Coffee & Your Gut
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Coffee, in moderation, is generally considered a healthful drink—speaking for the drink itself, at least! Because the same cannot be said for added sugar, various sorts of creamers, or iced caramelatte mocha frappucino dessert-style drinks:
The Bitter Truth About Coffee (or is it?)
Caffeine, too, broadly has more pros than cons (again, in moderation):
Caffeine: Cognitive Enhancer Or Brain-Wrecker?
Some people will be concerned about coffee and the heart. Assuming you don’t have a caffeine sensitivity (or you do but you drink decaf), it is heart-neutral in moderation, though there are some ways of preparing it that are better than others:
Make Your Coffee Heart-Healthier!
So, what about coffee and the gut?
The bacteria who enjoy a good coffee
Amongst our trillions of tiny friends, allies, associates, and enemies-on-the-inside, which ones like coffee, and what kind of coffee do they prefer?
A big (n=35,214) international multicohort analysis examined the associations between coffee consumption and very many different gut microbial species, and found:
115 species were positively associated with coffee consumption, mostly of the kind considered “friendly”, including ones often included in probiotic supplements, such as various Bifidobacterium and Lactobacillus species.
The kind that was most strongly associated with coffee consumption, however, was Lawsonibacter asaccharolyticus, a helpful little beast who converts chlorogenic acid (one of the main polyphenols in coffee) into caffeic acid, quinic acid, and various other metabolites that we can use.
More specifically: moderate coffee-drinkers, defined as drinking 1–3 cups per day, enjoyed a 300–400% increase in L. asaccharolyticus, while high coffee-drinkers (no, not that kind of high), defined as drinking 4 or more cups of coffee per day, enjoyed a 400–800% increase, compared to “never/rarely” coffee-drinkers (defined as drinking 2 or fewer cups per month).
Click here to see more data from the study, in a helpful infographic
Things that did not affect the outcome:
- The coffee-making method—it seems the bacteria are not fussy in this regard, as espresso or brewed, and even instant, yielded the same gut microbiome benefits
- The caffeine content—as both caffeinated and decaffeinated yielded the same gut microbiome benefits
You can read the paper itself in full for here:
Want to enjoy coffee, but not keen on the effects of caffeine or the taste of decaffeinated?
Taking l-theanine alongside coffee flattens the curve of caffeine metabolism, and means one can get the benefits without unwanted jitteriness:
Enjoy!
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Statin and Antidepressant Side Effects
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Questions and Answers 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!
This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! 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
Side effects of statins, are they worth it? Depression, are antidepressants worth it?
About statins, that depends a lot on you, your circumstances, and—as it happens—your gender. We covered this in a main feature recently, but a short answer is: for most people, they may not be the best first choice, and could even make things worse. For some people, however, they really are just what’s needed.
- Factors that make them more likely better for you: being a man, or having atherosclerosis
- Factors that make them more likely worse for you: being a woman in general
Check out the main feature we did: Statins: His & Hers?
As for antidepressants? That depends a lot on you, your physiology, your depression, your circumstances, and more. We’ll definitely do a main feature on that sometime soon, as there’s a lot that most people don’t know!
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Stickers and wristbands aren’t a reliable way to prevent mosquito bites. Here’s why
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Protecting yourself and family from mosquito bites can be challenging, especially in this hot and humid weather. Protests from young children and fears about topical insect repellents drive some to try alternatives such as wristbands, patches and stickers.
These products are sold online as well as in supermarkets, pharmacies and camping stores. They’re often marketed as providing “natural” protection from mosquitoes.
But unfortunately, they aren’t a reliable way to prevent mosquito bites. Here’s why – and what you can try instead.
Why is preventing mosquito bites important?
Mosquitoes can spread pathogens that make us sick. Japanese encephalitis and Murray Valley encephalitis viruses can have potentially fatal outcomes. While Ross River virus won’t kill you, it can cause potentially debilitating illnesses.
Health authorities recommend preventing mosquito bites by: avoiding areas and times of the day when mosquitoes are most active; covering up with long sleeved shirts, long pants, and covered shoes; and applying a topical insect repellent (a cream, lotion, or spray).
I don’t want to put sticky and smelly repellents on my skin!
While for many people, the “sting” of a biting mosquitoes is enough to prompt a dose of repellent, others are reluctant. Some are deterred by the unpleasant feel or smell of insect repellents. Others believe topical repellents contain chemicals that are dangerous to our health.
However, many studies have shown that, when used as recommended, these products are safe to use. All products marketed as mosquito repellents in Australia must be registered by the Australian Pesticides and Veterinary Medicines Authority; a process that provides recommendations for safe use.
How do topical repellents work?
While there remains some uncertainty about how the chemicals in topical insect repellents actually work, they appear to either block the sensory organs of mosquitoes that drive them to bite, or overpower the smells of our skin that helps mosquitoes find us.
Diethytolumide (DEET) is a widely recommended ingredient in topical repellents. Picaridin and oil of lemon eucalyptus are also used and have been shown to be effective and safe.
How do other products work?
“Physical” insect-repelling products, such as wristbands, coils and candles, often contain a botanically derived chemical and are often marketed as being an alternative to DEET.
However, studies have shown that devices such as candles containing citronella oil provide lower mosquito-bite prevention than topical repellents.
A laboratory study in 2011 found wristbands infused with peppermint oil failed to provide full protection from mosquito bites.
Even as topical repellent formulations applied to the skin, these botanically derived products have lower mosquito bite protection than recommended products such as those containing DEET, picaridin and oil of lemon eucalyptus.
Wristbands infused with DEET have shown mixed results but may provide some bite protection or bite reduction. DEET-based wristbands or patches are not currently available in Australia.
There is also a range of mosquito repellent coils, sticks, and other devices that release insecticides (for example, pyrethroids). These chemicals are primarily designed to kill or “knock down” mosquitoes rather than to simply keep them from biting us.
What about stickers and patches?
Although insect repellent patches and stickers have been available for many years, there has been a sudden surge in their marketing through social media. But there are very few scientific studies testing their efficacy.
Our current understanding of the way insect repellents work would suggest these small stickers and patches offer little protection from mosquito bites.
At best, they may reduce some bites in the way mosquito coils containing botanical products work. However, the passive release of chemicals from the patches and stickers is likely to be substantially lower than those from mosquito coils and other devices actively releasing chemicals.
One study in 2013 found a sticker infused with oil of lemon eucalyptus “did not provide significant protection to volunteers”.
Clothing impregnated with insecticides, such as permethrin, will assist in reducing mosquito bites but topical insect repellents are still recommended for exposed areas of skin.
Take care when using these products
The idea you can apply a sticker or patch to your clothing to protect you from mosquito bites may sound appealing, but these devices provide a false sense of security. There is no evidence they are an equally effective alternative to the topical repellents recommended by health authorities around the world. It only takes one bite from a mosquito to transmit the pathogens that result in serious disease.
It is also worth noting that there are some health warnings and recommendations for their use required by Australian Pesticides and Veterinary Medicines Authority. Some of these products warn against application to the skin (recommending application to clothing only) and to keep products “out of reach of children”. This is a challenge if attached to young children’s clothing.
Similar warnings are associated with most other topical and non-topical mosquito repellents. Always check the labels of these products for safe use recommendations.
Are there any other practical alternatives?
Topical insect repellents are safe and effective. Most can be used on children from 12 months of age and pose no health risks. Make sure you apply the repellent as a thin even coat on all exposed areas of skin.
But you don’t need “tropical strength” repellents for short periods of time outdoors; a range of formulations with lower concentrations of repellent will work well for shorter trips outdoors. There are some repellents that don’t smell as strong (for example, children’s formulations, odourless formulations) or formulations that may be more pleasant to use (for example, pump pack sprays).
Finally, you can always cover up. Loose-fitting long-sleeved shirts, long pants, and covered shoes will provide a physical barrier between you and mosquitoes on the hunt for your or your family’s blood this summer.
Cameron Webb, Clinical Associate Professor and Principal Hospital Scientist, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Stop The World…
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Some news highlights from this week:
“US vs Them”?
With the US now set to lose its WHO membership, what does that mean for Americans? For most, the consequences will be indirect:
- the nation’s scientists and institutions will be somewhat “left out in the cold” when it comes to international scientific collaboration in the field of health
- the US will no longer enjoy a position of influence and power within the WHO, which organization’s reports and position statements have a lot of sway over the world’s health practices
Are there any benefits (of leaving the WHO) for Americans? Yes, there is one: the US will no longer be paying into the WHO’s budget, which means:
- the US will save the 0.006% of the Federal budget that it was paying into the WHO annually
- for the average American’s monthly budget, that means (if the saving is passed on) you’ll have an extra dime
However, since US scientific institutions will still need access to international data, likely that access will need to be paid separately, at a higher rate than US membership in WHO cost.
In short: it seems likely to go the way that Brexit did: “saving” on membership fees and then paying more for access to less.
Why is the US leaving again? The stated reasons were mainly twofold:
- the cost of US membership (the US’s contribution constituted 15% of the the overall WHO budget)
- holding the US’s disproportionately high COVID death rate (especially compared to countries such as China) to be a case of WHO mismanagement
Read in full: What losing WHO membership means for the U.S.
Related: What Would a Second Trump Presidency Look Like for Health Care? ← this was a speculative post by KFF Health News, last year
Halt, You’re Under A Breast
More seriously, this is about halting the metastasis of cancerous tumors in the breast. It is reasonable to expect the same principle and thus treatment may apply to other cancers too, but this is where the research is at for now (breast cancer research gets a lot of funding).
And, what principle and treatment is this, you ask? It’s about the foxglove-derived drug digoxin, and how it stops cancerous cells from forming clusters, and even actively dissolves clusters that have already formed. No clusters means no new tumors, which means no metastasis. No metastasis, in turn, means the cancer becomes much more treatable because it’s no longer a game of whack-a-mole; instead of spreading to other places, it’s a much more manageable case of “here’s the tumor, now let’s kill it with something”.
Note: yes, that does mean the tumor still needs killing by some other means—digoxin won’t do that, it “just” stops it from spreading while treatment is undertaken.
Read in full: Proof-of-concept study dissolves clusters of breast cancer cells to prevent metastases
Related: The Hormone Therapy That Reduces Breast Cancer Risk & More
Force Of Habit
“It takes 21 days to make a habit”, says popular lore. Popular is not, however, evidence-based:
❝This systematic review of 20 studies involving 2601 participants challenges the prevailing notion of rapid habit formation, revealing that health-related habits typically require 2–5 months to develop, with substantial individual variability ranging from 4 to 335 days. The meta-analysis demonstrated significant improvements in habit scores across various health behaviours, with key determinants including morning practices, personal choice, and behavioural characteristics❞
So, this is not a lottery, “maybe it will take until Tuesday, maybe it will take nearly a year”, so much as “there are important factors that seriously change how long a habit takes to become engrained, and here is what those factors are”.
Read in full: Study reveals healthy habits take longer than 21 days to set in
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Get Past Executive Dysfunction
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In mathematics, there is a thing called the “travelling salesman problem”, and it is hard. Not just subjectively; it is classified in mathematical terms as an “NP-hard problem”, wherein NP stands for “nondeterministic polynomial”.
The problem is: a travelling salesman must visit a certain list of cities, order undetermined, by the shortest possible route that visits them all.
To work out what the shortest route is involves either very advanced mathematics, or else solving it by brute force, which means measuring every possible combination order (which number gets exponentially larger very quickly after the first few cities) and then selecting the shortest.
Why are we telling you this?
Executive dysfunction’s analysis paralysis
Executive dysfunction is the state of knowing you have things to do, wanting to do them, intending to do them, and then simply not doing them.
Colloquially, this can be called “analysis paralysis” and is considered a problem of planning and organizing, as much as it is a problem of initiating tasks.
Let’s give a simple example:
You wake up in the morning, and you need to go to the bathroom. But the bathroom will be cold, so you’ll want to get dressed first. However, it will be uncomfortable to get dressed while you still need to use the bathroom, so you contemplate doing that first. Those two items are already a closed loop now. You’re thirsty, so you want to have a drink, but the bathroom is calling to you. Sitting up, it’s colder than under the covers, so you think about getting dressed. Maybe you should have just a sip of water first. What else do you need to do today anyway? You grab your phone to check, drink untouched, clothes unselected, bathroom unvisited.
That was a simple example; now apply that to other parts of your day that have much more complex planning possible.
This is like the travelling salesman problem, except that now, some things are better if done before or after certain other things. Sometimes, possibly, they are outright required to be done before or after certain other things.
So you have four options:
- Solve the problem of your travelling-salesman-like tasklist using advanced mathematics (good luck if you don’t have advanced mathematics)
- Solve the problem by brute force, calculating all possible variations and selecting the shortest (good luck getting that done the same day)
- Go with a gut feeling and stick to it (people without executive dysfunction do this)
- Go towards the nearest item, notice another item on the way, go towards that, notice a different item on the way there, and another one, get stuck for a while choosing between those two, head towards one, notice another one, and so on until you’ve done a very long scenic curly route that has narrowly missed all of your targetted items (this is the executive dysfunction approach).
So instead, just pick one, do it, pick another one, do it, and so forth.
That may seem “easier said than done”, but there are tools available…
Task zero
We’ve mentioned this before in the little section at the top of our daily newsletter that we often use for tips.
One of the problems that leads to executive function is a shortage of “working memory”, like the RAM of a computer, so it’s easy to get overwhelmed with lists of things to do.
So instead, hold only two items in your mind:
- Task zero: the thing you are doing right now
- Task one: the thing you plan to do next
When you’ve completed task zero, move on to task one, renaming it task zero, and select a new task one.
With this approach, you will never:
- Think “what did I come into this room for?”
- Get distracted by alluring side-quests
Do not get corrupted by the cursed artefact
In fantasy, and occasionally science fiction, there is a trope: an item that people are drawn towards, but which corrupts them, changes their motivations and behaviors for the worse, as well as making them resistant to giving the item up.
An archetypal example of this would be the One Ring from The Lord of the Rings.
It’s easy to read/watch and think “well I would simply not be corrupted by the cursed artefact”.
And then pick up one’s phone to open the same three apps in a cycle for the next 40 minutes.
This is because technology that is designed to be addictive hijacks our dopamine processing, and takes advantage of executive dysfunction, while worsening it.
There are some ways to mitigate this:
Rebalancing Dopamine (Without “Dopamine Fasting”)
…but one way to avoid it entirely is to mentally narrate your choices. It’s a lot harder to make bad choices with an internal narrator going:
- “She picked up her phone absent-mindedly, certain that this time it really would be only a few seconds”
- “She picked up her phone for the eleventy-third time”
- “Despite her plan to put her shoes on, she headed instead for the kitchen”
This method also helps against other bad choices aside from those pertaining to executive dysfunction, too:
- “Abandoning her plan to eat healthily, she lingered in the confectionary aisle, scanning the shelves for sugary treats”
- “Monday morning will be the best time to start my new exercise regime”, she thought, for the 35th week so far this year
Get pharmaceutical or nutraceutical help
While it’s not for everyone, many people with executive dysfunction benefit from ADHD meds. However, they have their pros and cons (perhaps we’ll do a run-down one of these days).
There are also gentler options that can significantly ameliorate executive dysfunction, for example:
Bacopa Monnieri: A Well-Evidenced Cognitive Enhancer For Focus & More
Enjoy!
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Winter Wellness & The Pills That Increase Your Alzheimer’s Risk
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This week in health news…
Do not go gentle into that good night
As wildfires rage in California, snow is falling from Texas to Georgia, meaning that a lot of people are facing weather they’re not accustomed to, in houses that were not built for it. And that’s the lucky ones; there are many thousands of people who are homeless, of whom many will die.
Hopefully all our readers are safe, but it pays to watch out for the signs of hypothermia as it is a condition that really sneaks up on people and, in the process, takes away their ability to notice the hypothermia. You and your loved ones are not immune to this, so it’s good to keep an eye on each other, looking out for:
- Shivering, first ← when this stops, assuming it’s not because the temperature has risen, it is often a sign of hypothermia entering a later stage, in which the body is no longer responding appropriately to the cold
- Slurred speech or mumbling
- Slow, shallow breathing
- A weak pulse
- Clumsiness or lack of coordination
- Drowsiness or very low energy
- Confusion or memory loss
- Loss of consciousness
- In infants, bright red, cold skin
How cold is too cold? It doesn’t even have to be sub-zero. According to the CDC, temperatures of 4℃ (40℉) can be low enough to cause hypothermia.
Read in full: The warning signs to notice if someone has hypothermia
Related: Cold Weather Health Risks
Lethal lottery of pathogens
In Minnesota, hospital emergency room waiting times have skyrocketed since yesterday (at time of writing), with 40% of Minnesota’s 1,763 flu-related hospitalizations this fall and winter occurring in the same week, according to yesterday’s report. To put it further into perspective, 17 out of 20 of this season’s flu outbreaks have occurred in the past two weeks.
And that’s just the flu, without considering COVID, RSV, and Norovirus, which are also all running rampant in MN right now.
The advice presently is:
❝Go to the ER if you are super-sick. If you are not super-sick, go to urgent care, go to your clinic, schedule a virtual appointment.❞
And if you’re not in Minneapolis? These stats won’t apply, but definitely consider, before going to the hospital, whether you might leave sicker than you arrived, and plan accordingly, making use of telehealth where reasonably possible.
Read in full: Minnesota ERs stressed by “quad-demic” of COVID, flu, RSV, norovirus
Related: Move over, COVID and Flu! We Have “Hybrid Viruses” To Contend With Now
Sleep, but at what cost?
This was a study looking at the effects of sleeping pills on the brain, specifically zolpidem (most well-known by its brand name of Ambien).
What they found is that while it does indeed effectively induce sleep, part of how it does that is suppressing norepinephrine oscillations (which might otherwise potentially wake you up, though in healthy people these oscillations and the micro-arousals that they cause shouldn’t disrupt sleep at all, and are just considered part of our normal sleep cycles), which oscillations are necessary to generate the pumping action required to move cerebrospinal fluid through the glymphatic system while asleep.
This is a big problem, because the glymphatic system is almost entirely responsible for keeping the brain free from waste products such as beta-amyloids (whose build-up is associated with Alzheimer’s disease and is considered to be a significant part of Alzheimer’s pathogensesis) and alpha-synuclein (same but for Parkinson’s disease), amongst others:
Read in full: Common sleeping pill may pave way for disorders like Alzheimer’s
Related: How To Clean Your Brain (Glymphatic Health Primer)
Take care!
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Paracetamol pack sizes and availability are changing. Here’s what you need to know
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Changes are coming into effect from February 1 about how paracetamol is sold in Australia.
This mainly affects pack sizes of paracetamol sold outside pharmacies and how paracetamol is accessed in pharmacies.
The changes, announced by Australia’s drug regulator, are in line with moves internationally to reduce the harms of liver toxicity and the risk of overdose.
However, there are no new safety concerns when paracetamol is used as directed. And children’s products are not affected.
Bowonpat Sakaew/Shutterstock What is paracetamol?
Paracetamol is commonly sold under brand names such as Panadol, Dymadon and Panamax. It’s used to treat mild pain and fever for short periods or can be prescribed for chronic (long-term) pain.
Millions of packs of this cheap and accessible medicine are sold in Australia every year.
Small packs (up to 20 tablets) have been available from supermarkets and other retailers such as petrol stations. Larger packs (up to 100 tablets) are only available from pharmacies.
Paracetamol is relatively safe when used as directed. However, at higher-than-recommended doses, it can cause liver toxicity. In severe cases and when left untreated, this can be lethal.
Why are the rules changing?
In 2022, we wrote about how the Therapeutic Goods Administration (TGA) was considering changes to paracetamol access because of an increase in people going to hospital with paracetamol poisoning.
An expert review it commissioned found there were about 40–50 deaths every year from paracetamol poisoning between 2007 and 2020. Between 2009–10 and 2016–17, hospital admissions for this increased (from 8,617 to 11,697), before reducing in 2019–20 (8,723). Most admissions were due to intentional self-poisonings, and about half of these were among people aged ten to 24.
After the report, the TGA consulted with the public to work out how to prevent paracetamol poisonings.
Options included reducing pack sizes, limiting how many packs could be bought at once, moving larger packs behind the pharmacy counter and restricting access by age.
Responses were mixed. Although responses supported the need to prevent poisonings, there were concerns about how changes might affect:
- people with chronic pain, especially those in regional areas, where it may be harder to access pharmacies and, therefore, larger packs
- people on limited incomes, if certain products were made prescription-only.
Although deaths from paracetamol poisoning are tragic and preventable, they are rare considering how much paracetamol Australians use. There is less than one death due to poisoning for every million packs sold.
Because of this, it was important the TGA addressed concerns about poisonings while making sure Australians still had easy access to this essential medicine.
If you buy large packs of paracetamol for chronic pain, you’ll need to go to the pharmacy counter. StratfordProductions/Shutterstock So what’s changing?
The key changes being introduced relate to new rules about the pack sizes that can be sold outside pharmacies, and the location of products sold in pharmacies.
From February 1, packs sold in supermarkets and places other than pharmacies will reduce from a maximum 20 tablets to 16 tablets per pack. These changes bring Australia in line with other countries. These include the United Kingdom, which restricted supermarket packs to 16 tablets in 1998, and saw reductions in poisonings.
In all jurisdictions except Queensland and Western Australia, packs sold in pharmacies larger than 50 tablets will move behind the pharmacy counter and can only be sold under pharmacist supervision. In Queensland and WA, products containing more than 16 tablets will only be available from behind the pharmacy counter and sold under pharmacist supervision.
In all jurisdictions, any packs containing more than 50 tablets will need to be sold in blister packs, rather than bottles.
Several paracetamol products are not affected by these changes. These include children’s products, slow-release formulations (for example, “osteo” products), and products already behind the pharmacy counter or only available via prescription.
What else do I need to know?
These changes have been introduced to reduce the risk of poisonings from people exceeding recommended doses. The overall safety profile of paracetamol has not changed.
Paracetamol is still available from all current locations and there are no plans to make it prescription-only or remove it from supermarkets altogether. Many companies have already been updating their packaging to ensure there are no gaps in supply.
The reduction in pack sizes of paracetamol available in supermarkets means a pack of 16 tablets will now last two days instead of two-and-a-half days if taken at the maximum dose (two tablets, four times a day). Anyone in pain that does not improve after short-term use should speak to their pharmacist or GP.
For people who use paracetamol regularly for chronic pain, it is more cost-effective to continue buying larger packs from pharmacies. As larger packs (50+ tablets) need to be kept out of sight, you will need to ask at the pharmacy counter. Pharmacists know that for many people it’s appropriate to use paracetamol daily for chronic pain.
Natasa Gisev, Clinical pharmacist and Scientia Associate Professor at the National Drug and Alcohol Research Centre, UNSW Sydney and Ria Hopkins, Postdoctoral Research Fellow, National Drug and Alcohol Research Centre, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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