Built from Broken – by Scott Hogan, CPT, COES
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So many exercise programs come with the caveat “consult your doctor before engaging in any new activity”, and the safe-but-simple “do not try to train through an injury”.
Which is all very well and good for someone in fabulous health who sprained an ankle while running and can just wait a bit, but what about those of us carrying…
- long-term injuries
- recurring injuries
- or just plain unfixable physical disabilities?
That’s where physiotherapist Scott Hogan comes in. The subtitle line goes:
❝A Science-Based Guide to Healing Painful Joints, Preventing Injuries, and Rebuilding Your Body❞
…but he does also recognize that there are some things that won’t bounce back.
On the other hand… There are a lot of things that get written off by doctors as “here’s some ibuprofen” that, with consistent mindful training, could actually be fixed.
Hogan delivers again and again in this latter category! You’ll see on Amazon that the book has thousands of 4- and 5-star ratings and many glowing reviews, and it’s for a reason or three:
- The book first lays a foundational knowledge of the most common injuries likely to impede us from training
- It goes on to give step-by-step corrective exercises to guide your body through healing itself. Your body is trying to heal itself anyway; you might as well help it accomplish that!
- It finishes up with a comprehensive (and essential) guide to train for the strength and mobility that will help you avoid future problems.
In short: a potentially life-changing book if you have some (likely back- or joint-related) problem that needs overcoming!
And if you don’t? An excellent pre-emptive guide all the same. This is definitely one of those “an ounce of prevention is better than a pound of cure” things.
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Small Changes For A Healthier Life
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It’s Q&A Day 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!
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 am interested in what I can substitute for ham in bean soup?
Well, that depends on what the ham was like! You can certainly buy ready-made vegan lardons (i.e. small bacon/ham bits, often in tiny cubes or similar) in any reasonably-sized supermarket. Being processed, they’re not amazing for the health, but are still an improvement on pork.
Alternatively, you can make your own seitan! Again, seitan is really not a health food, but again, it’s still relatively less bad than pork (unless you are allergic to gluten, in which case, definitely skip this one).
Alternatively alternatively, in a soup that already contains beans (so the protein element is already covered), you could just skip the ham as an added ingredient, and instead bring the extra flavor by means of a little salt, a little yeast extract (if you don’t like yeast extract, don’t worry, it won’t taste like it if you just use a teaspoon in a big pot, or half a teaspoon in a smaller pot), and a little smoked paprika. If you want to go healthier, you can swap out the salt for MSG, which enhances flavor in a similar fashion while containing less sodium.
Wondering about the health aspects of MSG? Check out our main feature on this, from last month:
I thoroughly enjoy your daily delivery. I’d love to see one for teens too!
That’s great to hear! The average age of our subscribers is generally rather older, but it’s good to know there’s an interest in topics for younger people. We’ll bear that in mind, and see what we can do to cater to that without alienating our older readers!
That said: it’s never too soon to be learning about stuff that affects us when we’re older—there are lifestyle factors at 20 that affect Alzheimer’s risk at 60, for example (e.g. drinking—excessive drinking at 20* is correlated to higher Alzheimer’s risk at 60).
*This one may be less of an issue for our US readers, since the US doesn’t have nearly as much of a culture of drinking under 21 as some places. Compare for example with general European practices of drinking moderately from the mid-teens, or the (happily, diminishing—but historically notable) British practice of drinking heavily from the mid-teens.
How much turmeric should I take each day?
Dr. Michael Greger’s research (of “Dr. Greger’s Daily Dozen” and “How Not To Die” fame) recommends getting at least ¼ tsp turmeric per day
Remember to take it with black pepper though, for a 2000% absorption bonus!
A great way to get it, if you don’t want to take capsules and don’t want to eat spicy food every day, is to throw a teaspoon of turmeric in when making a pot of (we recommend wholegrain!) rice. Turmeric is very water-soluble, so it’ll be transferred into the rice easily during cooking. It’ll make the rice a nice golden yellow color, and/but won’t noticeably change the taste.
Again remember to throw in some black pepper, and if you really want to boost the nutritional content,some chia seeds are a great addition too (they’ll get cooked with the rice and so it won’t be like eating seeds later, but the nutrients will be there in the rice dish).
You can do the same with par-boiled potatoes or other root vegetables, but because cooking those has water to be thrown away at the end (unlike rice), you’ll lose some turmeric in the water.
Request: more people need to be aware of suicidal tendencies and what they can do to ward them off
That’s certainly a very important topic! We’ll cover that properly in one of our Psychology Sunday editions. In the meantime, we’ll mention a previous special that we did, that was mostly about handling depression (in oneself or a loved one), and obviously there’s a degree of crossover:
The Mental Health First-Aid That You’ll Hopefully Never Need
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What is Ryeqo, the recently approved medicine for endometriosis?
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For women diagnosed with endometriosis it is often a long sentence of chronic pain and cramping that impacts their daily life. It is a condition that is both difficult to diagnose and treat, with many women needing either surgery or regular medication.
A medicine called Ryeqo has just been approved for marketing specifically for endometriosis, although it was already available in Australia to treat a different condition.
Women who want the drug will need to consult their local doctor and, as it is not yet on the Pharmaceutical Benefits Scheme, they will need to pay the full cost of the script.
What does Ryeqo do?
Endometriosis affects 14% of women of reproductive age. While we don’t have a full understanding of the cause, the evidence suggests it’s due to body tissue that is similar to the lining of the uterus (called the endometrium) growing outside the uterus. This causes pain and inflammation, which reduces quality of life and can also affect fertility.
Ryeqo is a tablet containing three different active ingredients: relugolix, estradiol and norethisterone.
Relugolix is a drug that blocks a particular peptide from releasing other hormones. It is also used in the treatment of prostate cancer. Estradiol is a naturally occurring oestrogen hormone in women that helps regulate the menstrual cycle and is used in menopausal hormone therapy. Norethisterone is a synthetic hormone commonly used in birth control medications and to delay menstruation and help with heavy menstrual bleeding.
All three components work together to regulate the levels of oestrogen and progesterone in the body that contribute to endometriosis, alleviating its symptoms.
Relugolix reduces the overall levels of oestrogen and progesterone in the body. The estradiol compensates for the loss of oestrogen because low oestrogen levels can cause hot flushes (also called hot flashes) and bone density loss. And norethisterone blocks the effects of estradiol on the uterus (where too much tissue growth is unwanted).
Is it really new?
The maker of Ryeqo claims it is the first new drug for endometriosis in Australia in 13 years.
But individually, all three active ingredients in Ryeqo have been in use since 2019 or earlier.
Ryeqo has been available in Australia since 2022, but until now was not specifically indicated for endometriosis. It was originally approved for the treatment of uterine fibroids, which share some common symptoms with endometriosis and have related causes.
In addition to Ryeqo, current medical guidance lists other drugs that are suitable for endometriosis and some reformulations of these have also only been recently approved.
The oral medicine Dienogest was approved in 2021, and there have been a number of injectable drugs for endometriosis recently approved, such as Sayana Press which was approved in a smaller dose form for self-injection in 2023.
You can’t take the contraceptive pill with Ryeqo but the endometriosis drug could replace it.
ShutterstockHow to take it and what not to do
Ryeqo is a once-a-day tablet. You can take it with, or without food, but it should be taken about the same time each day.
It is recommended you start taking Ryeqo within the first five days after the start of your next period. If you start at another time during your period, you may experience initial irregular or heavier bleeding.
Because it contains both synthetic and natural hormones, you can’t use the contraceptive pill and Ryeqo together. However, because Ryeqo does contain norethisterone it can be used as your contraception, although it will take at least one month of use to be effective. So, if you are on Ryeqo, you should use a non-hormonal contraceptive – such as condoms – for a month when starting the medicine.
Ryeqo may be incompatible with other medicines. It might not be suitable for you if you take medicines for epilepsy, HIV and AIDS, hepatitis C, fungal or bacterial infections, high blood pressure, irregular heartbeat, angina (chest pain), or organ rejection. You should also not take Ryeqo if you have a liver tumour or liver disease.
The possible side effects of Ryeqo are similar to those of oral contraceptives. Blood clots are a risk with any medicine that contains an oestrogen or a progestogen, which Ryeqo does. Other potential side effects include bone loss, a reduction in menstrual blood loss or loss of your period.
It’s costly for now
Ryeqo can now be prescribed in Australia, so you should discuss whether Ryeqo is right for you with the doctor you usually consult for your endometriosis.
While the maker has made a submission to the Pharmaceutical Benefits Advisory Committee, it is not yet subsidised by the Australian government. This means that rather than paying the normal PBS price of up to A$31.60, it has been reported it may cost as much as $135 for a one-month supply. The committee will make a decision on whether to subsidise Ryeqo at its meeting next month.
Correction: this article has been updated to clarify the recent approval of specific formulations of drugs for endometriosis.
Nial Wheate, Associate Professor of the School of Pharmacy, University of Sydney and Jasmine Lee, Pharmacist and PhD Candidate, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Breakfasting For Health?
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Breakfast Time!
In yesterday’s newsletter, we asked you for your health-related opinions on the timings of meals.
But what does the science say?
Quick recap on intermittent fasting first:
Today’s article will rely somewhat on at least a basic knowledge of intermittent fasting, what it is, and how and why it works.
Armed with that knowledge, we can look at when it is good to break the fast (i.e. breakfast) and when it is good to begin the fast (i.e. eat the last meal of the day).
So, if you’d like a quick refresher on intermittent fasting, here it is:
Intermittent Fasting: We Sort The Science From The Hype
And now, onwards!
One should eat breakfast first thing: True or False?
True! Give or take one’s definition of “first thing”. We did a main feature about this previously, and you can read a lot about the science of it, and see links to studies:
The Circadian Rhythm: Far More Than Most People Know
In case you don’t have time to read that now, we’ll summarize the most relevant-to-today’s-article conclusion:
The optimal time to breakfast is around 10am (this is based on getting sunlight around 8:30am, so adjust if this is different for you)
It doesn’t matter when we eat; calories are calories & nutrients are nutrients: True or False?
Broadly False, for practical purposes. Because, indeed calories are calories and nutrients are nutrients at any hour, but the body will do different things with them depending on where we are in the circadian cycle.
For example, this study in the Journal of Nutrition found…
❝Our results suggest that in relatively healthy adults, eating less frequently, no snacking, consuming breakfast, and eating the largest meal in the morning may be effective methods for preventing long-term weight gain.
Eating breakfast and lunch 5-6 h apart and making the overnight fast last 18-19 h may be a useful practical strategy.❞
Read in full: Meal Frequency and Timing Are Associated with Changes in Body Mass Index
We should avoid eating too late at night: True or False?
False per se, True in the context of the above. Allow us to clarify:
There is nothing inherently bad about eating late at night; there is no “bonus calorie happy hour” before bed.
However…
If we are eating late at night, that makes it difficult to breakfast in the morning (as is ideal) and still maintain a >16hr fasting window as is optimal, per:
❝the effects of the main forms of fasting, activating the metabolic switch from glucose to fat and ketones (G-to-K), starting 12-16 h after cessation or strong reduction of food intake❞
~ Dr. Françoise Wilhelmi de Toledo et al.
So in other words: since the benefits of intermittent fasting start at 12 hours into the fast, you’re not going to get them if you’re breakfasting at 10am and also eating in the evening.
Summary:
- It is best to eat breakfast around 10am, generally (ideally after some sunlight and exercise)
- While there’s nothing wrong with eating in the evening per se, doing so means that a 10am breakfast will eliminate any fasting benefits you might otherwise get
- If a “one meal a day, and that meal is breakfast” lifestyle doesn’t suit you, then one possible good compromise is to have a large breakfast, and then a smaller meal in the late afternoon / early evening.
One last tip: the above is good, science-based information. Use it (or don’t), as you see fit. We’re not the boss of you:
- Maybe you care most about getting the best circadian rhythm benefits, in which case, prioritizing breakfast being a) in the morning and b) the largest meal of the day, is key
- Maybe you care most about getting the best intermittent fasting benefits, in which case, for many people’s lifestyle, a fine option is skipping eating in the morning, and having one meal in the late afternoon / early evening.
Take care!
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Healthy Heart, Healthy Brain – by Dr. Bradley Bale & Dr. Amy Doneen
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.
We’ve often written that “what’s good for your heart is good for your brain”, because the former feeds the latter and takes away detritus. You cannot have a healthy brain without a healthy heart.
This book goes into that in more detail than we have ever had room to here! This follows from their previous book “Beat The Heart Attack Gene”, but we’re jumping in here because that book doesn’t really contain anything not also included in this one.
The idea is the same though: it is the authors’ opinion that far too many interventions are occurring far too late, and they want to “wake everyone up” (including their colleagues in the field) to encourage earlier (and broader!) testing.
Fun fact: that also reminded this reviewer that she had a pending invitation for blood tests to check these kinds of things—phlebotomy appointment now booked, yay!
True the spirit of such exhortation to early testing, this book does include diagnostic questionnaires, to help the reader know where we might be at. And, interestingly, while the in-book questionnaire format of “so many points for this answer, so many for that one”, etc is quite normal, what they do differently in the diagnostics is that in cases of having to answer “I don’t know”, it assigns the highest-risk point value, i.e. the test will err on the side of assume the worst, in the case of a reader not knowing, for example, what our triglycerides are like. Which, when one thinks about it, is probably a very sensible reasoning.
There’s a lot of advice about specific clinical diagnostic tools and things to ask for, and also things that may raise an alarm that most people might overlook (including doctors, especially if they are only looking for something else at the time).
You may be wondering: do they actually give advice on what to actually do to improve heart and brain health, or just how to be aware of potential problems? And the answer is that the latter is a route to the former, and yes they do offer comprehensive advice—well beyond “eat fiber and get some exercise”, and even down to the pros and cons of various supplements and medications. When it comes to treating a problem that has been identified, or warding off a risk that has been flagged, the advice is a personalized, tailored, approach. Obviously there’s a limit to how much they can do that in the book, but even so, we see a lot of “if this then that” pointers to optimize things along the way.
The style is… a little salesy for this reviewer’s tastes. That is to say, while it has a lot of information of serious value, it’s also quite padded with self-congratulatory anecdotes about the many occasions the authors have pulled a Dr. House and saved the day when everyone else was mystified or thought nothing was wrong, the wonders of their trademarked methodology, and a lot of hype for their own book, as in, the book that’s already in your hands. Without all this padding, the book could have been cut by perhaps a third, if not more. Still, none of that takes away from the valuable insights that are in the book too.
Bottom line: if you’d like to have a healthier heart and brain, and especially if you’d like to avoid diseases of those two rather important organs, then this book is a treasure trove of information.
Click here to check out Healthy Heart, Healthy Brain, and secure your good health now, for later!
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Resistance band Training – by James Atkinson
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For those who’d like a full gym workout at home, without splashing out thousands on a home gym, resistance bands provide a lot of value. But how much value, really?
As James Atkinson demonstrates, there’s more exercise available than one might think.
Did you know that you can use the same band to strengthen your triceps as well as your biceps, for instance? and the same goes for your quadriceps and biceps femoris. And core strength? You bet.
The style here is not a sales pitch (though he does, at the end, offer extra resources if desired), but rather, instructional, and this book is in and of itself already a complete guide. With clear instructions and equally clear illustrations, you don’t need to spend a dime more (unless you don’t own a resistance band, in which case then yes, you will need one of those).
Bottom line: if you’d like to give your body the workout it deserves, this book is a potent resource.
Click here to check out Resistance Band Training, and get training!
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Dr. Greger’s Daily Dozen
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Give Us This Day Our Daily Dozen
This is Dr. Michael Greger. He’s a physician-turned-author-educator, and we’ve featured him and his work occasionally over the past year or so:
- Brain Food? The Eyes Have It! ← this is about dark leafy greens, lutein, & avoiding Alzheimer’s
- Twenty-One, No Wait, Twenty Tweaks For Better Health ← he says 21, but we say one of them is very skippable. Check it out and decide what you think!
- Dr. Greger’s Anti-Aging Eight ← his top well-evidenced interventions specifically for slowing aging
But what we’ve not covered, astonishingly, is one of the things for which he’s most famous, which is…
Dr. Greger’s Daily Dozen
Based on the research in the very information-dense tome that his his magnum opus How Not To Die (while it doesn’t confer immortality, it does help avoid the most common causes of death), Dr. Greger recommends that we take care to enjoy each of the following things per day:
Beans
- Servings: 3 per day
- Examples: ½ cup cooked beans, ¼ cup hummus
Greens
- Servings: 2 per day
- Examples: 1 cup raw, ½ cup cooked
Cruciferous vegetables
- Servings: 1 per day
- Examples: ½ cup chopped, 1 tablespoon horseradish
Other vegetables
- Servings: 2 per day
- Examples: ½ cup non-leafy vegetables
Whole grains
- Servings: 3 per day
- Examples: ½ cup hot cereal, 1 slice of bread
Berries
- Servings: 1 per day
- Examples: ½ cup fresh or frozen, ¼ cup dried
Other fruits
- Servings: 3 per day
- Examples: 1 medium fruit, ¼ cup dried fruit
Flaxseed
- Servings: 1 per day
- Examples: 1 tablespoon ground
Nuts & (other) seeds
- Servings: 1 per day
- Examples: ¼ cup nuts, 2 tablespoons nut butter
Herbs & spices
- Servings: 1 per day
- Examples: ¼ teaspoon turmeric
Hydrating drinks
- Servings: 60 oz per day
- Examples: Water, green tea, hibiscus tea
Exercise
- Servings: Once per day
- Examples: 90 minutes moderate or 40 minutes vigorous
Superficially it seems an interesting choice to, after listing 11 foods and drinks, have the 12th item as exercise but not add a 13th one of sleep—but perhaps he quite reasonably expects that people get a dose of sleep with more consistency than people get a dose of exercise. After all, exercise is mostly optional, whereas if we try to skip sleep for too long, our body will force the matter for us.
Further 10almonds notes:
- We’d consider chia superior to flax, but you do you. Flax is a fine choice also.
- We recommend trying to get each of these top 5 most health-giving spices in daily if you can.
Enjoy!
Don’t Forget…
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Learn to Age Gracefully
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