Dealing With Waking Up In The Night
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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
❝I’m now in my sixties and find that I invariably wake up at least once during the night. Is this normal? Even if it is, I would still like, once in a while, to sleep right through like a teenager. How might this be achieved, without pills?❞
Most people wake up briefly between sleep cycles, and forget doing so. But waking up for more than a brief moment is indeed best avoided. In men of your age, if you’re waking to pee (especially if it’s then not actually that easy to pee), it can be a sign of an enlarged prostate. Which is again a) normal b) not optimal.
By “without pills” we’ll assume you mean “without sleeping pills”. There are options to treat an enlarged prostate, including well-established supplements. We did a main feature on this:
Prostate Health: What You Should Know
If the cause of waking up is something else, then again this is common for everyone as we get older, and again it’s not optimal. But since there are so many possible causes (and thus solutions), it’s more than we can cover in less than a main feature, so we’ll have to revisit this later.
Meanwhile, take care!
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We Are Such Stuff As Fish Are Made Of
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Research Review: Collagen
For something that’s a very popular supplement, not many people understand what collagen is, where it comes from, or what it does.
In a nutshell:
Collagen is a kind of protein. Our bodies make it naturally, and we can also get more in our diet and/or take extra as a supplement.
Our bodies use collagen in connective tissue, skin, tendon, bone, and cartilage. It has many functions, but a broad description would be “holding things together”.
As we get older, our bodies produce less collagen. Signs of this include wrinkles, loss of skin hydration, and joint pain.
Quick test: pinch the skin on the middle of the back of one of your hands, and then watch what happens when you get low. How quickly and easily did your skin returns to its original shape?
If it was pretty much instantanous and flawless, congratulations, you have plenty of collagen (and also elastin). If you didn’t, you are probably low on both!
(they are quite similar proteins and are made from the same base “stuff”, so if you’re low on one, you’ll usually be low on both)
Quick note: A lot of research out there has been funded by beauty companies, so we had our work cut out for us today, and have highlighted where any research may be biased.
More than skin deep
While marketing for collagen is almost exclusively aimed at “reduce wrinkles and other signs of aging”, it does a lot more than that.
You remember we mentioned that many things from the bones outward are held together by collagen? We weren’t kidding…
Read: Osteoporosis, like skin ageing, is caused by collagen loss which is reversible
Taking extra collagen isn’t the only way
We can’t (yet!) completely halt the age-related loss of collagen, but we can slow it, with our lifestyle choices:
- Don’t smoke tobacco
- Drink only in moderation (or not at all)
- Avoid foods with added sugar, and high-processed foods in general
- Wear sunscreen when appropriate
Can I get collagen from food?
Yep! Just as collagen holds our bodies together, it holds the bodies of other animals together. And, just like collagen is found in most parts of our body but most plentifully in our skin and bones, that’s what to eat to get collagen from other animals, e.g:
- Chicken skin
- Fish skin
- Bone broth ← health benefits and recipes at this link!
What about vegans?
Yes, vegans are also held together by collagen! We do not, however, recommend eating their skin or boiling their bones into broth. Ethical considerations aside, cannibalism can give you CJD!
More seriously, if you’re vegan, you can’t get collagen from a plant-based diet, but you can get the stuff your body uses to make collagen. Basically, you want to make sure you get plenty of:
- Protein (beans, pulses, nuts, etc are all fine; it’s hard to go wrong with this)
- Vitamin C
- Vitamin D
- and Zinc
Just be sure to continue to remember to avoid highly-processed foods. So:
- Soy mince/chunks whose ingredients list reads: “soya”? Yes!
- The Incredible Burger or Linda McCartney’s Sausages? Sadly less healthy
Read: Advanced Glycation End Products in Foods and a Practical Guide to Their Reduction in the Diet
Meat-eaters might want to read that one too. By far the worst offenders for AGEs (Advanced Glycation End Products, which can not only cause collagen to stiffen, but also inactivate proteins responsible for collagen repair, along with doing much more serious damage to your body’s natural functions) include:
- Hot dogs
- Bacon
- Fried/roasted/grilled meats
Is it worth it as a supplement?
That depends on you, your age, and your lifestyle, but it’s generally considered safe*
*if you have a seafood allergy, be careful though, as many supplements are from fish or shellfish—you will need to find one that’s free from your allergen
Also, all collagen is animal-derived. So if you’re a vegan, decide for yourself whether this constitutes medicine and if so, whether that makes it ethically permissible to you.
With that out of the way:
What the science says on collagen supplementation
Collagen for skin
Read: Effects of collagen supplementation on skin aging (systematic review and meta-analysis)
The short version is that they selected 19 studies with over a thousand participants in total, and they found:
In the meta-analysis, a grouped analysis of studies showed favorable results of hydrolyzed collagen supplementation compared with placebo in terms of skin hydration, elasticity, and wrinkles.
The findings of improved hydration and elasticity were also confirmed in the subgroup meta-analysis.
Based on results, ingestion of hydrolyzed collagen for 90 days is effective in reducing skin aging, as it reduces wrinkles and improves skin elasticity and hydration.
Caveat: while that systematic review had no conflicts of interests, at least some of the 19 studies will have been funded by beauty companies. Here are two, so that you know what that looks like:
Funded by Quiris to investigate their own supplement, Elasten®:
A Collagen Supplement Improves Skin Hydration, Elasticity, Roughness, and Density
Funded by BioCell to investigate their own supplement, BioCell Collagen:
The Effects of Skin Aging Associated with the Use of BioCell Collagen
A note on funding bias: to be clear, the issue is not that the researchers might be corrupt (though that could happen).
The issue is more that sometimes companies will hire ten labs to do ten research studies… and then pull funding from ones whose results aren’t going the way they’d like.
So the “best” (for them) study is the one that gets published.
Here’s another systematic review—like the one at the top of this section—that found the same, with doses ranging from 2.5g–15g per day for 8 weeks or longer:
Read: Oral Collagen Supplementation: A Systematic Review of Dermatological Applications
Again, some of those studies will have been funded by beauty companies. The general weight of evidence does seem clear and favorable, though.
Collagen for bones
Here, we encountered a lot less in the way of potential bias, because this is simply marketed a lot less. Despite being arguably far more important!
We found a high quality multi-vector randomized controlled study with a sample size of 131 postmenopausal women. They had these women take 5g collagen supplement (or placebo), and studied the results over the course of a year.
They found:
- The intake of the supplement increased bone mineral density (BMD)
- Supplementation was also associated with a favorable shift in bone markers, indicating:
- increased bone formation
- reduced bone degradation
Read: Specific Collagen Peptides Improve Bone Mineral Density and Bone Markers in Postmenopausal Wome
A follow-up study with 31 of these women found that taking 5 grams of collagen daily for a total of 4 years was associated with a progressive increase in BMD.
You might be wondering if collagen also helps against osteoarthritis.
The answer is: yes, it does (at least, it significantly reduces the symptoms)
Read: Effect of collagen supplementation on osteoarthritis symptoms
In summary:
- You need collagen for health skin, bones, joints, and more
- Your body makes collagen from your food
- You can help it by getting plenty of protein, vitamins, and minerals
- You can also help it by not doing the usual Bad Things™ (smoking, drinking, eating processed foods, especially processed meats)
- You can also eat collagen directly in the form of other animals’ skin and bones
- You can also buy collagen supplements (but watch out for allergens)
Want to try collagen supplementation?
We don’t sell it (or anything else), but for your convenience…
Check it out: Hydrolyzed Collagen Peptides (the same as in most of the above studies), 90 days supply at 5g/day
We selected this one because it’s the same kind used in many of the studies, and it doesn’t contain any known allergens.
It’s bovine collagen, meaning it’s from cows, so it’s not vegan, and also some subscribers may want to abstain for religious reasons. We respect that, and/but make our recommendations based solely on the science of health and productivity.
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The Orchid That Renovates Your Gut (Gently)
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The Orchid That Renovates Your Gut (Gently)
Dendrobium officinale is an orchid that’s made its way from Traditional Chinese Medicine into modern science.
Read: Traditional Uses, Phytochemistry, Pharmacology, and Quality Control of Dendrobium officinale
To summarize its benefits, we’ll quote from Dr. Paharia’s article featured in our “what’s happening in the health world” section all so recently:
❝Gut microbes process Dendriobium officinale polysaccharides (DOPs) in the colon, producing short-chain fatty acids (SCFAs) and oligosaccharides that alter gut microbial composition and improve human health.
DOPs have been shown to decrease harmful bacteria like E. coli and Staphylococcus while promoting beneficial ones like Bifidobacterium.❞
We don’t stop at secondary sources, though, so we took a look at the science.
Dr. Wu et al. found (we’ll quote directly for these bullet points):
- DOPs have been shown to influence the gut microbiota, such as the abundance of Lactobacillus, Bifidobacterium, Akkermansia, Bacteroides, and Prevotella, and provide different benefits to the host due to structural differences.
- The dietary intake of DOPs has been shown to improve the composition of the gut microbiome and offers new intervention strategies for metabolic diseases such as obesity and type 2 diabetes as well as inflammatory diseases such as chronic obstructive pulmonary disease and colitis.
- Compared to drug therapy, intervention with DOPs is not specific and has a longer intervention duration
This is consistent with previous research on Dendrobium officinale, such as last year’s:
❝DOP significantly increased benign intestinal microbe proportion (Lactobacillus, etc.), but reduced harmful bacteria (Escherichia shigella) (P < 0.05), and significantly increased butyric acid production (P < 0.05)❞
In summary…
Research so far indicates that this does a lot of good for the gut, in a way that can “kickstart” healthier, self-regulating gut microbiota.
As to its further prospects, check out:
Very promising!
Where can I get it?
We don’t sell it, but for your convenience here’s an example product on Amazon
Be warned, it is expensive though!
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What Is “75 Hard”?
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This is Andy Frisella. He’s not a doctor, scientist, nutritionist, personal trainer, or professional athlete, but he has kicked off a viral fitness challenge, so let’s take a look at it:
What it is
Firstly, Frisella asserts that it’s not a fitness challenge, but rather, he describes it as a “transformative mental toughness program”.
Here’s what it consists of:
- Follow a healthy diet plan with no deviations from it (i.e. no “cheat days”)
- Abstain from alcohol
- Exercise 2x per day, 45 minutes each
- One of the exercise sessions each day must be outside
- No rest days
- Drink 3.5 liters of water per day
And the duration? 75 days, hence the name of the
fitness challengetransformative mental toughness program.Why it is
Frisella’s rationale is:
- we must cultivate mental toughness by doing hard things
- allowing ourselves any deviation would be a sign of mental weakness
- if we allow ourselves to deviate, it becomes a habit
For this reason, he does not “allow” any substitutions, for example if somebody wants to do such-and-such a thing slightly differently instead. We put “allow” in quotation marks because of course, he’s not the boss of you, but per the rules of his challenge, at least.
These reasonings are in and of themselves somewhat sound, however, we at 10almonds would argue:
- before doing hard things, it is good to first consider “is it a good idea?” (amputating your leg using only a spork is a “hard thing”, and demonstrates incredible mental toughness, but that doesn’t make it a good idea)
- while being able to decide to do a thing and then do it is great characteristic to have, it’s good to first consider science; for example, restrictive diets with no flexibility simply do not work, and our bodies do require adequate rest, especially if being pushed through hard things, or problems will happen (injuries, illnesses, etc).
- while it’s true that allowing ourselves to deviate can become a habit, it’s good to first consider what habits we want to make, and make those habits, instead of potentially unsustainable or even simply unpleasant ones.
See also: What Flexible Dieting Really Means: When Flexibility Is The Dish Of The Day
And for that matter: How To Really Pick Up (And Keep!) Those Habits
Want a “75 Gentle” instead?
If you like the idea of making new habits, but are not sure if extreme (and perhaps arbitrary) standards are the ones you want to hold, check out:
Cori Lefkowith’s 25 Healthy Habits That Will Change Your Life
Take care!
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Coenzyme Q10 From Foods & Supplements
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Coenzyme Q10 and the difference it makes
Coenzyme Q10, often abbreviated to CoQ10, is a popular supplement, and is often one of the more expensive supplements that’s commonly found on supermarket shelves as opposed to having to go to more specialist stores or looking online.
What is it?
It’s a compound naturally made in the human body and stored in mitochondria. Now, everyone remembers the main job of mitochondria (producing energy), but they also protect cells from oxidative stress, among other things. In other words, aging.
Like many things, CoQ10 production slows as we age. So after a certain age, often around 45 but lifestyle factors can push it either way, it can start to make sense to supplement.
Does it work?
The short answer is “yes”, though we’ll do a quick breakdown of some main benefits, and studies for such, before moving on.
First, do bear in mind that CoQ10 comes in two main forms, ubiquinol and ubiquinone.
Ubiquinol is much more easily-used by the body, so that’s the one you want. Here be science:
What is it good for?
Benefits include:
- Against aging
- Against skin cancer
- Against breast cancer
- Against prostate cancer
- Against heart failure
- Against obesity
- Against diabetes
- Against Alzheimer’s
- Against Parkinson’s
Can we get it from foods?
Yes, and it’s equally well-absorbed through foods or supplementation, so feel free to go with whichever is more convenient for you.
Read: Intestinal absorption of coenzyme Q10 administered in a meal or as capsules to healthy subjects
If you do want to get it from food, you can get it from many places:
- Organ meats: the top source, though many don’t want to eat them, either because they don’t like them or some of us just don’t eat meat. If you do, though, top choices include the heart, liver, and kidneys.
- Fatty fish: sardines are up top, along with mackerel, herring, and trout
- Vegetables: leafy greens, and cruciferous vegetables e.g. cauliflower, broccoli, sprouts
- Legumes: for example soy, lentils, peanuts
- Nuts and seeds: pistachios come up top; sesame seeds are great too
- Fruit: strawberries come up top; oranges are great too
If supplementing, how much is good?
Most studies have used doses in the 100mg–200mg (per day) range.
However, it’s also been found to be safe at 1200mg (per day), for example in this high-quality study that found that higher doses resulted in greater benefit, in patients with early Parkinson’s Disease:
Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline
Wondering where you can get it?
We don’t sell it (or anything else for that matter), and you can probably find it in your local supermarket or health food store. However, if you’d like to buy it online, here’s an example product on Amazon
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Lost Connections – by Johann Hari
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Johann Hari had a long journey through (and out of!) depression, and shares his personal findings, including his disappointment with medical options, and a focus on the external factors that lead to depression.
And that’s key to this book—while he acknowledges later in the book that there are physiological factors involved in depression, he wants to look past things we can’t change (like genes accounting for 37% of depression) or things that there may be unwanted side-effects to changing (as in the case of antidepressants, for many people), to things we genuinely can choose.
And no, it’s not a “think yourself happy” book either; rather, it looks at nine key external factorsthat a) influence depression b) can mostly be changed.
If the book has a downside, it’s that the author does tend to extrapolate his own experience a lot more than might be ideal. If SSRIs didn’t help him, they are useless, and also the only kind of antidepressant. If getting into a green space helped him, a Londoner, someone who lives in the countryside will not be depressed in the first place. And so forth. It can also be argued that he cherry-picked data to arrive at some of his pre-decided conclusions. He also misinterprets data sometimes; which is understandable; he is after all a journalist, not a scientist.
Nevertheless, he offers a fresh perspective with a lot of ideas, and whether or not we agree with them all, new ideas tend to be worth reading. And if even one of his nine ideas helps you, that’s a win.
Bottom line: if you’d like to explore the treatment of depression from a direction other than medicalization or psychotherapy, then this is will be a good book for you.
Click here to check out Lost Connections, and reforge yours!
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What Are The “Bright Lines” Of Bright Line Eating?
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This is Dr. Susan Thompson. She’s a cognitive neuroscientist who has turned her hand to helping people to lose weight and maintain it at a lower level, using psychology to combat overeating. She is the founder of “Bright Line Eating”.
We’ll say up front: it’s not without some controversy, and we’ll address that as we go, but we do believe the ideas are worth examining, and then we can apply them or not as befits our personal lives.
What does she want us to know?
Bright Line Eating’s general goal
Dr. Thompson’s mission statement is to help people be “happy, thin, and free”.
You will note that this presupposes thinness as desirable, and presumes it to be healthy, which frankly, it’s not for everyone. Indeed, for people over a certain age, having a BMI that’s slightly into the “overweight” category is a protective factor against mortality (which is partly a flaw of the BMI system, but is an interesting observation nonetheless):
When BMI Doesn’t Quite Measure Up
Nevertheless, Dr. Thompson makes the case for the three items (happy, thin, free) coming together, which means that any miserable or unhealthy thinness is not what the approach is valuing, since it is important for “thin” to be bookended by “happy” and “free”.
What are these “bright lines”?
Bright Line Eating comes with 4 rules:
- No flour (no, not even wholegrain flour; enjoy whole grains themselves yes, but flour, no)
- No sugar (and as a tag-along to this, no alcohol) (sugars naturally found in whole foods, e.g. the sugar in an apple if eating an apple, is ok, but other kinds are not, e.g. foods with apple juice concentrate as a sweetener; no “natural raw cane sugar” etc is not allowed either; despite the name, it certainly doesn’t grow on the plant like that)
- No snacking, just three meals per day(not even eating the ingredients while cooking—which also means no taste-testing while cooking)
- Weigh all your food (have fun in restaurants—but more seriously, the idea here is to plan each day’s 3 meals to deliver a healthy macronutrient balance and a capped calorie total).
You may be thinking: “that sounds dismal, and not at all bright and cheerful, and certainly not happy and free”
The name comes from the idea that these rules are lines that one does not cross. They are “bright” lines because they should be observed with a bright and cheery demeanour, for they are the rules that, Dr. Thompson says, will make you “happy, thin, and free”.
You will note that this is completely in opposition to the expert opinion we hosted last week:
What Flexible Dieting Really Means
Dr. Thompson’s position on “freedom” is that Bright Line Eating is “very structured and takes a liberating stand against moderation”
Which may sound a bit of an oxymoron—is she really saying that we are going to be made free from freedom?
But there is some logic to it, and it’s about the freedom from having to make many food-related decisions at times when we’re likely to make bad ones:
Where does the psychology come in?
Dr. Thompson’s position is that willpower is a finite, expendable resource, and therefore we should use it judiciously.
So, much like Steve Jobs famously wore the same clothes every day because he had enough decisions to make later in the day that he didn’t want unnecessary extra decisions to make… Bright Line Eating proposes that we make certain clear decisions up front about our eating, so then we don’t have to make so many decisions (and potentially the wrong decisions) later when hungry.
You may be wondering: ”doesn’t sticking to what we decided still require willpower?”
And… Potentially. But the key here is shutting down self-negotiation.
Without clear lines drawn in advance, one must decide, “shall I have this cake or not?”, perhaps reflecting on the pros and cons, the context of the situation, the kind of day we’re having, how hungry we are, what else there is available to eat, what else we have eaten already, etc etc.
In short, there are lots of opportunities to rationalize the decision to eat the cake.
With clear lines drawn in advance, one must decide, “shall I have this cake or not?” and the answer is “no”.
So while sticking to that pre-decided “no” still may require some willpower, it no longer comes with a slew of tempting opportunities to rationalize a “yes”.
Which means a much greater success rate, both in adherence and outcomes. Here’s an 8-week interventional study and 2-year follow-up:
Bright Line Eating | Research Publications
Counterpoint: pick your own “bright lines”
Dr. Thompson is very keen on her 4 rules that have worked for her and many people, but she recognizes that they may not be a perfect fit for everyone.
So, it is possible to pick and choose our own “bright lines”; it is after all a dietary approach, not a religion. Here’s her response to someone who adopted the first 3 rules, but not the 4th:
Bright Lines as Guidelines for Weight Loss
The most important thing for Bright Line Eating, therefore, is perhaps the action of making clear decisions in advance and sticking to them, rather than seat-of-the-pantsing our diet, and with it, our health.
Want to know more from Dr. Thompson?
You might like her book, which we reviewed a while ago:
Bright Line Eating – by Dr. Susan Peirce Thompson
Enjoy!
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