Cupping: How It Works (And How It Doesn’t)
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Good Health By The Cup?
In Tuesday’s newsletter, we asked you for your opinion of cupping (the medical practice), and got the above-depicted, below-described, set of responses:
- About 40% said “It may help by improving circulation and stimulating the immune system”
- About 26% said “I have never heard of the medical practice of cupping before this”
- About 19% said “It is pseudoscience and/or placebo at best, but probably not harmful
- About 9% said “It is a good, evidence-based practice that removes toxins and stimulates health”
- About 6% said “It is a dangerous practice that often causes harm to people who need medical help”
So what does the science say?
First, a quick note for those unfamiliar with cupping: it is the practice of placing a warmed cup on the skin (open side of the cup against the skin). As the warm air inside cools, it reduces the interior air pressure, which means the cup is now (quite literally) a suction cup. This pulls the skin up into the cup a little. The end result is visually, and physiologically, the same process as what happens if someone places the nozzle of a vacuum cleaner against their skin. For that matter, there are alternative versions that simply use a pump-based suction system, instead of heated cups—but the heated cups are most traditional and seem to be most popular. See also:
National Center for Complementary and Integrative Health | Cupping
It is a dangerous practice that often causes harm to people who need medical help: True or False?
False, for any practical purposes.
- Directly, it can (and usually does) cause minor superficial harm, much like many medical treatments, wherein the benefits are considered to outweigh the harm, justifying the treatment. In the case of cupping, the minor harm is usually a little bruising, but there are other risks; see the link we gave just above.
- Indirectly, it could cause harm by emboldening a person to neglect a more impactful treatment for their ailment.
But, there’s nothing for cupping akin to the “the most common cause of death is when someone gets a vertebral artery fatally severed” of chiropractic, for example.
It is a good, evidence-based practice that removes toxins and stimulates health: True or False?
True and False in different parts. This one’s on us; we included four claims in one short line. But let’s look at them individually:
- Is it good? Well, those who like it, like it. It legitimately has some mild health benefits, and its potential for harm is quite small. We’d call this a modest good, but good nonetheless.
- Is it evidence-based? Somewhat, albeit weakly; there are some papers supporting its modest health claims, although the research is mostly only published in journals of alternative medicine, and any we found were in journals that have been described by scientists as pseudoscientific.
- Does it remove toxins? Not directly, at least. There is also a version that involves making a small hole in the skin before applying the cup, the better to draw out the toxins (called “wet cupping”). This might seem a little medieval, but this is because it is from early medieval times (wet cupping’s first recorded use being in the early 7th century). However, the body’s response to being poked, pierced, sucked, etc is to produce antibodies, and they will do their best to remove toxins. So, indirectly, there’s an argument.
- Does it stimulate health? Yes! We’ll come to that shortly. But first…
It is pseudoscience and/or placebo at best, but probably not harmful: True or False?
True in that its traditionally-proposed mechanism of action is a pseudoscience and placebo almost certainly plays a strong part, and also in that it’s generally not harmful.
On it being a pseudoscience: we’ve talked about this before, but it bears repeating; just because something’s proposed mechanism of action is pseudoscience, doesn’t necessarily mean it doesn’t work by some other mechanism of action. If you tell a small child that “eating the rainbow” will improve their health, and they believe this is some sort of magical rainbow power imbuing them with health, then the mechanism of action that they believe in is a pseudoscience, but eating a variety of colorful fruit and vegetables will still be healthy.
In the case of cupping, its proposed mechanism of action has to do withbalancing qi, yin and yang, etc (for which scientific evidence does not exist), in combination with acupuncture lore (for which some limited weak scientific evidence exists). On balancing qi, yin and yang etc, this is a lot like Europe’s historically popular humorism, which was based on the idea of balancing the four humors (blood, yellow bile, black bile, phlegm). Needless to say, humorism was not only a pseudoscience, but also eventually actively disproved with the advent of germ theory and modern medicine. Cupping therapy is not more scientifically based than humorism.
On the placebo side of things, there probably is a little more to it than that; much like with acupuncture, a lot of it may be a combination of placebo and using counter-irritation, a nerve-tricking method to use pain to reduce pain (much like pressing with one’s nail next to an insect bite).
Here’s one of the few studies we found that’s in what looks, at a glance, to be a reputable journal:
Cupping therapy and chronic back pain: systematic review and meta-analysis
It may help by improving circulation and stimulating the immune system: True or False?
True! It will improve local circulation by forcing blood into the area, and stimulate the immune system by giving it a perceived threat to fight.
Again, this can be achieved by many other means; acupuncture (or just “dry needling”, which is similar but without the traditional lore), a cold shower, and/or exercise (and for that matter, sex—which combines exercise, physiological arousal, and usually also foreign bodies to respond to) are all options that can improve circulation and stimulate the immune system.
You can read more about using some of these sorts of tricks for improving health in very well-evidenced, robustly scientific ways here:
The Stress Prescription (Against Aging!)
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Lycopene’s Benefits For The Gut, Heart, Brain, & More
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.
What Doesn’t Lycopene Do?
Lycopene is an antioxidant carotenoid famously found in tomatoes; it actually appears in even higher levels in watermelon, though. If you are going to get it from tomato, know that cooking improves the lycopene content rather than removing it (watermelon, on the other hand, can be enjoyed as-is and already has the higher lycopene content).
Antioxidant properties
Let’s reiterate the obvious first, for the sake of being methodical and adding a source. Lycopene is a potent antioxidant with multiple health benefits:
Lycopene: A Potent Antioxidant with Multiple Health Benefits
…and as such, it does all the things you might reasonably expect and antioxidant to do. For example…
Anti-inflammatory properties
In particular, it regulates macrophage activity, reducing inflammation while improving immune response:
Lycopene Regulates Macrophage Immune Response through the Autophagy Pathway Mediated by RIPK1
As can be expected of most antioxidants and anti-inflammatory agents, it also has…
Anticancer properties
Scientific papers tend to be “per cancer type”, so we’re just going to give one example, but there’s pretty much evidence for its utility against most if not all types of cancer. We’re picking prostate cancer though, as it’s one that’s been studied the most in the context of lycopene intake—in this study, for example, it was found that men who enjoyed at least two servings of lycopene-rich tomato sauce per week were 30% less likely to develop prostate cancer than those who didn’t:
Dietary lycopene intake and risk of prostate cancer defined by ERG protein expression
If you’d like to see something more general, however, then check out:
Potential Use of Tomato Peel, a Rich Source of Lycopene, for Cancer Treatment
It also fights Candida albicans
Ok, this is not (usually) so life-and-death as cancer, but reducing our C. albicans content (specifically: in our gut) has a lot of knock-on effects for other aspects of our health, so this isn’t one to overlook:
The title does not make this clear, but yes: this does mean it has an antifungal effect. We mention this because often cellular apoptosis is good for an overall organism, but in this case, it simply kills the Candida.
It’s good for the heart
A lot of studies focus just on triglyceride markers (which lycopene improves), but more tellingly, here’s a 10-year observational study in which diets rich in lycopene were associated to a 17–26% lower risk of heart disease:
Relationship of lycopene intake and consumption of tomato products to incident CVD
…and a 39% overall reduced mortality in, well, we’ll let the study title tell it:
…which means also:
It’s good for the brain
As a general rule of thumb, what’s good for the heart is good for the brain (because the brain needs healthy blood flow to stay healthy, and is especially vulnerable when it doesn’t get that), and in this case that rule of thumb is also borne out by the post hoc evidence, specifically yielding a 31% decreased incidence of stroke:
Dietary and circulating lycopene and stroke risk: a meta-analysis of prospective studies
Is it safe?
As a common food product, it is considered very safe.
If you drink nothing but tomato juice all day for a long time, your skin will take on a reddish hue, which will go away if you stop getting all your daily water intake in tomato juice.
In all likelihood, even if you went to extremes, you would get sick from the excess of vitamin A (generally present in the same foods) sooner than you’d get sick from the excess of lycopene.
Want to try some?
We don’t sell it, and also we recommend simply enjoying tomatoes, watermelons, etc, but if you do want a supplement, here’s an example product on Amazon
Enjoy!
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Cottage Cheese vs Ricotta – Which is Healthier?
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Our Verdict
When comparing cottage cheese to ricotta, we picked the ricotta.
Why?
Cottage cheese is a famous health food, mostly for being a low-fat, low-carb, source of protein. And yet, ricotta beats it in most respects.
Looking at the macros first, cottage cheese has more carbs, while ricotta has more protein and fat. The fat profile is pretty much the same, and in both cases it’s two thirds saturated fat, which isn’t good in either case, but cottage cheese has less overall fat which means less saturated fat in total even if the percentage is the same. Because the difference in carbs and protein is not large, while ricotta has considerably more fat, we’ll call this category a win for cottage cheese.
In terms of vitamins, cottage cheese has more of vitamins B1, B5, and B12, while ricotta has more of vitamins A, B2, B3, B9, D, E, and K, so this one’s a win for ricotta.
In the category of minerals, cottage cheese has slightly more copper, while ricotta has much more calcium, iron, magnesium, manganese, potassium, selenium, and zinc. In particular, 2.5x more calcium, and 5x more iron! An easy and clear win for ricotta here.
Taking everything into account: yes, cottage cheese has less fat (and thus, in total, less saturated fat, although the percentage is the same), but that doesn’t make up for ricotta winning in pretty much every other respect. Still, enjoy either or both (in moderation!) if you be so inclined.
Want to learn more?
You might like to read:
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Statistical Models vs. Front-Line Workers: Who Knows Best How to Spend Opioid Settlement Cash?
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MOBILE, Ala. — In this Gulf Coast city, addiction medicine doctor Stephen Loyd announced at a January event what he called “a game-changer” for state and local governments spending billions of dollars in opioid settlement funds.
The money, which comes from companies accused of aggressively marketing and distributing prescription painkillers, is meant to tackle the addiction crisis.
But “how do you know that the money you’re spending is going to get you the result that you need?” asked Loyd, who was once hooked on prescription opioids himself and has become a nationally known figure since Michael Keaton played a character partially based on him in the Hulu series “Dopesick.”
Loyd provided an answer: Use statistical modeling and artificial intelligence to simulate the opioid crisis, predict which programs will save the most lives, and help local officials decide the best use of settlement dollars.
Loyd serves as the unpaid co-chair of the Helios Alliance, a group that hosted the event and is seeking $1.5 million to create such a simulation for Alabama.
The state is set to receive more than $500 million from opioid settlements over nearly two decades. It announced $8.5 million in grants to various community groups in early February.
Loyd’s audience that gray January morning included big players in Mobile, many of whom have known one another since their school days: the speaker pro tempore of Alabama’s legislature, representatives from the city and the local sheriff’s office, leaders from the nearby Poarch Band of Creek Indians, and dozens of addiction treatment providers and advocates for preventing youth addiction.
Many of them were excited by the proposal, saying this type of data and statistics-driven approach could reduce personal and political biases and ensure settlement dollars are directed efficiently over the next decade.
But some advocates and treatment providers say they don’t need a simulation to tell them where the needs are. They see it daily, when they try — and often fail — to get people medications, housing, and other basic services. They worry allocating $1.5 million for Helios prioritizes Big Tech promises for future success while shortchanging the urgent needs of people on the front lines today.
“Data does not save lives. Numbers on a computer do not save lives,” said Lisa Teggart, who is in recovery and runs two sober living homes in Mobile. “I’m a person in the trenches,” she said after attending the Helios event. “We don’t have a clean-needle program. We don’t have enough treatment. … And it’s like, when is the money going to get to them?”
The debate over whether to invest in technology or boots on the ground is likely to reverberate widely, as the Helios Alliance is in discussions to build similar models for other states, including West Virginia and Tennessee, where Loyd lives and leads the Opioid Abatement Council.
New Predictive Promise?
The Helios Alliance comprises nine nonprofit and for-profit organizations, with missions ranging from addiction treatment and mathematical modeling to artificial intelligence and marketing. As of mid-February, the alliance had received $750,000 to build its model for Alabama.
The largest chunk — $500,000 — came from the Poarch Band of Creek Indians, whose tribal council voted unanimously to spend most of its opioid settlement dollars to date on the Helios initiative. A state agency chipped in an additional $250,000. Ten Alabama cities and some private foundations are considering investing as well.
Stephen McNair, director of external affairs for Mobile, said the city has an obligation to use its settlement funds “in a way that is going to do the most good.” He hopes Helios will indicate how to do that, “instead of simply guessing.”
Rayford Etherton, a former attorney and consultant from Mobile who created the Helios Alliance, said he is confident his team can “predict the likely success or failure of programs before a dollar is spent.”
The Helios website features a similarly bold tagline: “Going Beyond Results to Predict Them.”
To do this, the alliance uses system dynamics, a mathematical modeling technique developed at the Massachusetts Institute of Technology in the 1950s. The Helios model takes in local and national data about addiction services and the drug supply. Then it simulates the effects different policies or spending decisions can have on overdose deaths and addiction rates. New data can be added regularly and new simulations run anytime. The alliance uses that information to produce reports and recommendations.
Etherton said it can help officials compare the impact of various approaches and identify unintended consequences. For example, would it save more lives to invest in housing or treatment? Will increasing police seizures of fentanyl decrease the number of people using it or will people switch to different substances?
And yet, Etherton cautioned, the model is “not a crystal ball.” Data is often incomplete, and the real world can throw curveballs.
Another limitation is that while Helios can suggest general strategies that might be most fruitful, it typically can’t predict, for instance, which of two rehab centers will be more effective. That decision would ultimately come down to individuals in charge of awarding contracts.
Mathematical Models vs. On-the-Ground Experts
To some people, what Helios is proposing sounds similar to a cheaper approach that 39 states — including Alabama — already have in place: opioid settlement councils that provide insights on how to best use the money. These are groups of people with expertise ranging from addiction medicine and law enforcement to social services and personal experience using drugs.
Even in places without formal councils, treatment providers and recovery advocates say they can perform a similar function. Half a dozen advocates in Mobile told KFF Health News the city’s top need is low-cost housing for people who want to stop using drugs.
“I wonder how much the results” from the Helios model “are going to look like what people on the ground doing this work have been saying for years,” said Chance Shaw, director of prevention for AIDS Alabama South and a person in recovery from opioid use disorder.
But Loyd, the co-chair of the Helios board, sees the simulation platform as augmenting the work of opioid settlement councils, like the one he leads in Tennessee.
Members of his council have been trying to decide how much money to invest in prevention efforts versus treatment, “but we just kind of look at it, and we guessed,” he said — the way it’s been done for decades. “I want to know specifically where to put the money and what I can expect from outcomes.”
Jagpreet Chhatwal, an expert in mathematical modeling who directs the Institute for Technology Assessment at Massachusetts General Hospital, said models can reduce the risk of individual biases and blind spots shaping decisions.
If the inputs and assumptions used to build the model are transparent, there’s an opportunity to instill greater trust in the distribution of this money, said Chhatwal, who is not affiliated with Helios. Yet if the model is proprietary — as Helios’ marketing materials suggest its product will be — that could erode public trust, he said.
Etherton, of the Helios Alliance, told KFF Health News, “Everything we do will be available publicly for anyone who wants to look at it.”
Urgent Needs vs. Long-Term Goals
Helios’ pitch sounds simple: a small upfront cost to ensure sound future decision-making. “Spend 5% so you get the biggest impact with the other 95%,” Etherton said.
To some people working in treatment and recovery, however, the upfront cost represents not just dollars, but opportunities lost for immediate help, be it someone who couldn’t find an open bed or get a ride to the pharmacy.
“The urgency of being able to address those individual needs is vital,” said Pamela Sagness, executive director of the North Dakota Behavioral Health Division.
Her department recently awarded $7 million in opioid settlement funds to programs that provide mental health and addiction treatment, housing, and syringe service programs because that’s what residents have been demanding, she said. An additional $52 million in grant requests — including an application from the Helios Alliance — went unfunded.
Back in Mobile, advocates say they see the need for investment in direct services daily. More than 1,000 people visit the office of the nonprofit People Engaged in Recovery each month for recovery meetings, social events, and help connecting to social services. Yet the facility can’t afford to stock naloxone, a medication that can rapidly reverse overdoses.
At the two recovery homes that Mobile resident Teggart runs, people can live in a drug-free space at a low cost. She manages 18 beds but said there’s enough demand to fill 100.
Hannah Seale felt lucky to land one of those spots after leaving Mobile County jail last November.
“All I had with me was one bag of clothes and some laundry detergent and one pair of shoes,” Seale said.
Since arriving, she’s gotten her driver’s license, applied for food stamps, and attended intensive treatment. In late January, she was working two jobs and reconnecting with her 4- and 7-year-old daughters.
After 17 years of drug use, the recovery home “is the one that’s worked for me,” she said.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Soap vs Sanitizer – Which is Healthier?
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.
Our Verdict
When comparing soap to sanitizer, we picked the soap.
Why?
Both are good at killing bacteria / inactivating viruses, but there are several things that set them apart:
- Soap doesn’t just kill them; it slides them off and away down the drain. That means that any it failed to kill are also off and down the drain, not still on your hands. This is assuming good handwashing technique, of course!
- Sanitizer gel kills them, but can take up to 4 minutes of contact to do so. Given that people find 20 seconds of handwashing laborious, 240 seconds of sanitizer gel use seems too much to hope for.
Both can be dehydrating for the hands; both can have ingredients added to try to mitigate that.
We recommend a good (separate) moisturizer in either case, but the point is, the dehydration factor doesn’t swing it far either way.
So, we’ll go with the one that gets rid of the germs the most quickly: the soap
10almonds tip: splash out on the extra-nice hand-soaps for your home—this will make you and others more likely to wash your hands more often! Sometimes, making something a more pleasant experience makes all the difference.
Want to know more?
Check out:
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Languishing – by Prof. Corey Keyes
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We’ve written before about depression and “flourishing” but what about when one isn’t exactly flourishing, but is not necessarily in the depths of depression either? That’s what this book is about.
Prof. Keyes offers, from his extensive research, hope for those who do not check enough of the boxes to be considered depressed, but who are also definitely more in the lane of “surviving” than “thriving”.
Specifically, he outlines five key ways to make the step from languishing to flourishing, based not on motivational rhetoric, but actual data-based science:
- Learn (creating your personal story of self-growth)
- Connect (building relationships, on the individual level and especially on the community level)
- Transcend (developing psychological resilience to the unexpected)
- Help (others! This is about finding your purpose, and then actively living it)
- Play (this is a necessary “recharge” element that many people miss, especially as we get older)
With regard to finding one’s purpose being given the one-word summary of “help”, this is a callback to our tribal origins, and how we thrive and flourish best and feel happiest when we have a role to fulfil and provide value to those around us)
Bottom line: if you’re not at the point of struggling to get out of bed each day, but you’re also not exactly leaping out of bed with a smile, this book can help get you from one place to the other.
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Macadamias vs Hazelnuts – Which is Healthier?
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Our Verdict
When comparing macadamias to hazelnuts, we picked the hazelnuts.
Why?
In terms of macros first, hazelnuts have 2x the protein, and slightly more carbs and fiber. We call this a win for hazelnuts.
When it comes to vitamins, macadamias have more of vitamins B1, B2, and B3, while hazelnuts have more of vitamins A, B5, B6, B7, B9, C, and E. Notably, 28x more vitamin E, so that’s not inconsiderable. Also 10x the vitamin B9, and 5x the vitamin C, and the rest, more modest wins. In any case, clearly a strong win for hazelnuts here.
In the category of minerals, macadamias have more selenium, while hazelnuts have more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc. Another clear win for hazelnuts.
In short, hazelnuts win in all categories. However, by all means enjoy either or both (unless you have a nut allergy, in which case, obviously don’t).
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
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