Good (Or Bad) Health Starts With Your Blood
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Blood Should Be Only Slightly Thicker Than Water
This is Dr. Casey Means, a physician, lecturer (mostly at Stanford), and CMO of a metabolic health company, Levels, as well as being Associate Editor of the International Journal of Diabetes Reversal and Prevention, where she serves alongside such names as Dr. Colin Campbell, Dr. Joel Fuhrman, Dr. Michael Greger, Dr. William Li, Dr. Dean Ornish, and you get the idea: it’s a star-studded cast.
What does she want us to know?
The big blood problem:
❝We’re spending 3.8 trillion dollars a year on healthcare costs in the U.S., and the reality is that people are getting sicker, fatter, and more depressed.
Over 50% of Americans have pre-diabetes or type 2 diabetes; it’s insane, that number should be close to zero.❞
~ Dr. Casey Means
Indeed, pre-diabetes and especially type 2 diabetes should be very avoidable in any wealthy nation.
Unfortunately, the kind of diet that avoids it tends to rely on having at least 2/3 of the following:
- Money
- Time
- Knowledge
For example:
- if you have money and time, you can buy lots of fresh ingredients without undue worry, and take the time to carefully prep and cook them
- if you have money and knowledge you can have someone else shop and cook for you, or at least get meal kits delivered
- if you have time and knowledge, you can actually eat very healthily on a shoestring budget
If you have all three, then the world’s your oyster mushroom steak sautéed in extra virgin olive oil with garlic and cracked black pepper served on a bed of Swiss chard and lashed with Balsamic vinegar.
However, many Americans aren’t in the happy position of having at least 2/3, and a not-insignificant portion of the population don’t even have 1/3.
As an aside: there is a food scientist and chef who’s made it her mission to educate people about food that’s cheap, easy, and healthy:
…but today is about Dr. Means, so, what does she suggest?
Know thyself thy blood sugars
Dr. Means argues (reasonably; this is well-backed up by general scientific consensus) that much of human disease stems from the diabetes and pre-diabetes that she mentioned above, and so we should focus on that most of all.
Our blood sugar levels being unhealthy will swiftly lead to other metabolic disorders:
Heart disease and non-alcoholic fatty liver disease are perhaps first in line, but waiting in the wings are inflammation-mediated autoimmune disorders, and even dementia, because neuroinflammation is at least as bad as inflammation anywhere else, arguably worse, and our brain can only be as healthy as the blood that feeds it and takes things that shouldn’t be there away.
Indeed,
❝Alzheimer’s dementia is now being called type 3 diabetes because it’s so related to blood sugar❞
~ Dr. Casey Means
…which sounds like a bold claim, but it’s true, even if the name is not “official” yet, it’s well-established in professional circulation:
❝We conclude that the term “type 3 diabetes” accurately reflects the fact that AD represents a form of diabetes that selectively involves the brain and has molecular and biochemical features that overlap with both T1DM and T2DM❞
~ Dr. Suzanne M. de la Monte & Dr. Jack Wands
Read in full: Alzheimer’s Disease Is Type 3 Diabetes–Evidence Reviewed ← this is from the very respectable Journal of Diabetes Science and Technology.
What to do about it
Dr. Means suggests we avoid the “glucose roller-coaster” that most Americans are on, meaning dramatic sugar spikes, or to put it in sciencese: high glycemic variability.
This leads to inflammation, oxidative stress, glycation (where sugar sticks to proteins and DNA), and metabolic dysfunction. Then there’s the flipside: reactive hypoglycemia, a result of a rapid drop in blood sugar after a spike, can cause anxiety, fatigue, weakness/trembling, brain fog, and of course cravings. And so the cycle repeats.
But it doesn’t have to!
By taking it upon ourselves to learn about what causes our blood sugars to rise suddenly or gently, we can manage our diet and other lifestyle factors accordingly.
And yes, it’s not just about diet, Dr. Means tells us. While added sugar and refined carbohydrates or indeed the main drivers of glycemic variability, our sleep, movement, stress management, and even toxin exposure play important parts too.
One way to do this, that Dr. Means recommends, is with a continuous glucose monitor:
Track Your Blood Sugars For Better Personalized Health
Another way is to just apply principles that work for almost everyone:
10 Ways To Balance Blood Sugars
Want to know more from Dr. Means?
You might like her book:
Good Energy – by Dr. Casey Means
…which goes into this in far more detail than we have room to today.
Enjoy!
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Tiramisu Crunch Bites
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It’s coffee, it’s creamy, it’s nutty, it’s chocolatey, what’s not to love? It has all the well-loved flavors of tiramisu, but this recipe is a simple one, and it’s essentially stuffed dates in a way you’ve never had them before. They’re delectable, decadent, and decidedly good for your health. These things are little nutrient-bombs that’ll keep you reaching for more.
You will need
- Coffee (we will discuss this)
- 150g (5.5oz) mascarpone (if vegan or lactose-intolerant, can be substituted with vegan varieties, or at a pinch, pressed silken tofu)
- 500g (1lb) dates (Medjool are ideal)
- Twice as many almonds as you have dates
- 50g (2oz) dark chocolate (the darkest, bitterest, you can find)
- Edible flower petals if you can source them (some shops sell dried rose petals for this purpose)
Method
(we suggest you read everything at least once before doing anything)
1) Take the mascarpone and whisk (or blend) it with the coffee. What kind of coffee, you ask? Many will use instant coffee (1tbsp granules mixed with enough boiling water to dissolve it), and that is actually healthiest (counterintuitive but true) but if you care for flavor over health, and have the means to make espresso, make it ristretto (so, stop it halfway through filling up an espresso cup), let it cool, and use that. Absolute bonus for flavor (not for health): if you have the means to make Turkish coffee, use an equivalent amount of that (again, cooled).
You will now have coffee-flavoured mascarpone. It’s great for your gut and full of antioxidant polyphenols. Set it aside for the moment.
2) Take the dark chocolate and melt it. Please don’t microwave it or try to do it in a pan directly over the hob; instead, you will need to use a Bain-Marie. If you don’t have one made-for-purpose, you can place a metal or heatproof glass bowl in a saucepan, with something to stop it from touching the floor of the pan. Then boil water in the pan (without letting the water get into the bowl), and melt the chocolate in the bowl—this will allow you to melt it evenly without burning the chocolate.
You will now have melted dark chocolate. It has its own set of polyphenols, and is great for everything from the brain to the gut microbiome.
3) Cut the dates lengthways on one side and remove the stone. Stuff them carefully with the coffee-flavored mascarpone (you can use a teaspoon, or use a piping kit if you have one). Add a couple of almonds to each one. Place them all on a big plate, and drizzle the melted chocolate over them. Add the petals if you have them.
The dates and almonds deliver extra vitamins and minerals in abundance (not to mention, lots of fiber), and also are an amazing combination even just by themselves. With the mascarpone and chocolate added, this winning on new levels. We’re not done yet, though…
4) Chill them in the fridge for about 30 minutes.
Serve!
Learn more
For those interested in some of the science of what we have going on today:
- Make The Heart-Healthiest Coffee ← this is about cafestol content and why instant is heart-healthiest (alas)
- The Bitter Truth About Coffee (Or Is It) ← this is about the health benefits (and some risks, but mostly benefits) of coffee
- Why You Should Diversify Your Nuts ← almonds are a top-tier choice, but other nuts are good too! This recipe could work well with hazelnuts, for example (we wouldn’t call it “tiramisu crunch bites” in that case, though, since the flavor profile would change)
- Which Sugars Are Healthier, And Which Are Just The Same? ← for any worrying “aren’t dates sugary, though?”
Enjoy!
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Are You Flourishing? (There’s a Scale)
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What does it mean, to flourish? And how can you do it more?
In 2009, psychologists Diener et al developed the “Flourishing Scale”, or as it was more prosaically called originally, “Subjective Wellness Scale”. The name was changed later, as it was noted that it went beyond what was typically considered mere “wellness”.
This scale was so useful, that colleagues scrambled to see if they could improve on it, such as with PERMA (2012), which looked at:
- Positive emotion
- Engagement
- positive Relationships
- Meaning
- Accomplishment/Achievement
While popular (despite the tenuous acronym, it is a very good list of things to foster in your life), this was studied and measured scientifically and found to not be an improvement on the Flourishing Scale / SWS, so we’re going to stick to the original version for now.
We couldn’t find an interactive online quiz for the scale though (apart from this NY Times one, which is paywalled for NYT subscribers, so enjoy if you’re a NYT subscriber!), so here’s the source material, still hosted on the website of the (now deceased, as of a couple of years ago) author:
Flourishing Scale (FS) ← it’s an eight-question, ranked choice scale
How did you score? And…
What are the keys to flourishing more?
According to Jeffrey Davis M.A., of Tracking Wonder, there are five key attributes that we must develop and/or maintain:
The ability to direct and re-direct your attention
This isn’t just a task-related thing.This is about your mind itself. For example, the ability to recognize what your emotions are telling you, thank them for the message, and then set them aside. Or the ability to cut through negative thought spirals! How often have you worried about future events that didn’t transpire, or twisted yourself in knots over a past event that you can’t change?
Action: check out our previous article “The Off-Button For Your Brain” ← this is a technique for switching off racing thoughts, and it’s really good
Want more? We also did this:
The tendency to shape your time with intention and for impact
Time is an incredibly precious asset. How you use it is a very personal choice. You don’t have to maximize productivity (though you can if you want), but for example there’s a difference between:
- Deciding to spend an hour watching a TV show you really enjoy
- Wondering what’s on TV, browsing aimlessly, watching listlessly, just a distraction
In the former case, you are enjoying your time. Literally: you are experiencing joy during your time.
In the latter case, to borrow from Jim Steinman, “you were only killing time and it’ll kill you right back”!
Action: do a time audit for a week, and see where your time really goes, rather than where you expect or hope for it to go. Use this information to plan your next week more intentionally. Repeat as and when it seems like it might be useful!
The practice of constant improvement
Fun fact: you are good enough already. And you can also improve. You don’t have to, but improving in the areas that are meaningful to you can really add up over time. This could be becoming excellent at something for which already have a passion… It could also be brushing up something that you feel might be holding you back.
Action: do a quick SWOT* self-assessment. Then plan your next step from there!
*Strengths, Weaknesses, Opportunities, Threats. What are yours?
The ability to communicate and listen to others
A lot of this is about feedback. Giving and receiving feedback are often amongst the hardest things we do in the category of communication… Especially if the feedback is negative. How to decide what to disregard as baseless criticism, and what to take on board (and try not to take it personally), or the other way around, how to present negative feedback in a way that won’t trigger defensiveness.
Action: check out our previous article “Save Time With Better Communication” for some tips that really make relationships (of any kind) so much easier.
The commitment to positive experiences
Many things in life are not fun. Often, we know in advance that they will not be fun. The key here is the ability to make the most of a bad situation, and seek out better situations by your actions. Not like a lost person in a desert seeks water, but like a chess player who employs a general strategy to make tactical advantages more likely to appear.
Action: think about something you have to do but don’t want to. How could it be made more fun? Or failing that, how could it be made at least more comfortable?
See also: Working Smarter < Working Brighter!
Want to read more?
Check out: What Is Flourishing in Positive Psychology? (+8 Tips & PDF)
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Diet Tips for Crohn’s Disease
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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
❝Doctors are great at saving lives like mine. I’m a two time survivor of colon cancer and have recently been diagnosed with Chron’s disease at 62. No one is the health system can or is prepared to tell me an appropriate diet to follow or what to avoid. Can you?❞
Congratulations on the survivorship!
As to Crohn’s, that’s indeed quite a pain, isn’t it? In some ways, a good diet for Crohn’s is the same as a good diet for most other people, with one major exception: fiber
…and unfortunately, that changes everything, in terms of a whole-foods majority plant-based diet.
What stays the same:
- You still ideally want to eat a lot of plants
- You definitely want to avoid meat and dairy in general
- Eating fish is still usually* fine, same with eggs
- Get plenty of water
What needs to change:
- Consider swapping grains for potatoes or pasta (at least: avoid grains)
- Peel vegetables that are peelable; discard the peel or use it to make stock
- Consider steaming fruit and veg for easier digestion
- Skip spicy foods (moderate spices, like ginger, turmeric, and black pepper, are usually fine in moderation)
Much of this latter list is opposite to the advice for people without Crohn’s Disease.
*A good practice, by the way, is to keep a food journal. There are apps that you can get for free, or you can do it the old-fashioned way on paper if prefer.
But the important part is: make a note not just of what you ate, but also of how you felt afterwards. That way, you can start to get a picture of patterns, and what’s working (or not) for you, and build up a more personalized set of guidelines than anyone else could give to you.
We hope the above pointers at least help you get going on the right foot, though!
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What is PMDD?
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Premenstrual dysphoric disorder (PMDD) is a mood disorder that causes significant mental health changes and physical symptoms leading up to each menstrual period.
Unlike premenstrual syndrome (PMS), which affects approximately three out of four menstruating people, only 3 percent to 8 percent of menstruating people have PMDD. However, some researchers believe the condition is underdiagnosed, as it was only recently recognized as a medical diagnosis by the World Health Organization.
Read on to learn more about its symptoms, the difference between PMS and PMDD, treatment options, and more.
What are the symptoms of PMDD?
People with PMDD typically experience both mood changes and physical symptoms during each menstrual cycle’s luteal phase—the time between ovulation and menstruation. These symptoms typically last seven to 14 days and resolve when menstruation begins.
Mood symptoms may include:
- Irritability
- Anxiety and panic attacks
- Extreme or sudden mood shifts
- Difficulty concentrating
- Depression and suicidal ideation
Physical symptoms may include:
- Fatigue
- Insomnia
- Headaches
- Changes in appetite
- Body aches
- Bloating
- Abdominal cramps
- Breast swelling or tenderness
What is the difference between PMS and PMDD?
Both PMS and PMDD cause emotional and physical symptoms before menstruation. Unlike PMS, PMDD causes extreme mood changes that disrupt daily life and may lead to conflict with friends, family, partners, and coworkers. Additionally, symptoms may last longer than PMS symptoms.
In severe cases, PMDD may lead to depression or suicide. More than 70 percent of people with the condition have actively thought about suicide, and 34 percent have attempted it.
What is the history of PMDD?
PMDD wasn’t added to the Diagnostic and Statistical Manual of Mental Disorders until 2013. In 2019, the World Health Organization officially recognized it as a medical diagnosis.
References to PMDD in medical literature date back to the 1960s, but defining it as a mental health and medical condition initially faced pushback from women’s rights groups. These groups were concerned that recognizing the condition could perpetuate stereotypes about women’s mental health and capabilities before and during menstruation.
Today, many women-led organizations are supportive of PMDD being an official diagnosis, as this has helped those living with the condition access care.
What causes PMDD?
Researchers don’t know exactly what causes PMDD. Many speculate that people with the condition have an abnormal response to fluctuations in hormones and serotonin—a brain chemical impacting mood— that occur throughout the menstrual cycle. Symptoms fully resolve after menopause.
People who have a family history of premenstrual symptoms and mood disorders or have a personal history of traumatic life events may be at higher risk of PMDD.
How is PMDD diagnosed?
Health care providers of many types, including mental health providers, can diagnose PMDD. Providers typically ask patients about their premenstrual symptoms and the amount of stress those symptoms are causing. Some providers may ask patients to track their periods and symptoms for one month or longer to determine whether those symptoms are linked to their menstrual cycle.
Some patients may struggle to receive a PMDD diagnosis, as some providers may lack knowledge about the condition. If your provider is unfamiliar with the condition and unwilling to explore treatment options, find a provider who can offer adequate support. The International Association for Premenstrual Disorders offers a directory of providers who treat the condition.
How is PMDD treated?
There is no cure for PMDD, but health care providers can prescribe medication to help manage symptoms. Some medication options include:
- Selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants that regulate serotonin in the brain and may improve mood when taken daily or during the luteal phase of each menstrual cycle.
- Hormonal birth control to prevent ovulation-related hormonal changes.
- Over-the-counter pain medication like Tylenol, which can ease headaches, breast tenderness, abdominal cramping, and other physical symptoms.
Providers may also encourage patients to make lifestyle changes to improve symptoms. Those lifestyle changes may include:
- Limiting caffeine intake
- Eating meals regularly to balance blood sugar
- Exercising regularly
- Practicing stress management using breathing exercises and meditation
- Having regular therapy sessions and attending peer support groups
For more information, talk to your health care provider.
If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Freekeh Tomato Feast
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Fiber-dense freekeh stars in this traditional Palestinian dish, and the whole recipe is very gut-healthy, not to mention delicious and filling, as well as boasting generous amounts of lycopene and other phytonutrients:
You will need
- 1 cup dried freekeh (if avoiding gluten, substitute a gluten-free grain, or pseudograin such as buckwheat; if making such a substitution, then also add 1 tbsp nutritional yeast—for the flavor as well as the nutrients)
- 1 medium onion, thinly sliced
- 1 2oz can anchovies (if vegan/vegetarian, substitute 1 can kimchi)
- 1 14oz can cherry tomatoes
- 1 cup halved cherry tomatoes, fresh
- ½ cup black olives, pitted
- 1 5oz jar roasted peppers, chopped
- ½ bulb garlic, thinly sliced
- 2 tsp black pepper
- 1 tsp chili flakes
- 1 sprig fresh thyme
- Extra virgin olive oil
Method
(we suggest you read everything at least once before doing anything)
1) Place a heavy-based (cast iron, if you have it) sauté pan over a medium heat. Add some olive oil, then the onion, stirring for about 5 minutes.
2) Add the anchovies, herbs and spices (including the garlic), and stir well to combine. The anchovies will probably soon melt into the onion; that’s fine.
3) Add the canned tomatoes (but not the fresh), followed by the freekeh, stirring well again to combine.
4) Add 2 cups boiling water, and simmer with the lid on for about 40 minutes. Stir occasionally and check the water isn’t getting too low; top it up if it’s getting dry and the freekeh isn’t tender yet.
5) Add the fresh chopped cherry tomatoes and the chopped peppers from the jar, as well as the olives. Stir for just another 2 minutes, enough to let the latest ingredients warm through.
6) Serve, adding a garnish if you wish:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
- Eat More (Of This) For Lower Blood Pressure
- Making Friends With Your Gut (You Can Thank Us Later)
- Lycopene’s Benefits For The Gut, Heart, Brain, & More
- Our Top 5 Spices: How Much Is Enough For Benefits?
Take care!
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Sweet Potato vs Winter Squash – Which is Healthier?
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Our Verdict
When comparing sweet potato to winter squash, we picked the sweet potato.
Why?
In terms of macros, the sweet potato has 2x the protein, 2x the carbs, and slightly more fiber. Because the protein numbers are small, the carb:fiber ratio is the deciding factor here, and has winter squash has the lower glycemic index (assuming cooking them both on a like-for-like basis), we’re going with that on macros, but it’s subjective.
In the category of vitamins, sweet potato has more of vitamins A, B1, B2, B3, B5, B6, C, E, and choline, while winter squash has more of vitamins B9 and K. It’s interesting to note that while sweet potato is rightly famous for its vitamin A content, winter squash is actually very good for that too. Still, by the numbers, it’s a clear 9:2 victory for sweet potato here.
When it comes to minerals, sweet potato has more calcium copper, iron, magnesium, manganese, phosphorus, potassium, and zinc, while winter squash has more selenium, meaning an 8:1 victory for sweet potato this time.
In short, enjoy either or both, but sweet potato is the more nutritionally dense option for sure.
Want to learn more?
You might like to read:
Carb-Strong or Carb-Wrong? Should You Go Light Or Heavy On Carbs?
Enjoy!
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