Eat To Beat Chronic Fatigue!

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How To Eat To Beat Chronic Fatigue

Chronic fatigue is on the rise, and it can make life a living Hell. Days blur into one, and you try to take each day as it comes, but sometimes several days gang up on you at once.

You probably know some lifestyle changes that might help—if only you had the energy to implement them.

You’d like to eat well, but you need to…

  1. Buy the fresh produce (and take a little rest after)
  2. Put the groceries away (and take a little rest after)
  3. Wash the vegetables (and take a little rest after)
  4. Chop the things as necessary (and take a little rest after)
  5. Cook dinner (and take a little rest after)

…and now you’re too exhausted to eat it.

So, what can be done?

First, avoid things that cause inflammation, as this is a major contributor to chronic fatigue. You might like our previous main feature:

Keep Inflammation At Bay!

Next up, really do stay hydrated. It’s less about quantity, and more about ubiquity. Hydrate often.

Best is if you always have some (hydrating) drink on the go.

Do experiment with your diet, and/but keep a food journal of what you eat and how you feel 30–60 minutes after eating it. Only make one change at a time, otherwise you won’t know which change made the difference.

Notice what patterns emerge over time, and adjust your ingredients accordingly.

Limit your caffeine intake. We know that sometimes it seems like the only way to get through the day, but you will always crash later, because it was only ever taxing your adrenal system (thus: making you more tired in the long run) and pulling the wool over the eyes of your adenosine receptors (blocking you from feeling how tired you are, but not actually reducing your body’s tiredness).

Put simply, caffeine is the “payday loan” of energy.

Eat more non-starchy vegetables, and enjoy healthy fats. Those healthy fats can come from nuts and seeds, avocado, or fish (not fried, though!).

The non-starchy vegetables will boost your vitamins and fiber while being easy on your beleaguered metabolism, while the healthy fats will perk up your energy levels without spiking insulin like sugars would.

Pay the fatigue tax up front. What this means is… Instead of throwing away vegetables that didn’t get used because it would take too much effort and you just need an easier dinner today, buy ready-chopped vegetables, for example.

And if you buy vegetables frozen, they’re also often not only cheaper, but also (counterintuitively) contain more nutrients.

A note of distinction:

Many more people have chronic fatigue (the symptom: being exhausted all the time) than have chronic fatigue syndrome (the illness: myalgic encephalomyelitis).

This is because fatigue can be a symptom of many, many other conditions, and can be heavily influenced by lifestyle factors too.

A lot of the advice for dealing with chronic fatigue is often the same in both cases, but some will be different, because for example:

  • If your fatigue is from some other condition, that condition probably impacts what lifestyle factors you are (and are not) able to change, too
  • If your fatigue is from lifestyle factors, that hopefully means you can change those and enjoy less fatigue…
    • But if it’s not from lifestyle factors, as in ME/CFS, then advice to “exercise more” etc is not going to help so much.

There are ways to know the difference though:

Check out: Do You Have Chronic Fatigue Syndrome?

Don’t Forget…

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  • How To Nap Like A Pro (No More “Sleep Hangovers”!)

    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.

    How To Be An Expert Nap-Artist

    There’s a lot of science to say that napping can bring us health benefits—but mistiming it can just make us more tired. So, how to get some refreshing shut-eye, without ending up with a case of the midday melatonin blues?

    First, why do we want to nap?

    Well, maybe we’re just tired, but there are specific benefits even if we’re not. For example:

    What can go wrong?

    There are two main things that can go wrong, physiologically speaking:

    1. We can overdo it, and not sleep well at night
    2. We can awake groggy and confused and tired

    The first is self-explanatory—it messes with the circadian rhythm. For this reason, we should not sleep more than 90 minutes during the day. If that seems like a lot, and maybe you’ve heard that we shouldn’t sleep more than half an hour, there is science here, so read on…

    The second is a matter of sleep cycles. Our brain naturally organizes our sleep into multiples of 20-minute segments, with a slight break of a few minutes between each. Consequently, naps should be:

    • 25ish minutes
    • 40–45 minutes
    • 90ish minutes

    If you wake up mid-cycle—for example, because your alarm went off, or someone disturbed you, or even because you needed to pee, you will be groggy, disoriented, and exhausted.

    For this reason, a nap of one hour (a common choice, since people like “round” numbers) is a recipe for disaster, and will only work if you take 15 minutes to fall asleep. In which case, it’d really be a nap of 45 minutes, made up of two 20-minute sleep cycles.

    Some interruptions are better/worse than others

    If you’re in light or REM sleep, a disruption will leave you not very refreshed, but not wiped out either. And as a bonus, if you’re interrupted during a REM cycle, you’re more likely to remember your dreams.

    If you’re in deep sleep, a disruption will leave you with what feels like an incredible hangover, minus the headache, and you’ll be far more tired than you were before you started the nap.

    The best way to nap

    Taking these factors into account, one of the “safest” ways to nap is to set your alarm for the top end of the time-bracket above the one you actually want to nap for (e.g., if you want to nap for 25ish minutes, set your alarm for 45).

    Unless you’re very sleep-deprived, you’ll probably wake up briefly after 20–25 minutes of sleep. This may seem like nearer 30 minutes, if it took you some minutes to fall asleep!

    If you don’t wake up then, or otherwise fail to get up, your alarm will catch you later at what will hopefully be between your next sleep cycles, or at the very least not right in the middle of one.

    When you wake up from a nap before your alarm, get up. This is not the time for “5 more minutes” because “5 more minutes” will never, ever, be refreshing.

    Rest well!

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  • How influencers and content creators discuss birth control on social media: What research shows

    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.

    News articles in recent weeks have documented the spread of misinformation about hormonal birth control methods on popular social media platforms like TikTok, YouTube and X, formerly called Twitter. Influencers with large and small followings are sharing unsubstantiated claims about the side effects of contraceptives, while directly or indirectly encouraging others to stop using them.

    This trend has not escaped researchers, who for several years have been investigating what people who can get pregnant are posting on social media platforms about hormonal and non-hormonal birth control methods. Understanding the drivers of these trends is important because they have implications for policy and patient care, according to researchers. Some worry that during the post-Dobbs era, when there are continued strikes against reproductive rights in the U.S., misinformation about birth control on social media could have a negative influence on contraceptive preferences — potentially leading to more unwanted pregnancies.

    More than 90% of women of reproductive age have used at least one contraceptive method, according to a 2023 report by the U.S. National Center for Health Statistics. However, the report also finds that the use of male condoms and withdrawal methods increased between 2006 and 2019, while the use of the birth control pill decreased. Non-hormonal contraception methods, including condoms, spermicides, withdrawal and menstrual cycle tracking, are 10% or less effective than hormonal contraceptives. The only exceptions are surgical sterilization and the copper intrauterine device.

    To be sure, not all birth control-related content posted on social media platforms is negative, studies show. Health care professionals are sharing educational material with a high rate of engagement and non-health care professional users share their positive experiences with the birth control methods they use.

    But as you will see in the studies curated below, researchers also find that social media users, including influencers, share inaccurate information about hormonal contraceptives on various social media platforms, discuss their discontinuation of birth control in favor of non-hormonal methods and engage in unsubstantiated fear-mongering of hormonal contraceptives.

    Researchers also have learned that the content posted on social media platforms has changed in tone over time, mirroring the shift in the national political discourse.

    In a 2021 study published in the American Journal of Obstetrics & Gynecology, researchers analyzed more than 800,000 English-language tweets mentioning at least one contraceptive method between March 2006, when Twitter was founded, and December 2019. They coded the sentiment of tweets as positive, neutral or negative.

    “What we found over time was that the number of neutral tweets went down for each and every one of the birth control methods, and people became more polarized with regards to how they talk on these social media platforms over those 13 years,” says study co-author Dr. Deborah Bartz, an OB-GYN at Brigham and Women’s Hospital with expertise in complex family planning and an associate professor at Harvard Medical School.

    In a February 2024 commentary in the Journal of Women’s Health, University of Delaware researchers Emily Pfender and Leah Fowler argue that ongoing dialogue about contraception on social media provides “a glimpse into public sentiment about available options” to people who can get pregnant.

    The authors also note that misinformation and disinformation about hormonal contraception may have a larger effect on health disparities, especially among historically marginalized groups who may already mistrust the medical establishment.

    “This may contribute to unintended pregnancy and delayed care, further widening health disparities and hindering progress toward equitable reproductive health outcomes,” Pfender and Fowler write.

    Side effects

    There are known side effects to hormonal birth control methods, including headaches, nausea, sore breasts and spotting. Most are mild and disappear with continued use or with switching to another method. Among hormonal contraceptives, only the Depo-Provera injection has been linked with weight gain, studies show.  

    But some social media influencers have spread false claims about the potential side effects of hormonal birth control methods, ranging from infertility to abortion to unattractiveness. Despite these false claims, physicians and professional organizations such as the American College of Obstetricians and Gynecologists find today’s contraceptive options safe and very effective.

    “They’re about the most low-risk prescription that I give,” says Dr. Megana Dwarakanath, an adolescent medicine physician in Pittsburgh. “I always joke that if something goes wrong in someone’s life, they’re within the reproductive years, it always gets blamed on birth control.”

    Dwarakanath says her young patients are most worried about two side effects: weight gain and mood. “Those are the things that they will almost always attribute to their birth control at a time that their bodies are also changing very rapidly,” she says. “Things like mental health diagnoses or personality disorders also tend to crop up during the time young people have started or have been on birth control.”

    Most research on the link between oral contraceptives and cancer risk comes from observational studies, according to the National Cancer Institute. Overall, the studies have consistently shown that the risks of breast and cervical cancer are slightly increased for women who use oral contraceptives, whereas the risk of endometrial, ovarian and colorectal cancers are reduced.

    The use of hormonal birth control has also been associated with an increase in the risk of developing blood clots, studies show. But that risk is not universal for everyone who takes hormonal birth control. This risk is higher for women 35 and older, those who smoke, are very overweight or have a history of cardiovascular disease. Overall, 3 to 9 out of 10,000 women who take the pill are at risk of developing blood clots within a given year. The risk for women who don’t take the pill is 1 to 5 out of 10,000.

    There is no association between the pill and mood disorders, according to a large body of research, including a 2021 cohort study of nearly 740,000 young women. 

    It’s worth noting the dearth of research into women’s reproductive health due to chronic underfunding of women’s health research. An analysis of funding by the U.S. National Institutes of Health finds that in nearly three-quarters of the cases where a disease affects mainly one gender, the institute’s funding pattern favored males. Either the disease affected more women and was underfunded, or the disease affected more men and was overfunded, according to the 2021 study published in the Journal of Women’s Health.

    Aside from underfunding, conducting robust research into the long-term effects of birth control is complex.

    “Historically, people haven’t felt that it’s ethically OK to randomize people to birth control methods in large part because the outcome of unintended pregnancy is greater,” for people who are given the placebo, Bartz says.

    Research on birth control misinformation on social media

    Social media use is widespread among young adults. More than 90% of Americans between 18 and 29 reported ever using YouTube, while 78% said they had used Instagram, 62% used TikTok and 42% used Twitter, according to a 2023 survey of 5,733 U.S. adults by Pew Research Center.

    These years overlap with the demographic of people who are most likely to use birth control. And because the use of contraceptives is less stigmatized today, people are more likely to talk with one another about their questions and concerns or share that information online.

    In addition to investigating the general landscape of social media posts about birth control, researchers are also interested in the type of content influencers, who typically have 20,000 or more followers, post, because of their persuasive power over their audiences.

    “When influencers disclose personal experiences and beliefs about various topics, audience members tend to form similar attitudes especially when they feel connected to the influencer,” Pfender and M. Marie Devlin write in a 2023 study published in the journal Health Communication.

    Below we have curated several studies published in recent years documenting the spread of birth control misinformation on social media. The roundup is followed by a quick reference guide on female contraceptives and their actual potential side effects.

    Contraceptive Content Shared on Social Media: An Analysis of Twitter
    Melody Huang, et al. Contraception and Reproductive Medicine, February 2024.

    The study: The authors explore how contraceptive information is shared on X and understand how those posts affect women’s decisions. They analyze a random 1% of publicly available English-language tweets about reversible prescription contraceptive methods, from January 2014 and December 2019. The 4,434 analyzed tweets included at least 200 tweets per birth control method — IUDs, implants, the pill, patch and ring.

    The findings: 26.7% of tweets about contraceptive methods discussed decision-making and 20.5% discussed side effects, especially the side effects of IUDs and the depot medroxyprogesterone acetate (DMPA or Depo-Provera) shot. Discussions about the pill, patch or ring prompted more discussions on logistics and adherence. About 6% of tweets explicitly requested information. Tweets about IUDs were most popular in terms of likes.

    More importantly, 50.6% of the tweets were posted by contraceptive users, while only 6% came from official health or news sources. Tweets from news or journalistic sources were more frequent than tweets from a health care professional or organization.

    Some tweets contained misinformation represented as facts, such as the unsubstantiated claim that IUDs can cause fertility issues. Others were outwardly misogynistic, shaming women and claiming that they wouldn’t be able to have kids because of using hormonal birth control.

    One takeaway: “While Twitter may provide valuable insight, with more tweets being created by personal contraceptive users than official healthcare sources, the available information may vary in reliability. Asking patients about information from social media can help reaffirm to patients the importance of social networks in contraceptive decision-making while also addressing misconceptions to improve contraceptive counseling,” the authors write.

    What Do Social Media Influencers Say About Birth Control? A Content Analysis of YouTube Vlogs About Birth Control
    Emily J. Pfender and M. Marie Devlin. Health Communication, January 2023.

    The study: To explore what social media influencers shared on YouTube about their experiences with hormonal and non-hormonal methods of birth control, the researchers analyzed 50 vlogs posted between December 2019 and December 2021. Most of the 50 influencers were categorized on YouTube as Lifestyle (72%) and Fitness (16%). They had between 20,000 and 2.2 million subscribers each.

    The findings: In total, 74% of the influencers talked about discontinuing hormonal birth control. About 44% said the main reason they were discontinuing birth control was to be more natural, while 32% said they wanted to improve their mental health and 20% were concerned about weight gain.

    Forty percent of influencers mentioned using non-hormonal birth control methods such as menstrual cycle tracking, condoms, non-hormonal IUDs and the pull-out method. Twenty percent reported switching from hormonal to non-hormonal methods.

    One takeaway: “Our content analysis revealed that discontinuation of hormonal birth control is commonly discussed among [social media influencers] on YouTube and sexual health information from influencers might not provide accurate educational information and tools… this is especially concerning given that social media is young adults’ primary tool for sexual health information. Future research is needed to understand the effects of SMI birth control content on sexual health behaviors,” the authors write.

    Hormonal Contraceptive Side Effects and Nonhormonal Alternatives on TikTok: A Content Analysis
    Emily J. Pfender, Kate Tsiandoulas, Stephanie R. Morain and Leah R. Fowler. Health Promotion Practice, January 2024.

    The study: The authors analyzed the content of 100 TikTok videos that used the hashtags #birthcontrolsideeffects and #nonhormonalcontraception. Their goal was to understand the types of content about side effects of hormonal and non-hormonal contraceptives on TikTok.

    The findings: The videos averaged about 1 minute and garnered an average of 27,795 likes, 251 comments and 623 shares. For #birthcontrolsideeffects, 80% of the audience was 18 to 24 years old and videos with that hashtag had 43 million views worldwide as of July 7, 2023.

    Thirty-two percent of the videos were by regular users (non-influencers), 26 by clinicians, 13% by health coaches and 2% by companies. Only 3% had a sponsorship disclosure and 6% included a medical disclaimer, that the person was not a doctor or was not providing medical advice.

    Most of the 100 videos (71%) mentioned hormonal contraception. Among them 51% discussed unspecific hormonal contraceptives, 31% talked about the pill and 11% about hormonal IUDs. Four of the 71 creators explicitly recommended against using hormonal contraceptives.

    Claims about hormonal contraceptives were mostly based on personal experience. About 25% of the creators cited no basis for their claims, 23% included outside evidence, including unspecified studies or information from the FDA insert, and 11% used a combination of personal and outside evidence.

    Almost half (49%) mentioned discontinuing their hormonal contraception, with negative side effects cited as the most common reason.

    The creators talked about mental health issues, weight gain, headaches, and less common risks of various cancers or chronic illness, change in personality and blood clots. They were less likely to mention the positive aspects of birth control.

    About 52% of videos mentioned non-hormonal contraception, including copper IUDs and cycle tracking.

    Nine of the 100 creators expressed feeling dismissed, pressured, gaslit or insufficiently informed about contraception by medical providers.

    One takeaway: “Our findings support earlier work suggesting social media may fuel ‘hormonophobia,’ or negative framing and scaremongering about hormonal contraception and that this phobia is largely driven by claims of personal experience rather than scientific evidence,” the authors write. “Within these hashtag categories, TikTok creators frame their provider interactions negatively. Many indicate feeling ignored or upset after medical appointments, not sufficiently informed about contraceptive options, and pressured to use hormonal contraceptives. This finding aligns with previous social media research and among the general population, suggesting opportunities for improvements in contraceptive counseling.”

    Popular Contraception Videos on TikTok: An Assessment of Content Topics
    Rachel E. Stoddard, et al. Contraception, January 2024.

    The study: Researchers analyzed 700 English-language TikTok videos related to hormonal contraception, with a total of 1.2 billion views and 1.5 million comments, posted between October 2019 and December 2021. Their aim was to explore the types of contraception content on TikTok and to understand how the platform influences the information patients take into birth control counseling visits.

    The findings: More than half of the videos (52%) were about patient experiences and how to use contraceptives. Other common topics included side effects (35%) and pregnancy (39%).

    Only 19% of the videos were created by health care professionals, including midwives, physician assistants and medical doctors, although those videos garnered 41% of the total views, indicating higher engagement. While 93% of health care providers shared educational content, 23% of non-health care providers shared educational content.

    One takeaway: “Our findings show an exceptional opportunity for education around contraception for young reproductive-aged individuals, given the accessibility and popularity of these videos. This may also extend to other topics around sex education and family planning, including sexually transmitted infection prevention and treatment and procuring abortion care,” the authors write.

    TikTok, #IUD, and User Experience With Intrauterine Devices Reported on Social Media
    Jenny Wu, Esmé Trahair, Megan Happ and Jonas Swartz. Obstetrics & Gynecology, January 2023.

    The study: Researchers used a web-scraping application to collect the top 100 TikTok videos tagged #IUD on April 6, 2022, based on views, comments, likes and shares. Their aim was to understand the perspectives and experiences of people with IUDs shared on TikTok. The videos had a total of 471 million views, 32 million likes and 1 million shares. Their average length was 33 seconds.

    The findings: Some 89% of the creators identified as female and nearly 90% were from the United States; 37% were health care professionals; and 78% were 21 years or older.

    Video types included patients’ own experiences with IUD removal (32%), educational (30%) and humorous (25%). More videos (38%) had a negative tone compared with 19% with a positive tone. The videos that portrayed negative user experiences emphasized pain and distrust of health care professionals.

    Half of the videos were very accurate, while nearly a quarter were inaccurate (the authors did not use the term misinformation).

    One takeaway: “The most liked #IUD videos on TikTok portray negative experiences related to pain and informed consent. Awareness of this content can help health care professionals shape education given the high prevalence of TikTok use among patients,” the authors write. “TikTok differs from other platforms because users primarily engage with an algorithmically curated feed individualized to the user’s interests and demographics.”

    Types of female birth control

    Most female hormonal contraceptives contain the synthetic version of natural female hormones estrogen and progesterone. They affect women’s hormone levels, preventing mature eggs from being released by the ovaries, a process that’s known as ovulation, hence, preventing a possible pregnancy.

    Of the two hormones, progesterone (called progestin in synthetic form) is primarily responsible for preventing pregnancy. In addition to playing a role in preventing ovulation, progesterone inhibits sperm from penetrating through the cervix. Estrogen inhibits the development of follicles in the ovaries.

    The information below is sourced from the CDC, the National Library of Medicine, the Cleveland Clinic and the Mayo Clinic.

    Intrauterine contraception

    Also called Long-Acting Reversible Contraception, or LARC, this method works by thickening the cervical mucus so the sperm can’t reach an egg. There are two types of IUDs: hormonal and non-hormonal.

    • Levonorgestrel intrauterine system is a T-shaped device that’s placed inside the uterus by a doctor. It releases a small amount of progestin daily to prevent pregnancy. It can stay in place for 3 to 8 years. Its failure rate is 0.1% to 0.4%.
    • Copper T intrauterine device is also T-shaped and is placed inside the uterus by a doctor. It does not contain hormones and can stay in place for up to 10 years. Its failure rate is 0.8%.
    • Side effects: Copper IUDs may cause more painful and heavy periods, while progestin IUDs may cause irregular bleeding. In the very rare cases of pregnancy while having an IUD, there’s a greater chance of an ectopic pregnancy, which is when a fertilized egg grows outside of the uterus.

    Hormonal methods

    • The implant is a single, thin rod that’s inserted under the skin of the upper arm. It releases progestin over 3 years. Its failure rate is 0.1%, making it the most effective form of contraception available.
    • Side effects: The most common side effect of an implant is irregular bleeding.
    • The injection Depo-Provera or “shot” or “Depo” delivers progestin in the buttocks or arms every three months at the doctor’s office. Its failure rate is 4%.
    • Side effects: The shot may cause irregular bleeding. The shot is also the only contraceptive that may cause weight gain. It may also be more difficult to predict when fertility returns once the shot is stopped.
    • Combined oral contraceptives or “the pill” contain estrogen and progestin. They’re prescribed by a doctor. The pill has to be taken at the same time daily. The pill is not recommended for people who are older than 35 and smoke, have a history of blood clots or breast cancer. Its failure rate is 7%. Among women aged 15 to 44 who use contraception, about 25% use the pill.
    • The skin patch is worn on the lower abdomen, buttocks or upper body, releasing progestin and estrogen. It is prescribed by a doctor. A new patch is used once a week for three weeks. No patch is worn for the fourth week. Its failure rate is 7%.
    • Hormonal vaginal contraceptive ring releases progestin and estrogen. It’s placed inside the vagina. It is worn for three weeks and taken out on the fourth week. Its typical failure rate is 7%.
    • Side effects: Contraceptives with estrogen, including the pill, the patch and the ring, increase the risk of developing blood clots.
    • Progestin-only pill or “mini-pill” only has progestin and is prescribed by a doctor. It has to be taken daily at the same time. It may be a good option for women who can’t take estrogen. Its typical failure rate is 7%.
    • Opill is the first over-the-counter daily oral contraceptive in the U.S., approved by the Food and Drug Administration in 2023. Opill only has progestin and like other birth control pills, it has to be taken at the same time every day. It should not be used by those who have or have had breast cancer. Its failure rate is 7%.
    • Side effects: The most common side effect of progestin-only pills is irregular bleeding, although the bleeding tends to be light.

    Non-hormonal birth control methods include using barriers such as a diaphragm or sponge, condoms and spermicides, withdrawal, and menstrual cycle tracking. Emergency contraception, including emergency contraception pills (the morning-after pill), is not a regular method of birth control.

    Additional research studies to consider

    Population Attitudes Toward Contraceptive Methods Over Time on a Social Media Platform
    Allison A. Merz, et al. American Journal of Obstetrics & Gynecology, December 2020.

    Social Media and the Intrauterine Device: A YouTube Content Analysis
    Brian T. Nguyen and Allison J. Allen. BMJ Sexual and Reproductive Health, November 2017.

    This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.

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  • Real Self-Care – by Pooja Lakshmin MD

    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.

    As the subtitle says, “crystals, cleanses, and bubble baths not included”. So, if it’s not about that sort of self-care, what is it about?

    Dr. Lakshmin starts by acknowledging something that many self-help books don’t:

    We can do everything correctly and still lose. Not only that, but for many of us, that is the probable outcome. Not because of any fault or weakness of ours, but simply because one way or another the game is rigged against us from the start.

    So, should we throw in the towel, throw our hands in the air, and throw the book out of the window?

    Nope! Dr. Lakshmin has actually helpful advice, that pertains to:

    • creating healthy boundaries and challenging guilt
    • treating oneself with compassion
    • identifying and aligning oneself with one’s personal values
    • asserting one’s personal power to fight for one’s own self-interest

    If you’re reading this and thinking “that seems very selfish”, then let’s remember the “challenging guilt” part of that. We’ve all-too-often been conditioned to neglect our own needs and self-sacrifice for others.

    And, while selfless service really does have its place, needlessly self-destructive martyrdom does not!

    Bottom line: this book delivers a lot of “real talk” on a subject that otherwise often gets removed from reality rather. In short, it’s a great primer for finding the right place to draw the line between being a good-hearted person and being a doormat.

    Click here to check out Real Self-Care and “put your own oxygen mask on first”!

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Related Posts

  • Eat To Avoid (Or Beat) PCOS
  • Better Than BMI

    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.

    BMI is a very flawed system, and there are several more useful ways of measuring our bodies. Let’s take a look at them!

    What’s wrong with BMI?

    Oof, what isn’t wrong with BMI?

    In short, it was developed as a demographic-based tool to specifically chart the weight-related health of working-age European white men a little under 200 years ago.

    This means that if you are, perchance, not a working-age European white man in 1830 or so, then it’s not so useful. It’d be like first establishing height norms based on NBA basketball players, and then applying it to the general population, and thus coming to the conclusion that someone who is 6’2″ is very short.

    In long, we did a deep-dive into it here, and in particular what things go dangerously wrong when it’s applied to women, non-white people, athletic people, pregnant people, people under 16 or over 65 and more:

    When BMI Doesn’t Quite Measure Up

    What we usually recommend instead

    For heart disease risk and diabetes risk both, waist circumference is a much more universally reliable indicator. And since those two things tend to affect a lot of other health risks, it becomes an excellent starting point for being aware of many aspects of health.

    Pregnancy will still throw off waist circumference a little (measure below the bump, not around it!), but it will nevertheless be more helpful than BMI even then, as it becomes necessary to just increase the numbers a little, according to gestational month and any confounding factors e.g. twins, triplets, etc. Ask your obstetrician about this, as it’s beyond the scope of our article today!

    As to what’s considered a risk:
    • Waist circumference of more than 35 inches for women
    • Waist circumference of more than 40 inches for men

    These numbers are considered applicable across demographics of age, ethnicity, and lifestyle.

    Source: Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity

    Bonus extra measurement based on the above

    Important also is waist to hip ratio.

    How to calculate it:

    1. measure your waist circumference
    2. measure your hip circumference
    3. divide the first measurement by the second one

    Because it’s a ratio, it doesn’t matter what units you use (e.g. inches, cm, etc) so long as you use the same units for both measurements.

    The World Health Organization offers the following chart:

    Health riskWomenMen
    Low0.80 or lower0.95 or lower
    Moderate0.81–0.850.96–1.0
    High0.86 or higher1.1 or higher

    Source: Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation

    This is especially relevant for cardiovascular disease risk:

    Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies

    …and also holds true for all-cause mortality:

    Waist-Hip-Ratio as a Predictor of All-Cause Mortality in High-Functioning Older Adults

    An ancient contender that’s still more useful than BMI

    Remember Archimedes? The (perhaps apocryphal) story of his “Eureka” moment in the bathtub when he realized that water displacement could be used to measure the volume of an irregular shape?

    Just like Archimedes (who, the story goes, had been hired to determine the composition of a crown that might or might not have been pure gold), we can use this method to determine body composition, because we have references for how much a given volume of a given substance will weigh, so combing what we know about a body’s weight and volume will tell us about its composition in ways that neither metric could give us alone.

    Indeed, it’s one of the commonly-mentioned flaws of BMI that muscle weighs more than fat, and Archimedes’ method not only avoids that problem, but also, actually turns that knowledge (muscle weighs more than fat) to our advantage.

    It’s called “hydrostatic weighing” now:

    Hydrostatic Weighing: Evaluation of body composition parameters using various diagnostic methods: A meta analysis study

    You may be wondering: what about bones? Or internal organs?

    The fact is that those are slightly confounding factors that do get in the way of a truly accurate analysis, but the variation in how much one person’s skeleton weighs vs another’s, or one person’s set of organs weigh than another’s, is too small to make an important difference to the health implications.

    Lastly…

    Hydrostatic weighing isn’t the only way to work out how much of our body is made of fat; if you have for example a smart scale at home (like this one) that tells you your body fat percentage, that is an estimate based on bioelectrical impedance analysis.

    It’s less accurate than the hydrostatic method, but easier to do at home!

    As to what percentages are “best”, healthy body fat percentages are (assuming normal hormones) generally considered to be in the range of 20–25% for women and 15–20% for men.

    You can read more about this here:

    Is A Visible Six-Pack Obtainable Regardless Of Genetic Predisposition?

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  • Can You Reverse Gray Hair? A Dermatologist Explains

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    Betteridge’s Law of Headlines states “any headline that ends in a question mark can be answered by the word no“—it’s not really a universal truth, but it’s true surprisingly often, and, as board certified dermatologist “The Beauty MD” Dr. Sam Ellis explains, it’s true in this case.

    But, all is not lost.

    Physiological Factors

    Hair color is initially determined by genes and gene expression, instructing the body to color it with melanin (brown and black) and/or pheomelanin (blonde and red). If and when the body produces less of those pigments, our hair will go gray.

    Factors that affect if/when our hair will go gray include:

    • Genetics: primary determinant, essentially a programmed change
    • Age: related to the above, but critically, the probability of going gray in any given year increases with age
    • Ethnicity: the level of melanin in our skin is an indicator of how long we are likely to maintain melanin in our hair. Black people with the darkest skintones will thus generally go gray last, whereas white people with the lightest skintones will generally go gray first, and so on for a spectrum between the two.
    • Medical conditions: immune conditions such as vitiligo, thyroid disease, and pernicious anemia promote an earlier loss of pigmentation
    • Stress: oxidative stress, mainly, so factors like smoking will cause earlier graying. But yes, also chronic emotional stress does lead to oxidative stress too. Interestingly, this seems to be more about norepinephrine than cortisol, though.
    • Nutrient deficiencies: the body can make a lot of things, but it needs the raw ingredients. Not having the right amounts of important vitamins and minerals will result in a loss of pigmentation (amongst other more serious problems). Vitamins B6, B9, and B12 are talked about in the video, as are iron and zinc. Copper is also needed for some hair colors. Selenium is needed for good hair health in general (but not too much, as an excess of selenium paradoxically causes hair loss), and many related things will stop working properly without adequate magnesium. Hair health will also benefit a lot from plenty of vitamin B7.

    So, managing the above factors (where possible; obviously some of the above aren’t things we can influence) will result in maintaining one’s hair pigment for longer. As for texture, by the way, the reason gray hair tends to have a rougher texture is not for the lack of pigment itself, but is due to decreased sebum production. Judicious use of exogenous hair oils (e.g. argan oil, coconut oil, or whatever your preference may be) is a fine way to keep your grays conditioned.

    However, once your hair has gone gray, there is no definitive treatment with good evidence for reversing that, at present. Dye it if you want to, or don’t. Many people (including this writer, who has just a couple of streaks of gray herself) find gray hair gives a distinguished look, and such harmless signs of age are a privilege not everyone gets to reach, and thus may be reasonably considered a cause for celebration

    For more on all of the above, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Gentler Hair Health Options

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  • Pistachios vs Pine Nuts – Which is Healthier?

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    Our Verdict

    When comparing pistachios to pine nuts, we picked the pistachios.

    Why?

    First looking at the macros, pistachios have nearly 2x the protein while pine nuts have nearly 2x the fat. The fats are healthy in moderation (mostly polyunsaturated, a fair portion of monounsaturated, and a little saturated), but we’re going to value the protein content higher. Also, pistachios have approximately 2x the carbs, and/but nearly 3x the fiber. All in all, we’ll call this section a moderate win for pistachios.

    When it comes to vitamins, pistachios have more of vitamins A, B1, B5, B6, B9, and C, while pine nuts have more of vitamins B2, B3, E, K, and choline. All in all, pistachios are scraping a 6:5 win here, or we could call it a tie if we want to value pine nuts’ vitamins more (due to the difference in how many foods each vitamin is found in, and thus the likelihood of having a deficiency or not).

    In the category of minerals, pistachios have more calcium, copper, potassium, and selenium, while pine nuts have more iron, magnesium, manganese, and zinc. This would be a tie if we just call it 4:4, but what’s worth noting is that while both of these nuts are a good source of most of the minerals mentioned, pine nuts aren’t a very good source of calcium or selenium, so we’re going to declare this section a very marginal win for pistachios.

    Adding up the moderate win, the scraped win, and the barely scraped win, all adds up to a win for pistachios. However, as you might have noticed, both are great so do enjoy both if you can!

    Want to learn more?

    You might like to read:

    Why You Should Diversify Your Nuts

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