Do you have knee pain from osteoarthritis? You might not need surgery. Here’s what to try instead

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Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to updated treatment guidelines from the Australian Commission on Safety and Quality in Health Care.

So what is knee osteoarthritis and what are the best ways to manage it?

Pexels/Kindelmedia

More than 2 million Australians have osteoarthritis

Osteoarthritis is the most common joint disease, affecting 2.1 million Australians. It costs the economy A$4.3 billion each year.

Osteoarthritis commonly affects the knees, but can also affect the hips, spine, hands and feet. It impacts the whole joint including bone, cartilage, ligaments and muscles.

Most people with osteoarthritis have persistent pain and find it difficult to perform simple daily tasks, such as walking and climbing stairs.

Is it caused by ‘wear and tear’?

Knee osteoarthritis is most likely to affect older people, those who are overweight or obese, and those with previous knee injuries. But contrary to popular belief, knee osteoarthritis is not caused by “wear and tear”.

Research shows the degree of structural wear and tear visible in the knee joint on an X-ray does not correlate with the level of pain or disability a person experiences. Some people have a low degree of structural wear and tear and very bad symptoms, while others have a high degree of structural wear and tear and minimal symptoms. So X-rays are not required to diagnose knee osteoarthritis or guide treatment decisions.

Telling people they have wear and tear can make them worried about their condition and afraid of damaging their joint. It can also encourage them to try invasive and potentially unnecessary treatments such as surgery. We have shown this in people with osteoarthritis, and other common pain conditions such as back and shoulder pain.

This has led to a global call for a change in the way we think and communicate about osteoarthritis.

What’s the best way to manage osteoarthritis?

Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms. These include education and self-management, exercise and physical activity, weight management and nutrition, and certain pain medicines.

Education is important to dispel misconceptions about knee osteoarthritis. This includes information about what osteoarthritis is, how it is diagnosed, its prognosis, and the most effective ways to self-manage symptoms.

Health professionals who use positive and reassuring language can improve people’s knowledge and beliefs about osteoarthritis and its management.

Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as paracetamol and anti-inflammatories and can prevent or delay the need for joint replacement surgery in the future.

Many types of exercise are effective for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi. So you can do whatever type of exercise best suits you.

Increasing general physical activity is also important, such as taking more steps throughout the day and reducing sedentary time.

Weight management is important for those who are overweight or obese. Weight loss can reduce knee pain and disability, particularly when combined with exercise. Losing as little as 5–10% of your body weight can be beneficial.

Pain medicines should not replace treatments such as exercise and weight management but can be used alongside these treatments to help manage pain. Recommended medicines include paracetamol and non-steroidal anti-inflammatory drugs.

Opioids are not recommended. The risk of harm outweighs any potential benefits.

What about surgery?

People with knee osteoarthritis commonly undergo two types of surgery: knee arthroscopy and knee replacement.

Knee arthroscopy is a type of keyhole surgery used to remove or repair damaged pieces of bone or cartilage that are thought to cause pain.

However, high-quality research has shown arthroscopy is not effective. Arthroscopy should therefore not be used in the management of knee osteoarthritis.

Joint replacement involves replacing the joint surfaces with artificial parts. In 2021–22, 53,500 Australians had a knee replacement for their osteoarthritis.

Joint replacement is often seen as being inevitable and “necessary”. But most people can effectively manage their symptoms through exercise, physical activity and weight management.

The new guidelines (known as “care standard”) recommend joint replacement surgery only be considered for those with severe symptoms who have already tried non-surgical treatments.

I have knee osteoarthritis. What should I do?

The care standard links to free evidence-based resources to support people with osteoarthritis. These include:

If you have osteoarthritis, you can use the care standard to inform discussions with your health-care provider, and to make informed decisions about your care.

Belinda Lawford, Postdoctoral research fellow in physiotherapy, The University of Melbourne; Giovanni E. Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney; Joshua Zadro, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, University of Sydney, and Rana Hinman, Professor in Physiotherapy, The University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Why do I poo in the morning? A gut expert explains

    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.

    No, you’re not imagining it. People really are more likely to poo in the morning, shortly after breakfast. Researchers have actually studied this.

    But why mornings? What if you tend to poo later in the day? And is it worth training yourself to be a morning pooper?

    To understand what makes us poo when we do, we need to consider a range of factors including our body clock, gut muscles and what we have for breakfast.

    Here’s what the science says.

    H_Ko/Shutterstock

    So morning poos are real?

    In a UK study from the early 1990s, researchers asked nearly 2,000 men and women in Bristol about their bowel habits.

    The most common time to poo was in the early morning. The peak time was 7-8am for men and about an hour later for women. The researchers speculated that the earlier time for men was because they woke up earlier for work.

    About a decade later, a Chinese study found a similar pattern. Some 77% of the almost 2,500 participants said they did a poo in the morning.

    But why the morning?

    There are a few reasons. The first involves our circadian rhythm – our 24-hour internal clock that helps regulate bodily processes, such as digestion.

    For healthy people, our internal clock means the muscular contractions in our colon follow a distinct rhythm.

    There’s minimal activity in the night. The deeper and more restful our sleep, the fewer of these muscle contractions we have. It’s one reason why we don’t tend to poo in our sleep.

    Diagram of digestive system including colon and rectum
    Your lower gut is a muscular tube that contracts more strongly at certain times of day. Vectomart/Shutterstock

    But there’s increasing activity during the day. Contractions in our colon are most active in the morning after waking up and after any meal.

    One particular type of colon contraction partly controlled by our internal clock are known as “mass movements”. These are powerful contractions that push poo down to the rectum to prepare for the poo to be expelled from the body, but don’t always result in a bowel movement. In healthy people, these contractions occur a few times a day. They are more frequent in the morning than in the evening, and after meals.

    Breakfast is also a trigger for us to poo. When we eat and drink our stomach stretches, which triggers the “gastrocolic reflex”. This reflex stimulates the colon to forcefully contract and can lead you to push existing poo in the colon out of the body. We know the gastrocolic reflex is strongest in the morning. So that explains why breakfast can be such a powerful trigger for a bowel motion.

    Then there’s our morning coffee. This is a very powerful stimulant of contractions in the sigmoid colon (the last part of the colon before the rectum) and of the rectum itself. This leads to a bowel motion.

    How important are morning poos?

    Large international surveys show the vast majority of people will poo between three times a day and three times a week.

    This still leaves a lot of people who don’t have regular bowel habits, are regular but poo at different frequencies, or who don’t always poo in the morning.

    So if you’re healthy, it’s much more important that your bowel habits are comfortable and regular for you. Bowel motions do not have to occur once a day in the morning.

    Morning poos are also not a good thing for everyone. Some people with irritable bowel syndrome feel the urgent need to poo in the morning – often several times after getting up, during and after breakfast. This can be quite distressing. It appears this early-morning rush to poo is due to overstimulation of colon contractions in the morning.

    Can you train yourself to be regular?

    Yes, for example, to help treat constipation using the gastrocolic reflex. Children and elderly people with constipation can use the toilet immediately after eating breakfast to relieve symptoms. And for adults with constipation, drinking coffee regularly can help stimulate the gut, particularly in the morning.

    A disturbed circadian rhythm can also lead to irregular bowel motions and people more likely to poo in the evenings. So better sleep habits can not only help people get a better night’s sleep, it can help them get into a more regular bowel routine.

    Man preparing Italian style coffee at home, adding coffee to pot
    A regular morning coffee can help relieve constipation. Caterina Trimarchi/Shutterstock

    Regular physical activity and avoiding sitting down a lot are also important in stimulating bowel movements, particularly in people with constipation.

    We know stress can contribute to irregular bowel habits. So minimising stress and focusing on relaxation can help bowel habits become more regular.

    Fibre from fruits and vegetables also helps make bowel motions more regular.

    Finally, ensuring adequate hydration helps minimise the chance of developing constipation, and helps make bowel motions more regular.

    Monitoring your bowel habits

    Most of us consider pooing in the morning to be regular. But there’s a wide variation in normal so don’t be concerned if your poos don’t follow this pattern. It’s more important your poos are comfortable and regular for you.

    If there’s a major change in the regularity of your bowel habits that’s concerning you, see your GP. The reason might be as simple as a change in diet or starting a new medication.

    But sometimes this can signify an important change in the health of your gut. So your GP may need to arrange further investigations, which could include blood tests or imaging.

    Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • How anti-vaccine figures abuse data to trick you

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    The anti-vaccine movement is nearly as old as vaccines themselves. For as long as humans have sought to harness our immune system’s incredible ability to recognize and fight infectious invaders, critics and conspiracy theorists have opposed these efforts. 

    Anti-vaccine tactics have advanced since the early days of protesting “unnatural” smallpox inoculation, and the rampant abuse of scientific data may be the most effective strategy yet. 

    Here’s how vaccine opponents misuse data to deceive people, plus how you can avoid being manipulated.

    Misappropriating raw and unverified safety data

    Perhaps the oldest and most well-established anti-vaccine tactic is the abuse of data from the federal Vaccine Adverse Event Reporting System, or VAERS. The Centers for Disease Control and Prevention and the Food and Drug Administration maintain VAERS as a tool for researchers to detect early warning signs of potential vaccine side effects. 

    Anyone can submit a VAERS report about any symptom experienced at any point after vaccination. That does not mean that these symptoms are vaccine side effects.

    VAERS was not designed to determine if a specific vaccine caused a specific adverse event. But for decades, vaccine opponents have misinterpreted, misrepresented, and manipulated VAERS data to convince people that vaccines are dangerous. 

    Anyone relying on VAERS to draw conclusions about vaccine safety is probably trying to trick you. It isn’t possible to determine from VAERS data alone if a vaccine caused a specific health condition.

    VAERS isn’t the only federal data that vaccine opponents abuse. Originally created for COVID-19 vaccines, V-safe is a vaccine safety monitoring system that allows users to report—via text message surveys—how they feel and any health issues they experience up to a year after vaccination. Anti-vaccine groups have misrepresented data in the system, which tracks all health experiences, whether or not they are vaccine-related.

    The U.S. Department of Defense’s Defense Medical Epidemiology Database (DMED) has also become a target of anti-vaccine misinformation. Vaccine opponents have falsely claimed that DMED data reveals massive spikes in strokes, heart attacks, HIV, cancer, and blood clots among military service members since the COVID-19 vaccine rollout. The spike was due to an updated policy that corrected underreporting in the previous years

    Misrepresenting legitimate studies

    A common tactic vaccine opponents use is misrepresenting data from legitimate sources such as national health databases and peer-reviewed studies. For example, COVID-19 vaccines have repeatedly been blamed for rising cancer and heart attack rates, based on data that predates the pandemic by decades. 

    A prime example of this strategy is a preliminary FDA study that detected a slight increase in stroke risk in older adults after a high-dose flu vaccine alone or in combination with the bivalent COVID-19 vaccine. The study found no “increased risk of stroke following administration of the COVID-19 bivalent vaccines.”

    Yet vaccine opponents used the study to falsely claim that COVID-19 vaccines were uniquely harmful, despite the data indicating that the increased risk was almost certainly driven by the high-dose flu vaccine. The final peer-reviewed study confirmed that there was no elevated stroke risk following COVID-19 vaccination. But the false narrative that COVID-19 vaccines cause strokes persists.

    Similarly, the largest COVID-19 vaccine safety study to date confirmed the extreme rarity of a few previously identified risks. For weeks, vaccine opponents overstated these rare risks and falsely claimed that the study proves that COVID-19 vaccines are unsafe. 

    Citing preprint and retracted studies

    When a study has been retracted, it is no longer considered a credible source. A study’s retraction doesn’t deter vaccine opponents from promoting it—it may even be an incentive because retracted papers can be held up as examples of the medical establishment censoring so-called “truthtellers.” For example, anti-vaccine groups still herald Andrew Wakefield nearly 15 years after his study falsely linking the measles, mumps, and rubella (MMR) vaccine to autism was retracted for data fraud. 

    The COVID-19 pandemic brought the lasting impact of retracted studies into sharp focus. The rush to understand a novel disease that was infecting millions brought a wave of scientific publications, some more legitimate than others. 

    Over time, the weaker studies were reassessed and retracted, but their damage lingers. A 2023 study found that retracted and withdrawn COVID-19 studies were cited significantly more frequently than valid published COVID-19 studies in the same journals. 

    In one example, a widely cited abstract that found that ivermectin—an antiparasitic drug proven to not treat COVID-19—dramatically reduced mortality in COVID-19 patients exemplifies this phenomenon. The abstract, which was never peer reviewed, was retracted at the request of its authors, who felt the study’s evidence was weak and was being misrepresented. 

    Despite this, the study—along with the many other retracted ivermectin studies—remains a touchstone for proponents of the drug that has shown no effectiveness against COVID-19.

    In a more recent example, a group of COVID-19 vaccine opponents uploaded a paper to The Lancet’s preprint server, a repository for papers that have not yet been peer reviewed or published by the prestigious journal. The paper claimed to have analyzed 325 deaths after COVID-19 vaccination, finding COVID-19 vaccines were linked to 74 percent of the deaths. 

    The paper was promptly removed because its conclusions were unsupported, leading vaccine opponents to cry censorship. 

    Applying animal research to humans

    Animals are vital to medical research, allowing scientists to better understand diseases that affect humans and develop and screen potential treatments before they are tested in humans. Animal research is a starting point that should never be generalized to humans, but vaccine opponents do just that.

    Several animal studies are frequently cited to support the claim that mRNA COVID-19 vaccines are dangerous during pregnancy. These studies found that pregnant rats had adverse reactions to the COVID-19 vaccines. The results are unsurprising given that they were injected with doses equal to or many times larger than the dose given to humans rather than a dose that is proportional to the animal’s size. 

    Similarly, a German study on rat heart cells found abnormalities after exposure to mRNA COVID-19 vaccines. Vaccine opponents falsely insinuated that this study proves COVID-19 vaccines cause heart damage in humans and was so universally misrepresented that the study’s author felt compelled to dispute the claims. 

    The author noted that the study used vaccine doses significantly higher than those administered to humans and was conducted in cultured rat cells, a dramatically different environment than a functioning human heart. 

    How to avoid being misled

    The internet has empowered vaccine opponents to spread false information with an efficiency and expediency that was previously impossible. Anti-vaccine narratives have advanced rapidly due to the rampant exploitation of valid sources and the promotion of unvetted, non-credible sources. 

    You can avoid being tricked by using multiple trusted sources to verify claims that you encounter online. Some examples of credible sources are reputable public health entities like the CDC and World Health Organization, personal health care providers, and peer-reviewed research from experts in fields relevant to COVID-19 and the pandemic. 

    Read more about anti-vaccine tactics:

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • Do We Need Supplements, And Do They Work?

    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.

    Does our diet need a little help?

    We asked you for your take on supplements, and got the above-illustrated, below-described set of results.

    • The largest minority of respondents (a little over a third) voted for “I just take something very specific”
    • The next most respondents voted for “I take so many supplements; every little helps!”
    • Almost as many voted for “I just take a vitamin or two / a multivitamin”
    • Fewest, about 8%, voted for “I get everything I need from my diet”

    But what does the science say?

    Food is less nutritious now than it used to be: True or False?

    True or False depending on how you measure it.

    An apple today and an apple from a hundred years ago are likely to contain the same amounts of micronutrients per apple, but a lower percentage of micronutrients per 100g of apple.

    The reason for this is that apples (and many other food products; apples are just an arbitrary example) have been selectively bred (and in some cases, modified) for size, and because the soil mineral density has remained the same, the micronutrients per apple have not increased commensurate to the increase in carbohydrate weight and/or water weight. Thus, the resultant percentage will be lower, despite the quantity remaining the same.

    We’re going to share some science on this, and/but would like to forewarn readers that the language of this paper is a bit biased, as it looks to “debunk” claims of nutritional values dropping while skimming over “yes, they really have dropped percentage-wise” in favor of “but look, the discrete mass values are still the same, so that’s just a mathematical illusion”.

    The reality is, it’s no more a mathematical illusion than is the converse standpoint of saying the nutritional value is the same, despite the per-100g values dropping. After all, sometimes we eat an apple as-is; sometimes we buy a bag of frozen chopped fruit. That 500g bag of chopped fruit is going to contain less copper (for example) than one from decades past.

    Here’s the paper, and you’ll see what we mean:

    Mineral nutrient composition of vegetables, fruits and grains: The context of reports of apparent historical declines

    Supplements aren’t absorbed properly and thus are a waste of money: True or False?

    True or False depending on the supplement (and your body, and the rest of your diet)

    Many people are suffering from dietary deficiencies of vitamins and minerals, that could be easily correctable by supplementation:

    However, as this study by Dr. Fang Fang Zhang shows, a lot of vitamin and mineral supplementation does not appear to have much of an effect on actual health outcomes, vis-à-vis specific diseases. She looks at:

    • Cardiovascular disease
    • Cancer
    • Type 2 diabetes
    • Osteoporosis

    Her key take-aways from this study were:

    • Randomised trial evidence does not support use of vitamin, mineral, and fish oil supplements to reduce the risk of non-communicable diseases
    • People using supplements tend to be older, female, and have higher education, income, and healthier lifestyles than people who do not use them
    • Use of supplements appreciably reduces the prevalence of inadequate intake for most nutrients but also increases the prevalence of excess intake for some nutrients
    • Further research is needed to assess the long term effects of supplements on the health of the general population and in individuals with specific nutritional needs, including those from low and middle income countries

    Read her damning report: Health effects of vitamin and mineral supplements

    On the other hand…

    This is almost entirely about blanket vitamin-and-mineral supplementation. With regard to fish oil supplementation, many commercial fish oil supplements break down in the stomach rather than the intestines, and don’t get absorbed well. Additionally, many people take them in forms that aren’t pleasant, and thus result in low adherence (i.e., they nominally take them, but in fact they just sit on the kitchen counter for a year).

    One thing we can conclude from this is that it’s good to check the science for any given supplement before taking it, and know what it will and won’t help for. Our “Monday Research Review” editions of 10almonds do this a lot, although we tend to focus on herbal supplements rather than vitamins and minerals.

    We can get everything we need from our diet: True or False?

    Contingently True (but here be caveats)

    In principle, if we eat the recommended guideline amounts of various macro- and micro-nutrients, we will indeed get all that we are generally considered to need. Obviously.

    However, this may come with:

    • Make sure to get enough protein… Without too much meat, and also without too much carbohydrate, such as from most plant sources of protein
    • Make sure to get enough carbohydrates… But only the right kinds, and not too much, nor at the wrong time, and without eating things in the wrong order
    • Make sure to get enough healthy fats… Without too much of the unhealthy fats that often exist in the same foods
    • Make sure to get the right amount of vitamins and minerals… We hope you have your calculators out to get the delicate balance of calcium, magnesium, potassium, phosphorus, and vitamin D right.

    That last one’s a real pain, by the way. Too much or too little of one or another and the whole set start causing problems, and several of them interact with several others, and/or compete for resources, and/or are needed for the others to do their job.

    And, that’s hard enough to balance when you’re taking supplements with the mg/µg amount written on them, never mind when you’re juggling cabbages and sardines.

    On the topic of those sardines, don’t forget to carefully balance your omega-3, -6, and -9, and even within omega-3, balancing ALA, EPA, and DHA, and we hope you’re juggling those HDL and LDL levels too.

    So, when it comes to getting everything we need from our diet, for most of us (who aren’t living in food deserts and/or experiencing food poverty, or having a medical condition that restricts our diet), the biggest task is not “getting enough”, it’s “getting enough of the right things without simultaneously overdoing it on the others”.

    With supplements, it’s a lot easier to control what we’re putting in our bodies.

    And of course, unless our diet includes things that usually can’t be bought in supermarkets, we’re not going to get the benefits of taking, as a supplement, such things as:

    Etc.

    So, there definitely are supplements with strong science-backed benefits, that probably can’t be found on your plate!

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  • Experience life lessons with the powerful message of "Make Your Bed" beyond the comfort of a picture.

    Beyond “Make Your Bed”—life lessons from experience

    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.

    Beyond “Make Your Bed”—life lessons from experience

    This is Admiral William H. McRaven, a former United States Navy four-star admiral who served as the ninth commander of the United States Special Operations Command.

    So, for those of us whose day-to-day lives don’t involve coordinating military operations, what does he have to offer?

    Quick note: 10almonds’ mission statement is “to make health and productivity crazy simple”.

    We tend to focus on the health side of this, and in the category of productivity, it’s often what most benefits our mental health.

    We’re writing less for career-driven technopreneurs in the 25–35 age bracket and more for people with a more holistic view of productivity and “a good life well-lived”.

    So today’s main feature is more in that vein!

    Start each day with an accomplishment

    McRaven famously gave a speech (and wrote a book) that began with the advice, “make your bed”. The idea here doesn’t have to be literal (if you’ll pardon the pun). Indeed, if you’re partnered, then depending on schedules and habits, it could be you can’t (sensibly) make your bed first thing because your partner is still in it. But! What you can do is start the day with an accomplishment—however small. A short exercise routine is a great example!

    Success in life requires teamwork

    We’re none of us an island (except in the bathtub). The point is… Nobody can do everything alone. Self-sufficiency is an illusion. You can make your own coffee, but could you have made the coffee machine, or even the cup? How about, grown the coffee? Transported it? So don’t be afraid to reach out for (and acknowledge!) help from others. Teamwork really does make the dream work.

    It’s what’s inside that counts

    It’s a common trap to fall into, getting caught up the outside appearance of success, rather than what actually matters the most. We need to remember this when it comes to our own choices, as well as assessing what others might bring to the table!

    A setback is only permanent if you let it be

    No, a positive attitude won’t reverse a lifelong degenerative illness, for example. But what we can do, is take life as comes, and press on with the reality, rather than getting caught up in the “should be”.

    Use failure to your advantage

    Learn. That’s all. Learn, and improve.

    Be daring in life

    To borrow from another military force, the SAS has the motto “Who dares, wins”. Caution has it place, but if we’ve made reasonable preparations*, sometimes being bold is the best (or only!) way forward.

    *Meanwhile the Parachute Regiment, from which come 80% of all SAS soldiers, has the motto “Utrinque paratus”, “prepared on all sides”.

    Keep courage close

    This is about not backing down when we know what’s right and we know what we need to do. Life can be scary! But if we don’t overcome our fears, they can become self-realizing.

    Writer’s note: a good example of this is an advice I sometimes gave during my much more exciting (military) life of some decades ago, and it pertains to getting into a knife-fight (top advice for civilians: don’t).

    But, if you’re in one, you need to not be afraid of getting cut.

    Because if you’re not afraid of getting cut, you will probably get cut.

    But if you are afraid of getting cut, you will definitely get cut.

    Hopefully your life doesn’t involve knives outside of the kitchen (mine doesn’t, these days, and I like it), but the lesson applies to other things too.

    Sometimes the only way out is through.

    Be your best at your worst

    Sometimes life is really, really hard. But if we allow those moments to drive us forwards, they’re also a place we can find more strength than we ever knew we had.

    Keep on swimming

    It’s said that the majority in life is about showing up—and often it is. But you have to keep showing up, day after day. So make what you’re doing sustainable for you, and keep on keeping on.

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  • Pine Bark’s Next-Level Antioxidant Properties

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    Pine Bark’s Next-Level Antioxidant Properties

    Pine bark extract has been used by the indigenous peoples of N. America for a very long time, to treat a variety of ailments.

    This one falls into the category of “things from traditional medicine that eventually got investigated and their scientific worth noticed by people from outside of those cultures”.

    Not all pine trees!

    If you happen to have pine trees near you, be aware that without sufficient botanical knowledge, you could find yourself bark-harvesting from the wrong tree—but many species of pine do have these qualities.

    Useful (for this purpose) pine trees include, but are not limited to:

    • Pinus banksiana
    • Pinus massoniana
    • Pinus pinaster
    • Pinus radiata
    • Pinus resinosa
    • Pinus strobus

    …which is already a fair list, but there are dozens more that have not been studied, and/or found lacking in medicinal qualities, and/or just didn’t make our list here today.

    What does it do & How does it work?

    We sneakily put those two questions together today because it’s easiest to explain in one:

    The Pinus family in general has powerful antioxidant qualities, and not just like blueberries or coffee (wonderful as those are).

    Rather, it has:

    • Phenolic acids: these are the polyphenols found in many plant foods rich in antioxidants. These are great, but they aren’t the exciting part here.
    • Catechins: these aren’t classified as antioxidants, but they are flavonoids that do the same job in a slightly different way
    • Procyanidins: another class of flavonoids, and this is where pine bark really comes into its own

    And yes, as ever, “those three things that always seem to come together”, it having these antioxidant properties means it is also anti-inflammatory and anti-cancer:

    Procyanidin fractions from pine (Pinus pinaster) bark: radical scavenging power in solution, antioxidant activity in emulsion, and antiproliferative effect in melanoma cells

    …and anti-aging:

    Pleiotropic Effects of French Maritime Pine Bark Extract to Promote Healthy Aging

    …which does of course mean that it almost certainly fights age-related cognitive decline, though studies for that have been animal studies so far, such as:

    Where to get it?

    As ever, we don’t sell it, but here’s an example product on Amazon for your convenience; we recommend shopping around though, as prices vary a lot!

    Enjoy!

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  • Psychology Sunday Rewind: Healing Family Rifts

    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.

    Estrangement, And How To Heal It

    The following article was first published a little under six months ago, and it proved to be our most popular “Psychology Sunday” article of the year.

    We republish it today, in case it might also be of value to readers who have joined us since

    Having written before about how deleterious to the health loneliness and isolation can be, and what things can be done about it, we had a request to write about…

    ❝Reconciliation of relationships in particular estrangement mother adult daughter❞

    And, this is not only an interesting topic, but a very specific one that affects more people than is commonly realized!

    In fact, a recent 800-person study found that more than 43% of people experienced family estrangement of one sort or another, and a more specific study of more than 2,000 mother-child pairs found that more than 11% of mothers were estranged from at least one adult child.

    So, if you think of the ten or so houses nearest to you, probably at least one of them contains a parent estranged from at least one adult child. Maybe it’s yours. Either way, we hope this article will give you some pause for thought.

    Which way around?

    It makes a difference to the usefulness of this article whether any given reader experiencing estrangement is the parent or the adult child. We’re going to assume the reader is the parent. It also makes a difference who did the estranging. That’s usually the adult child.

    So, we’re broadly going to write with that expectation.

    Why does it happen?

    When our kids are small, we as parents hold all the cards. It may not always feel that way, but we do. We control our kids’ environment, we influence their learning, we buy the food they eat and the clothes they wear. If they want to go somewhere, we probably have to take them. We can even set and enforce rules on a whim.

    As they grow, so too does their independence, and it can be difficult for us as parents to relinquish control, but we’re going to have to at some point. Assuming we are good parents, we just hope we’ve prepared them well enough for the world.

    Once they’ve flown the nest and are living their own adult lives, there’s an element of inversion. They used to be dependent on us; now, not only do they not need us (this is a feature not a bug! If we have been good parents, they will be strong without us, and in all likelihood one day, they’re going to have to be), but also…

    We’re more likely to need them, now. Not just in the “oh if we have kids they can look after us when we’re old” sense, but in that their social lives are growing as ours are often shrinking, their family growing, while ours, well, it’s the same family but they’re the gatekeepers to that now.

    If we have a good relationship, this goes fine. However, it might only take one big argument, one big transgression, or one “final straw”, when the adult child decides the parent is more trouble than they’re worth.

    And, obviously, that’s going to hurt. But it’s pretty much how it pans out, according to studies:

    Here be science: Tensions in the Parent and Adult Child Relationship: Links to Solidarity and Ambivalence

    How to fix it, step one

    First, figure out what went wrong.

    Resist any urge to protect your own feelings with a defensive knee-jerk “I don’t know; I was a good, loving parent”. That’s a very natural and reasonable urge and you’re quite possibly correct, but it won’t help you here.

    Something pushed them away. And, it will almost certainly have been a push factor from you, not a pull factor from whoever is in their life now. It’s easy to put the blame externally, but that won’t fix anything.

    And, be honest with yourself; this isn’t a job interview where we have to present a strength dressed up as a “greatest weakness” for show.

    You can start there, though! If you think “I was too loving”, then ok, how did you show that love? Could it have felt stifling to them? Controlling? Were you critical of their decisions?

    It doesn’t matter who was right or wrong, or even whether or not their response was reasonable. It matters that you know what pushed them away.

    How to fix it, step two

    Take responsibility, and apologize. We’re going to assume that your estrangement is such that you can, at least, still get a letter to them, for example. Resist the urge to argue your case.

    Here’s a very good format for an apology; please consider using this template:

    The 10-step (!) apology that’s so good, you’ll want to make a note of it

    You may have to do some soul-searching to find how you will avoid making the same mistake in the future, that you did in the past.

    If you feel it’s something you “can’t change”, then you must decide what is more important to you. Only you can make that choice, but you cannot expect them to meet you halfway. They already made their choice. In the category of negotiation, they hold all the cards now.

    How to fix it, step three

    Now, just wait.

    Maybe they will reply, forgiving you. If they do, celebrate!

    Just be aware that once you reconnect is not the time to now get around to arguing your case from before. It will never be the time to get around to arguing your case from before. Let it go.

    Nor should you try to exact any sort of apology from them for estranging you, or they will at best feel resentful, wonder if they made a mistake in reconnecting, and withdraw.

    Instead, just enjoy what you have. Many people don’t get that.

    If they reply with anger, maybe it will be a chance to reopen a dialogue. If so, family therapy could be an approach useful for all concerned, if they are willing. Chances are, you all have things that you’d all benefit from talking about in a calm, professional, moderated, neutral environment.

    You might also benefit from a book we reviewed previously, “Parent Effectiveness Training”. This may seem like “shutting the stable door after the horse has bolted”, but in fact it’s a very good guide to relationship dynamics in general, and extensively covers relations between parents and adult children.

    If they don’t reply, then, you did your part. Take solace in knowing that much.

    Some final thoughts:

    At the end of the day, as parents, our kids living well is (hopefully) testament to that we prepared them well for life, and sometimes, being a parent is a thankless task.

    But, we (hopefully) didn’t become parents for the plaudits, after all.

    Don’t Forget…

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