Burned Out By Tuesday?
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Avoiding Burnout, The Active Way
This is Dr. Claudine Holt. She’s double board-certified, in Occupational & Environmental Medicine, and Lifestyle Medicine.
In short: preventative medicine in all parts of our life.
Hopefully, you are reading this bright-eyed and bushy-tailed and ready to take on another exciting day in this wonderful, beautiful world!
On the other hand, it’s possible that you’re reading this semi-focussed, looking for a crumb of dopamine as much as you are looking for information.
If you’ve ever had the “What a week!” / “It’s only Tuesday” moment, this one’s for you.
What does Dr. Holt want us to know?
You can recover from burnout without guilt
Sometimes, we overreach ourselves. Sometimes, life overreaches us! Sometimes it’s not that we overcommitted—it’s just that we were taking each day as it comes, but sometimes several days gang up on us at once.
Sometimes, even, we can feel exhausted when it seems like we haven’t done anything.
Note: if you feel exhausted and it seems like you haven’t done anything, then be aware: you are exhausted for a reason!
What that reason might be may vary, but contrary to popular belief, energy does not just vanish. It went somewhere.
This goes double if you have any chronic illness(es), even if you’re not aware of having had a flare-up, chances are you were just exceptionally busy (on a cellular level).
And it’s easy to think that “mere” cellular activity shouldn’t be exhausting, but that is 100% of where our energy transactions happen—whether or not we are consciously aware of them!
See also: Eat To Beat Chronic Fatigue ← yes, this also covers when you are too exhausted to shop and cook like a TV chef
Dr. Holt specializes in working with burned out medical professionals (and also specifically specializes in working with women), but there are lessons for everyone in her advice. For example:
Fiction: ”Medicine is my calling–it’s who I am.”
Fact: You are more than medicine! Remember that your career is just one aspect of your life. Don’t forget to create your big-picture vision and tend the garden of the other areas of your life too.
Read more: Dr. Claudine Holt | Burnout: Fact vs Fiction
This same thing can go for whatever part of your identity frequently follows “I’m a…”, and is somewhere that you put a lot of your energy; it could equally be a non-professional job like “homemaker”, or a relational status like “husband”, or a cultural identifier like “Christian”, or a hobby like “gardener” (assuming that is not also your profession, in which case, same item, different category).
Indeed, a lot of women especially get hit by “the triple burden” of professional work, housework, and childcare. And it’s not even necessarily that we resent any of those things or feel like they’re a burden; we (hopefully) love our professions, homes, children. But, here’s the thing:
No amount of love will add extra hours to the day.
So what does she recommend doing about it, when sometimes we’re juggling things that can’t be dropped?
Start simple, but start!
Dr. Holt recommends to start with a smile (yes even if, and sometimes especially when, the circumstances do not feel like they merit it), and deploy some CBT tools:
Two Hacks to Quickly Rise Above Burnout (Or Any Circumstance)
We’ve expanded on this topic here:
With a more level head on, it becomes easier to take on the next step, which creating healthy boundaries—and that doesn’t just mean with other people!
It also means slaying our own perfectionism and imposter syndrome—both things that will have us chasing our tails 36 hours per day if we let them.
See also:
- Perfectionism, And How To Make Yours Work For You
- Imposter Syndrome (And Why Almost Everyone Has It)
❝Burnout is the culture of our times. A culture that expects us to do more and think our way out of everything. A culture that asks for more than the body can bear. Unfortunately, even though the situation might not be of our creation, burnout culture is our inheritance.
An inheritance we can either perpetuate—or change—depending on what we embody.❞
Source: The Embodied MD on Burnout with Dr Claudine Holt
That “embodiment” is partly our choices and actions that we bring and own just as we bring and own our body—and it’s partly our relationship with our body itself, and learning to love it, and work with it to achieve wonderful things, instead of just getting through the day.
Which yes, does also mean making space for good diet, exercise, sleep and so forth, per:
These Top Five Things Make The Biggest Difference To Health
Want to know more?
You might like to check out Dr. Holt’s website:
The Embodied M.D. | Burnout Coach
…where she also offers resources such as a blog and a podcast.
Enjoy!
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Bananas vs Grapes – Which is Healthier?
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Our Verdict
When comparing bananas to grapes, we picked the bananas.
Why?
In terms of macros, bananas have more fiber and carbs, the ratio of which gives them the (very slightly) lower glycemic index. The difference in GI is marginal enough that it’d be tied on that point alone, but looking at total fiber figures, we say that having nearly 3x the fiber counts for a win here.
In the category of vitamins, bananas have more of vitamins B2, B3, B5, B6, B7, B9, C, and choline, while grapes have more of vitamins A, B1, E, and K. Thus, an 8:4 win for bananas (and with considerable margins of difference, too).
When it comes to minerals, bananas have more copper, magnesium, phosphorus, potassium*, selenium, and zinc, while grapes have more calcium and manganese. Thus, a 6:2 win for bananas this time.
*because of some popular mentions in TV shows, people get hung up on bananas being a good source of potassium. Which they are, but they’re not even in the top 10 of fruits for potassium. Here’s a non-exhaustive list of fruits that have more potassium than bananas, portion for portion:
- Honeydew melon
- Papaya
- Mango
- Prunes
- Figs
- Dates
- Nectarine
- Cantaloupe melon
- Kiwi
- Orange
See also: The Other “Special K”: The Top Micronutrient Deficiency In High Blood Pressure
It’s worth mentioning polyphenols: black/red grapes do have more abundant polyphenols than bananas, and this is very much a point in their favor; however, we don’t think it’s enough to compensate for bananas beating them in every other category, so we still declare bananas the winner.
Of course, the solution to this dilemma is to enjoy both!
Want to learn more?
You might like to read:
Can We Drink To Good Health? ← while there are polyphenols such as resveratrol in red wine that per se would boost heart health, there’s so little per glass that you may need 100–1000 glasses per day to get the dosage that provides benefits in mouse studies.
If you’re not a mouse, you might even need more than that!
To this end, many people prefer resveratrol supplementation ← link is to an example product on Amazon, but there are plenty more so feel free to shop around 😎
Enjoy!
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Is Your Gut Leading You Into Osteoporosis?
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Bacterioides Vulgatus & Bone Health
We’ve talked before about the importance of gut health:
And we’ve shared quite some information and resources on osteoporosis:
- The Bare-bones Truth: Osteoporosis Mythbusting
- Osteoporosis Exercises (What To Do, And What To Avoid)
- Vit D + Calcium: Too Much Of A Good Thing?
- Collagen For Bones: We Are Such Stuff As Fish Are Made Of
- Which Osteoporosis Medication, If Any, Is Right For You?
How the two are connected
A recent study looked at Bacterioides vulgatus, a very common gut bacterium, and found that it suppresses the gut’s production of valeric acid, a short-chain fatty acid that enhances bone density:
❝For the study, researchers analyzed the gut bacteria of more than 500 peri- and post-menopausal women in China and further confirmed the link between B. vulgatus and a loss of bone density in a smaller cohort of non-Hispanic White women in the United States.❞
Pop-sci source: Does gut bacteria cause osteoporosis?
The study didn’t stop there, though. They proceeded to test, with a rodent model, the effect of giving them either:
- more B. vulgatus, or
- valeric acid supplements
The results of this were as expected:
- Those who were given more B. vulgatus got worse bone microstructure
- Those who were given valeric acid supplements got stronger bones overall
Study source: Gut microbiota impacts bone via Bacteroides vulgatus-valeric acid-related pathways
Where can I get valeric acid?
We couldn’t find a handy supplement for this, but it is in many foods, including avocados, blueberries, cocoa beans, and an assortment of birds.
Click here to see a more extensive food list (you’ll need to scroll down a little)
Bonus: if you happen to be on HRT in the form of Estradiol valerate (e.g: Progynova), then that “valerate” is an ester of valeric acid, that your body can metabolize and use as such.
Enjoy!
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What’s Keeping the US From Allowing Better Sunscreens?
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When dermatologist Adewole “Ade” Adamson sees people spritzing sunscreen as if it’s cologne at the pool where he lives in Austin, Texas, he wants to intervene. “My wife says I shouldn’t,” he said, “even though most people rarely use enough sunscreen.”
At issue is not just whether people are using enough sunscreen, but what ingredients are in it.
The Food and Drug Administration’s ability to approve the chemical filters in sunscreens that are sold in countries such as Japan, South Korea, and France is hamstrung by a 1938 U.S. law that has required sunscreens to be tested on animals and classified as drugs, rather than as cosmetics as they are in much of the world. So Americans are not likely to get those better sunscreens — which block the ultraviolet rays that can cause skin cancer and lead to wrinkles — in time for this summer, or even the next.
Sunscreen makers say that requirement is unfair because companies including BASF Corp. and L’Oréal, which make the newer sunscreen chemicals, submitted safety data on sunscreen chemicals to the European Union authorities some 20 years ago.
Steven Goldberg, a retired vice president of BASF, said companies are wary of the FDA process because of the cost and their fear that additional animal testing could ignite a consumer backlash in the European Union, which bans animal testing of cosmetics, including sunscreen. The companies are asking Congress to change the testing requirements before they take steps to enter the U.S. marketplace.
In a rare example of bipartisanship last summer, Sen. Mike Lee (R-Utah) thanked Rep. Alexandria Ocasio-Cortez (D-N.Y.) for urging the FDA to speed up approvals of new, more effective sunscreen ingredients. Now a bipartisan bill is pending in the House that would require the FDA to allow non-animal testing.
“It goes back to sunscreens being classified as over-the-counter drugs,” said Carl D’Ruiz, a senior manager at DSM-Firmenich, a Switzerland-based maker of sunscreen chemicals. “It’s really about giving the U.S. consumer something that the rest of the world has. People aren’t dying from using sunscreen. They’re dying from melanoma.”
Every hour, at least two people die of skin cancer in the United States. Skin cancer is the most common cancer in America, and 6.1 million adults are treated each year for basal cell and squamous cell carcinomas, according to the Centers for Disease Control and Prevention. The nation’s second-most-common cancer, breast cancer, is diagnosed about 300,000 times annually, though it is far more deadly.
Dermatologists Offer Tips on Keeping Skin Safe and Healthy
– Stay in the shade during peak sunlight hours, 10 a.m. to 4 p.m. daylight time.– Wear hats and sunglasses.– Use UV-blocking sun umbrellas and clothing.– Reapply sunscreen every two hours.You can order overseas versions of sunscreens from online pharmacies such as Cocooncenter in France. Keep in mind that the same brands may have different ingredients if sold in U.S. stores. But importing your sunscreen may not be affordable or practical. “The best sunscreen is the one that you will use over and over again,” said Jane Yoo, a New York City dermatologist.
Though skin cancer treatment success rates are excellent, 1 in 5 Americans will develop skin cancer by age 70. The disease costs the health care system $8.9 billion a year, according to CDC researchers. One study found that the annual cost of treating skin cancer in the United States more than doubled from 2002 to 2011, while the average annual cost for all other cancers increased by just 25%. And unlike many other cancers, most forms of skin cancer can largely be prevented — by using sunscreens and taking other precautions.
But a heavy dose of misinformation has permeated the sunscreen debate, and some people question the safety of sunscreens sold in the United States, which they deride as “chemical” sunscreens. These sunscreen opponents prefer “physical” or “mineral” sunscreens, such as zinc oxide, even though all sunscreen ingredients are chemicals.
“It’s an artificial categorization,” said E. Dennis Bashaw, a retired FDA official who ran the agency’s clinical pharmacology division that studies sunscreens.
Still, such concerns were partly fed by the FDA itself after it published a study that said some sunscreen ingredients had been found in trace amounts in human bloodstreams. When the FDA said in 2019, and then again two years later, that older sunscreen ingredients needed to be studied more to see if they were safe, sunscreen opponents saw an opening, said Nadim Shaath, president of Alpha Research & Development, which imports chemicals used in cosmetics.
“That’s why we have extreme groups and people who aren’t well informed thinking that something penetrating the skin is the end of the world,” Shaath said. “Anything you put on your skin or eat is absorbed.”
Adamson, the Austin dermatologist, said some sunscreen ingredients have been used for 30 years without any population-level evidence that they have harmed anyone. “The issue for me isn’t the safety of the sunscreens we have,” he said. “It’s that some of the chemical sunscreens aren’t as broad spectrum as they could be, meaning they do not block UVA as well. This could be alleviated by the FDA allowing new ingredients.”
Ultraviolet radiation falls between X-rays and visible light on the electromagnetic spectrum. Most of the UV rays that people come in contact with are UVA rays that can penetrate the middle layer of the skin and that cause up to 90% of skin aging, along with a smaller amount of UVB rays that are responsible for sunburns.
The sun protection factor, or SPF, rating on American sunscreen bottles denotes only a sunscreen’s ability to block UVB rays. Although American sunscreens labeled “broad spectrum” should, in theory, block UVA light, some studies have shown they fail to meet the European Union’s higher UVA-blocking standards.
“It looks like a number of these newer chemicals have a better safety profile in addition to better UVA protection,” said David Andrews, deputy director of Environmental Working Group, a nonprofit that researches the ingredients in consumer products. “We have asked the FDA to consider allowing market access.”
The FDA defends its review process and its call for tests of the sunscreens sold in American stores as a way to ensure the safety of products that many people use daily, rather than just a few times a year at the beach.
“Many Americans today rely on sunscreens as a key part of their skin cancer prevention strategy, which makes satisfactory evidence of both safety and effectiveness of these products critical for public health,” Cherie Duvall-Jones, an FDA spokesperson, wrote in an email.
D’Ruiz’s company, DSM-Firmenich, is the only one currently seeking to have a new over-the-counter sunscreen ingredient approved in the United States. The company has spent the past 20 years trying to gain approval for bemotrizinol, a process D’Ruiz said has cost $18 million and has advanced fitfully, despite attempts by Congress in 2014 and 2020 to speed along applications for new UV filters.
Bemotrizinol is the bedrock ingredient in nearly all European and Asian sunscreens, including those by the South Korean brand Beauty of Joseon and Bioré, a Japanese brand.
D’Ruiz said bemotrizinol could secure FDA approval by the end of 2025. If it does, he said, bemotrizinol would be the most vetted and safest sunscreen ingredient on the market, outperforming even the safety profiles of zinc oxide and titanium dioxide.
As Congress and the FDA debate, many Americans have taken to importing their own sunscreens from Asia or Europe, despite the risk of fake products.
“The sunscreen issue has gotten people to see that you can be unsafe if you’re too slow,” said Alex Tabarrok, a professor of economics at George Mason University. “The FDA is just incredibly slow. They’ve been looking at this now literally for 40 years. Congress has ordered them to do it, and they still haven’t done it.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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Foods for Stronger Bones
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It’s Q&A Day!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! 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
Q: Foods that help build stronger bones and cut inflammation? Thank you!
We’ve got you…
For stronger bones / To cut inflammation
That “stronger bones” article is about the benefits of collagen supplementation for bones, but there’s definitely more to say on the topic of stronger bones, so we’ll do a main feature on it sometime soon!
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Grains: Bread Of Life, Or Cereal Killer?
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Going Against The Grain?
In Wednesday’s newsletter, we asked you for your health-related opinion of grains (aside from any gluten-specific concerns), and got the above-depicted, below-described, set of responses:
- About 69% said “They are an important cornerstone of a healthy balanced diet”
- About 22% said “They can be enjoyed in moderation, but watch out”
- About 8% said “They are terrible health-drainers that will kill us”
So, what does the science say?
They are terrible health-drainers that will kill us: True or False?
True or False depending on the manner of their consumption!
There is a big difference between the average pizza base and a bowl of oats, for instance. Or rather, there are a lot of differences, but what’s most critical here?
The key is: refined and ultraprocessed grains are so inferior to whole grains as to be actively negative for health in most cases for most people most of the time.
But! It’s not because processing is ontologically evil (in reality: some processed foods are healthy, and some unprocessed foods are poisonous). although it is a very good general rule of thumb.
So, we need to understand the “why” behind the “key” that we just gave above, and that’s mostly about the resultant glycemic index and associated metrics (glycemic load, insulin index, etc).
In the case of refined and ultraprocessed grains, our body gains sugar faster than it can process it, and stores it wherever and however it can, like someone who has just realised that they will be entertaining a houseguest in 10 minutes and must tidy up super-rapidly by hiding things wherever they’ll fit.
And when the body tries to do this with sugar from refined grains, the result is very bad for multiple organs (most notably the liver, but the pancreas takes quite a hit too) which in turn causes damage elsewhere in the body, not to mention that we now have urgently-produced fat stored in unfortunate places like our liver and abdominal cavity when it should have gone to subcutaneous fat stores instead.
In contrast, whole grains come with fiber that slows down the absorption of the sugars, such that the body can deal with them in an ideal fashion, which usually means:
- using them immediately, or
- storing them as muscle glycogen, or
- storing them as subcutaneous fat
👆 that’s an oversimplification, but we only have so much room here.
For more on this, see:
Glycemic Index vs Glycemic Load vs Insulin Index
And for why this matters, see:
Which Sugars Are Healthier, And Which Are Just The Same?
And for fixing it, see:
They can be enjoyed in moderation, but watch out: True or False?
Technically True but functionally False:
- Technically true: “in moderation” is doing a lot of heavy lifting here. One person’s “moderation” may be another person’s “abstemiousness” or “gluttony”.
- Functionally false: while of course extreme consumption of pretty much anything is going to be bad, unless you are Cereals Georg eating 10,000 cereals each day and being a statistical outlier, the issue is not the quantity so much as the quality.
Quality, we discussed above—and that is, as we say, paramount. As for quantity however, you might want to know a baseline for “getting enough”, so…
They are an important cornerstone of a healthy balanced diet: True or False?
True! This one’s quite straightforward.
3 servings (each being 90g, or about ½ cup) of whole grains per day is associated with a 22% reduction in risk of heart disease, 5% reduction in all-cause mortality, and a lot of benefits across a lot of disease risks:
❝This meta-analysis provides further evidence that whole grain intake is associated with a reduced risk of coronary heart disease, cardiovascular disease, and total cancer, and mortality from all causes, respiratory diseases, infectious diseases, diabetes, and all non-cardiovascular, non-cancer causes.
These findings support dietary guidelines that recommend increased intake of whole grain to reduce the risk of chronic diseases and premature mortality.❞
~ Dr. Dagfinn Aune et al.
We’d like to give a lot more sources for the same findings, as well as papers for all the individual claims, but frankly, there are so many that there isn’t room. Suffice it to say, this is neither controversial nor uncertain; these benefits are well-established.
Here’s a very informative pop-science article, that also covers some of the things we discussed earlier (it shows what happens during refinement of grains) before getting on to recommendations and more citations for claims than we can fit here:
Harvard School Of Public Health | Whole Grains
“That’s all great, but what if I am concerned about gluten?”
There certainly are reasons you might be, be it because of a sensitivity, allergy, or just because perhaps you’d like to know more.
Let’s first mention: not all grains contain gluten, so it’s perfectly possible to enjoy naturally gluten-free grains (such as oats and rice) as well as gluten-free pseudocereals, which are not actually grains but do the same job in culinary and nutritional terms (such as quinoa and buckwheat, despite the latter’s name).
Finally, if you’d like to know more about gluten’s health considerations, then check out our previous mythbusting special:
Enjoy!
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How To Gain Weight (Healthily!)
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What Do You Have To Gain?
We have previously promised a three-part series about changing one’s weight:
- Losing weight (specifically, losing fat)
- Gaining weight (specifically, gaining muscle)
- Gaining weight (specifically, gaining fat)
There will be, however, no need for a “losing muscle” article, because (even though sometimes a person might have some reason to want to do this), it’s really just a case of “those things we said for gaining muscle? Don’t do those and the muscle will atrophy naturally”.
Here’s our first article: How To Lose Weight (Healthily!)
While some people will want to lose fat, please do be aware that the association between weight loss and good health is not nearly so strong as the weight loss industry would have you believe:
And, while BMI is not a useful measure of health in general, it’s worth noting that over the age of 65, a BMI of 27 (which is in the high end of “overweight”, without being obese) is associated with the lowest all-cause mortality:
BMI and all-cause mortality in older adults: a meta-analysis
Here was our second article: How To Build Muscle (Healthily!)
And now, it’s time for the last part, which yes, is also something that some people want/need to do (healthily!), and want/need help with that.
How to gain fat, healthily
Fat gets a bad press, but when it comes to health, we would die without it.
Even in the case of having excess fat, the fat itself is not generally the problem, so much as comorbid metabolic issues that are often caused by the same things as the excess fat.
So, how to gain fat healthily?
- Obvious but potentially dangerously misleading answer: “in moderation”
- More useful answer: “carefully”
Because, you can “in moderation” put on less than one pound per week for a few years and be in very bad health by the end of it. So how does this “carefully” work any differently to “in moderation”?
The key is in how we store the fat
Not merely where we store it (though that’ll follow from the “how”), but specifically: how we store it.
- When we consume energy from food in excess of our immediate survival needs, our body stores what it can. This is good!
- When our body is receiving energy from food faster than it can physically process it to store it healthily, it will start shoving it wherever it can instead. This is bad!
This is the physiological equivalent of the difference between tidying a room carefully, and cramming everything into one cupboard in 30 seconds just to get it out of sight.
So, you do need to consume calories yes, but you need to consume them in a way your body can take its time about storing them.
We’ve written before about the science of this, so we’ll share some links, but first, here are the practical tips:
- Do not drink your calories. Drinking calories tends to be the equivalent of injecting sugars directly into your veins, in terms of how quickly it gets received.
- See also: How To Unfatty A Fatty Liver ← this is highly relevant, because the same process that results in unhealthy weight gain, results in liver disease, by the same mechanism (the liver gets overwhelmed).
- Eat your greens. No, they won’t provide many calories, but they are critical to your body not being overwhelmed by the arrival of sugars.
- See also: 10 Ways To Balance Blood Sugars ← the other 9 things are also helpful for not putting on fat unhealthily, so using these alongside a calorie-dense diet can result in healthy fat gain as needed
- Get more of your calories from fats than carbs. Fats will not overwhelm your body’s glycemic response in the same way that carbs will.
- Again this is about getting calories while not getting metabolic disease. See also: How To Prevent And Reverse Type Two Diabetes as the advice is the same for that, for the same reason!
- Consider going low-carb, but even if you choose not to, go for carbs with a low glycemic index instead of a high glycemic index.
- For reference, see: Glycemic Index Chart: Glycemic index and glycemic load ratings for 500+ foods
- Need healthy fats in a snack? Enjoy nuts (unless you have an allergy); they will be your best friend in this regard. As an example, a mere 1oz portion of cashew nuts has 157 calories.
- See also: Why You Should Diversify Your Nuts
- Need healthy fats for cooking? Enjoy olive oil, as it has one of the healthiest lipids profiles available, and is a great way to increase the calorific content of many meals.
Lastly…
Be patient, enjoy your food, and stick as best you can to the above considerations. All strength to you.
Take care!
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