A Tale Of Two Cinnamons
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Cinnamon’s Health Benefits (But Watch Out!)
Cinnamon is enjoyed for its sweet and punchy flavor. It also has important health properties!
Let’s take a look at the science…
A Tale Of Two Cinnamons
In your local supermarket, there is likely “cinnamon” and if you’re lucky, also “sweet cinnamon”. The difference between these is critical to understand before we continue:
“Cinnamon” = Cinnamomum cassia or Cinnamomum aromaticum. This is cheapest and most readily available. It has a relatively high cinnamaldehyde content, and a high coumarin content.
“Sweet cinnamon” Cinnamomum verum or Cinnamomum zeylanicum. It has a lower cinnamaldehyde content, and/but a much lower (almost undetectable) coumarin content.
You may be wondering: what’s with the “or” in both of those cases? Each simply has two botanical names in use. It’s inconvenient and confusing, but that’s how it is.
Great! What’s cinnamaldehyde and what’s coumarin?
Cinnamaldehyde is what gives cinnamon its “spice” aspect; it’s strong and fragrant. It also gives cinnamon most of its health benefits.
As a quick aside: it’s also used as the flavoring element in cinnamon flavored vapes, and in that form, it can cause health problems. So do eat it, but we recommend not to vape it.
Coumarin is toxic in large quantities.
The recommended safe amount is 0.1mg/kg, so you could easily go over this with a couple of teaspoons of cassia cinnamon:
Toxicology and risk assessment of coumarin: focus on human data
…while in Sweet/True/Ceylon cinnamon, those levels are almost undetectable:
Medicinal properties of ‘true’ cinnamon (Cinnamomum zeylanicum): a systematic review
If you have a cinnamon sensitivity, it is likely, but not necessarily, tied to the coumarin content rather than the cinnamaldehyde content.
Summary of this section before moving on:
“Cinnamon”, or cassia cinnamon, has about 50% stronger health benefits than “Sweet Cinnamon”, also called Ceylon cinnamon.
“Cinnamon”, or cassia cinnamon, has about 250% stronger health risks than “Sweet Cinnamon”, also called Ceylon cinnamon.
The mathematics here is quite simple; sweet cinnamon is the preferred way to go.
The Health Benefits
We spent a lot of time/space today looking at the differences. We think this was not only worth it, but necessary. However, that leaves us with less time/space for discussing the actual benefits. We’ll summarize, with links to supporting science:
“Those three things that almost always go together”:
Heart and blood benefits:
- Reduces triglyceride levels
- Reduces high blood pressure
- Reduces insulin insensitivity
- Reduces fasting blood sugar levels
Neuroprotective benefits:
The science does need more testing in these latter two, though.
Where to get it?
You may be able to find sweet cinnamon in your local supermarket, or if you prefer capsule form, here’s an example product on Amazon
Enjoy!
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How Much Weight Gain Do Antidepressants Cause?
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There’s a lot of talk in the news lately about antidepressants and weight gain, so let’s look at some numbers.
Here’s a study from July 2024 that compared the weight gain of eight popular antidepressants, and pop-science outlets have reported it with such snippets as:
❝Bupropion users were approximately 15–20% less likely to gain a clinically significant amount of weight than those taking the most common medication, sertraline.
The researchers considered weight gain of 5% or more as clinically significant.❞
Read in full: Study compares weight gain across eight common antidepressants
At this point, you might (especially if you or a loved one is on sertraline) be grabbing a calculator and seeing what 5% of your weight is, and might be concerned at the implications.
However, this is a little like if, in our This or That section, we were to report that food A has 17x more potassium than food B, without mentioning that food A has 0.01mg/100g and food A has 0.17mg/100g, and thus that, while technically “17x more”, the difference is trivial.
As a quick aside: we do, by the way, try to note when things like that might skew the stats and either wipe them out by not mentioning that they contain potassium at all (as they barely do), or if it’s a bit more, describing them as being “approximately equal in potassium” or else draw attention to the “but the amounts are trivial in both cases”.
Back to the antidepressants: in fact, for those two antidepressants compared in that snippet, the truth is (when we go looking in the actual research paper and the data within):
- sertraline was associated with an average weight change of +1.5kg (just over 3lb) over the course of 24 months
- bupropion was associated with an average weight change of +0.5kg (just under 1lb) over the course of 24 months
Sertraline being the most weight-gain-inducing of the 8 drugs compared, and bupropion being the least, this means (with them both having fairly even curves):
- sertraline being associated with an average weight change of 0.06kg (about 2oz) per month
- bupropion being associated with an average weight change of 0.02kg (less than 1oz) per month
For all eight, see the chart here in the paper itself:
Medication-Induced Weight Change Across Common Antidepressant Treatments ← we’ve made the link go straight to the chart, for your convenience, but you can also read the whole paper there
While you’re there, you might also see that for some antidepressants, such as duloxetine, fluoxetine, and venlafaxine, there’s an initial weight gain, but then it clearly hits a plateau and weight ceases to change after a certain point, which is worth considering too, since “you’ll gain a little bit of weight and then stay at that weight” is a very different prognosis from “you’ll gain a bit of weight and keep gaining it forever until you die”.
But then again, consider this:
Most adults will gain half a kilo this year – and every year. Here’s how to stop “weight creep”
That’s more weight gain than one gets on sertraline, the most weight-gain-inducing antidepressant tested!
What about over longer-term use?
Here’s a more recent study (December 2024) that looked at antidepressant use over 6 years, and found an average 2% weight gain over those 6 years, but it didn’t break it down by antidepressant type, sadly:
…which seems like quite a wasted opportunity, since some of the medications considered are very different, working on completely different systems (for example, SSRIs vs NDRIs, working on serotonin or norepinephrine+dopamine, respectively—see our Neurotransmitter Cheatsheet for more about those) and having often quite different side effects. Nevertheless, the study (despite collecting this information) didn’t then tabulate the data, and instead considered them all to be the same factor, “antidepressants”.
What this study did do that was useful was included a control group not on antidepressants so we know that on average:
- never-users of antidepressants gained an average of 1% of their bodyweight over those 6 years
- users-and-desisters of antidepressants gained an average of 1.8% of their bodyweight over those 6 years*
- continuing users of antidepressants gained an average of 2% of their bodyweight over those 6 years
*for this group, weight gain was a commonly cited reason for stopping taking the antidepressants in question
Writer’s anecdote: I’ve been on mirtazapine (a presynaptic alpha2-adrenoreceptor antagonist which increases central noradrenergic and serotonergic neurotransmission) for some years and can only say that I wish I’d been on it decades previously. I requested mirtazapine specifically, because I’m me and I know my stuff and considered it would most likely be by far the best fit for me out of the options available. Starting at a low dose, the only meaningful side effect was mild sedation (expected, and associated only with low-dose use); increasing after a couple of weeks to a moderate dose, that side effect disappeared and now the only remaining side effect is a slight dryness of the mouth, which is fine, as it ensures I remember to stay hydrated 🙂 anyway, my weight hasn’t changed (beyond very small temporary fluctuations) in the time I’ve been on mirtazapine. Disclaimer: the plural of anecdote is not data, and I can only speak for my own experience, and am not making any particular recommendation here. Your personal physiology will be different from mine, and may respond well or badly to any given treatment according to your own physiology.
Further considerations
This is touched on in the “Discussion” section of the latter paper (so do check that out if you want all the details, more than we can reasonably put here), but there are other factors to consider, for example:
- whether people were underweight/healthy weight/overweight at baseline (sometimes, a weight gain can be a good thing, recovering from an illness, and in the case of the illness that is depression, weight can swing either way)
- antidepressants changing eating and exercise habits (generally speaking: more likely to eat more and exercise more)
- body composition! How did they not cover this (neither paper did)?! Muscle weighs more than fat, and improvements in exercise can result in an increase in muscle and thus an increase in overall weight.
As researchers like to say, “this highlights the need for more high-quality studies to look into…” (and then the various things that went unexamined).
Want to know more?
Check out our previous main feature:
Antidepressants: Personalization Is Key!
Take care!
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How To Dodge The “Keto Flu”
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We have written before about the ketogenic diet, in one of our mythbusting editions:
Ketogenic Diet: Burning Fat Or Burning Out?
The answer to the titular question there, by the way, is both: keto is good for short-term weight loss, but long-term adherence can bring health risks that may make it not worthwhile.
To this end, we could flippantly say that the best way to dodge the “keto flu” (the unwanted symptoms commonly associated with the transition to a ketogenic diet) is to not do keto, but the fact is that there are valid reasons why some people will want to do keto, e.g:
- to do it short-term, enjoy the weight loss, and then keep the weight off with a more rounded diet (such as the Mediterranean diet)
- to do it long-term, in order to manage refractory epilepsy symptoms (the only reason the ketogenic diet was first created and popularized)
- to do it long-term, despite the health risks associated with such (because we’re not the boss of you, and you get to decide for yourself which risks are worth it and which aren’t)
So, with that in mind…
What is the “keto flu”?
The “keto flu” is not in fact a flu of any kind (“flu” gets bandied around a lot in general parlance, but really the term should only be used to refer to variants of the influenza virus), nor indeed even an infection of any kind.
Instead, it’s a collection of symptoms that typically appear a few days into starting the ketogenic diet, and usually continue for a few weeks to a month or so.
The most commonly-reported symptoms are fatigue, brain fog, headache, mood changes, lightheadedness, bad breath, muscle cramps, reduced exercise capacity, constipation, and/or diarrhea.
About those latter two, you may be wondering “how can you have both constipation and diarrhea?” and the answer is that often people will get one of them and try to treat it, and now find they have the other and so they try to treat that, and so oscillate between the two for a bit. Which we cannot imagine is fun, but it’s a pattern that does play out a lot.
A big reason for this is that any sudden change in diet will cause a commensurately sudden change in gut microbiota, which will have many effects on the rest of a person’s health.
There are other reasons too, though, including hypoglycemia (very common when suddenly drastically cutting carbs, for obvious reasons of: fewer carbs in means less sugar in the blood) and electrolyte loss.
In a recent large review of studies found that symptoms like halitosis, constipation, nausea, and vomiting were the most frequently reported; children experienced more issues like hypoglycemia and vomiting, while adults reported dizziness and fatigue. Kidney stones were rare in short-term studies but occurred in an average of 14% of long-term ketogenic diet adherents:
How to avoid it (aside from “don’t do keto”)
There are several main things to consider:
- a more gradual shift into a ketogenic diet, rather than doing it overnight, will allow the gut microbiota to change more gradually, which will avoid many of the symptoms associated with gastrointestinal upset
- electrolyte replacement (sodium, potassium) and again, doing a slower transition, can help avoid the symptoms associated with electrolyte loss
- medium-chain triglyceride (MCT) supplementation helps maintain ketone levels and may ease symptoms (though may cause—rather than alleviate—gastrointestinal problems if not introduced gradually)
About those electrolytes:
Are Electrolyte Supplements Worth It? Here’s When To Take Electrolytes (And When We Shouldn’t!)
And about those MCTs:
How Beneficial Is MCT Oil, Really?
Not sure if keto’s for you?
Check out:
Which Diet? Top Diets Ranked By Experts ← this is great for comparisons of the various dietary approaches
Or if you prefer to do things your own way, then consider:
What Macronutrient Balance Is Right For You? ← this one’s really quite comprehensive, if you’d like to figure out your own best approach in a personalized fashion.
Enjoy!
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Zuranolone: What to know about the pill for postpartum depression
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In the year after giving birth, about one in eight people who give birth in the U.S. experience the debilitating symptoms of postpartum depression (PPD), including lack of energy and feeling sad, anxious, hopeless, and overwhelmed.
Postpartum depression is a serious, potentially life-threatening condition that can affect a person’s bond with their baby. Although it’s frequently confused with the so-called “baby blues,” it’s not the same.
The baby blues include similar, temporary symptoms that affect up to 80 percent of people who have recently given birth and usually go away within the first few weeks. PPD usually begins within the first month after giving birth and can last for months and interfere with a person’s daily life if left untreated. Thankfully, PPD is treatable and there is help available.
On August 4, the FDA approved zuranolone, branded as Zurzuvae, the first-ever oral medication to treat PPD. Until now, besides other common antidepressants, the only medication available to treat PPD specifically was the IV injection brexanolone, which is difficult to access and expensive and can only be administered in a hospital or health care setting.
Read on to find out more about zuranolone: what it is, how it works, how much it costs, and more.
What is zuranolone?
Zurzuvae is the brand name for zuranolone, an oral medication to treat postpartum depression. Developed by Sage Therapeutics in partnership with Biogen, it’s now available in the U.S. Zurzuvae is typically prescribed as two 25 mg capsules a day for 14 days. In clinical trials, the medication showed to be fast-acting, improving PPD symptoms in just three days.
How does zuranolone work?
Zuranolone is a neuroactive steroid, a type of medication that helps the neurotransmitter GABA’s receptors, which affect how the body reacts to anxiety, stress, and fear, function better.
“Zuranolone can be thought of as a synthetic version of [the neuroactive steroid] allopregnanolone,” says Dr. Katrina Furey, a reproductive psychiatrist, clinical instructor at Yale University, and co-host of the Analyze Scripts podcast. “Women with PPD have lower levels of allopregnenolone compared to women without PPD.”
How is it different from other antidepressants?
“What differentiates zuranolone from other previously available oral antidepressants is that it has a much more rapid response and a shorter course of treatment,” says Dr. Asima Ahmad, an OB-GYN, reproductive endocrinologist, and founder of Carrot Fertility.
“It can take effect as early as on day three of treatment, versus other oral antidepressants that can take up to six to 12 weeks to take full effect.”
What are Zurzuvae’s side effects?
According to the FDA, the most common side effects of Zurzuvae include dizziness, drowsiness, diarrhea, fatigue, the common cold, and urinary tract infection. Similar to other antidepressants, the medication may increase the risk of suicidal thoughts and actions in people 24 and younger. However, NPR noted that this type of labeling is required for all antidepressants, and researchers didn’t see any reports of suicidal thoughts in their trials.
“Drug trials also noted that the side effects for zuranolone were not as severe,” says Ahmad. “[There was] no sudden loss of consciousness as seen with brexanolone or weight gain and sexual dysfunction, which can be seen with other oral antidepressants.”
She adds: “Given the lower incidence of side effects and more rapid-acting onset, zuranolone could be a viable option for many,” including those looking for a treatment that offers faster symptom relief.
Can someone breastfeed while taking zuranolone?
It’s complicated. In clinical trials, participants were asked to stop breastfeeding (which, according to Furey, is common in early clinical trials).
A small study of people who were nursing while taking zuranolone found that 0.3 percent of the medication dose was passed on to breast milk, which, Furey says, is a pretty low amount of exposure for the baby. Ahmad says that “though some data suggests that the risk of harm to the baby may be low, there is still overall limited data.”
Overall, people should talk to their health care provider about the risks and benefits of breastfeeding while on the medication.
“A lot of factors will need to be weighed, such as overall health of the infant, age of the infant, etc., when making this decision,” Furey says.
How much does Zurzuvae cost?
Zurzuvae’s price before insurance coverage is $15,900 for the 14-day treatment. However, the Policy Center for Maternal Mental Health says insurance companies and Medicaid are expected to cover it because it’s the only drug of its kind.
Less than 1 percent of U.S. insurers have issued coverage guidelines so far, so it’s still unknown how much it will cost patients after insurance. Some insurers require patients to try another antidepressant first (like the more common SSRIs) before covering Zurzuvae. For uninsured and underinsured people, Sage Therapeutics said it will offer copay assistance.
The hefty price tag and potential issues with coverage may widen existing health disparities, says Ahmad. “We need to ensure that we are seeking out solutions to enable wide-scale access to all PPD treatments so that people have access to whatever treatment may work best for them.”
If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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The Well Plated Cookbook – by Erin Clarke
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Clarke’s focus here is on what she calls “stealthy healthy”, with the idea of dishes that feel indulgent while being great for the health.
The recipes, of which there are well over 100, are indeed delicious and easy to make without being oversimplified, and since she encourages the use of in-season ingredients, many recipes come with a “market swaps” substitution guide, to make each recipe seasonal.
The book is largely not vegetarian, let alone vegan, but the required substitutions will be second-nature to any seasoned vegetarian or vegan. Indeed, “skip the meat sometimes” is one of the advices she offers near the beginning of the book, in the category of tips to make things even healthier.
Bottom line: if you want to add dishes to your repertoire that are great for entertaining and still super-healthy, this book will be a fine addition to your collection.
Click here to check out The Well Plated Cookbook, and get cooking!
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The 9-Day Liver Detox Diet – by Patrick Holford
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While the author is not “Dr. Patrick Holford”, it’s worth mentioning that he is a career nutritionist with half the alphabet after his name, and decades of experience in the field.
Now, about the detox diet: being well-informed 10almonds readers, you probably know that most detox diets do little to nothing, and your liver detoxes itself; that is literally one of its main jobs.
However! Depending on diet and lifestyle, sometimes it can get a backlog of work, and then it starts struggling. We wrote about that in our article: How To Unfatty A Fatty Liver.
The premise of this book is in the largest part very similar to what we wrote there, and it’s about giving your liver a metabolic break, for which it will be grateful and use the slack to do its own internal clean-up and regeneration.
The way Holford recommends doing this is consistent with what we’ve written before, just, in a lot more detail because it’s a whole book. It’s also more extreme, because it’s a 9-day thing rather than our usual focus on sustainability, so for example he’ll often say “cut out” many things where we have often said “reduce” or “avoid”.
In few words:
- Cut out foods with a high glycemic load (e.g. most starches and sugars)
- Cut out foods that are known to be inflammatory (e.g. meat and dairy)
- Enjoy foods that have anti-inflammatory properties (e.g. foods high in antioxidants)
He offers a dietary approach (and of course, a 9-day meal plan, with recipes), and also recommends a lot of supplements. However, if you don’t love taking supplements, then the diet plan is already just fine.
Oddly, he does include a chapter on reintroducing all the “bad” things, which seems like a strange thing to choose to do especially in the cases of things like alcohol if you literally just quit it, but of course it’s an option.
The style is quite old-school pop-science, but still very readable, easy to navigate if looking for specific things, and there’s a bibliography as well as a resource list at the back.
Bottom line: if you’d like to take radical short-term action to improve your liver health quickly, this book will indeed help you to do that!
Click here to check out The 9-Day Liver Detox Diet, and give your liver a chance to get better!
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Quick Healthy Recipe Ideas
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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 was superb !! Just loved that healthy recipe !!! I would love to see one of those every day, if possible !! Keep up the fabulous work !!! ”
We’re glad you enjoyed! We can’t promise a recipe every day, but here’s one just for you:
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