Blind Spots – by Dr. Marty Makary
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From the time the US recommended not giving peanuts to infants for the first three years of life “in order to avoid peanut allergies” (whereupon non-exposure to peanuts early in life led to, instead, an increase in peanut allergies and anaphylactic incidents), to the time the US recommended not taking HRT on the strength of the claim that “HRT causes breast cancer” (whereupon the reduced popularity of HRT led to, instead, an increase in breast cancer incidence and mortality), to many other such incidents of very bad public advice being given on the strength of a single badly-misrepresented study (for each respective thing), Dr. Makary puts the spotlight on what went wrong.
This is important, because this is not just a book of outrage, exclaiming “how could this happen?!”, but rather instead, is a book of inquisition, asking “how did this happen?”, in such a way that we the reader can spot similar patterns going forwards.
Oftentimes, this is a simple matter of having a basic understanding of statistics, and checking sources to see if the dataset really supports what the headlines are claiming—and indeed, whether sometimes it suggests rather the opposite.
The style is a little on the sensationalist side, but it’s well-supported with sound arguments, good science, and clear mathematics.
Bottom line: if you’d like to improve your scientific literacy, this book is an excellent illustrative guide.
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“I Stretched Every Day For 30 Days: Game Changer!”
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How much can an unflexible person really improve in just 20 minutes per day for a month? Makari Espe finds out:
Consistency really is key
We’re supposed to stretch at least 3 times per week; for many people, the reality is often more like 2 times per year (often the 1st and 2nd of January).
So, how quickly can such neglect be turned around?
Upon initial testing, she found she was even less flexible than thought, and set about her work:
The stretches she used were from random 20-minute full body stretch videos on YouTube, of which there are many, but she used a different one each day. As she went along, she found some favorite kinds of stretching and some favorite instructors, and settled on mostly Peloton stretching videos—she also switched to evening stretching sessions instead of morning.
Along the way, she already noticed gradual improvement in mobility and reduced body tension, and after 3 weeks, it had become a habit that she started craving.
The final test? There’s a marked improvement; see the video:
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Want to learn more?
You might also like to read:
Yoga Teacher: “If I wanted to get flexible in 2025, here’s what I’d do”
Take care!
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How the HHS impacts your community’s health
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The U.S. Department of Health and Human Services is responsible for programs that impact every community in the country. But most Americans aren’t aware of the department’s scope.
“Most of the power in the agency, most of the administrative authority comes from laws that Congress has passed,” former HHS Secretary Kathleen Sebelius told NPR. She added that the HHS secretary “could redefine terms that had a huge impact on people. And that could be done all administratively, not by going back to Congress.”
HHS is comprised of 13 agencies, all of which play an important role in promoting the health of all Americans. These are just some of the ways that HHS affects people’s lives and health.
Vaccines
One of HHS’s most salient roles is developing, approving, and monitoring vaccines after they are on the market. The National Institutes of Health funds and conducts research to develop new vaccines and improve existing ones. The NIH’s Vaccine Research Center spearheads research to develop vaccines against deadly diseases like HIV/AIDS, malaria, and tuberculosis.
The Food and Drug Administration is responsible for overseeing clinical trials that test product safety and effectiveness, approving new vaccines, and monitoring the safety of all vaccines before and after approval. In conjunction with the Centers for Disease Control and Prevention, the FDA also manages the national surveillance systems that record and flag potential vaccine side effects.
In addition to safety monitoring, the CDC conducts research on vaccine safety and effectiveness and issues vaccination guidance. The agency’s recommended immunization schedule guides school and child care vaccination requirements and health care provider recommendations nationwide.
Although the CDC does not have the authority over school and childcare vaccination requirements at the state level, changes to the agency’s recommendations could have wide-ranging impacts.
“If this recommendation changes, there’s downstream effects, like insurance companies could stop covering them. And adding cost could easily deter uptake,” epidemiologist and creator of the Your Local Epidemiologist newsletter Katelyn Jetelina told PBS.
However, CDC vaccine recommendations are just that: recommendations. The agency cannot dictate, for example, vaccine requirements for school enrollment. Those standards are set at the state level, with the possible exception during a national public health emergency.
Drug safety
The FDA oversees all clinical trials in the United States. Every prescription drug and many medical products undergo a rigorous, closely regulated, multistep trial to test their safety and effectiveness. At the end of that process, the FDA determines whether a drug meets its standards for approval. Without FDA approval, a drug cannot be sold in the U.S.
Like with vaccines, the FDA monitors potential safety concerns related to over-the-counter and prescription medications, medical devices, and other products the agency regulates. Health care providers, FDA-regulated companies, and patients can report suspected safety issues to the agency, which evaluates each report for further investigation.
The FDA also alerts the public to safety concerns related to medical products by releasing safety notices, adding warning labels, and issuing drug recalls.
Pandemic and public health emergency response
Several HHS agencies are tasked with preventing, preparing for, and responding to disease outbreaks. This responsibility includes tracking potentially dangerous infectious diseases in the U.S. and globally, developing pandemic response strategies, and issuing guidance to contain ongoing outbreaks.
Both the CDC and FDA inform the public about public health concerns, including pandemics. The Administration for Strategic Preparedness and Response works with communities, medical facilities, local and state governments, and industry partners to enhance responses to disasters and public health emergencies.
The CDC also tracks pathogens like the flu, norovirus, and sexually transmitted infections to better understand where diseases are spreading, how they are evolving, and how best to prepare for outbreaks.
In the event of a public health emergency, the CDC may issue guidance on how to stay safe and minimize health impacts. For example, in January, the agency released tips on how to protect against smoke during the wildfires affecting southern California and how to avoid frostbite and hypothermia, as extreme cold weather affected much of the country.
The FDA can issue emergency use authorizations, which allow the use of “unapproved medical products or unapproved uses of approved medical products … to diagnose, treat, or prevent serious or life-threatening diseases … when certain criteria are met” during public health emergencies. These authorizations help ensure that the standard FDA approval process is not a barrier to the public receiving lifesaving medical products, such as authorizing specific vaccines during a pandemic.
Food and water safety
The FDA, along with the U.S. Department of Agriculture, plays an important role in regulating food safety. The agency approves and monitors the safety of food additives, like sweeteners, dyes, and preservatives. It also regulates how food is prepared, packaged, and stored, including conducting inspections of food facilities and farms.
FDA food safety testing detects dangerous foodborne illnesses like salmonella and E. coli. For example, in late December 2024, the FDA began testing raw (unpasteurized) milk products for bird flu contamination. The CDC investigates outbreaks of foodborne illnesses and, along with the FDA and USDA, provides the public with information about food safety.
The FDA also regulates most food labels, including nutrition facts, ingredient lists, and health claims on food packaging. In January, the agency proposed new front-of-package nutrition labels that highlight sugar, fat, and sodium content in packaged food products.
HHS and the USDA are responsible for updating the Dietary Guidelines for Americans, which are updated every five years. These guidelines are the basis of all federal food assistance programs for children, older adults, and low-income families.
HHS sets the guidelines for the maximum fluoride level in drinking water and periodically makes recommendations about fluoride levels. However, the department has no authority to require or ban fluoridation, which is regulated at the state and local level. U.S. cities began adding fluoride to drinking water in the 1940s to improve dental health and reduce cavities by 25 percent.
Health care access
The HHS secretary regulates the Centers for Medicare & Medicaid Services, which provides health insurance to adults 65 and older, people with disabilities, low-income families, and eligible children through the Children’s Health Insurance Program. Together, Medicare, Medicaid, and CHIP insure over 145 million Americans, or roughly 42 percent of the U.S. population. Changes to either of these programs could impact health care access and quality for millions of Americans.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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The Sweet Truth About Glycine
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Make Your Collagen Work Better
This is Dr. James Nicolantonio. He’s a doctor of pharmacy, and a research scientist. He has a passion for evidence-based nutrition, and has written numerous books on the subject.
Controversy! Dr. DiNicolatonio’s work has included cardiovascular research, in which field he has made the case for increasing (rather than decreasing) the recommended amount of salt in our diet. This, of course, goes very much against the popular status quo.
We haven’t reviewed that research so we won’t comment on it here, but we thought it worth a mention as a point of interest. We’ll investigate his claims in that regard another time, though!
Today, however, we’ll be looking at his incisive, yet not controversial, work pertaining to collagen and glycine.
A quick recap on collagen
We’ve written about collagen before, and its importance for maintaining… Well, pretty much most of our body, really, buta deficiency in collagen can particularly weaken bones and joints.
On a more surface level, collagen’s also important for healthy elastic skin, and many people take it for that reason alone,
Since collagen is found only in animals, even collagen supplements are animal-based (often marine collagen or bovine collagen). However, if we don’t want to consume those, we can (like most animals) synthesize it ourselves from the relevant amino acids, which we can get from plants (and also laboratories, in some cases).
You can read our previous article about this, here:
We Are Such Stuff As Fish Are Made Of
What does he want us to know about collagen?
We’ll save time and space here: first, he’d like us to know the same as what we said in our article above
However, there is also more:
Let’s assume that your body has collagen to process. You either consumed it, or your body has synthesized it. We’ll skip describing the many steps of collagen synthesis, fascinating as that is, and get to the point:
When our body weaves together collagen fibrils out of the (triple-helical) collagen molecules…
- the cross-linking of the collagen requires lysyl oxidase
- the lysyl oxidase (which we make inside us) deanimates some other amino acids yielding aldehydes that allow the stable cross-links important for the high tensile strength of collagen, but to do that, it requires copper
- in order to use the copper it needs to be in its reduced cuprous form and that requires vitamin C
- but moving it around the body requires vitamin A
So in other words: if you are taking (or synthesizing) collagen, you also need copper and vitamins A and C.
However! Just to make things harder, if you take copper and vitamin C together, it’ll reduce the copper too soon in the wrong place.
Dr. DiNicolantonio therefore advises taking vitamin C after copper, with a 75 minutes gap between them.
What does he want us to know about glycine?
Glycine is one of the amino acids that makes up collagen. Specifically, it makes up every third amino acid in collagen, and even more specifically, it’s also the rate-limiting factor in the formation of glutathione, which is a potent endogenous (i.e., we make it inside us) antioxidant that works hard to fight inflammation inside the body.
What this means: if your joints are prone to inflammation, being glycine-deficient means a double-whammy of woe.
As well as being one of the amino acids most key to collagen production, glycine has another collagen-related role:
First, the problem: as we age, glycated collagen accumulates in the skin and cartilage (that’s bad; there is supposed to be collagen there, but not glycated).
More on glycation and what it is and why it is so bad:
Are You Eating Advanced Glycation End-Products? The Trouble Of The AGEs
Now, the solution: glycine suppresses advanced glycation end products, including the glycation of collagen.
See for example:
With these three important functions of glycine in mind…
Dr. DiNicolantonio therefore advises getting glycine at a dose of 100mg/kg/day. So, if you’re the same size as this rather medium-sized writer, that means 7.2g/day.
Where can I get it?
Glycine is found in many foods, including gelatin for those who eat that, eggs for the vegetarians, and spinach for vegans.
However, if you’d like to simply take it as a supplement, here’s an example product on Amazon
(the above product is not clear whether it’s animal-derived or not, so if that’s important to you, shop around. This writer got some locally that is certified vegan, but is in Europe rather than N. America, which won’t help most of our subscribers)
Note: pure glycine is a white crystalline powder that has the same sweetness as glucose. Indeed, that is how it got its name, from the Greek “γλυκύς”, pronounced /ɡly.kýs/, meaning “sweet”. Yes, same etymology as glucose.
So don’t worry that you’ve been conned if you order it and think “this is sugar!”; it just looks and tastes the same.
That does mean you should buy from a reputable source though, as a con would be very easy!
this does also mean that if you like a little sugar/sweetener in your tea or coffee, glycine can be used as a healthy substitute.
If you don’t like sweet tastes, then, condolences. This writer pours two espresso coffees (love this decaffeinated coffee that actually tastes good), puts the glycine in the first, and then uses the second to get rid of the sweet taste of the first. So that’s one way to do it.
Enjoy (if you can!)
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What You Don’t Know Can Kill You
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Knowledge Is Power!
This is Dr. Simran Malhotra. She’s triple board-certified (in lifestyle medicine, internal medicine, and palliative care), and is also a health and wellness coach.
What does she want us to know?
Three things:
Wellness starts with your mindset
Dr. Malhotra shifted her priorities a lot during the initial and perhaps most chaotic phase of the COVID pandemic:
❝My husband, a critical care physician, was consumed in the trenches of caring for COVID patients in the ICU. I found myself knee-deep in virtual meetings with families whose loved ones were dying of severe COVID-related illnesses. Between the two of us, we saw more trauma, suffering, and death, than we could have imagined.
The COVID-19 pandemic opened my eyes to how quickly life can change our plans and reinforced the importance of being mindful of each day. Harnessing the power to make informed decisions is important, but perhaps even more important is focusing on what is in our control and taking action, even if it is the tiniest step in the direction we want to go!❞
~ Dr. Simran Malhotra
We can only make informed decisions if we have good information. That’s one of the reasons we try to share as much information as we can each day at 10almonds! But a lot will always depend on personalized information.
There are one-off (and sometimes potentially life-saving) things like health genomics:
The Real Benefit Of Genetic Testing
…but also smaller things that are informative on an ongoing basis, such as keeping track of your weight, your blood pressure, your hormones, and other metrics. You can even get fancy:
Track Your Blood Sugars For Better Personalized Health
Lifestyle is medicine
It’s often said that “food is medicine”. But also, movement is medicine. Sleep is medicine. In short, your lifestyle is the most powerful medicine that has ever existed.
Lifestyle encompasses very many things, but fortunately, there’s an “80:20 rule” in play that simplifies it a lot because if you take care of the top few things, the rest will tend to look after themselves:
These Top Few Things Make The Biggest Difference To Overall Health
Gratitude is better than fear
If we receive an unfavorable diagnosis (and let’s face it, most diagnoses are unfavorable), it might not seem like something to be grateful for.
But it is, insofar as it allows us to then take action! The information itself is what gives us our best chance of staying safe. And if that’s not possible e.g. in the worst case scenario, a terminal diagnosis, (bearing in mind that one of Dr. Malhotra’s three board certifications is in palliative care, so she sees this a lot), it at least gives us the information that allows us to make the best use of whatever remains to us.
See also: Managing Your Mortality
Which is very important!
…and/but possibly not the cheeriest note on which to end, so when you’ve read that, let’s finish today’s main feature on a happier kind of gratitude:
How To Get Your Brain On A More Positive Track (Without Toxic Positivity)
Want to hear more from Dr. Malhotra?
Showing how serious she is about how our genes do not determine our destiny and knowledge is power, here she talks about her “previvor’s journey”, as she puts it, with regard to why she decided to have preventative cancer surgery in light of discovering her BRCA1 genetic mutation:
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Fix Your Upper Back With These Three Steps
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When it comes to back pain, the lower back gets a lot of attention, but what about when it’s nearer the neck and shoulders?
Reaching for better health
In this short video, Liv describes and shows three exercises:
Exercise 1: Thoracic Pullover (Dumbbell Pullover)
Purpose: Improves overhead reach and shoulder mobility.
Equipment: light weight, yoga block, or foam roller.
Steps:- Lie on the floor with the foam roller/block beneath the upper back.
- Hold the weight in both hands, arms extended upward.
- Inhale deeply and reach the weight toward the ceiling.
- Exhale and arc your spine over the block, moving the weight backward.
- Keep core tension to maintain a neutral lower back position.
- Perform 10 repetitions.
Exercise 2: Rotational Mobility Stretch
Purpose: enhances torso rotation, core strength, and hip mobility.
Equipment: none (or a mat)
Steps:- Lie on your side with knees stacked at 90° and arms extended in front.
- Hold a weight in the top hand.
- Inhale and lift the top arm toward the ceiling, extending the shoulder blade.
- Exhale and twist your torso, allowing the arm to move toward the floor.
- Modify by extending the bottom leg for a deeper twist if needed.
- Perform 6 reps per side, switching legs and repeating on the other side.
Exercise 3: Doorway/Pole Side Stretch
Purpose: targets multiple areas for a deep, satisfying stretch.
Equipment: door frame, pole, or wall.
Steps:- Stand at arm’s length from the wall or frame.
- Cross the outer leg (furthest from the wall) behind the inner leg.
- Place the closest hand on the wall and reach the other arm overhead.
- Grip the wall or frame with the top hand, pressing away with the bottom hand.
- Lean into a banana-shaped curve and rotate your chest upward for a deeper stretch.
- Hold for 20–30 seconds per side and repeat 2–3 times.
For more on all of these, plus visual demonstrations, enjoy:
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Want to learn more?
You might also like:
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Hormones & Health, Beyond The Obvious
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Wholesome Health
This is Dr. Sara Gottfried, who some decades ago got her MD from Harvard and specialized as an OB/GYN at MIT. She’s since then spent the more recent part of her career educating people (mostly: women) about hormonal health, precision, functional, & integrative medicine, and the importance of lifestyle medicine in general.
What does she want us to know?
Beyond “bikini zone health”
Dr. Gottfried urges us to pay attention to our whole health, in context.
“Women’s health” is often thought of as what lies beneath a bikini, and if it’s not in those places, then we can basically treat a woman like a man.
And that’s often not actually true—because hormones affect every living cell in our body, and as a result, while prepubescent girls and postmenopausal women (specifically, those who are not on HRT) may share a few more similarities with boys and men of similar respective ages, for most people at most ages, men and women are by default quite different metabolically—which is what counts for a lot of diseases! And note, that difference is not just “faster” or “slower””, but is often very different in manner also.
That’s why, even in cases where incidence of disease is approximately similar in men and women when other factors are controlled for (age, lifestyle, medical history, etc), the disease course and response to treatment may vary considerable. For a strong example of this, see for example:
- The well-known: Heart Attack: His & Hers ← most people know these differences exist, but it’s always good to brush up on what they actually are
- The less-known: Statins: His & Hers ← most people don’t know these differences exist, and it pays to know, especially if you are a woman or care about one
Nor are brains exempt from his…
The female brain (kinda)
While the notion of an anatomically different brain for men and women has long since been thrown out as unscientific phrenology, and the idea of a genetically different brain is… Well, it’s an unreliable indicator, because technically the cells will have DNA and that DNA will usually (but not always; there are other options) have XX or XY chromosomes, which will usually (but again, not always) match apparent sex (in about 1/2000 cases there’s a mismatch, which is more common than, say, red hair; sometimes people find out about a chromosomal mismatch only later in life when getting a DNA test for some unrelated reason), and in any case, even for most of us, the chromosomal differences don’t count for much outside of antenatal development (telling the default genital materials which genitals to develop into, though this too can get diverted, per many intersex possibilities, which is also a lot more common than people think) or chromosome-specific conditions like colorblindness…
The notion of a hormonally different brain is, in contrast to all of the above, a reliable and easily verifiable thing.
See for example:
Alzheimer’s Sex Differences May Not Be What They Appear
Dr. Gottfried urges us to take the above seriously!
Because, if women get Alzheimer’s much more commonly than men, and the disease progresses much more quickly in women than men, but that’s based on postmenopausal women not on HRT, then that’s saying “Women, without women’s usual hormones, don’t do so well as men with men’s usual hormones”.
She does, by the way, advocate for bioidentical HRT for menopausal women, unless contraindicated for some important reason that your doctor/endocrinologist knows about. See also:
Menopausal HRT: A Tale Of Two Approaches (Bioidentical vs Animal)
The other very relevant hormone
…that Dr. Gottfried wants us to pay attention to is insulin.
Or rather, its scrubbing enzyme, the prosaically-named “insulin-degrading enzyme”, but it doesn’t only scrub insulin. It also scrubs amyloid beta—yes, the same that produces the amyloid beta plaques in the brain associated with Alzheimer’s. And, there’s only so much insulin-degrading enzyme to go around, and if it’s all busy breaking down excess insulin, there’s not enough left to do the other job too, and thus can’t break down amyloid beta.
In other words: to fight neurodegeneration, keep your blood sugars healthy.
This may actually work by multiple mechanisms besides the amyloid hypothesis, by the way:
The Surprising Link Between Type 2 Diabetes & Alzheimer’s
Want more from Dr. Gottfried?
You might like this interview with Dr. Gottfried by Dr. Benson at the IMCJ:
Integrative Medicine: A Clinician’s Journal | Conversations with Sara Gottfried, MD
…in which she discusses some of the things we talked about today, and also about her shift from a pharmaceutical-heavy approach to a predominantly lifestyle medicine approach.
Enjoy!
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