
Should You Go Light Or Heavy On Carbs?
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Carb-Strong or Carb-Wrong?

We asked you for your health-related view of carbs, and got the above-depicted, below-described, set of responses
- About 48% said “Some carbs are beneficial; others are detrimental”
- About 27% said “Carbs are a critical source of energy, and safer than fats”
- About 18% said “A low-carb diet is best for overall health (and a carb is a carb)”
- About 7% said “We do not need carbs to live; a carnivore diet is viable”
But what does the science say?
Carbs are a critical source of energy, and safer than fats: True or False?
True and False, respectively! That is: they are a critical source of energy, and carbs and fats both have an important place in our diet.
❝Diets that focus too heavily on a single macronutrient, whether extreme protein, carbohydrate, or fat intake, may adversely impact health.❞
Source: Low carb or high carb? Everything in moderation … until further notice
(the aforementioned lead author Dr. de Souza, by the way, served as an external advisor to the World Health Organization’s Nutrition Guidelines Advisory Committee)
Some carbs are beneficial; others are detrimental: True or False?
True! Glycemic index is important here. There’s a big difference between eating a raw carrot and drinking high-fructose corn syrup:
Which Sugars Are Healthier, And Which Are Just The Same?
While some say grains and/or starchy vegetables are bad, best current science recommends:
- Eat some whole grains regularly, but they should not be the main bulk of your meal (non-wheat grains are generally better)
- Starchy vegetables are not a critical food group, but in moderation they are fine.
To this end, the Mediterranean Diet is the current gold standard of healthful eating, per general scientific consensus:
A low-carb diet is best for overall health (and a carb is a carb): True or False?
True-ish and False, respectively. We covered the “a carb is a carb” falsehood earlier, so we’ll look at “a low-carb diet is best”.
Simply put: it can be. One of the biggest problems facing the low-carb diet though is that adherence tends to be poor—that is to say, people crave their carby comfort foods and eat more carbs again. As for the efficacy of a low-carb diet in the context of goals such as weight loss and glycemic control, the evidence is mixed:
❝There is probably little to no difference in weight reduction and changes in cardiovascular risk factors up to two years’ follow-up, when overweight and obese participants without and with T2DM are randomised to either low-carbohydrate or balanced-carbohydrate weight-reducing diets❞
Source: Low-carbohydrate versus balanced-carbohydrate diets for reducing weight and cardiovascular risk
❝On the basis of moderate to low certainty evidence, patients adhering to an LCD for six months may experience remission of diabetes without adverse consequences.
Limitations include continued debate around what constitutes remission of diabetes, as well as the efficacy, safety, and dietary satisfaction of longer term LCDs❞
~ Dr. Joshua Goldenberg et al.
Source: Efficacy and safety of low and very low carbohydrate diets for type 2 diabetes remission
❝There should be no “one-size-fits-all” eating pattern for different patient´s profiles with diabetes.
It is clinically complex to suggest an ideal percentage of calories from carbohydrates, protein and lipids recommended for all patients with diabetes.❞
Source: Current Evidence Regarding Low-carb Diets for The Metabolic Control of Type-2 Diabetes
We do not need carbs to live; a carnivore diet is viable: True or False?
False. For a simple explanation:
The Carnivore Diet: Can You Have Too Much Meat?
There isn’t a lot of science studying the effects of consuming no plant products, largely because such a study, if anything other than observational population studies, would be unethical. Observational population studies, meanwhile, are not practical because there are so few people who try this, and those who do, do not persist after their first few hospitalizations.
Putting aside the “Carnivore Diet” as a dangerous unscientific fad, if you are inclined to meat-eating, there is some merit to the Paleo Diet, at least for short-term weight loss even if not necessarily long-term health:
What’s The Real Deal With The Paleo Diet?
For longer-term health, we refer you back up to the aforementioned Mediterranean Diet.
Enjoy!
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Behaving During the Holidays
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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
❝It’s hard to “behave” when it comes to holiday indulging…I’m on a low sodium, sugar restricted regimen from my doctor. Trying to get interested in bell peppers as a snack…wish me luck!❞
Good luck! Other low sodium, low sugar snacks include:
- Nuts! Unsalted, of course. We’re biased towards almonds 😉
- Mixed nuts are an especially healthy way to snack, though (assuming you don’t have an allergy, obviously)
- Air-popped popcorn (you can season it, just not with salt/sugar!)
- Fruit (but not fruit juice; it has to be in solid form)
- Peas (not a classic snack food, we know, but they can be enjoyed many ways)
- Seriously, try them frozen or raw! Frozen/raw peas are a great sweet snack.
- Chickpeas are great dried/roasted, by the way, and give much of the same pleasure as a salty snack without being salty! Obviously, this means cooking them without salt, but that’s fine, or if using tinned, choose “in water” rather than “in brine”
- Hummus is also a great healthy snack (check the ingredients for salt if not making it yourself, though) and can be enjoyed as a dip using raw vegetables (celery, carrot sticks, cruciferous vegetables, whatever you prefer)
Enjoy!
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- Nuts! Unsalted, of course. We’re biased towards almonds 😉
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Elon Musk says ketamine can get you out of a ‘negative frame of mind’. What does the research say?
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X owner Elon Musk recently described using small amounts of ketamine “once every other week” to manage the “chemical tides” that cause his depression. He says it’s helpful to get out of a “negative frame of mind”.
This has caused a range of reactions in the media, including on X (formerly Twitter), from strong support for Musk’s choice of treatment, to allegations he has a drug problem.
But what exactly is ketamine? And what is its role in the treatment of depression?
It was first used as an anaesthetic
Ketamine is a dissociative anaesthetic used in surgery and to relieve pain.
At certain doses, people are awake but are disconnected from their bodies. This makes it useful for paramedics, for example, who can continue to talk to injured patients while the drug blocks pain but without affecting the person’s breathing or blood flow.
Ketamine is also used to sedate animals in veterinary practice.
Ketamine is a mixture of two molecules, usually referred to a S-Ketamine and R-Ketamine.
S-Ketamine, or esketamine, is stronger than R-Ketamine and was approved in 2019 in the United States under the drug name Spravato for serious and long-term depression that has not responded to at least two other types of treatments.
Ketamine is thought to change chemicals in the brain that affect mood.
While the exact way ketamine works on the brain is not known, scientists think it changes the amount of the neurotransmitter glutamate and therefore changes symptoms of depression.How was it developed?
Ketamine was first synthesised by chemists at the Parke Davis pharmaceutical company in Michigan in the United States as an anaesthetic. It was tested on a group of prisoners at Jackson Prison in Michigan in 1964 and found to be fast acting with few side effects.
The US Food and Drug Administration approved ketamine as a general anaesthetic in 1970. It is now on the World Health Organization’s core list of essential medicines for health systems worldwide as an anaesthetic drug.
In 1994, following patient reports of improved depression symptoms after surgery where ketamine was used as the anaesthetic, researchers began studying the effects of low doses of ketamine on depression.
Researchers have been investigating ketamine for depression for 30 years.
SB Arts Media/ShutterstockThe first clinical trial results were published in 2000. In the trial, seven people were given either intravenous ketamine or a salt solution over two days. Like the earlier case studies, ketamine was found to reduce symptoms of depression quickly, often within hours and the effects lasted up to seven days.
Over the past 20 years, researchers have studied the effects of ketamine on treatment resistant depression, bipolar disorder, post-traumatic sress disorder obsessive-compulsive disorder, eating disorders and for reducing substance use, with generally positive results.
One study in a community clinic providing ketamine intravenous therapy for depression and anxiety found the majority of patients reported improved depression symptoms eight weeks after starting regular treatment.
While this might sound like a lot of research, it’s not. A recent review of randomised controlled trials conducted up to April 2023 looking at the effects of ketamine for treating depression found only 49 studies involving a total of 3,299 patients worldwide. In comparison, in 2021 alone, there were 1,489 studies being conducted on cancer drugs.
Is ketamine prescribed in Australia?
Even though the research results on ketamine’s effectiveness are encouraging, scientists still don’t really know how it works. That’s why it’s not readily available from GPs in Australia as a standard depression treatment. Instead, ketamine is mostly used in specialised clinics and research centres.
However, the clinical use of ketamine is increasing. Spravato nasal spray was approved by the Australian Therapuetic Goods Administration (TGA) in 2021. It must be administered under the direct supervision of a health-care professional, usually a psychiatrist.
Spravato dosage and frequency varies for each person. People usually start with three to six doses over several weeks to see how it works, moving to fortnightly treatment as a maintenance dose. The nasal spray costs between A$600 and $900 per dose, which will significantly limit many people’s access to the drug.
Ketamine can be prescribed “off-label” by GPs in Australia who can prescribe schedule 8 drugs. This means it is up to the GP to assess the person and their medication needs. But experts in the drug recommend caution because of the lack of research into negative side-effects and longer-term effects.
What about its illicit use?
Concern about use and misuse of ketamine is heightened by highly publicised deaths connected to the drug.
Ketamine has been used as a recreational drug since the 1970s. People report it makes them feel euphoric, trance-like, floating and dreamy. However, the amounts used recreationally are typically higher than those used to treat depression.
Information about deaths due to ketamine is limited. Those that are reported are due to accidents or ketamine combined with other drugs. No deaths have been reported in treatment settings.
Reducing stigma
Depression is the third leading cause of disability worldwide and effective treatments are needed.
Seeking medical advice about treatment for depression is wiser than taking Musk’s advice on which drugs to use.
However, Musk’s public discussion of his mental health challenges and experiences of treatment has the potential to reduce stigma around depression and help-seeking for mental health conditions.
Clarification: this article previously referred to a systematic review looking at oral ketamine to treat depression. The article has been updated to instead cite a review that encompasses other routes of administration as well, such as intravenous and intranasal ketamine.
Julaine Allan, Associate Professor, Mental Health and Addiction, Rural Health Research Institute, Charles Sturt University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Teriyaki Chickpea Burgers
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Burgers are often not considered the healthiest food, but they can be! Ok, so the teriyaki sauce component itself isn’t the healthiest, but the rest of this recipe is, and with all the fiber this contains, it’s a net positive healthwise, even before considering the protein, vitamins, minerals, and assorted phytonutrients.
You will need
- 2 cans chickpeas, drained and rinsed (or 2 cups of chickpeas, cooked drained and rinsed)
- ¼ cup chickpea flour (also called gram flour or garbanzo bean flour)
- ¼ cup teriyaki sauce
- 2 tbsp almond butter (if allergic, substitute with a seed butter if available, or else just omit; do not substitute with actual butter—it will not work)
- ½ bulb garlic, minced
- 1 large chili, minced (your choice what kind, color, or even whether or multiply it)
- 1 large shallot, minced
- 1″ piece of ginger, grated
- 2 tsp teriyaki sauce (we’re listing this separately from the ¼ cup above as that’ll be used differently)
- 1 tsp yeast extract (even if you don’t like it; trust us, it’ll work—this writer doesn’t like it either but uses it regularly in recipes like these)
- 1 tbsp black pepper
- 1 tsp fennel powder
- ½ tsp sweet cinnamon
- ½ tsp MSG or 1 tsp low-sodium salt
- Extra virgin olive oil for frying
For serving:
- Burger buns (you can use our Delicious Quinoa Avocado Bread recipe)
- Whatever else you want in there; we recommend mung bean sprouts, red onion, and a nice coleslaw
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 400℉ / 200℃.
2) Roast the chickpeas spaced out on a baking tray (lined with baking paper) for about 15 minutes. Leave the oven on afterwards; we still need it.
3) While that’s happening, heat a little oil in a skillet to a medium heat and fry the shallot, chili, garlic, and ginger, for about 2–3 minutes. You want to release the flavors, but not destroy them.
4) Let them cool, and when the chickpeas are done, let them cool for a few minutes too, before putting them all into a food processor along with the rest of the ingredients from the main section, except the oil and the ¼ cup teriyaki sauce. Process them into a dough.
5) Form the dough into patties; you should have enough dough for 4–6 patties depending on how big you want them.
6) Brush them with the teriyaki sauce; turn them onto a baking tray (lined with baking paper) and brush the other side too. Be generous.
7) Bake them for about 15 minutes, turn them (taking the opportunity to add more teriyaki sauce if it seems to merit it) and bake for another 5–10 minutes.
8) Assemble; we recommend the order: bun, a little coleslaw, burger, red onion, more coleslaw, mung bean sprouts, bun, but follow your heart!
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Three Daily Servings of Beans/Legumes?
- Hoisin Sauce vs Teriyaki Sauce – Which is Healthier?
- Sprout Your Seeds, Grains, Beans, Etc
- Our Top 5 Spices: How Much Is Enough For Benefits? ← we scored 4/5 today!
- Monosodium Glutamate: Sinless Flavor-Enhancer Or Terrible Health Risk?
Take care!
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People with dementia aren’t currently eligible for voluntary assisted dying. Should they be?
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Dementia is the second leading cause of death for Australians aged over 65. More than 421,000 Australians currently live with dementia and this figure is expected to almost double in the next 30 years.
There is ongoing public discussion about whether dementia should be a qualifying illness under Australian voluntary assisted dying laws. Voluntary assisted dying is now lawful in all six states, but is not available for a person living with dementia.
The Australian Capital Territory has begun debating its voluntary assisted dying bill in parliament but the government has ruled out access for dementia. Its view is that a person should retain decision-making capacity throughout the process. But the bill includes a requirement to revisit the issue in three years.
The Northern Territory is also considering reform and has invited views on access to voluntary assisted dying for dementia.
Several public figures have also entered the debate. Most recently, former Australian Chief Scientist, Ian Chubb, called for the law to be widened to allow access.
Others argue permitting voluntary assisted dying for dementia would present unacceptable risks to this vulnerable group.
Inside Creative House/Shutterstock Australian laws exclude access for dementia
Current Australian voluntary assisted dying laws exclude access for people who seek to qualify because they have dementia.
In New South Wales, the law specifically states this.
In the other states, this occurs through a combination of the eligibility criteria: a person whose dementia is so advanced that they are likely to die within the 12 month timeframe would be highly unlikely to retain the necessary decision-making capacity to request voluntary assisted dying.
This does not mean people who have dementia cannot access voluntary assisted dying if they also have a terminal illness. For example, a person who retains decision-making capacity in the early stages of Alzheimer’s disease with terminal cancer may access voluntary assisted dying.
What happens internationally?
Voluntary assisted dying laws in some other countries allow access for people living with dementia.
One mechanism, used in the Netherlands, is through advance directives or advance requests. This means a person can specify in advance the conditions under which they would want to have voluntary assisted dying when they no longer have decision-making capacity. This approach depends on the person’s family identifying when those conditions have been satisfied, generally in consultation with the person’s doctor.
Another approach to accessing voluntary assisted dying is to allow a person with dementia to choose to access it while they still have capacity. This involves regularly assessing capacity so that just before the person is predicted to lose the ability to make a decision about voluntary assisted dying, they can seek assistance to die. In Canada, this has been referred to as the “ten minutes to midnight” approach.
But these approaches have challenges
International experience reveals these approaches have limitations. For advance directives, it can be difficult to specify the conditions for activating the advance directive accurately. It also requires a family member to initiate this with the doctor. Evidence also shows doctors are reluctant to act on advance directives.
Particularly challenging are scenarios where a person with dementia who requested voluntary assisted dying in an advance directive later appears happy and content, or no longer expresses a desire to access voluntary assisted dying.
What if the person changes their mind? Jokiewalker/Shutterstock Allowing access for people with dementia who retain decision-making capacity also has practical problems. Despite regular assessments, a person may lose capacity in between them, meaning they miss the window before midnight to choose voluntary assisted dying. These capacity assessments can also be very complex.
Also, under this approach, a person is required to make such a decision at an early stage in their illness and may lose years of otherwise enjoyable life.
Some also argue that regardless of the approach taken, allowing access to voluntary assisted dying would involve unacceptable risks to a vulnerable group.
More thought is needed before changing our laws
There is public demand to allow access to voluntary assisted dying for dementia in Australia. The mandatory reviews of voluntary assisted dying legislation present an opportunity to consider such reform. These reviews generally happen after three to five years, and in some states they will occur regularly.
The scope of these reviews can vary and sometimes governments may not wish to consider changes to the legislation. But the Queensland review “must include a review of the eligibility criteria”. And the ACT bill requires the review to consider “advanced care planning”.
Both reviews would require consideration of who is able to access voluntary assisted dying, which opens the door for people living with dementia. This is particularly so for the ACT review, as advance care planning means allowing people to request voluntary assisted dying in the future when they have lost capacity.
The legislation undergoes a mandatory review. Jenny Sturm/Shutterstock This is a complex issue, and more thinking is needed about whether this public desire for voluntary assisted dying for dementia should be implemented. And, if so, how the practice could occur safely, and in a way that is acceptable to the health professionals who will be asked to provide it.
This will require a careful review of existing international models and their practical implementation as well as what would be feasible and appropriate in Australia.
Any future law reform should be evidence-based and draw on the views of people living with dementia, their family caregivers, and the health professionals who would be relied on to support these decisions.
Ben White, Professor of End-of-Life Law and Regulation, Australian Centre for Health Law Research, Queensland University of Technology; Casey Haining, Research Fellow, Australian Centre for Health Law Research, Queensland University of Technology; Lindy Willmott, Professor of Law, Australian Centre for Health Law Research, Queensland University of Technology, Queensland University of Technology, and Rachel Feeney, Postdoctoral research fellow, Queensland University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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From Lupus To Arthritis: New Developments
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This week’s health news round-up highlights some things that are getting better, and some things that are getting worse, and how to be on the right side of both:
New hope for lupus sufferers
Lupus is currently treated mostly with lifelong medications to suppress the immune system, which is not only inconvenient, but also can leave people more open to infectious diseases. The latest development uses CAR T-cell technology (as has been used in cancer treatment for a while) to genetically modify cells to enable the body’s own immune system to behave properly:
Read in full: Exciting new lupus treatment could end need for lifelong medication
Related: How to Prevent (Or Reduce The Severity Of) Inflammatory Diseases
It’s in the hips
There are a lot of different kinds of hip replacements, and those with either delta ceramic or oxidised zirconium head with a highly cross-linked polyethylene liner/cup have the lowest risk of need for revision in the 15 years after surgery. This is important, because obviously, once it’s in there, you want it to be able to stay in there and not have to be touched again any time soon:
Read in full: Study identifies hip implant materials with the lowest risk of needing revision
Related: Nobody Likes Surgery, But Here’s How To Make It Much Less Bad
Sooner is better than later
Often, people won’t know about an unwanted pregnancy in the first six weeks, but for those who are able to catch it early, Very Early Medical Abortion (VEMA) offers a safe an effective way of doing so, with success rate being linked to earliness of intervention:
Read in full: Very early medication abortion is effective and safe, study finds
Related: What Might A Second Trump Presidency Look Like for Health Care?
Increased infectious disease risks from cattle farms
Many serious-to-humans infectious diseases enter the human population via the animal food chain, and in this case, bird flu becoming more rampant amongst cows is starting to pose a clear threat to humans, so this is definitely something to be aware of:
Read in full: Bird flu infects 1 in 14 dairy workers exposed; CDC urges better protections
Related: With Only Gloves To Protect Them, Farmworkers Say They Tend Sick Cows Amid Bird Flu
Herald of woe
Gut health affects most of the rest of health, and there are a lot of links between gut and bone health. In this case, an association has been found between certain changes in the gut microbiome, and subsequent onset of rheumatoid arthritis:
Read in full: Changes in gut microbiome could signal onset of rheumatoid arthritis
Related: Stop Sabotaging Your Gut
Take care!
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The Body Is Not an Apology – by Sonya Renee Taylor
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First, a couple of things that this book is not about:
- Self-confidence (it’s about more than merely thinking highly of oneself)
- Self-acceptance (it’s about more than merely settling for “good enough”)
In contrast, it’s about loving and celebrating what is, while striving for better, for oneself and for others.
You may be wondering: whence this “radical” in the title?
The author argues that often, the problem with our bodies is not actually our bodies. If we have cancer, or diabetes, then sure, that’s a problem with the body. But most of the time, the “problem with our bodies” is simply society’s rejection of our “imperfect” bodies as somehow “less than”, and something we must invest time and money to correct. Hence, the need for a radical uprooting of ideas, to fix the real problem.
Bottom line: if, like most of us, you have a body that would not entirely pass for that of a Marvel Comics superhero, this is a book for you. And if you do have a MCU body? This is also a book for you, because we have bad news for you about what happens with age.
Click here to check out The Body Is Not An Apology, and appreciate more about yours!
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