Are You A Calorie-Burning Machine?
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Burn, Calorie, Burn
In Tuesday’s newsletter, we asked you whether you count calories, and got the above-depicted, below-described set of answers:
- About 56% said “I am somewhat mindful of calories but keep only a rough tally”
- About 32% said “I do not count calories / I don’t think it’s important for my health”
- About 13% said “I rigorously check and record the calories of everything I consume”
So what does the science say, about the merits of all these positions?
A food’s calorie count is a good measure of how much energy we will, upon consuming the food, have to use or store: True or False?
False, broadly. It can be, at best, a rough guideline. Do you know what a calorie actually is, by the way? Most people don’t.
One thing to know before we get to that: there’s “cal” vs “kcal”. The latter is generally used when it comes to foodstuffs, and it’s what we’ll be meaning whenever we say “calorie” here. 1cal is 1/1000th of a kcal, that’s all.
Now, for what a calorie actually is:
A calorie is the amount of energy needed to raise the temperature of 1 liter of water by 1℃
Question: so, how to we measure how much food is needed to do that?
Answer: by using a bomb calorimeter! Which is the exciting name for the apparatus used to literally burn food and capture the heat produced to indeed raise the temperature of 1 liter of water by 1℃.
If you’re having trouble imagining such equipment, here it is:
Bomb Calorimeter: Definition, Construction, & Operation (with diagram and FAQs)
The unfortunate implication of the above information
A kilogram of sawdust contains about a 1000 kcal, give or take what wood was used and various other conditions.
However, that does not mean you can usefully eat the sawdust. In other words:
Calorie count tells us only how good something is at raising the temperature of water if physically burned.
Now do you see why oils and sugars have such comparably high calorie counts?
And while we may talk about “burning calories” as a metaphor, we do not, in fact, have a little wood stove inside us burning the food we eat.
A calorie is a calorie: True or False?
Definitely False! Building on from the above… We will get very little energy from sawdust; it’s not just that we can’t use it; we can’t store it either; it’ll mostly pass through as fiber.
(however, please do not use sawdust to get your daily dose of fiber either, as it is not safe for human consumption and may give you diseases, depending on what is lurking in it)
But let’s look at oil and sugar, two very high-calorie categories of food, because they’re really easy to physically burn and they give off a good flame.
A bomb calorimeter may treat them quite equally, but to our body, they are metabolically very different indeed.
For a start, most sugars will get absorbed and processed much more quickly than most oils, and that can overwhelm the liver (responsible for glycogen management), and lead to non-alcoholic fatty liver disease, diabetes, and more. Metabolic syndrome in general, and if you keep it up too much and you may find it’s now a lottery between dying of NAFLD, diabetes, or heart disease (it’ll usually be the heart disease that kills).
See also:
- Which Sugars Are Healthier, And Which Are Just The Same?
- 10 Ways To Balance Blood Sugars
- How To Unfatty A Fatty Liver
Meanwhile, we know all about the different kinds of nutritional profiles that oils can have, and some can promote having high energy without putting on fat, while others can strain the heart. Not even “a fat is a fat”, so “a calorie is a calorie” doesn’t get much mileage outside of a bomb calorimeter!
See also:
A calorie-controlled / calorie-restricted diet is an effective weight loss strategy: True or False?
True, usually! Surprise!
- On the one hand: calories are a wildly imprecise way to reckon the value of food, and using them as a guide to health can be dangerously misleading
- On the other hand: the very activity of calorie-counting itself promotes mindful eating, which is very good for the health
There is a strong difference between the mind of somebody who is carefully logging their pre-bedtime piece of chocolate and reflecting on its nutritional value, vs someone who isn’t sure whether this is their second or third glass of wine, nor how much the glass contained.
So if you want to get most of the benefits of a calorie-controlled diet without counting calories, you may try taking a “mindful eating” approach to diet.
However! If you want to do this for weight loss, be aware, that you will have to practice it all the time, not just for one meal here and there.
You can read more on how to do “mindful eating” here:
Dr. Rupy Aujla: The Kitchen Doctor | Mindful Eating & Interoception
Take care!
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The Teenage Brain – by Dr. Frances Jensen
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We realize that we probably have more grandparents of teenagers than parents of teenagers here, but most of us have at least some teenage relative(s). Which makes this book interesting.
There are a lot of myths about the teenage brain, and a lot of popular assumptions that usually have some basis in fact but are often misleading.
Dr. Jensen gives us a strong foundational grounding in the neurophysiology of adolescence, from the obvious-but-often-unclear (such as the role of hormones) to less-known things like the teenage brain’s general lack of myelination. Not just “heightened neuroplasticity” but, if you imagine the brain as an electrical machine, then think of myelin as the insulation between the wires. Little wonder some wires may get crossed sometimes!
She also talks about such things as the teenage circadian rhythm’s innate differences, the impact of success and failure on the brain, and harder topics such as addiction—and the adolescent cortisol functions that can lead to teenagers needing to seek something to relax in the first place.
In criticism, we can only say that sometimes the author makes sweeping generalizations without acknowledging such, but that doesn’t detract from what she has to say on the topic of neurophysiology.
Bottom line: if there’s a teenager in your life whose behavior and/or moods are sometimes baffling to you, and whose mysteries you’d like to unravel, this is a great book.
Click here to check out the Teenage Brain, and better understand those around you!
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The Herbal Supplement That Rivals Prozac
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Flower Power: St. John’s Wort’s Drug-Level Effectiveness
St. John’s wort is a small yellow flower, extract of which can be bought inexpensively off-the-shelf in pretty much any pharmacy in most places.
It’s sold and used as a herbal mood-brightener.
Does it work?
Yes! It’s actually very effective. This is really uncontroversial, so we’ll keep it brief.
The main findings of studies are that St. John’s wort not only gives significant benefits over placebo, but also works about as well as prescription anti-depressants:
A systematic review of St. John’s wort for major depressive disorder
They also found that fewer people stop taking it, compared to how many stop taking antidepressants. It’s not known how much of this is because of its inexpensive, freely-accessible nature, and how much might be because it gave them fewer adverse side effects:
Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis
How does it work?
First and foremost, it’s an SSRI—a selective serotonin reuptake inhibitor. Basically, it doesn’t add serotonin, but it makes whatever serotonin you have, last longer. Same as most prescription antidepressants. It also affects adenosine and GABA pathways, which in lay terms, means it promotes feelings of relaxation, in a similar way to many prescription antianxiety medications.
Mechanism of action of St John’s wort in depression: what is known?
Any problems we should know about?
Yes, definitely. To quote directly from the National Center for Complementary and Integrative Health:
St. John’s wort can weaken the effects of many medicines, including crucially important medicines such as:
- Antidepressants
- Birth control pills
- Cyclosporine, which prevents the body from rejecting transplanted organs
- Some heart medications, including digoxin and ivabradine
- Some HIV drugs, including indinavir and nevirapine
- Some cancer medications, including irinotecan and imatinib
- Warfarin, an anticoagulant (blood thinner)
- Certain statins, including simvastatin
I’ve read all that, and want to try it!
As ever, we don’t sell it (or anything else), but here’s an example product on Amazon.
Please be safe and do check with your doctor and/or pharmacist, though!
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Better Sex Through Mindfulness – by Dr. Lori Brotto
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Female sexuality is such a taboo topic that, if one searches for (ob/gyn professor, women’s health research director, and psychologist) Dr. Brotto’s book on Google or Amazon, it suggests only “lori brotto mindfulness book”. So, for those brave enough to read a book that would have shocked Victorians, what does this one contain?
The focus is on, as the title suggests, better sex, by and for women. That said, it’s mostly because typically women are more likely to experience the problems described in the book; it’s nothing actually intrinsic to womanhood. A man with the same problems could read this book and benefit just the same.
While the book covers many possible problems between the sheets, the overarching theme is problems of the mind, such as:
- Not getting into the mood in the first place
- Losing the mood quickly and easily, such as by becoming distracted
- Difficulty achieving orgasm even when mechanically everything’s delightful
- Physical discomfort creating a barrier to enjoyment
…and yes, that last one is in part mind-stuff too! Though Dr. Brotto isn’t arguing that mindfulness is a panacea, just an incredibly useful tool. And, it’s one she not only explains very well, but also explains from the position of a wealth of scientific evidence… Enough so, that we see a one-star Amazon reviewer from Canada complained that it was too well-referenced! For us, though, it’s what we like to see.
Good science, presented clearly and usefully, giving practical tips that improve people’s lives.
Bottom line: if you’ve ever lost the mood because you got distracted into thinking about taxes or that meeting on Tuesday, this is the book for you.
Click here to check out Better Sex Through Mindfulness—you can thank us later!
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Rosehip’s Benefits, Inside & Out
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It’s In The Hips
Rosehip (often also written: “rose hip”, “rosehips”, or “rose hips”, but we’ll use the singular compound here to cover its use as a supplement) is often found as an extra ingredient in various supplements, and also various herbal teas. But what is it and what does it actually do?
What it is: it’s the fruiting body that appears on rose plants underneath where the petals appear. They are seasonal.
As for what it does, read on…
Anti-inflammatory
Rosehip is widely sought for (and has been well-studied for) its anti-inflammatory powers.
Because osteoarthritis is one of the most common inflammatory chronic diseases around, a lot of the studies are about OA, but the mechanism of action is well-established as being antioxidant and anti-inflammatory in general:
❝Potent antioxidant radical scavenging effects are well documented for numerous rose hip constituents besides Vitamin C.
Furthermore, anti-inflammatory activities include the reduction of pro-inflammatory cytokines and chemokines, reduction of NF-kB signaling, inhibition of pro-inflammatory enzymes, including COX1/2, 5-LOX and iNOS, reduction of C-reactive protein levels, reduction of chemotaxis and chemoluminescence of PMNs, and an inhibition of pro-inflammatory metalloproteases.❞
Note that while rosehip significantly reduces inflammation, it doesn’t affect the range of movement in OA—further making clear its mechanism of action:
Read: Rosa canina fruit (rosehip) for osteoarthritis: a cochrane review
Anti-aging
This is partly about its antioxidant effect, but when it comes to skin, also partly its high vitamin C content. In this 8-week study, for example, taking 3mg/day resulted in significant reductions of many measures of skin aging:
Heart healthy
The dose required to achieve this benefit is much higher, but nonetheless its effectiveness is clear, for example:
❝Daily consumption of 40 g of rose hip powder for 6 weeks can significantly reduce cardiovascular risk in obese people through lowering of systolic blood pressure and plasma cholesterol levels. ❞
~ Dr. Mona Landin-Olsson et al.
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon
Enjoy!
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Chatter – by Dr. Ethan Kross
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This book is about much more than just one’s internal monologue. It does tackle that, but also the many non-verbal rabbit-holes that our brains can easily disappear into.
The author is an experimental psychologist, and brings his professional knowledge and experience to bear on this problem—citing many studies, including his own studies from his own lab, in which he undertook to answer precisely the implicit questions of “How can I…” in terms of tackling these matters, from root anxiety (for example) to end-state executive dysfunction (for example).
The writing style isn’t dense science though, and is very approachable for all.
The greatest value in this book lies in its prescriptive element, that is to say, its advice, especially in the category of evidence-based things we can do to improve matters for ourselves; beyond generic things like “mindfulness-based stress reduction” to much more specific things like “observe yourself in the 3rd person for a moment” and “take a break to imagine looking back on this later” and “interrupt yourself with a brief manual task”. With these sorts of interventions and more, we can shift the voice in our head from critic to coach.
Bottom line: if you would like your brain to let you get on with the things you actually want to do instead of constantly sidetracking you, this is the book for you.
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Palliative care as a true art form
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How do you ease the pain from an ailment amidst lost words? How can you serve the afflicted when lines start to blur? When the foundation of communication begins to crumble, what will be the pillar health-care professionals can lean on to support patients afflicted with dementia during their final days?
The practice of medicine is both highly analytical and evidence based in nature. However, it is considered a “practice” because at the highest level, it resembles a musician navigating an instrument. It resembles art. Between lab values, imaging techniques and treatment options, the nuances for individualized patient care so often become threatened.
Dementia, a non-malignant terminal illness, involves the progressive cognitive and social decline in those afflicted. Though there is no cure, dementia is commonly met in the setting of end-of-life care. During this final stage of life, the importance of comfort via symptomatic management and communication usually is a priority in patient care. But what about the care of a patient suffering from dementia? While communication serves as the vehicle to deliver care at a high level, medical professionals are suddenly met with a roadblock. And there … behind the pieces of shattered communication and a dampened map of ethical guidelines, health-care providers are at a standstill.
It’s 4:37 a.m. You receive a text message from the overnight nurse at a care facility regarding a current seizure. After lorazepam is ordered and administered, Mr. H, a quick-witted 76-year-old, stabilizes. Phenobarbital 15mg SC qhs was also added to prevent future similar events. You exhale a sigh of relief.
Mr. H. has been admitted to the floor 36 hours earlier after having a seizure while playing poker with colleagues. Since he became your patient, he’s shared many stories from professional and family life with you, along with as many jokes as he could fit in between. However, over the course of the next seven days, Mr. H. would develop aspiration pneumonia, progressing to ventilator dependency and, ultimately, multi-organ failure with rapid cognitive decline.
What strategies and tools would you use to maximize the well-being of your patient during his decline? How would you bridge the gap of understanding between the patient’s family and health-care team to provide the standard of care that all patients are owed?
To give Mr. H. the type of care he would have wanted, upon his hospital admission, he should have been questioned about his understanding of illness along with the goals of care of the medical team. The patient should have been informed that it is imperative to adhere to the medical regimen implemented by his team along with the risks of not doing so. In the event disease-related complications arose, advanced directives should have been documented to avoid any unnecessary measures.
It is important to note, that with each change in status of the patient’s health status, the goal of treatment must be reassessed. The patient or surrogate decision-maker’s understanding of these goals is paramount in maintaining the patient’s autonomy. It is often said that effective communication is the bedrock of a healthy relationship. This is true regardless of type of relationship.
This is why I and Megan Vierhout wrote Integrated End of Life Care in Dementia: A Comprehensive Guide, a book targeted at providing a much-needed road map to navigate the many challenges involved in end-of-life care for individuals with dementia. Ultimately, our aim is to provide a compass for both health-care professionals and the families of those affected by the progressive effects of dementia. We provide practical advice on optimizing communication with individuals with dementia while taking their cognitive limitations, preferences and needs into account.
I invite you to explore the unpredictable terrain of end-of-life care for patients with dementia. Together, we can pave a smoother, sturdier path toward the practice of medicine as a true art form.
This article is republished from healthydebate under a Creative Commons license. Read the original article.
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