – Which is Healthier?
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Our Verdict
When comparing artichoke to Brussels sprouts, we picked the sprouts.
Why?
Finally, a vegetable that beats artichoke—after it previously beat heart-of-palm, asparagus, and even cabbage! It was still close though, which is impressive for artichoke, considering what a nutritional powerhouse Brussels sprouts are:
In terms of macros, the only meaningful difference is that artichoke has slightly more carbs and fiber, so artichoke gets the most marginal of nominal wins in this category.
In the category of vitamins, however, artichoke has more of vitamins B3, B9, and choline, while Brussels sprouts have more of vitamins A, B1, B2, B6, C, E, and K, giving sprouts the clear victory here, especially with much higher margins of difference (e.g. 58x more vitamin A, as well as 7x more vitamin C, and 10x more vitamin K).
When it comes to minerals, artichoke has more copper, magnesium, phosphorus, and zinc, while Brussels sprouts have more iron, manganese, potassium, and selenium, resulting in a 4:4 tie, and the small margins of difference are mostly comparable, with the exception that sprouts have 8x more selenium. So, Brussels sprouts win this category very marginally on that tie-breaker.
Adding up the sections we see that macros and minerals gave a small win each to artichoke and sprouts respectively, while the vitamins category was an overwhelming win for sprouts, so—with this deciding factor in mind—sprouts win the day today.
Want to learn more?
You might like to read:
Sprout Your Seeds, Grains, Beans, Etc
Enjoy!
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The Snooze-Button Controversy
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To Snooze Or Not To Snooze? (Science Has Answers)
This is Dr. Jennifer Kanaan. She’s a medical doctor with a focus on pulmonary critical care, sleep disorders, and sleep medicine.
What does she want to tell us?
She wants us to be wary of the many news articles that have jumped on a certain recent sleep study, such as:
- Is hitting the snooze button really a bad idea? Study sheds light on the impact of morning alarms on sleep and cognition
- Hitting Snooze May Help You Feel Less Sleepy and More Alert, Research Says
- Is it okay to press the snooze button?
- Hitting Snooze May Help You Feel Less Sleepy and More Alert, Research Says
- Hitting the snooze button on your alarm doesn’t make you more tired
For the curious, here is the paper itself, by Dr. Tina Sundelin et al. It’s actually two studies, by the way, but one paper:
The authors of this study concluded:
❝There were no clear effects of snoozing on the cortisol awakening response, morning sleepiness, mood, or overnight sleep architecture.
A brief snooze period may thus help alleviate sleep inertia, without substantially disturbing sleep, for late chronotypes and those with morning drowsiness.❞
Notably, people tend to snooze because an alarm clock will, if not “smart” about it, wake us up mid sleep-cycle more often than not, and that will produce a short “sleep hangover”. By snoozing, we are basically re-rolling the dice on being woken up between sleep cycles, and thus feeling more refreshed.
What’s Dr. Kanaan’s counterpoint?
Dr. Kanaan says:
❝If you’re coming in and out of sleep for 30 minutes, after the alarm goes off the first time, you’re costing yourself 30 minutes of uninterrupted, quality, restorative sleep. This study doesn’t change that fact.❞
She advises that rather than snoozing, we should prioritize getting good sleep in the first place, and once we do wake up, mid sleep-cycle or not, get sunlight. That way, our brain will start promptly scrubbing melatonin and producing the appropriate wakefulness hormones instead. That means serotonin, and also a spike of cortisol.
Remember: cortisol is only bad when it’s chronically elevated. It’s fine, and even beneficial, to have a short spike of cortisol. We make it for a reason!
If you’d like to hear more from Dr. Kanaan, you might like this interview with her at the University of Connecticut:
Want the best of both worlds?
A great option to avoid getting woken in the middle of a sleep cycle, and also not needing to hit snooze, is a sunrise alarm clock. Specifics of these devices vary, but for example, the kind this writer has starts gently glowing an hour before the set alarm time,and gradually gets brighter and lighter over the course of the hour.
We don’t sell them, but here’s an example sunrise alarm clock on Amazon, for your convenience
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The Science of Nutrition – by Rhiannon Lambert
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While there are a lot of conflicting dietary approaches out there, the science itself is actually fairly cohesive in most regards. This book does a lot of what we do here at 10almonds, and presents the science in a clear fashion without having any particular agenda to push.
The author is a nutritionist (BSc, MSc, RNutr) and therefore provides an up-to-date evidence-based approach for eating.
As a result, the only part of this book that brings it down in this reviewer’s opinion is the section on Intermittent Fasting. Being not strictly about nutrition, she has less expertise on that topic, and it shows.
The information is largely presented in double-page spreads each answering a particular question. Because of this, and the fact there are colorful graphic representations of information too, we do recommend the print version over Kindle*.
Bottom line: if you like the notion of real science being presented in a clear and simple fashion (we like to think our subscribers do!), then you’ll surely enjoy this book.
Click here to check out the Science of Nutrition, and get a clear overview!
*Writer’s note: I realize I’ve two days in a row recommended this (yesterday because there are checkboxes to check, worksheets to complete, etc), but it’s not a new trend; just how it happened to be with these two books. I love my Kindle dearly, but sometimes print has the edge for one reason or another!
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The Osteoporosis Breakthrough – by Dr. Doug Lucas
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.
“Osteoporosis” and “break” often don’t go well together, but here they do. So, what’s the breakthrough here?
There isn’t one, honestly. But if we overlook the marketing choices and focus on the book itself, the content here is genuinely good:
The book offers a comprehensive multivector approach to combatting osteoporosis, e.g:
- Diet
- Exercise
- Other lifestyle considerations
- Supplements
- Hormones
- Drugs
The author considers drugs a good and important tool for some people with osteoporosis, but not most. The majority of people, he considers, will do better without drugs—by tackling things more holistically.
The advice here is sound and covers all reasonable angles without getting hung up on the idea of there being a single magical solution for all.
Bottom line: if you’re looking for a book that’s a one-stop-shop for strategies against osteoporosis, this is a good option.
Click here to check out The Osteoporosis Breakthrough, and keep your bones strong!
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Could not getting enough sleep increase your risk of type 2 diabetes?
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Not getting enough sleep is a common affliction in the modern age. If you don’t always get as many hours of shut-eye as you’d like, perhaps you were concerned by news of a recent study that found people who sleep less than six hours a night are at higher risk of type 2 diabetes.
So what can we make of these findings? It turns out the relationship between sleep and diabetes is complex.
The study
Researchers analysed data from the UK Biobank, a large biomedical database which serves as a global resource for health and medical research. They looked at information from 247,867 adults, following their health outcomes for more than a decade.
The researchers wanted to understand the associations between sleep duration and type 2 diabetes, and whether a healthy diet reduced the effects of short sleep on diabetes risk.
As part of their involvement in the UK Biobank, participants had been asked roughly how much sleep they get in 24 hours. Seven to eight hours was the average and considered normal sleep. Short sleep duration was broken up into three categories: mild (six hours), moderate (five hours) and extreme (three to four hours). The researchers analysed sleep data alongside information about people’s diets.
Some 3.2% of participants were diagnosed with type 2 diabetes during the follow-up period. Although healthy eating habits were associated with a lower overall risk of diabetes, when people ate healthily but slept less than six hours a day, their risk of type 2 diabetes increased compared to people in the normal sleep category.
The researchers found sleep duration of five hours was linked with a 16% higher risk of developing type 2 diabetes, while the risk for people who slept three to four hours was 41% higher, compared to people who slept seven to eight hours.
One limitation is the study defined a healthy diet based on the number of servings of fruit, vegetables, red meat and fish a person consumed over a day or a week. In doing so, it didn’t consider how dietary patterns such as time-restricted eating or the Mediterranean diet may modify the risk of diabetes among those who slept less.
Also, information on participants’ sleep quantity and diet was only captured at recruitment and may have changed over the course of the study. The authors acknowledge these limitations.
Why might short sleep increase diabetes risk?
In people with type 2 diabetes, the body becomes resistant to the effects of a hormone called insulin, and slowly loses the capacity to produce enough of it in the pancreas. Insulin is important because it regulates glucose (sugar) in our blood that comes from the food we eat by helping move it to cells throughout the body.
We don’t know the precise reasons why people who sleep less may be at higher risk of type 2 diabetes. But previous research has shown sleep-deprived people often have increased inflammatory markers and free fatty acids in their blood, which impair insulin sensitivity, leading to insulin resistance. This means the body struggles to use insulin properly to regulate blood glucose levels, and therefore increases the risk of type 2 diabetes.
Further, people who don’t sleep enough, as well as people who sleep in irregular patterns (such as shift workers), experience disruptions to their body’s natural rhythm, known as the circadian rhythm.
This can interfere with the release of hormones like cortisol, glucagon and growth hormones. These hormones are released through the day to meet the body’s changing energy needs, and normally keep blood glucose levels nicely balanced. If they’re compromised, this may reduce the body’s ability to handle glucose as the day progresses.
These factors, and others, may contribute to the increased risk of type 2 diabetes seen among people sleeping less than six hours.
Millions of people around the world have diabetes. WESTOCK PRODUCTIONS/Shutterstock While this study primarily focused on people who sleep eight hours or less, it’s possible longer sleepers may also face an increased risk of type 2 diabetes.
Research has previously shown a U-shaped correlation between sleep duration and type 2 diabetes risk. A review of multiple studies found getting between seven to eight hours of sleep daily was associated with the lowest risk. When people got less than seven hours sleep, or more than eight hours, the risk began to increase.
The reason sleeping longer is associated with increased risk of type 2 diabetes may be linked to weight gain, which is also correlated with longer sleep. Likewise, people who don’t sleep enough are more likely to be overweight or obese.
Good sleep, healthy diet
Getting enough sleep is an important part of a healthy lifestyle and may reduce the risk of type 2 diabetes.
Based on this study and other evidence, it seems that when it comes to diabetes risk, seven to eight hours of sleep may be the sweet spot. However, other factors could influence the relationship between sleep duration and diabetes risk, such as individual differences in sleep quality and lifestyle.
While this study’s findings question whether a healthy diet can mitigate the effects of a lack of sleep on diabetes risk, a wide range of evidence points to the benefits of healthy eating for overall health.
The authors of the study acknowledge it’s not always possible to get enough sleep, and suggest doing high-intensity interval exercise during the day may offset some of the potential effects of short sleep on diabetes risk.
In fact, exercise at any intensity can improve blood glucose levels.
Giuliana Murfet, Casual Academic, Faculty of Health, University of Technology Sydney and ShanShan Lin, Senior Lecturer, School of Public Health, University of Technology Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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When Carbs, Proteins, & Fats Switch Metabolic Roles
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Strange Things Happening In The Islets Of Langerhans
It is generally known and widely accepted that carbs have the biggest effect on blood sugar levels (and thus insulin response), fats less so, and protein least of all.
And yet, there was a groundbreaking study published yesterday which found:
❝Glucose is the well-known driver of insulin, but we were surprised to see such high variability, with some individuals showing a strong response to proteins, and others to fats, which had never been characterized before.
Insulin plays a major role in human health, in everything from diabetes, where it is too low*, to obesity, weight gain and even some forms of cancer, where it is too high.
These findings lay the groundwork for personalized nutrition that could transform how we treat and manage a range of conditions.❞
*saying ”too low” here is potentially misleading without clarification; yes, Type 1 Diabetics will have too little [endogenous] insulin (because the pancreas is at war with itself and thus isn’t producing useful quantities of insulin, if any). Type 2, however, is more a case of acquired insulin insensitivity, because of having too much at once too often, thus the body stops listening to it, “boy who cried wolf”-style, and the pancreas also starts to get fatigued from producing so much insulin that’s often getting ignored, and does eventually produce less and less while needing more and more insulin to get the same response, so it can be legitimately said “there’s not enough”, but that’s more of a subjective outcome than an objective cause.
Back to the study itself, though…
What they found, and how they found it
Researchers took pancreatic islets from 140 heterogenous donors (varied in age and sex; ostensibly mostly non-diabetic donors, but they acknowledge type 2 diabetes could potentially have gone undiagnosed in some donors*) and tested cell cultures from each with various carbs, proteins, and fats.
They found the expected results in most of the cases, but around 9% responded more strongly to the fats than the carbs (even more strongly than to glucose specifically), and even more surprisingly 8% responded more strongly to the proteins.
*there were also some known type 2 diabetics amongst the donors; as expected, those had a poor insulin response to glucose, but their insulin response to proteins and fats were largely unaffected.
What this means
While this is, in essence, a pilot study (the researchers called for larger and more varied studies, as well as in vivo human studies), the implications so far are important:
It appears that, for a minority of people, a lot of (generally considered very good) antidiabetic advice may not be working in the way previously understood. They’re going to (for example) put fat on their carbs to reduce the blood sugar spike, which will technically still work, but the insulin response is going to be briefly spiked anyway, because of the fats, which very insulin response is what will lower the blood sugars.
In practical terms, there’s not a lot we can do about this at home just yet—even continuous glucose monitors won’t tell us precisely, because they’re monitoring glucose, not the insulin response. We could probably measure everything and do some math and work out what our insulin response has been like based on the pace of change in blood sugar levels (which won’t decrease without insulin to allow such), but even that is at best grounds for a hypothesis for now.
Hopefully, more publicly-available tests will be developed soon, enabling us all to know our “insulin response type” per the proteome predictors discovered in this study, rather than having to just blindly bet on it being “normal”.
Ironically, this very response may have hidden itself for a while—if taking fats raised insulin response without raising blood sugar levels, then if blood sugar levels are the only thing being measured, all we’ll see is “took fats at dinner; blood sugars returned to normal more quickly than when taking carbs without fats”.
You can read the study in full here:
Proteomic predictors of individualized nutrient-specific insulin secretion in health and disease
Want to know more about blood sugar management?
You might like to catch up on:
- 10 Ways To Balance Your Blood Sugars
- Track Your Blood Sugars For Better Personalized Health
- How To Turn Back The Clock On Insulin Resistance
Take care!
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