Bone on Bone – by Dr. Meredith Warner
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What this is not: a book about one specific condition, injury, or surgery.
What this is: a guide to dealing with the common factors of many musculoskeletal conditions, inflammatory diseases, and their consequences.
Dr. Warner takes the opportunity to address the whole patient—presumably: the reader, though it could equally be a reader’s loved one, or even a reader’s patient, insofar as this book will probably be read by doctors also.
She takes an “inside-out and outside-in” approach; that is to say, addressing the problem from as many vectors as reasonably possible—including supplements, diet, dietary habits (things like intermittent fasting etc), exercise, and even sleep. And yes, she knows how difficult those latter items can be, and addresses them not merely with a “but it’s important” but also with practical advice.
As an orthopedic surgeon, she’s not a fan of surgery, and counsels the reader to avoid that if reasonably possible. She also talks about how many people in the US are encouraged to have MRI scans for financial reasons (as in, they can be profitable for the doctor/institution), and then any abnormality is used as justification for surgery, to backwards-justify the use of the MRI, even if the abnormality is not actually the cause of the pain.
Noteworthily, humans in general are a typically a pile of abnormalities in a trenchcoat. Our propensity to mutation has made us one of the most adaptable species on the planet, yet many would have us pretend that the insides of people look like they do in textbooks, or else are wrong. The reality is not so, and Dr. Warner rightly shows this for what it is.
Bottom line: if you or a loved one are suffering from, or at risk of, musculoskeletal and/or inflammatory conditions, this is a top-tier book for having a much easier time of it.
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Beat Sugar Addiction Now! – by Dr. Jacob Teitelbaum & Chrystle Fiedler
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Sugar isn’t often thought of as an addiction in the same category as alcohol or nicotine, but it’s actually very similar in some ways…
A bold claim, but: in each case, it has to do with dopamine responses to something that has:
- an adverse effect on our health,
- a quickly developed tolerance to same,
- and unpleasant withdrawal symptoms when quitting.
However, not all sugar addictions are created equal, and Dr. Teitelbaum lays four different types of sugar addiction out for us:
- Most related to “I need to perform and I need to perform now”
- Most related to “I just need something to get me through one more stressful day, again, just like every day before it”
- Most related to “ate too much sugar because of the above, and now a gut overgrowth of C. albicans is at the wheel”
- Most related to “ate too much sugar because of the above, and now insulin resistance is a problem that perpetuates itself too”
Of course, these may overlap, and indeed, they tend to stack cumulatively as time goes by.
However, Dr. Teitelbaum notes that as readers we may recognize ourselves as being at a particular point in the above, and there are different advices for each of them.
You thought it was just going to be about going cold turkey? Nope!
Instead, a multi-vector approach is recommended, including adjustments to sleep, nutrition, immune health, hormonal health, and more.
In short: if you’ve been trying to to kick the “White Death” habit as Gloria Swanson called it (sugar, that is, not the WW2 Finnish sniper of the same name—we can’t help you with that one), then this book is really much more helpful than others that take the “well, just don’t eat it, then” approach!
Pick up your copy of Beat Sugar Addiction Now from Amazon, and start your journey!
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Hearty Healthy Ragù
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Ragù is a traditional Italian meaty sauce with tomato, and is the base for a number of other Italian dishes. It can be enjoyed as-is, or with very minor modifications can be turned into a Bolognese sauce or a lasagna filling or various other things. Our variations from tradition are mainly twofold here: we’re using nutrition-packed lentils instead of meat (but with a couple of twists that make them meatier), and we’re not using wine.
Traditionally, red wine is used in a ragù (white wine if you want to make it into a Bolognese sauce, by the way), but with all we’re doing it’s not necessary. If you want to add a splash of wine, we’re not going to call that a healthy ingredient, but we’re also not the boss of you
You will need
- 1 large onion (or equivalent small ones), chopped roughly
- 1 bulb garlic (or to your heart’s content), chopped finely or crushed
- 4 large tomatoes, chopped (or 2 cans chopped tomatoes)
- 1 tube (usually about 7 oz) tomato purée
- 1 cup brown lentils (green lentils will do if you can’t get brown)
- 1 tbsp chia seeds
- 1 tbsp black pepper, cracked or coarse ground
- 1 bunch fresh basil, finely chopped (or 1 tbsp, freeze-dried)
- 1 bunch fresh oregano, finely chopped (or 1 tbsp, freeze-dried)
- 1 tbsp nutritional yeast (failing that, 1 tbsp yeast extract, yes, even if you don’t like it, we promise it won’t taste like it once it’s done; it just makes the dish meatier in taste and also adds vitamin B12)
- 1 tsp cumin, ground (note that this one was tsp, not tbsp like the others)
- 1 tsp MSG, or 2 tsp low-sodium salt
- 4 cups water
- Olive oil for frying (ideally Extra Virgin, but so long as it’s at least marked virgin olive oil and not cut with other oils, that’s fine)
- Parsley, chopped, to garnish
Method
(we suggest you read everything at least once before doing anything)
1) Put the lentils in a small saucepan, or if you have one, a rice cooker (the rice cooker is better; works better and requires less attention), adding the chia seeds, MSG or low sodium salt, and nutritional yeast (or yeast extract). as well as the cumin. Add 4 cups boiling water and turn on the heat to cook them. This will probably take about 15–20 minutes; you want the lentils to be soft; a tiny bit past al dente, but not so far as mushy.
2) Fry the onion in some olive oil in a big pan (everything is going in here eventually if the pan is big enough; if it isn’t, you’ll need to transfer to a bigger pan in a bit). Once they’re nearly done, throw in the garlic too. If the lentils aren’t done yet, take the onions and garlic off the heat while you wait. After a few times of doing this recipe, you’ll be doing everything like clockwork and it’ll all align perfectly.
3) Drain the lentils (if all the water wasn’t absorbed; again, after doing it a few times, you’ll just use the right amount of water for your apparatus) but don’t rinse them (remember you put seasonings in here!), and add them to the pan with the onions and garlic; add a splash more olive oil if necessary, and stir until all the would-be-excess fat is absorbed into the lentils.
Note: the excess fat to be absorbed by the lentils was a feature not a bug; we wanted a little fat in the lentils! Makes the dish meatier and tastier, as well as more nutrient-dense.
4) add the tomatoes and tomato purée, stirring them in thoroughly; add the basil and oregano too and stir those in as well. Set it on a low heat for at least 10–15 minutes, stirring occasionally to let the flavors blend.
(if you happen to be serving pasta with it, then the time it takes to boil water and cook the pasta is a good time for the flavors to do their thing)
5) take it off the heat, and add the parsley garnish. It’s done!
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- What Is The Mediterranean Diet, Anyway?
- Four Ways To Upgrade The Mediterranean
- Eat More (Of This) For Lower Blood Pressure ← one more reason for the brown lentils today
- Chia: The Tiniest Seeds With The Most Value
- Black Pepper’s Impressive Anti-Cancer Arsenal
- The Many Health Benefits of Garlic
- Olive Oil: Is “Extra Virgin” Worth It?
Take care!
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Beyond “Make Your Bed”—life lessons from experience
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Beyond “Make Your Bed”—life lessons from experience
This is Admiral William H. McRaven, a former United States Navy four-star admiral who served as the ninth commander of the United States Special Operations Command.
So, for those of us whose day-to-day lives don’t involve coordinating military operations, what does he have to offer?
Quick note: 10almonds’ mission statement is “to make health and productivity crazy simple”.
We tend to focus on the health side of this, and in the category of productivity, it’s often what most benefits our mental health.
We’re writing less for career-driven technopreneurs in the 25–35 age bracket and more for people with a more holistic view of productivity and “a good life well-lived”.
So today’s main feature is more in that vein!
Start each day with an accomplishment
McRaven famously gave a speech (and wrote a book) that began with the advice, “make your bed”. The idea here doesn’t have to be literal (if you’ll pardon the pun). Indeed, if you’re partnered, then depending on schedules and habits, it could be you can’t (sensibly) make your bed first thing because your partner is still in it. But! What you can do is start the day with an accomplishment—however small. A short exercise routine is a great example!
Success in life requires teamwork
We’re none of us an island (except in the bathtub). The point is… Nobody can do everything alone. Self-sufficiency is an illusion. You can make your own coffee, but could you have made the coffee machine, or even the cup? How about, grown the coffee? Transported it? So don’t be afraid to reach out for (and acknowledge!) help from others. Teamwork really does make the dream work.
It’s what’s inside that counts
It’s a common trap to fall into, getting caught up the outside appearance of success, rather than what actually matters the most. We need to remember this when it comes to our own choices, as well as assessing what others might bring to the table!
A setback is only permanent if you let it be
No, a positive attitude won’t reverse a lifelong degenerative illness, for example. But what we can do, is take life as comes, and press on with the reality, rather than getting caught up in the “should be”.
Use failure to your advantage
Learn. That’s all. Learn, and improve.
Be daring in life
To borrow from another military force, the SAS has the motto “Who dares, wins”. Caution has it place, but if we’ve made reasonable preparations*, sometimes being bold is the best (or only!) way forward.
*Meanwhile the Parachute Regiment, from which come 80% of all SAS soldiers, has the motto “Utrinque paratus”, “prepared on all sides”.
Keep courage close
This is about not backing down when we know what’s right and we know what we need to do. Life can be scary! But if we don’t overcome our fears, they can become self-realizing.
Writer’s note: a good example of this is an advice I sometimes gave during my much more exciting (military) life of some decades ago, and it pertains to getting into a knife-fight (top advice for civilians: don’t).
But, if you’re in one, you need to not be afraid of getting cut.
Because if you’re not afraid of getting cut, you will probably get cut.
But if you are afraid of getting cut, you will definitely get cut.
Hopefully your life doesn’t involve knives outside of the kitchen (mine doesn’t, these days, and I like it), but the lesson applies to other things too.
Sometimes the only way out is through.
Be your best at your worst
Sometimes life is really, really hard. But if we allow those moments to drive us forwards, they’re also a place we can find more strength than we ever knew we had.
Keep on swimming
It’s said that the majority in life is about showing up—and often it is. But you have to keep showing up, day after day. So make what you’re doing sustainable for you, and keep on keeping on.
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Gymnema Sylvestre: The “Sugar Destroyer”
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The Leaf That Stops Sugar From “Working”
Gymnema sylvestre, whose botanical name in Greek and Latin means “naked thread of the woods”, and is in various Indian languages referred to be names that translate as “sugar destroyer”, has the most prosaic name in Australia: the Australian cowplant.
In English it’s mostly called by the Greek “gymnema” though, so that’s what we’ll call it here.
You may be wondering: “the sugar destroyer?”
And no, it doesn’t actually destroy sugar. But it does do quite a bit of sugar-related stuff. Here’s the science for it…
Blocks sugar receptors in your tongue
This is what it is most well-known for, and it is a topical effect, so you won’t get this from a pill, but you will get this from the leaves, or from drinking it as a tea made from the leaves.
The effect last several hours, during which time your ability to taste sweetness will be reduced, which not only makes sweet foods less appealing because they’re no longer tasting sweet, but also, once you get used to it, when you actually do taste sweet foods, they will now taste too sweet.
So, it doesn’t just temporarily curb cravings; it offers a long-term escape from such, too.
You may be wondering: “what about artificially sweetened foods and drinks?”
And the answer is: yes, it blocks perception of the sweetness of those too:
Effects of sweetness perception and caloric value of a preload on short term intake ← this study used gymnema as the sweetness-blocker, testing sugary drinks, aspartame-sweetened drinks, and unsweetened drinks
Blocks sugar receptors in the gut, too
Long story short: this slows down the absorption of sugars from the gut, thus resulting in a gentler blood sugar curve, minimizing spikes, and (because of the body’s use of blood sugars as it goes) overall lower blood sugar levels.
Want the long version? Here it is:
Benefits beyond sugar-blocking
It also prevents the accumulation of triglycerides in muscles and the liver, as well as decreasing fatty acid accumulation in the blood. In simpler terms: it lowers LDL (“bad” cholesterol”, including VLDL). As a bonus, it increases HDL (“good” cholesterol) while it’s at it.
The vast majority of the studies for this are on rats and mice though, of which you can see very many listed in the “similar articles” under this systematic review of studies:
A systematic review of Gymnema sylvestre in obesity and diabetes management
We did find one good quality human RCT, testing gymnema along with several other treatments (they found that each worked, and/but using a combination yielded the best results):
(the title says “on weight loss”, but rest assured the study also gives information about its effects on total cholesterol, LDL, HDL, overall triglycerides, and serum leptin levels, as well as excretion of urinary fat metabolites—suffice it to say, they were thorough)
Is it safe?
It has a good safety profile in general, but if you are diabetic, proceed with caution and discuss it with your endocrinologist, since it will be affecting your blood sugar levels and insulin levels. While it’s probably not enough to replace metformin or similar, it is enough that taking it carelessly could result in an unexpected hypo.
Similarly, if you have any heart condition and especially if you are being treated for that with medication, do speak with your cardiologist since its antilipemic action could potentially lower your cholesterol more than expected, and doctors don’t like surprises.
As ever, no list of contraindications will be exhaustive, and we can’t speak for your specific situation, so checking with your pharmacist/doctor is always a good idea.
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon ← we’ve linked to a tea version of it so you can enjoy the full effects; if you prefer capsule form, you can click through from there to shop around 😎
Enjoy!
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What is a virtual emergency department? And when should you ‘visit’ one?
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For many Australians the emergency department (ED) is the physical and emblematic front door to accessing urgent health-care services.
But health-care services are evolving rapidly to meet the population’s changing needs. In recent years, we’ve seen growing use of telephone, video, and online health services, including the national healthdirect helpline, 13YARN (a crisis support service for First Nations people), state-funded lines like 13 HEALTH, and bulk-billed telehealth services, which have helped millions of Australians to access health care on demand and from home.
The ED is similarly expanding into new telehealth models to improve access to emergency medical care. Virtual EDs allow people to access the expertise of a hospital ED through their phone, computer or tablet.
All Australian states and the Northern Territory have some form of virtual ED at least in development, although not all of these services are available to the general public at this stage.
So what is a virtual ED, and when is it appropriate to consider using one?
Shutterstock/Nils Versemann How does a virtual ED work?
A virtual ED is set up to mirror the way you would enter the physical ED front door. First you provide some basic information to administration staff, then you are triaged by a nurse (this means they categorise the level of urgency of your case), then you see the ED doctor. Generally, this all takes place in a single video call.
In some instances, virtual ED clinicians may consult with other specialists such as neurologists, cardiologists or trauma experts to make clinical decisions.
A virtual ED is not suitable for managing medical emergencies which would require immediate resuscitation, or potentially serious chest pains, difficulty breathing or severe injuries.
A virtual ED is best suited to conditions that require immediate attention but are not life-threatening. These could include wounds, sprains, respiratory illnesses, allergic reactions, rashes, bites, pain, infections, minor burns, children with fevers, gastroenteritis, vertigo, high blood pressure, and many more.
People with these sorts of conditions and concerns may not be able to get in to see a GP straight away and may feel they need emergency advice, care or treatment.
When attending the ED, they can be subject to long wait times and delayed specialist attention because more serious cases are naturally prioritised. Attending a virtual ED may mean they’re seen by a doctor more quickly, and can begin any relevant treatment sooner.
From the perspective of the health-care system, virtual EDs are about redirecting unnecessary presentations away from physical EDs, helping them be ready to respond to emergencies. The virtual ED will not hesitate in directing callers to come into the physical ED if staff believe it is an emergency.
The doctor in the virtual ED may also direct the patient to a GP or other health professional, for example if their condition can’t be assessed visually, or if they need physical treatment.
The results so far
Virtual EDs have developed significantly over the past three years, predominantly driven by the COVID pandemic. We are now starting to slowly see assessments of these services.
A recent evaluation my colleagues and I did of Queensland’s Metro North Virtual ED found roughly 30% of calls were directed to the physical ED. This suggests 70% of the time, cases could be managed effectively by the virtual ED.
Preliminary data from a Victorian virtual ED indicates it curbed a similar rate of avoidable ED presentations – 72% of patients were successfully managed by the virtual ED alone. A study on the cost-effectiveness of another Victorian virtual ED suggested it has the potential to generate savings in health-care costs if it prevents physical ED visits.
Only 1.2% of people assessed in Queensland’s Metro North Virtual ED required unexpected hospital admission within 48 hours of being “discharged” from the virtual ED. None of these cases were life-threatening. This indicates the virtual ED is very safe.
The service experienced an average growth rate of 65% each month over a two-year evaluation period, highlighting increasing demand and confidence in the service. Surveys suggested clinicians also view the virtual ED positively.
The right advice could tell you whether you need to visit hospital in person or not. 1st footage/Shutterstock What now?
We need further research into patient outcomes and satisfaction, as well as the demographics of those using virtual EDs, and how these measures compare to the physical ED across different triage categories.
There are also challenges associated with virtual EDs, including around technology (connection and skills among patients and health professionals), training (for health professionals) and the importance of maintaining security and privacy.
Nonetheless, these services have the potential to reduce congestion in physical EDs, and offer greater convenience for patients.
Eligibility differs between different programs, so if you want to use a virtual ED, you may need to check you are eligible in your jurisdiction. Most virtual EDs can be accessed online, and some have direct phone numbers.
Jaimon Kelly, Senior Research Fellow in Telehealth delivered health services, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How To Stay In Shape At 70
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Questions and Answers at 10almonds
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! 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
I have a question: what are the pros and cons of older people (60+) taking creatine every day?
It depends what else you’re doing, as creatine mostly helps the muscles recover after exercise. So:
- iff you’re doing resistance training (such as weights or bodyweight training), or HIIT (High Intensity Interval Training), then creatine monohydrate may help you keep at that and keep doing well.
- if you’re just doing light-to-moderate exercises, you might not get much benefit from creatine!
The topic merits diving deeper though, so we’ll queue that for one of our “Research Review Monday” days!
I wanted to ask if you think marine collagen is decent to take. I’ve heard a lot of bad press about it
We don’t know what you’ve heard, but generally speaking it’s been found to be very beneficial to bones, joints, and skin! We wrote about it quite recently on a “Research Review Monday”:
See: We Are Such Stuff As Fish Are Made Of
Natural alternatives to medication for depression?
Great question! We did a mean feature a while back, but we definitely have much more to say! We’ll do another main feature soon, but in the meantime, here’s what we previously wrote:
See: The Mental Health First-Aid That You’ll Hopefully Never Need
^This covers not just the obvious, but also why the most common advice is not helpful, and practical tips to actually make manageable steps back to wellness, on days when “literally just survive the day” is one’s default goal.
I am now in the “aging” population. A great concern for me is Alzheimers. My father had it and I am so worried. What is the latest research on prevention?
One good thing to note is that while Alzheimer’s has a genetic component, it doesn’t appear to be hereditary per se. Still, good to be on top of these things, and it’s never too early to start with preventive measures!
You might like a main feature we did on this recently:
See: How To Reduce Your Alzheimer’s Risk
Side effects of statins, are they worth it? Depression, are antidepressants worth it?
About statins, that depends a lot on you, your circumstances, and—as it happens—your gender. We covered this in a main feature recently, but a short answer is: for most people, they may not be the best first choice, and could even make things worse. For some people, however, they really are just what’s needed.
- Factors that make them more likely better for you: being a man, or having atherosclerosis
- Factors that make them more likely worse for you: being a woman in general
Check out the main feature we did: Statins: His & Hers?
As for antidepressants? That depends a lot on you, your physiology, your depression, your circumstances, and more. We’ll definitely do a main feature on that sometime soon, as there’s a lot that most people don’t know!
I am interested in the following: Aging, Exercise, Diet, Relationships, Purpose, Lowering Stress
You’re going to love our Psychology Sunday editions of 10almonds!
You may particularly like some of these:
- Seriously Useful Communication Skills! ← this is about relationship stuff
- Lower Your Cortisol! (Here’s Why & How) ← about “the stress hormone”
- How To Set Your Anxiety Aside ← these methods work for stress too
(This coming Psychology Sunday will have a feature specifically on stress, so do make sure to read that when it comes out!)
Hair growth strategies for men combing caffeine and minoxidil?
Well, the strategy for that is to use caffeine and minoxidil! Some more specific tips, though:
- Both of those things need to be massaged (gently!) into your scalp especially around your hairline.
- In the case of caffeine, that boosts hair growth. No extra thought or care needed for that one.
- In the case of minoxidil, it reboots the hair growth cycle, so if you’ve only recently started, don’t be surprised (or worried) if you see more shedding in the first three months. It’s jettisoning your old hairs because new ones were just prompted (by the minoxidil) to start growing behind them. So: it will get briefly worse before it gets better, but then it’ll stay better… provided you keep using it.
- If you’d like other options besides minoxidil, finasteride is a commonly prescribed oral drug that blocks the conversion of testosterone to DHT, which latter is what tells your hairline to recede.
- If you’d like other options besides prescription drugs, saw palmetto performs comparably to finasteride (and works the same way).
- You may also want to consider biotin supplementation if you don’t already enjoy that
- Consider also using a dermaroller on your scalp. If you’re unfamiliar, this is a device that looks like a tiny lawn aerator, with many tiny needles, and you roll it gently across your skin.
- It can be used for promoting hair growth, as well as for reducing wrinkles and (more slowly) healing scars.
- It works by breaking up the sebum that may be blocking new hair growth, and also makes the skin healthier by stimulating production of collagen and elastin (in response to the thousands of microscopic wounds that the needles make).
- Sounds drastic, but it doesn’t hurt and doesn’t leave any visible marks—the needles are that tiny. Still, practise good sterilization and ensure your skin is clean when using it.
See: How To Use A Dermaroller ← also explains more of the science of it
PS: this question was asked in the context of men, but the information goes the same for women suffering from androgenic alepoceia—which is a lot more common than most people think!
How to get to sleep at night as fast and as naturally as possible? Thank you!
We’ll definitely write more on that! You might like these articles we wrote already, meanwhile:
- Beating The Insomnia Blues ← this one is general advice and tips
- Time For Some Pillow Talk ← this one compares and reviews some popular sleep apps
- Insomnia? High Blood Pressure? Try these! ← this one tackles the matter from a dietary angle
Q: How to be your best self after 60: Self motivation / Avoiding or limiting salt, sugar & alcohol: Alternatives / Ways to sneak in more movements/exercise
…and, from a different subscriber…
Q: Inflammation & over 60 weight loss. Thanks!
Here are some of our greatest hits on those topics:
- Where Nutrition Meets Habits ← focusing on food that’s all three of: healthy + easy + cheap
- How To Keep On Keeping On ← exercise tips for when the motivation wanes
- Keep Inflammation At Bay ← science-based tips and advice
Also, while we’ve recommended a couple of books on stopping (or reducing) drinking, we’ve not done a main feature on that, so we definitely will one of these days!
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