Burn – by Dr. Herman Pontzer
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We all have reasons to want to focus on our metabolism. Speed it up to burn more fat; slow it down to live longer. Tweak it for more energy in the day. But what actually is it, and how does it work?
Dr. Herman Pontzer presents a very useful overview of not just what our metabolism is and how it works, but also why.
The style of the book is casual, but doesn’t skimp on the science. Whether we are getting campfire stories of Hadza hunter-gatherers, or an explanation of the use of hydrogen isotopes in metabolic research, Dr. Pontzer keeps things easy-reading.
One of the main premises of the book is that our caloric expenditure is not easy to change—if we exercise more, our bodies will cut back somewhere else. After all, the body uses energy for a lot more than just moving. With this in mind, Dr. Pontzer makes the science-based case for focusing more on diet than exercise if weight management is our goal.
In short, if you’d like your metabolism to be a lot less mysterious, this book can help render a lot of science a lot more comprehensible!
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Why You Should Diversify Your Nuts!
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Time to go nuts for nuts!
Nuts, in popular perception, range from “basically the healthiest food anyone can eat” to “basically high calorie salty snacks”. And, they can be either!
Some notes, then:
- Raw is generally better that not
- Dry roasted is generally better than the kind with added oils
- Added salt is neither necessary nor good
Quick tip: if “roasted salted” are the cheapest or most convenient to buy, you can at least mitigate that by soaking them in warm water for 5 minutes, before rinsing and (if you don’t want wet nuts) drying.
You may be wondering: who does want wet nuts? And the answer is, if for example you’re making a delicious cashew and chickpea balti, the fact you didn’t dry them before throwing them in won’t make a difference.
Now, let’s do a quick run-down; we don’t usually do “listicles” but it seemed a good format here, so we’ve picked a top 5 for nutritional potency:
Almonds
We may have a bias. We accept it. But almonds are also one of the healthiest nuts around, and generally considered by most popular metrics the healthiest.
Not only are they high in protein, healthy fat, fiber, vitamins, and minerals, but they’re even a natural prebiotic that increases the populations of healthy gut bacteria, while simultaneously keeping down the populations of gut pathogens—what more can we ask of a nut?
Read more: Prebiotic effects of almonds and almond skins on intestinal microbiota in healthy adult humans
Pistachios
Not only are these super tasty and fun to eat (and mindful eating is all but guaranteed, as shelling them by hand slows us down and makes us more likely to eat them one at a time rather than by the handful), but also they contain lots of nutrients and are lower in calories than most nuts, so they’re a great option for anyone who’d like to eat more nuts but is doing a calorie-controlled diet and doesn’t want to have half a day’s calories in a tiny dish of nuts.
Walnuts
Popularly associated with brain health (perhaps easy to remember because of their appearance), they really are good for the brain:
Check it out: Beneficial Effects of Walnuts on Cognition and Brain Health
Cashews
A personal favorite of this writer for their versatility in cooking, food prep, or just as a snack, they also do wonders for metabolic health:
Brazil nuts
The most exciting thing about these nuts is that they’re an incredibly potent source of selenium, which is important not just for hair/skin/nails as popularly marketed, but also for thyroid hormone production and DNA synthesis.
But don’t eat too many, because selenium is definitely one of those “you can have too much of a good thing” nutrients, and selenium poisoning can make your hair (however beautiful and shiny it got because of the selenium) fall out if you take too much.
Know the numbers: Brazil nuts and selenium—health benefits and risks
Bottom line on nuts:
- Nuts are a great and healthful part of almost anyone’s diet
- Obviously, if you have a nut allergy, then we’re sorry; this one won’t have helped you so much
- Almonds are one of the most healthful nuts out there
- Brazil nuts are incredibly potent, to the point where moderation is recommended
- A handful of mixed nuts per day is a very respectable option—when it comes to food and health, diversity is almost always good!
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Horse Sedative Use Among Humans Spreads in Deadly Mixture of ‘Tranq’ and Fentanyl
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TREASURE ISLAND, Fla. — Andrew McClave Jr. loved to lift weights. The 6-foot-4-inch bartender resembled a bodybuilder and once posed for a photo flexing his muscles with former pro wrestler Hulk Hogan.
“He was extremely dedicated to it,” said his father, Andrew McClave Sr., “to the point where it was almost like he missed his medication if he didn’t go.”
But the hobby took its toll. According to a police report, a friend told the Treasure Island Police Department that McClave, 36, suffered from back problems and took unprescribed pills to reduce the pain.
In late 2022, the friend discovered McClave in bed. He had no pulse. A medical examiner determined he had a fatal amount of fentanyl, cocaine, and xylazine, a veterinary tranquilizer used to sedate horses, in his system, an autopsy report said. Heart disease was listed as a contributing factor.
McClave is among more than 260 people across Florida who died in one year from accidental overdoses involving xylazine, according to a Tampa Bay Times analysis of medical examiner data from 2022, the first year state officials began tracking the substance. Numbers for 2023 haven’t been published.
The death toll reflects xylazine’s spread into the nation’s illicit drug supply. Federal regulators approved the tranquilizer for animals in the early 1970s and it’s used to sedate horses for procedures like oral exams and colic treatment, said Todd Holbrook, an equine medicine specialist at the University of Florida. Reports of people using xylazine emerged in Philadelphia, then the drug spread south and west.
What’s not clear is exactly what role the sedative plays in overdose deaths, because the Florida data shows no one fatally overdosed on xylazine alone. The painkiller fentanyl was partly to blame in all but two cases in which the veterinary drug was included as a cause of death, according to the Times analysis. Cocaine or alcohol played roles in the cases in which fentanyl was not involved.
Fentanyl is generally the “800-pound gorilla,” according to Lewis Nelson, chair of the emergency medicine department at Rutgers New Jersey Medical School, and xylazine may increase the risk of overdose, though not substantially.
But xylazine appears to complicate the response to opioid overdoses when they do happen and makes it harder to save people. Xylazine can slow breathing to dangerous levels, according to federal health officials, and it doesn’t respond to the overdose reversal drug naloxone, often known by the brand name Narcan. Part of the problem is that many people may not know they are taking the horse tranquilizer when they use other drugs, so they aren’t aware of the additional risks.
Lawmakers in Tallahassee made xylazine a Schedule 1 drug like heroin or ecstasy in 2016, and several other states including Pennsylvania, Ohio, and West Virginia have taken action to classify it as a scheduled substance, too. But it’s not prohibited at the federal level. Legislation pending in Congress would criminalize illicit xylazine use nationwide.
The White House in April designated the combination of fentanyl and xylazine, often called “tranq dope,” as an emerging drug threat. A study of 20 states and Washington, D.C., found that overdose deaths attributed to both illicit fentanyl and xylazine exploded from January 2019 to June 2022, jumping from 12 a month to 188.
“We really need to continue to be proactive,” said Amanda Bonham-Lovett, program director of a syringe exchange in St. Petersburg, “and not wait until this is a bigger issue.”
‘A Good Business Model’
There are few definitive answers about why xylazine use has spread — and its impact on people who consume it.
The U.S. Drug Enforcement Administration in September said the tranquilizer is entering the country in several ways, including from China and in fentanyl brought across the southwestern border. The Florida attorney general’s office is prosecuting an Orange County drug trafficking case that involves xylazine from a New Jersey supplier.
Bonham-Lovett, who runs IDEA Exchange Pinellas, the county’s anonymous needle exchange, said some local residents who use drugs are not seeking out xylazine — and don’t know they’re consuming it.
One theory is that dealers are mixing xylazine into fentanyl because it’s cheap and also affects the brain, Nelson said.
“It’s conceivable that if you add a psychoactive agent to the fentanyl, you can put less fentanyl in and still get the same kick,” he said. “It’s a good business model.”
In Florida, men accounted for three-quarters of fatal overdoses involving xylazine, according to the Times analysis. Almost 80% of those who died were white. The median age was 42.
Counties on Florida’s eastern coast saw the highest death tolls. Duval County topped the list with 46 overdoses. Tampa Bay recorded 19 fatalities.
Cocaine was also a cause in more than 80 cases, including McClave’s, the Times found. The DEA in 2018 warned of cocaine laced with fentanyl in Florida.
In McClave’s case, Treasure Island police found what appeared to be marijuana and a small plastic bag with white residue in his room, according to a police report. His family still questions how he took the powerful drugs and is grappling with his death.
He was an avid fisherman, catching snook and grouper in the Gulf of Mexico, said his sister, Ashley McClave. He dreamed of being a charter boat captain.
“I feel like I’ve lost everything,” his sister said. “My son won’t be able to learn how to fish from his uncle.”
Mysterious Wounds
Another vexing challenge for health officials is the link between chronic xylazine use and open wounds.
The wounds are showing up across Tampa Bay, needle exchange leaders said. The telltale sign is blackened, crusty tissue, Bonham-Lovett said. Though the injuries may start small — the size of a dime — they can grow and “take over someone’s whole limb,” she said.
Even those who snort fentanyl, instead of injecting it, can develop them. The phenomenon is unexplained, Nelson said, and is not seen in animals.
IDEA Exchange Pinellas has recorded at least 10 cases since opening last February, Bonham-Lovett said, and has a successful treatment plan. Staffers wash the wounds with soap and water, then dress them.
One person required hospitalization partly due to xylazine’s effects, Bonham-Lovett said. A 31-year-old St. Petersburg woman, who asked not to be named due to concerns over her safety and the stigma of drug use, said she was admitted to St. Anthony’s Hospital in 2023. The woman, who said she uses fentanyl daily, had a years-long staph infection resistant to some antibiotics, and a wound recently spread across half her thigh.
The woman hadn’t heard of xylazine until IDEA Exchange Pinellas told her about the drug. She’s thankful she found out in time to get care.
“I probably would have lost my leg,” she said.
This article was produced in partnership with the Tampa Bay Times.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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What Flexible Dieting Really Means
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When Flexibility Is The Dish Of The Day
This is Alan Aragon. Notwithstanding not being a “Dr. Alan Aragon”, he’s a research scientist with dozens of peer-reviewed nutrition science papers to his name, as well as being a personal trainer and fitness educator. Most importantly, he’s an ardent champion of making people’s pursuit of health and fitness more evidence-based.
We’ll be sharing some insights from a book of his that we haven’t reviewed yet, but we will link it at the bottom of today’s article in any case.
What does he want us to know?
First, get out of the 80s and into the 90s
In the world of popular dieting, the 80s were all about calorie-counting and low-fat diets. They did not particularly help.
In the 90s, it was discovered that not only was low-fat not the way to go, but also, regardless of the diet in question, rigid dieting leads to “disinhibition”, that is to say, there comes a point (usually not far into a diet) whereby one breaks the diet, at which point, the floodgates open and the dieter binges unhealthily.
Aragon would like to bring our attention to a number of studies that found this in various ways over the course of the 90s measuring various different metrics including rigid vs flexible dieting’s impacts on BMI, weight gain, weight loss, lean muscle mass changes, binge-eating, anxiety, depression, and so forth), but we only have so much room here, so here’s a 1999 study that’s pretty much the culmination of those:
Flexible vs. Rigid Dieting Strategies: Relationship with Adverse Behavioral Outcomes
So in short: trying to be very puritan about any aspect of dieting will not only not work, it will backfire.
Next, get out of the 90s into the 00s
…which is not only fun if you read “00s” out loud as “naughties”, but also actually appropriate in this case, because it is indeed important to be comfortable being a little bit naughty:
In 2000, Dr. Marika Tiggemann found that dichotomous perceptions of food (e.g. good/bad, clean/dirty, etc) were implicated as a dysfunctional cognitive style, and predicted not only eating disorders and mood disorders, but also adverse physical health outcomes:
Dieting and Cognitive Style: The Role of Current and Past Dieting Behaviour and Cognitions
This was rendered clearer, in terms of physical health outcomes, by Dr. Susan Byrne & Dr. Emma Dove, in 2009:
❝Weight loss was negatively associated with pre-treatment depression and frequency of treatment attendance, but not with dichotomous thinking. Females who regard their weight as unacceptably high and who think dichotomously may experience high levels of depression irrespective of their actual weight, while depression may be proportionate to the degree of obesity among those who do not think dichotomously❞
Aragon’s advice based on all this: while yes, some foods are better than others, it’s more useful to see foods as being part of a spectrum, rather than being absolutist or “black and white” about it.
Next: hit those perfect 10s… Imperfectly
The next decade expanded on this research, as science is wont to do, and for this one, Aragon shines a spotlight on Dr. Alice Berg’s 2018 study with obese women averaging 69 years of age, in which…
In other words (and in fact, to borrow Dr. Berg’s words from that paper),
❝encouraging a flexible approach to eating behavior and discouraging rigid adherence to a diet may lead to better intentional weight loss for overweight and obese older women❞
You may be wondering: what did this add to the studies from the 90s?
And the key here is: rather than being observational, this was interventional. In other words, rather than simply observing what happened to people who thought one way or another, this study took people who had a rigid, dichotomous approach to food, and gave them a 6-month behavioral intervention (in other words, support encouraging them to be more flexible and open in their approach to food), and found that this indeed improved matters for them.
Which means, it’s not a matter of fate or predisposition, as it could have been back in the 90s, per “some people are just like that; who’s to say which factor causes which”. Instead, now we know that this is an approach that can be adopted, and it can be expected to work.
Beyond weight loss
Now, so far we’ve talked mostly about weight loss, and only touched on other health outcomes. This is because:
- weight loss a very common goal for many
- it’s easy to measure so there’s a lot of science for it
Incidentally, if it’s a goal of yours, here’s what 10almonds had to say about that, along with two follow-up articles for other related goals:
Spoiler: we agree with Aragon, and recommend a relaxed and flexible approach to all three of these things
Aragon’s evidence-based approach to nutrition has found that this holds true for other aspects of healthy eating, too. For example…
To count or not to count?
It’s hard to do evidence-based anything without counting, and so Aragon talks a lot about this. Indeed, he does a lot of counting in scientific papers of his own, such as:
and
The effect of protein timing on muscle strength and hypertrophy: a meta-analysis
…as well as non-protein-related but diet-related topics such as:
But! For the at-home health enthusiast, Aragon recommends that the answer to the question “to count or not to count?” is “both”:
- Start off by indeed counting and tracking everything that is important to you (per whatever your current personal health intervention is, so it might be about calories, or grams of protein, or grams of carbs, or a certain fat balance, or something else entirely)
- Switch to a more relaxed counting approach once you get used to the above. By now you probably know the macros for a lot of your common meals, snacks, etc, and can tally them in your head without worrying about weighing portions and knowing the exact figures.
- Alternatively, count moderately standardized portions of relevant foods, such as “three servings of beans or legumes per day” or “no more than one portion of refined carbohydrates per day”
- Eventually, let habit take the wheel. Assuming you have established good dietary habits, this will now do you just fine.
This latter is the point whereby the advice (that Aragon also champions) of “allow yourself an unhealthy indulgence of 10–20% of your daily food”, as a budget of “discretionary calories”, eventually becomes redundant—because chances are, you’re no longer craving that donut, and at a certain point, eating foods far outside the range of healthiness you usually eat is not even something that you would feel inclined to do if offered.
But until that kicks in, allow yourself that budget of whatever unhealthy thing you enjoy, and (this next part is important…) do enjoy it.
Because it is no good whatsoever eating that cream-filled chocolate croissant and then feeling guilty about it; that’s the dichotomous thinking we had back in the 80s. Decide in advance you’re going to eat and enjoy it, then eat and enjoy it, then look back on it with a sense of “that was enjoyable” and move on.
The flipside of this is that the importance of allowing oneself a “little treat” is that doing so actively helps ensure that the “little treat” remains “little”. Without giving oneself permission, then suddenly, “well, since I broke my diet, I might as well throw the whole thing out the window and try again on Monday”.
On enjoying food fully, by the way:
Mindful Eating: How To Get More Nutrition Out Of The Same Food
Want to know more from Alan Aragon?
Today we’ve been working heavily from this book of his; we haven’t reviewed it yet, but we do recommend checking it out:
Enjoy!
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Teen Daily Delivery Requested
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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 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.
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10 Simple Japanese Habits For Healthier & Longer Life
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You don’t have to be Japanese or live in Okinawa to enjoy the benefits of healthy longevity. A lot of it comes down to simple habits:
Easy to implement
We’ll not keep the 10 habits a mystery; they are:
- Start the day with hot water: drinking hot water in the morning helps with hydration, warming the body, and aiding digestion.
- Enjoy a hearty breakfast: Japanese breakfasts are traditionally filling, nutritious, and help promote energy and longevity. Typical components include rice, miso soup, fish, and pickles.
- Take balanced meals: Japanese education emphasizes nutrition from a young age, promoting balanced meals with proteins, fiber, and vitamins & minerals.
- Enjoy fermented foods: fermented foods, such as nattō and soy-based condiments, support digestion, heart health, and the immune system.
- Drink green tea and matcha: both are rich in health benefits; preparing matcha mindfully adds a peaceful ritual to daily life too.
- Keep the “80% full” rule: “hara hachi bu” encourages eating until 80% full, which can improve longevity and, of course, prevent overeating.
- Use multiple small dishes: small servings and a variety of dishes help prevent overeating and ensure a diverse intake of nutrients.
- Gratitude before and after meals: saying “itadakimasu” and “gochisousama” promotes mindful eating, and afterwards, good digestion. Speaking Japanese is of course not the key factor here, but rather, do give yourself a moment of reflection before and after meals.
- Use vinegar in cooking: vinegar, often used in sushi rice and sauces like ponzu, adds flavor and offers health benefits, mostly pertaining to blood sugar balance.
- Eat slowly: Eating at a slower pace will improve digestion, and can enhance satiety and prevent accidentally overeating.
For more on all of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
How To Get More Out Of What’s On Your Plate
Take care!
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If I’m diagnosed with one cancer, am I likely to get another?
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Receiving a cancer diagnosis is life-changing and can cause a range of concerns about ongoing health.
Fear of cancer returning is one of the top health concerns. And managing this fear is an important part of cancer treatment.
But how likely is it to get cancer for a second time?
Why can cancer return?
While initial cancer treatment may seem successful, sometimes a few cancer cells remain dormant. Over time, these cancer cells can grow again and may start to cause symptoms.
This is known as cancer recurrence: when a cancer returns after a period of remission. This period could be days, months or even years. The new cancer is the same type as the original cancer, but can sometimes grow in a new location through a process called metastasis.
Actor Hugh Jackman has gone public about his multiple diagnoses of basal cell carcinoma (a type of skin cancer) over the past decade.
The exact reason why cancer returns differs depending on the cancer type and the treatment received. Research is ongoing to identify genes associated with cancers returning. This may eventually allow doctors to tailor treatments for high-risk people.
What are the chances of cancer returning?
The risk of cancer returning differs between cancers, and between sub-types of the same cancer.
New screening and treatment options have seen reductions in recurrence rates for many types of cancer. For example, between 2004 and 2019, the risk of colon cancer recurring dropped by 31-68%. It is important to remember that only someone’s treatment team can assess an individual’s personal risk of cancer returning.
For most types of cancer, the highest risk of cancer returning is within the first three years after entering remission. This is because any leftover cancer cells not killed by treatment are likely to start growing again sooner rather than later. Three years after entering remission, recurrence rates for most cancers decrease, meaning that every day that passes lowers the risk of the cancer returning.
Every day that passes also increases the numbers of new discoveries, and cancer drugs being developed.
What about second, unrelated cancers?
Earlier this year, we learned Sarah Ferguson, Duchess of York, had been diagnosed with malignant melanoma (a type of skin cancer) shortly after being treated for breast cancer.
Although details have not been confirmed, this is likely a new cancer that isn’t a recurrence or metastasis of the first one.
Australian research from Queensland and Tasmania shows adults who have had cancer have around a 6-36% higher risk of developing a second primary cancer compared to the risk of cancer in the general population.
Who’s at risk of another, unrelated cancer?
With improvements in cancer diagnosis and treatment, people diagnosed with cancer are living longer than ever. This means they need to consider their long-term health, including their risk of developing another unrelated cancer.
Reasons for such cancers include different types of cancers sharing the same kind of lifestyle, environmental and genetic risk factors.
The increased risk is also likely partly due to the effects that some cancer treatments and imaging procedures have on the body. However, this increased risk is relatively small when compared with the (sometimes lifesaving) benefits of these treatment and procedures.
While a 6-36% greater chance of getting a second, unrelated cancer may seem large, only around 10-12% of participants developed a second cancer in the Australian studies we mentioned. Both had a median follow-up time of around five years.
Similarly, in a large US study only about one in 12 adult cancer patients developed a second type of cancer in the follow-up period (an average of seven years).
The kind of first cancer you had also affects your risk of a second, unrelated cancer, as well as the type of second cancer you are at risk of. For example, in the two Australian studies we mentioned, the risk of a second cancer was greater for people with an initial diagnosis of head and neck cancer, or a haematological (blood) cancer.
People diagnosed with cancer as a child, adolescent or young adult also have a greater risk of a second, unrelated cancer.
What can I do to lower my risk?
Regular follow-up examinations can give peace of mind, and ensure any subsequent cancer is caught early, when there’s the best chance of successful treatment.
Maintenance therapy may be used to reduce the risk of some types of cancer returning. However, despite ongoing research, there are no specific treatments against cancer recurrence or developing a second, unrelated cancer.
But there are things you can do to help lower your general risk of cancer – not smoking, being physically active, eating well, maintaining a healthy body weight, limiting alcohol intake and being sun safe. These all reduce the chance of cancer returning and getting a second cancer.
Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute and Terry Boyle, Senior Lecturer in Cancer Epidemiology, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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