Dark Calories – by Dr. Catherine Shanahan
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You may be wondering: do we really need a 416-page book to say “don’t use vegetable oils”?
The author, who was a biochemist before becoming a family physician, takes a lot of care to explain in ways the non-chemists amongst us can understand (with molecular diagrams very well-labelled), exactly why certain seed/vegetable oils (both of those names being imprecise and unhelpful as umbrella terms) cause metabolic problems for us, when in contrast olive oil, avocado oil, and even peanut oil, do not.
Understanding is, for many, the root foundation of compliance. We are more likely to abide by rules we understand the logic behind, than seemingly arbitrary “thou shalt not…” proclamations.
So that’s an important strength of the book, demystifying various fats and how our body responds to them on a biochemical level, not just “is associated with such-and-such, based on observational population studies”. This kind of explanation clears up why, for example, seed oils correlate with obesity more than calories, sugar, wheat, or beef—having as it does to do with affecting our body’s ability to generate and use energy.
She also offers practical tips/reminders throughout, such as how “organic” does not necessarily mean “healthy” (indeed, many poisonous plants can be grown “organically”), and nor does “organic” mean “unrefined”, it speaks only for the conditions in which the raw product was first made, before other things were done to it later.
We learn a lot, too, about the processes of oxidation, the biochemistry behind that (more diagrams!), and of course the inflammatory response to same (an important factor in most if not all chronic disease).
The style is mostly very easy-to-read pop-science, though if you’re not a chemist, you’ll probably need to slow down for the biochemistry explanations (this reviewer certainly did).
Bottom line: this is more than just a litany against vegetable oils; it’s a ground-upwards education in metabolic biochemistry for the layperson, and what that means for us in terms of chronic disease risks.
Click here to check out Dark Calories, and learn what’s going on with these oils!
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Gentle Nutrition – by Rachel Hartley, RD, LD
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The subtitle here claims “a non-diet approach”, but doesn’t everything, nowadays? Even books titled “The such-and-such Diet” tend to also assure us “it’s not actually a diet; it’s just a way of eating”, as if a diet is not—by definition—a way of eating. Usually what they want to communicate is that it’s not a restrictive diet, usually meaning not restrictive in quantity, or not restrictive in food type (rarely both).
This book is about intuitive eating, which is about as non-restrictive as any dietary approach can be, since it doesn’t restrict food type at at all, and it doesn’t restrict quantity in advance—rather, we learn to pay closer attention to our full signals.
No wait, we don’t. This time, it’s not about “full”, it’s about “satisfied”. This comes in two forms:
- A principle somewhat akin to the “eat until 80% full” idea
- A principle of ensuring the good is culinarily satisfying
This latter is important, if we want to have a good relationship with eating, and it also helps reduce portion sizes, when we truly take the time to mindfully savor a tasty morsel, rather than wolf down a plate of mediocre food.
The style is one that balance being encouraging with delivering science to back up that encouragement. This not only means encouragement to take up this dietary approach, but also, encouragement to let go of things like calorie-counting and BMI.
The recipes arranged per meal type, and indeed include things not found in many healthy eating books, such as gyoza dumplings, gnocchi, wontons, and shortbread. The recipes are mostly not, by default, vegan, vegetarian, gluten-free, dairy-free, or such. So if you have your own food restriction(s), the number of usable recipes will be diminished, barring any substitutions you can make yourself.
Bottom line: this is more about about how to go about intuitive eating, than it is a book with a lot of nutritional information (though there is some of that too). If you’d like to get going with intuitive eating, then this book can help.
Click here to check out Gentle Nutrition, and nourish gently!
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Is “Extra Virgin” Worth It?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
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
❝I was wondering, is the health difference important between extra virgin olive oil and regular?❞
Assuming that by “regular” you mean “virgin and still sold as a food product”, then there are health differences, but they’re not huge. Or at least: not nearly so big as the differences between those and other oils.
Virgin olive oil (sometimes simply sold as “olive oil”, with no claims of virginity) has been extracted by the same means as extra virgin olive oil, that is to say: purely mechanical.
The difference is that extra virgin olive oil comes from the first pressing*, so the free fatty acid content is slightly lower (later checked and validated and having to score under a 0.8% limit for “extra virgin” instead of 2% limit for a mere “virgin”).
*Fun fact: in Arabic, extra virgin is called “البكر الممتاز“, literally “the amazing first-born”, because of this feature!
It’s also slightly higher in mono-unsaturated fatty acids, which is a commensurately slight health improvement.
It’s very slightly lower in saturated fats, which is an especially slight health improvement, as the saturated fats in olive oil are amongst the healthiest saturated fats one can consume.
On which fats are which:
The truth about fats: the good, the bad, and the in-between
And our own previous discussion of saturated fats in particular:
Can Saturated Fats Be Healthy?
Probably the strongest extra health-benefit of extra virgin is that while that first pressing squeezes out oil with the lowest free fatty acid content, it squeezes out oil with the highest polyphenol content, along with other phytonutrients:
If you enjoy olive oil, then springing for extra virgin is worth it if that’s not financially onerous, both for health reasons and taste.
However, if mere “virgin” is what’s available, it’s no big deal to have that instead; it still has a very similar nutritional profile, and most of the same benefits.
Don’t settle for less than “virgin”, though.
While some virgin olive oils aren’t marked as such, if it says “refined” or “blended”, then skip it. These will have been extracted by chemical means and/or blended with completely different oils (e.g. canola, which has a very different nutritional profile), and sometimes with a dash of virgin or extra virgin, for the taste and/or so that they can claim in big writing on the label something like:
a blend of
EXTRA VIRGIN OLIVE OIL
and other oils…despite having only a tiny amount of extra virgin olive oil in it.
Different places have different regulations about what labels can claim.
The main countries that produce olives (and the EU, which contains and/or directly trades with those) have this set of rules:
International Olive Council: Designations and definitions of Olive Oils
…which must be abided by or marketers face heavy fines and sanctions.
In the US, the USDA has its own set of rules based on the above:
USDA | Olive Oil and Olive-Pomace Oil Grades and Standards
…which are voluntary (not protected by law), and marketers can pay to have their goods certified if they want.
So if you’re in the US, look for the USDA certification or it really could be:
- What the USDA calls “US virgin olive oil not fit for human consumption”, which in the IOC is called “lamp oil”*
- crude pomace-oil (oil made from the last bit of olive paste and then chemically treated)
- canola oil with a dash of olive oil
- anything yellow and oily, really
*This technically is virgin olive oil insofar as it was mechanically extracted, but with defects that prevent it from being sold as such, such as having a free fatty acid content above the cut-off, or just a bad taste/smell, or some sort of contamination.
See also: Potential Health Benefits of Olive Oil and Plant Polyphenols
(the above paper has a handy infographic if you scroll down just a little)
Where can I get some?
Your local supermarket, probably, but if you’d like to get some online, here’s an example product on Amazon for your convenience
Enjoy!
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Does exercise really work for osteoarthritis?
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Osteoarthritis is a common degenerative joint disease that causes pain, stiffness and swelling, and reduces your range of motion. It often affects the knees, hips and hands, although it can also occur in other joints throughout the body.
If you’ve been diagnosed with osteoarthritis, your doctor has probably recommended exercise. This has become standard treatment advice in recent years.
However, a new review suggests exercise might not be as beneficial as first thought.
But when you take a closer look at the study, there are reasons to be cautious. So it shouldn’t prompt you to ditch your exercise regimen.
FG Trade/Getty Images What the review did
The research team conducted an “umbrella review” – an overview of systematic reviews, which collate and analyse the findings from individual studies to answer a specific question. Reviewing previously published systematic reviews provides an even bigger snapshot of a given research topic.
After searching thousands of studies, they included five major systematic reviews (comprised of 100 individual studies, with 8,631 patients) before adding another 28 recent trials (involving another 4,360 patients).
Using this data, they looked at the effect of exercise on knee, hip and hand osteoarthritis, and compared it to several alternatives, including doing nothing, placebo (fake) treatments, education, manual therapy, painkillers, injections and surgery.
What did they find?
Compared to doing nothing and placebos, they found that exercise resulted in small reductions in pain in the hip, knee and hand: between 6 and 12 points on a 100-point scale.
However, exercise did not seem to improve function any more than either of these comparisons.
For knee and hip osteoarthritis, there was evidence that exercise was just as effective at reducing pain and improving function as medicines such as ibuprofen and corticosteroids, which are injected into the joint to reduce inflammation. These also reduced pain by around 5–10%.
The researchers concluded exercise was less effective at improving pain and function than a total joint replacement in people with knee and hip osteoarthritis.
What were the limitations?
First, the authors lumped all types of exercise together. This means strength training, aerobic exercise, stretching, aquatic exercise and tai chi were all considered to be the same.
This is crucial, because we know not all exercise is created equal. Previous reviews have shown, for example, that aerobic exercise might be best for reducing pain and function in people with knee osteoarthritis, while stretching was least effective.
Similarly, the authors didn’t consider the clinical status of the patients. Evidence has shown people with more severe pain and worse function at the start of an intervention see better responses to exercise than those with less pain and good function.
Second, the review treated both supervised and unsupervised exercise the same.
However, research shows supervised training results in much better outcomes than unsupervised – likely because a trainer is there to help push the patient along.
Third, the authors didn’t account for the duration of the exercise, and most study periods were quite short: around 12 weeks.
It’s likely that sticking to an exercise regime over the long term will have better results, leading to a larger scope for improvement than if you just did something for a few weeks.
As such, the results of this review may not accurately reflect the benefits of exercise in people with osteoarthritis who commit to consistent exercise as an ongoing part of their weekly routine (which is often recommended).
Finally, the review didn’t account for the dose of exercise the studies used. Improvements in pain and function seem to increase with total weekly exercise in people with osteoarthritis. One review, for example, found the optimal benefits occurred at around 150 minutes of moderate intensity exercise per week.
These limitations suggest this new review likely undersells the benefits of exercise for osteoarthritis.
Less pain and better physical and mental health
Putting aside the limitations of the review, the small reductions in pain the review reports might still have a positive impact on someone’s life. A 10% reduction in pain could make a meaningful difference to your ability to move around, work, socialise and care for others.
The review also found exercise can reduce pain to the same extent as non-steriodal anti-inflammatory medications and corticosteroids – without the side-effects or the costs.
Exercise can also improve heart health, enhance your mood, help with weight management and reduce the risk of chronic diseases, such as cancer and diabetes.
These factors can have a huge impact on your health and happiness.
What should you do now?
Based on the findings of this new review, you should be confident that any type of exercise will lead to some degree of pain relief.
However, based on prior evidence, it’s likely you can get even greater overall health benefits from exercising if you stick with it.
The best type of exercise is the one that gets done. If you enjoy being outdoors and walking, then this is going to be a great choice as it will improve all aspects of your health as well as reduce pain.
And if pain permits, don’t be afraid to occasionally challenge yourself by upping the intensity to the point where holding a conversation starts to become difficult.
If going to the gym is more your thing, lifting weights will also bring significant overall health benefits – especially if you stick to it long term.
Hunter Bennett, Lecturer in Exercise Science, Adelaide University and Lewis Ingram, Lecturer in Physiotherapy, Adelaide University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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When You Know What You “Should” Do (But Knowing Isn’t The Problem)
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When knowing what to do isn’t the problem
Often, we know what we need to do. Sometimes, knowing isn’t the problem!
The topic today is going to be a technique used by therapeutic service providers to help people to enact positive changes in their lives.
While this is a necessarily dialectic practice (i.e., it involves a back-and-forth dialogue), it’s still perfectly possible to do it alone, and that’s what we’ll be focussing on in this main feature.
What is Motivational Interviewing?
❝Motivational interviewing (MI) is a technique that has been specifically developed to help motivate ambivalent patients to change their behavior.❞
Read in full: Motivational Interviewing: An Evidence-Based Approach for Use in Medical Practice
It’s mostly used for such things as helping people reduce or eliminate substance abuse, or manage their weight, or exercise more, things like that.
However, it can be employed for any endeavour that requires motivation and sustained willpower to carry it through.
Three Phases
Motivational Interviewing traditionally has three phases:
- Exploring and understanding the issue at hand
- Guiding and deciding importance and goals
- Choosing and setting an action plan
In self-practice, maybe you can already know and understand what it is that you want/need to change.
If not, consider asking yourself such questions as:
- What does a good day look like? What does a bad day look like?
- If things are not good now, when were they good? What changed?
- If everything were perfect now, what would that look like? How would you know?
Once you have a clear idea of where you want to be, the next thing to know is: how much do you want it? And how confident are you in attaining it?
This is a critical process:
- Give your answers numerically on a scale from 0 to 10
- Whatever your score, ask yourself why it’s not lower. For example, if you scored your motivation 4 and your confidence 2, what factors made your motivation not a lower number? What factors made your confidence not a lower number?
- In the unlikely event that you gave yourself a 0, ask whether you can really afford to scrap the goal. If you can’t, find something, anything, to bring it to at least a 1.
- After you’ve done that, then you can ask yourself the more obvious question of why your numbers aren’t higher. This will help you identify barriers to overcome.
Now you’re ready to choose what to focus on and how to do it. Don’t bite off more than you can chew; it’s fine to start low and work up. You should revisit this regularly, just like you would if you had a counsellor helping you.
Some things to ask yourself at this stage of the motivational self-interviewing:
- What’s a good SMART goal to get you started?
- What could stop you from achieving your goal?
- How could you overcome that challenge?
- What is your backup plan, if you have to scale back your goal for some reason?
A conceptual example: if your goal is to stick to a whole foods Mediterranean diet, but you are attending a wedding next week, then now is the time to decide in advance 1) what personal lines-in-the-sand you will or will not draw 2) what secondary, backup plan you will make to not go too far off track.
The same example in practice: wedding menus often offer meat/fish/vegetarian options, so you might choose the fish or vegetarian, and as for sugar and alcohol, you might limit yourself to “a small slice of wedding cake only; coffee/cheese option instead of dessert”, and “alcohol only for toasts”.
Giving yourself the permission well in advance for small (clearly defined and boundaried!) diversions from the plan, will stop you from falling into the trap of “well, since today’s a cheat-day now…”
Secret fourth stage
The secret here is to keep going back and reassessing at regular intervals. Set your own calendar; you might want to start out weekly and then move to monthly when you’re more strongly on-track.
For this reason, it’s good to keep a journal with your notes from your self-interview sessions, the scores you gave yourself, the goals and plans you set, etc.
When conducting your regular review, be sure to examine what worked for you, and what didn’t (and why). That way, you can practice trial-and-improvement as you go.
Want to learn more?
We only have so much room here, but there are lots of resources out there.
Here’s a high-quality page that:
- explains motivational interviewing in more depth than we have room for here
- offers a lot of free downloadable resource packs and the like
Check it out: Motivational Interviewing Theory & Resources
Enjoy!
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Cherries vs Raspberries – Which is Healthier?
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Our Verdict
When comparing cherries to raspberries, we picked the raspberries.
Why?
Both are great! But…
In terms of macros, raspberries have more than 4x the fiber, for similar carbs and similar (minimal) protein, winning this round easily.
In the category of vitamins, cherries have more vitamin A, while raspberries have more of vitamins B1, B2, B3, B5, B6, B7, B9, C, E, and K, for another overwhelming win.
Looking at minerals, cherries have (very slightly) more copper and potassium, while raspberries have rather more calcium, iron, magnesium, manganese, phosphorus, selenium, and zinc, winning a third round just as easily as the previous two.
In other considerations, cherries have some special phytochemical benefits of their own (see the “learn more” below), while raspberries have a lot more polyphenols, so we’ll call this round a tie.
Adding up the sections makes for a clear overall win for raspberries but by all means enjoy either or both, as diversity is good!
Want to learn more?
You might like:
Cherries’ Very Healthy Wealth Of Benefits!
Enjoy!
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Hantavirus quarantine has started. Two infection control experts explain what to expect
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Six passengers from the hantavirus cruise ship have started their quarantine at Australia’s purpose-built facility in Western Australia.
Over the next three weeks, the Australians and one New Zealander will be housed at the 500-bed Bullsbrook facility north-east of Perth, one of three purpose-built “centres for national resilience” around the country.
There, staff from the National Critical Care and Trauma Response Centre will monitor the returned passengers’ health, before authorities decide what happens next.
We are both infection prevention and control experts who advised the Victorian government on best-practice quarantine arrangements during COVID. This included the design of a dedicated quarantine facility.
Here’s how the Perth facility – and similar purpose-built ones in Melbourne and Brisbane – have been designed to minimise the spread of infectious diseases.
Multiplex What actually is quarantine?
The word itself comes from the Italian phrase quaranta giorni, meaning “40 days”. Back during the Black Death, ships had to anchor off the coast for 40 days before they could land in European cities to make sure no one on board was sick.
Today, quarantine is specifically for people who have been exposed to a virus – in this case the Andes strain of hantavirus – but aren’t showing any symptoms yet.
Experience from managing other infectious diseases, including COVID, has taught us that people can spread a virus before they even feel sick. We use quarantine to protect the community and also to make sure the person who was exposed doesn’t catch anything else.
During the early stages of the COVID pandemic, Australia was among countries that used hotels for quarantine purposes. But hotels are designed for comfort, not for stopping airborne pathogens. Shared spaces, inadequate ventilation systems, poor workflow (see points two and three below), and staff often with little or no expertise in infection control contributed to several breaches.
Many of these hotels were in the middle of busy cities. This was risky because any breach could immediately expose a lot of people in a crowded area.
So Australia built three centres for national resilience in Mickleham (near Melbourne), Perth and Brisbane. These were placed outside crowded city centres but still close to airports.
So what are these facilities like?
When architects and health experts design these facilities, they focus on four main things: fresh air, design, workflow and dignity.
1. Fresh air inside and out
These buildings need a constant supply of fresh air. The air is never recirculated (reused). Instead, old air is pushed outside so people aren’t breathing in “re-breathed” particles from someone else. So a lot of thought goes into air handling, that is, stopping germs from hanging around in the air and spreading to others.
That includes designing facilities with verandahs (for residents) and open-air walkways (for staff).
Perth’s facility has verandahs and open-air walkways to minimise the spread of infectious diseases. Multiplex 2. Designed with zones
The safest way to run a facility is to split it into three “traffic light” zones:
- the green zone (clean): where staff enter, have their offices, and take breaks
- orange zone (transition): a buffer area, like a verandah or porch, where staff put on their protective gear or hand over meals and medical samples
- red zone (contaminated): the actual room or area where the person stays. Anyone entering this area must wear full personal protective equipment. This often includes properly fitted long-sleeved gowns, gloves, N95 masks and face shields or goggles, combined with mandatory training in “donning and doffing” (putting on and taking off personal protective equipment).
3. One-way workflow
A crucial rule in infection control is that you never move “dirty” items back into “clean” areas. Everything must move in one direction: from clean to dirty.
So staff and supplies follow a strict path to ensure nothing from the “red zone” accidentally moves back into the “green zone”. This could include infectious air, as well as people and objects or equipment.
Sometimes, however, objects from the “red zone” have to move back into other zones, but need to be cleaned and disinfected first. This would be the case for the dirty laundry of people in quarantine. In this case, there are strict protocols to make sure any risk is minimised. Once cleaned and disinfected, these items can then be re-used.
4. Ensuring dignity
One of the hardest parts of quarantine is the mental toll. Staying in a room for weeks is hard. Those in quarantine often experience mental health stressors.
This may include a fear of infection, constantly being on alert for symptoms, and having trouble sleeping.
In the old hotel quarantine, some people couldn’t even go outside. By contrast, purpose-built facilities are designed to be more humane. This means:
- accessing natural light, outdoor space and fresh air
- good quality food and water
- internet and entertainment so they can stay connected
- emotional support to help with the stress of being isolated.
What happens now?
If anyone in the Perth facility does become sick, there is a medical clinic on-site so they can be treated or stabilised before transferring to hospital. People in quarantine also have access to telehealth.
What happens after the three-week period is up has yet to be decided. The World Health Organization recommends active monitoring and home or facility quarantine of high-risk contacts for 42 days after their last potential exposure.
As hantaviruses are rarely transmitted between people, the risk to the general public remains low and the virus is not a pandemic threat.
But this outbreak is a reminder that we need to be prepared for future outbreaks of infectious diseases. So our quarantine facilities need to be ready to go should they be needed again.
Philip Russo, Professor, Director of Research, Nursing and Midwifery, Monash University and Brett Mitchell, Professor of Nursing and Health Services Research, University of Newcastle
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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