Drug Metabolism (When You’re Not Average!)

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When Your Medications Run Out… Of You

Everybody knows that alcohol can affect medications’ effects, but what of smoking, and what of obesity? And how does the alcohol thing work anyway?

It’s all about the enzymes

Medicines that are processed by the liver (which is: most medicines) are metabolized there by specialist enzymes, and the things we do can increase or decrease the quantity of those enzymes—and/or how active they are.

Dr. Kata Wolff Pederson and her team of researchers at Aarhus University in Denmark examined the livers of recently deceased donors in ways that can’t (ethically) be done with live patients, and were able to find the associations between various lifestyle factors and different levels of enzymes responsible for drug metabolism.

And it’s not always how you might think!

Some key things they found:

  • Smokers have twice as high levels of enzyme CYP1A2 than non-smokers, which results in the faster metabolism of a lot of drugs.
  • Drinkers have 30% higher levels of enzyme CYP2E1, which also results in a faster metabolism of a lot of drugs.
  • Patients with obesity have 50% lower levels of enzyme CYP3A4, resulting in slower metabolism of many drugs

This gets particularly relevant when we take into account the next fact:

  • Of the individuals in the study, 40% died from poisoning from a mixture of drugs (usually: prescription and otherwise)

Read in full: Sex- and Lifestyle-Related Factors are Associated with Altered Hepatic CYP Protein Levels

Read a pop-sci article about it: Your lifestyle can determine how well your medicine will work

How much does the metabolism speed matter?

It can matter a lot! If you’re taking drugs and carefully abiding by the dosage instructions, those instructions were assuming they know your speed of metabolism, and this is based on an average.

  • If your metabolism is faster, you can get too much of a drug too quickly, and it can harm you
  • If your metabolism is faster, it also means that while yes it’ll start working sooner, it’ll also stop working sooner
    • If it’s a painkiller, that’s inconvenient. If it’s a drug that keeps you alive, then well, that’s especially unfortunate.
  • If your metabolism is slower, it can mean your body is still processing the previous dose(s) when you take the next one, and you can overdose (and potentially die)

We touched on this previously when we talked about obesity in health care settings, and how people can end up getting worse care:

Let’s Shed Some Obesity Myths

As for alcohol and drugs? Obviously we do not recommend, but here’s some of the science of it with many examples:

Why it’s a bad idea to mix alcohol with some medications

Take care!

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  • Life Is in the Transitions – by Bruce Feiler

    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.

    Change happens. Sometimes, because we choose it. More often, we don’t get a choice.

    Our bodies change; with time, with illness, with accident or incident, or even, sometimes, with effort. People in our lives change; they come, they go, they get sick, they die. Our working lives change; we get a job, we lose a job, we change jobs, our jobs change, we retire.

    Whether we’re undergoing cancer treatment or a religious conversion, whether our families are growing or down to the last few standing, change is inescapable.

    Our author makes the case that on average, we each undergo at least 5 major “lifequakes”; changes that shake our lives to the core. Sometimes one will come along when we’ve barely got back on our feet from the previous—if we have at all.

    What, then, to do about this? We can’t stop change from occurring, and some changes aren’t easy to “roll with”. Feiler isn’t prescriptive about this, but rather, descriptive:

    By looking at the stories of hundreds of people he interviewed for this book, he looks at how people pivoted on the spot (or picked up the pieces!) and made the best of their situation—or didn’t.

    Bottom line: zooming out like this, looking at many people’s lives, can remind us that while we don’t get to choose what winds we get swept by, we at least get to choose how we set the sails. The examples of others, as this book gives, can help us make better decisions.

    Click here to check out Life Is In The Transitions, and get conscious about how you handle yours!

    Share This Post

  • Self-Compassion – by Dr. Kristin Neff

    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.

    A lot of people struggle with self-esteem, and depending on one’s surrounding culture, it can even seem socially obligatory to be constantly valuing oneself highly (or else, who else will if we do not?). But, as Dr. Neff points out, there’s an inherent problem with reinforcing for oneself even a positive message like “I am smart, strong, and capable!” because sometimes all of us have moments of being stupid, weak, and incapable (occasionally all three at once!), which places us in a position of having to choose between self-deceit and self-deprecation, neither of which are good.

    Instead, Dr. Neff advocates for self-compassion, for treating oneself as one (hopefully) would a loved one—seeing their/our mistakes, weaknesses, failures, and loving them/ourself anyway.

    She does not, however, argue that we should accept just anything from ourselves uncritically, but rather, we identify our mistakes, learn, grow, and progress. So not “I should have known better!”, nor even “How was I supposed to know?!”, but rather, “Now I have learned a thing”.

    The style of the book is quite personal, as though having a heart-to-heart over a hot drink perhaps, but the format is organized and progresses naturally from one idea to the next, taking the reader to where we need to be.

    Bottom line: if you have trouble with self-esteem (as most people do), then that’s a trap that there is a way out of, and it doesn’t require being perfect or lowering one’s standards, just being kinder to oneself along the way—and this book can help inculcate that.

    Click here to check out Self-Compassion, and indeed be kind to yourself!

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  • Self-Care That’s Not Just Self-Indulgence

    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.

    Self-Care That’s Not Just Self-Indulgence

    Self-care is often seen as an excuse for self-indulgence. Worse, it’s often used as an excuse for self-indulgence—in ways that can end up making us feel worse.

    It’s a bit like dietary “cheat days”. If your diet needs cheat days, your diet probably isn’t right for you!

    How to recognize the difference between self-care and self-indulgence?

    Statistically, the majority of our subscribers are parents (whose children are now mostly grown up, but still, the point is that parenting experience has been gleaned), and/or are or have been caregivers of some form or other.

    When a small child is ill, we (hopefully!) look after them carefully:

    • We don’t expect too much of them, but…
    • …we do expect them to adhere to things consistent with their recovery.

    Critically: an important part of self-care is that it actually should be care.

    Let’s spell something out: neglect is not care!

    How this works for physical and mental health

    If you overdo it in physical exercise, it’s right and correct to take a break to recover, and during that time, do things that will hasten one’s recovery. For example:

    Overdone It? How To Speed Up Recovery After Exercise

    But it’s well-known that if you just do nothing, your condition will likely deteriorate. Also, “a break to recover” is going to be as short as is necessary to recover. Then you’ll ease back into exercise, but you will get back to it.

    For mental health it’s just the same. If we for whatever reason need to take a step back, it’s right and correct to do take a break to recover, and during that time, do things that will hasten one’s recovery.

    Sometimes, if for example it’s just a case of burnout, rest is the best medicine, and even rest can be an active process. See for example:

    How To Rest More Efficiently (Yes, Really)

    So the question to ask, when it comes to self-care vs self-indulgence, is:

    “Is this activity helping me to get better?”

    Some examples:

    Probably not great self-care activities:

    • Oversleeping (unless you were sleep-deprived, in which case, it’s better to get an earlier night than a later morning, if possible)
    • Overeating (comfort-eating is a thing, but your actual problems will still be there)
    • Mindless activities (mindless scrolling, TV-watching, game-playing, etc)

    Probably better self-care activities:

    • Enjoyable physical activity (whatever that may be for you)
    • Preparing your favorite food, and then enjoying it mindfully
    • Engaging in a personal project that might not be that important, but it’s fulfilling to you (hobbies etc can fall into this category)
    • Scheduling some time, and committing some resources, to tackling whatever problem(s) you are facing that’s prompting you to need this self-care.
    • Doing the tasks you want to hide away from, but making them fun.

    What’s your go-to self-care? We love to hear from you, so feel free to hit “reply” to this email, or use the handy feedback form at the bottom!

    Share This Post

Related Posts

  • 7 things you can do if you think you sweat too much
  • Self-Care That’s Not Just Self-Indulgence

    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.

    Self-Care That’s Not Just Self-Indulgence

    Self-care is often seen as an excuse for self-indulgence. Worse, it’s often used as an excuse for self-indulgence—in ways that can end up making us feel worse.

    It’s a bit like dietary “cheat days”. If your diet needs cheat days, your diet probably isn’t right for you!

    How to recognize the difference between self-care and self-indulgence?

    Statistically, the majority of our subscribers are parents (whose children are now mostly grown up, but still, the point is that parenting experience has been gleaned), and/or are or have been caregivers of some form or other.

    When a small child is ill, we (hopefully!) look after them carefully:

    • We don’t expect too much of them, but…
    • …we do expect them to adhere to things consistent with their recovery.

    Critically: an important part of self-care is that it actually should be care.

    Let’s spell something out: neglect is not care!

    How this works for physical and mental health

    If you overdo it in physical exercise, it’s right and correct to take a break to recover, and during that time, do things that will hasten one’s recovery. For example:

    Overdone It? How To Speed Up Recovery After Exercise

    But it’s well-known that if you just do nothing, your condition will likely deteriorate. Also, “a break to recover” is going to be as short as is necessary to recover. Then you’ll ease back into exercise, but you will get back to it.

    For mental health it’s just the same. If we for whatever reason need to take a step back, it’s right and correct to do take a break to recover, and during that time, do things that will hasten one’s recovery.

    Sometimes, if for example it’s just a case of burnout, rest is the best medicine, and even rest can be an active process. See for example:

    How To Rest More Efficiently (Yes, Really)

    So the question to ask, when it comes to self-care vs self-indulgence, is:

    “Is this activity helping me to get better?”

    Some examples:

    Probably not great self-care activities:

    • Oversleeping (unless you were sleep-deprived, in which case, it’s better to get an earlier night than a later morning, if possible)
    • Overeating (comfort-eating is a thing, but your actual problems will still be there)
    • Mindless activities (mindless scrolling, TV-watching, game-playing, etc)

    Probably better self-care activities:

    • Enjoyable physical activity (whatever that may be for you)
    • Preparing your favorite food, and then enjoying it mindfully
    • Engaging in a personal project that might not be that important, but it’s fulfilling to you (hobbies etc can fall into this category)
    • Scheduling some time, and committing some resources, to tackling whatever problem(s) you are facing that’s prompting you to need this self-care.
    • Doing the tasks you want to hide away from, but making them fun.

    What’s your go-to self-care? We love to hear from you, so feel free to hit “reply” to this email, or use the handy feedback form at the bottom!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

    Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:

  • Behind Book Recommendations

    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.

    It’s Q&A Day!

    Each Thursday, we respond to subscriber questions and requests! If it’s something small, we’ll answer it directly; if it’s something bigger, we’ll do a main feature in a follow-up day instead!

    So, no question/request to big or small; they’ll just get sorted accordingly

    Remember, you can always hit reply to any of our emails, or use the handy feedback widget at the bottom. We always look forward to hearing from you!

    Q: What’s the process behind the books you recommend? You seem to have a limitless stream of recommendations

    We do our best!

    The books we recommend are books that…

    • are on Amazon—it makes things tidy, consistent, and accessible. And if you end up buying one of the books, we get a small affiliate commission*.
    • we have read—we would say “obviously”, but you might be surprised how many people write about books without having read them.
    • pertain in at least large part to health and/or productivity.
    • are written by humans—bookish people (and especially Kindle Unlimited users) may have noticed lately that there are a lot of low quality AI-written books flooding the market, sometimes with paid 5-star reviews to bolster them. It’s frustrating, but we can tell the difference and screen those out.
    • are of a certain level of quality. They don’t have to be “top 5 desert-island books”, because well, there’s one every day and the days keep coming. But they do have to genuinely deliver the value that we describe, and merit a sincere recommendation.
    • are varied—we try to not give a run of “samey” books one after another. We will sometimes review a book that covers a topic another previously-reviewed book did, but it must have something about it that makes it different. It may be a different angle or a different writing style, but it needs something to set it apart.

    *this is from Amazon and isn’t product-specific, so this is not affecting our choice of what books to review at all—just that they will be books that are available on Amazon.

    Don’t Forget…

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    Learn to Age Gracefully

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  • Are plant-based burgers really bad for your heart? Here’s what’s behind the scary headlines

    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.

    We’re hearing a lot about ultra-processed foods and the health effects of eating too many. And we know plant-based foods are popular for health or other reasons.

    So it’s not surprising new research out this week including the health effects of ultra-processed, plant-based foods is going to attract global attention.

    And the headlines can be scary if that research and the publicity surrounding it suggests eating these foods increases your risk of heart disease, stroke or dying early.

    Here’s how some media outlets interpreted the research. The Daily Mail ran with:

    Vegan fake meats are linked to increase in heart deaths, study suggests: Experts say plant-based diets can boost health – but NOT if they are ultra-processed

    The New York Post’s headline was:

    Vegan fake meats linked to heart disease, early death: study

    But when we look at the study itself, it seems the media coverage has focused on a tiny aspect of the research, and is misleading.

    So does eating supermarket plant-based burgers and other plant-based, ultra-processed foods really put you at greater risk of heart disease, stroke and premature death?

    Here’s what prompted the research and what the study actually found.

    Nina Firsova/Shutterstock

    Remind me, what are ultra-processed foods?

    Ultra-processed foods undergo processing and reformulation with additives to enhance flavour, shelf-life and appeal. These include everything from packet macaroni cheese and pork sausages, to supermarket pastries and plant-based mince.

    There is now strong and extensive evidence showing ultra-processed foods are linked with an increased risk of many physical and mental chronic health conditions.

    Although researchers question which foods should be counted as ultra-processed, or if all of them are linked to poorer health, the consensus is that, generally, we should be eating less of them.

    We also know plant-based diets are popular. These are linked with a reduced risk of chronic health conditions such as heart disease and stroke, cancer and diabetes. And supermarkets are stocking more plant-based, ultra-processed food options.

    How about the new study?

    The study looked for any health differences between eating plant-based, ultra-processed foods compared to eating non-plant based, ultra-processed foods. The researchers focused on the risk of cardiovascular disease (such as heart disease and stroke) and deaths from it.

    Plant-based, ultra-processed foods in this study included mass-produced packaged bread, pastries, buns, cakes, biscuits, cereals and meat alternatives (fake meats). Ultra-processed foods that were not plant-based included milk-based drinks and desserts, sausages, nuggets and other reconstituted meat products.

    The researchers used data from the UK Biobank. This is a large biomedical database that contains de-identified genetic, lifestyle (diet and exercise) and health information and biological samples from half a million UK participants. This databank allows researchers to determine links between this data and a wide range of diseases, including heart disease and stroke.

    They used data from nearly 127,000 people who provided details of their diet between 2009 and 2012. The researchers linked this to their hospital records and death records. On average, the researchers followed each participant’s diet and health for nine years.

    Rows of packaged bread on supermarket shelf
    Plant-based, ultra-processed foods included in this study included packaged supermarket bread. doublelee/Shutterstock

    What did the study find?

    With every 10% increase of total energy from plant-sourced, ultra-processed foods there was an associated 5% increased risk of cardiovascular disease (such as heart disease or stroke) and a 12% higher risk of dying from cardiovascular disease.

    But for every 10% increase in plant-sourced, non-ultra-processed foods consumed there was an associated 7% lower risk of cardiovascular disease and a 13% lower risk of dying from cardiovascular disease.

    The researchers found no evidence for an association between all plant-sourced foods (whether or not they were ultra-processed) and either an increased or decreased risk of cardiovascular disease or dying from it.

    This was an observational study, where people recalled their diet using questionnaires. When coupled with other data, this can only tell us if someone’s diet is associated with a particular risk of a health outcome. So we cannot say that, in this case, the ultra-processed foods caused the heart disease and deaths from it.

    Why has media coverage focused on fake meats?

    Much of the media coverage has focused on the apparent health risks associated with eating fake meats, such as sausages, burgers, nuggets and even steaks.

    These are considered ultra-processed foods. They are made by deconstructing whole plant foods such as pea, soy, wheat protein, nuts and mushrooms, and extracting the protein. They are then reformulated with additives to make the products look, taste and feel like traditional red and white meats.

    However this was only one type of plant-based, ultra-processed food analysed in this study. This only accounted for an average 0.2% of the dietary energy intake of all the participants.

    Compare this to bread, pastries, buns, cakes and biscuits, which are other types of plant-based, ultra-processed foods. These accounted for 20.7% of total energy intake in the study.

    Plant-based foods such as burgers and sausages in trays
    This image was at the top of the media release. Screenshot/Imperial

    It’s hard to say why the media focused on fake meat. But there is one clue in the media release issued to promote the research.

    Although the media release did not mention the words “fake meat”, an image of plant-based burgers, sausages and meat balls or rissoles featured prominently.

    The introduction of the study itself also mentions plant-sourced, ultra-processed foods, such as sausages, nuggets and burgers.

    So it’s no wonder people can be confused.

    Does this mean fake meats are fine?

    Not necessarily. This study analysed the total intake of plant-based, ultra-processed foods, which included fake meats, albeit a very small proportion of people’s diets.

    From this study alone we cannot tell if there would be a different outcome if someone ate large amounts of fake meats.

    In fact, a recent review of fake meats found there was not enough evidence to determine their impact on health.

    We also need more recent data to reflect current eating patterns of fake meats. This study used dietary data collected from 2009 to 2012, and fake meats have become more popular since.

    What if I really like fake meat?

    We have known for a while that ultra-processed foods can harm our health. This study tells us that regardless if an ultra-processed food is plant-based or not, it may still be harmful.

    We know fake meat can contain large amounts of saturated fats (from coconut or palm oil), salt and sugar.

    So like other ultra-processed foods, they should be eaten infrequently. The Australian Dietary Guidelines currently recommends people should only consume foods like this sometimes and in small amounts.

    Are some fake meats healthier than others?

    Check the labels and nutrition information panels. Look for those lowest in fat and salt. Burgers and sausages that are a “pressed cake” of minced ingredients such as nuts, beans and vegetables will be preferable to reformulated products that look identical to meat.

    You can also eat whole plant-based protein foods such as legumes. These include beans, lentils, chickpeas and soy beans. As well as being high in protein and fibre, they also provide essential nutrients such as iron and zinc. Using spices and mushrooms alongside these in your recipes can replicate some of the umami taste associated with meat.

    Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia

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

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