Eat Better, Feel Better – by Giada de Laurentis
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In yesterday’s edition of 10almonds, we reviewed Dr. Aujla’s “The Doctor’s Kitchen“; today we’re reviewing a different book about healing through food—in this case, with a special focus on maintaining energy and good health as we get older.
De Laurentis may not be a medical doctor, but she is a TV chef, and not only holds a lot of influence, but also has access to a lot of celebrity doctors and such; that’s reflected a lot in her style and approach here.
The recipes are clear and easy to follow; well-illustrated and nicely laid-out.
This cookbook’s style is less “enjoy this hearty dish of rice and beans with these herbs and spices” and more “you can serve your steak salad with white beans and sweet shallot dressing on a bed of organic quinoa if you haven’t already had your day’s serving of grains, of course”.
It’s a little fancier, in short, and more focused on what to cut out, than what to include. On account of that, this could make it a good contrast to yesterday’s book, which had the opposite focus.
She also recommends assorted adjuvant practices; some that are evidence-based, like intermittent fasting and meditation, and some that are not, like extreme detox-dieting, and acupuncture (which has no bearing on gut health).
Bottom line: if you like the idea of eating for good health, and prefer a touch of celebrity lifestyle to your meals, this one’s a good book for you.
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Ear Candling: Is It Safe & Does It Work?
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Does This Practice Really Hold A Candle To Evidence-Based Medicine?
In Tuesday’s newsletter, we asked you your opinion of ear candling, and got the above-depicted, below-described set of responses:
- Exactly 50% said “Under no circumstances should you put things in your ear and set fire to them”
- About 38% said “It is a safe, drug-free way to keep the ears free from earwax and pathogens”
- About 13% said “Done correctly, thermal-auricular therapy is harmless and potentially beneficial”
This means that if we add the two positive-to-candling answers together, it’s a perfect 50:50 split between “do it” and “don’t do it”.
(Yes, 38%+13%=51%, but that’s because we round to the nearest integer in these reports, and more precisely it was 37.5% and 12.5%)
So, with the vote split, what does the science say?
First, a quick bit of background: nobody seems keen to admit to having invented this. One of the major manufacturers of ear candles refers to them as “Hopi” candles, which the actual Hopi tribe has spent a long time asking them not to do, as it is not and never has been used by the Hopi people. Other proposed origins offered by advocates of ear candling include Traditional Chinese Medicine (not used), Ancient Egypt (no evidence of such whatsoever), and Atlantis:
Quackwatch | Why Ear Candling Is Not A Good Idea
It is a safe, drug-free way to keep the ears free from earwax and pathogens: True or False?
False! In a lot of cases of alternative therapy claims, there’s an absence of evidence that doesn’t necessarily disprove the treatment. In this case, however, it’s not even an open matter; its claims have been actively disproven by experimentation:
- It doesn’t remove earwax; on the contrary, experimentation “showed no removal of cerumen from the external auditory canal. Candle wax was actually deposited in some“
- It doesn’t remove pathogens, and the proposed mechanism of action for removing pathogens, that of the “chimney effect”: the idea that the burning candle creates a vacuum that draws wax out of the ear along with debris and bacteria, simply does not work; on the contrary, “Tympanometric measurements in an ear canal model demonstrated that ear candles do not produce negative pressure”.
- It isn’t safe; on the contrary, “Ear candles have no benefit in the management of cerumen and may result in serious injury”
In a medium-sized survey (n=122), the following injuries were reported:
- 13 x burns
- 7 x occlusion of the ear canal
- 6 x temporary hearing loss
- 3 x otitis externa (this also called “swimmer’s ear”, and is an inflammation of the ear, accompanied by pain and swelling)
- 1 x tympanic membrane perforation
Indeed, authors of one paper concluded:
❝Ear candling appears to be popular and is heavily advertised with claims that could seem scientific to lay people. However, its claimed mechanism of action has not been verified, no positive clinical effect has been reliably recorded, and it is associated with considerable risk.
No evidence suggests that ear candling is an effective treatment for any condition. On this basis, we believe it can do more harm than good and we recommend that GPs discourage its use❞
Source: Canadian Family Physician | Ear Candling
Under no circumstances should you put things in your ear and set fire to them: True or False?
True! It’s generally considered good advice to not put objects in general in your ears.
Inserting flaming objects is a definite no-no. Please leave that for the Cirque du Soleil.
You may be thinking, “but I have done this and suffered no ill effects”, which seems reasonable, but is an example of survivorship bias in action—it doesn’t make the thing in question any safer, it just means you were one of the one of the ones who got away unscathed.
If you’re wondering what to do instead… Ear oils can help with the removal of earwax (if you don’t want to go get it sucked out at a clinic—the industry standard is to use a suction device, which actually does what ear candles claim to do). For information on safely getting rid of earwax, see our previous article:
Take care!
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Managing Sibling Relationships In Adult Life
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Managing Sibling Relationships In Adult Life
After our previous main feature on estrangement, a subscriber wrote to say:
❝Parent and adult child relationships are so important to maintain as you age, but what about sibling relationships? Adult choices to accept and move on with healthier boundaries is also key for maintaining familial ties.❞
And, this is indeed critical for many of us, if we have siblings!
Writer’s note: I don’t have siblings, but I do happen to have one of Canada’s top psychologists on speed-dial, and she has more knowledge about sibling relationships than I do, not to mention a lifetime of experience both personally and professionally. So, I sought her advice, and she gave me a lot to work with.
Today I bring her ideas, distilled into my writing, for 10almonds’ signature super-digestible bitesize style.
A foundation of support
Starting at the beginning of a sibling story… Sibling relationships are generally beneficial from the get-go.
This is for reasons of mutual support, and an “always there” social presence.
Of course, how positive this experience is may depend on there being a lack of parental favoritism. And certainly, sibling rivalries and conflict can occur at any age, but the stakes are usually lower, early in life.
Growing warmer or colder
Generally speaking, as people age, sibling relationships likely get warmer and less conflictual.
Why? Simply put, we mature and (hopefully!) get more emotionally stable as we go.
However, two things can throw a wrench into the works:
- Long-term rivalries or jealousies (e.g., “who has done better in life”)
- Perceptions of unequal contribution to the family
These can take various forms, but for example if one sibling earns (or otherwise has) much more or much less than another, that can cause resentment on either or both sides:
- Resentment from the side of the sibling with less money: “I’d look after them if our situations were reversed; they can solve my problems easily; why do they resent that and/or ignore my plight?”
- Resentment from the side of the sibling with more money: “I shouldn’t be having to look after my sibling at this age”
It’s ugly and unpleasant. Same goes if the general job of caring for an elderly parent (or parents) falls mostly or entirely on one sibling. This can happen because of being geographically closer or having more time (well… having had more time. Now they don’t, it’s being used for care!).
It can also happen because of being female—daughters are more commonly expected to provide familial support than sons.
And of course, that only gets exacerbated as end-of-life decisions become relevant with regard to parents, and tough decisions may need to be made. And, that’s before looking at conflicts around inheritance.
So, all that seems quite bleak, but it doesn’t have to be like that.
Practical advice
As siblings age, working on communication about feelings is key to keeping siblings close and not devolving into conflict.
Those problems we talked about are far from unique to any set of siblings—they’re just more visible when it’s our own family, that’s all.
So: nothing to be ashamed of, or feel bad about. Just, something to manage—together.
Figure out what everyone involved wants/needs, put them all on the table, and figure out how to:
- Make sure outright needs are met first
- Try to address wants next, where possible
Remember, that if you feel more is being asked of you than you can give (in terms of time, energy, money, whatever), then this discussion is a time to bring that up, and ask for support, e.g.:
“In order to be able to do that, I would need… [description of support]; can you help with that?”
(it might even sometimes be necessary to simply say “No, I can’t do that. Let’s look to see how else we can deal with this” and look for other solutions, brainstorming together)
Some back-and-forth open discussion and even negotiation might be necessary, but it’s so much better than seething quietly from a distance.
The goal here is an outcome where everyone’s needs are met—thus leveraging the biggest strength of having siblings in the first place:
Mutual support, while still being one’s own person. Or, as this writer’s psychology professor friend put it:
❝Circling back to your original intention, this whole discussion adds up to: siblings can be very good or very bad for your life, depending on tons of things that we talked about, especially communication skills, emotional wellness of each person, and the complexity of challenges they face interdependently.❞
Our previous main feature about good communication can help a lot:
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Better Sex = Longer Life (Here’s How)
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This is Dr. Candice Hargons. She’s a professor of psychology, and has served on the Kentucky Psychological Association Board, the Society of Counseling Psychology Executive Board, and the American Psychological Association (APA)’s Council of Representatives. She also served on the APA Board of Directors, after receiving the APA’s Presidential Citation award for her research and leadership.
She leads the Study of Mental And Sexual Health Equity in Relationships (SMASHER Lab), with a predominant focus on promoting good sex, sexual wellness, and liberation among couples and communities.
In her own words:
❝Sex is one of the most common and normal human behaviors, and yet it remains relatively taboo as a topic. Many people worry about being judged, either for being perceived as too sexual or not sexual enough, and a major focus of my work is to normalize talking and learning about sex to improve sexual functioning across the adult lifespan.❞
~ Dr. Candice Hargons
So, let’s do that!
What does good sex do for health?
We’ve written previously about the health aspects of orgasms specifically:
“Early To Bed…” (Mythbusting Orgasms) ← including resources pertaining to anorgasmia, the inability to orgasm
…but orgasms are not the be-all-and-end-all of sex; see for example:
A Urologist Explains Edging: What, Why, & Is It Safe? ← when the journey is genuinely more of a focus than the destination
And certainly, good sex is simply a very good way to relax and de-stress, which is important, given how important stress management is to general health in very many ways (affecting things ranging from inflammation to heart health and more).
Plus, while the level of athleticism deployed may vary, sex is a physical activity, and physical activity is, as a rule, good.
There’s more to it than that though! It also can help us bind closely to our loved ones, in a positive way, which—critically—has a very positive impact on healthy longevity:
Only One Kind Of Relationship Promotes Longevity This Much! ← this is about the seriousness of the relationship, not the sex, but for most people, a strong and fulfilling relationship will include having good sex.
The scientific relationship between sex and longevity also got a whole chapter in this excellent book that we reviewed all so recently:
Age Proof: The New Science of Living a Longer and Healthier Life – by Dr. Rose Anne Kenny
What makes it “good”?
Dr. Hargons considers (and her opinion is backed by extensive research in the SMASHER Lab, if you’ll pardon the mental image that that might conjure) that first and foremost… It has to feel good to all parties involved.
In contrast, oftentimes, one partner’s pleasure is prioritized over another’s, and that becomes a problem.*
*assuming that’s not part of an established kink dynamic with enthusiastic affirmative consent, such as if the partner whose pleasure is being deprioritized is enthusiastically requesting to be denied orgasms, for example. Yes, that’s a real kink and even a popular one, but it’s not what’s happening in most sexually uneven relationships.
This kind of unplanned disparity often goes undiscussed by the couple in question—especially in heterosexual couples if the man is getting what he wants/needs and the woman isn’t, because there’s a rather lop-sided societal expectation in that regard. And even a loving, well-intentioned man can simply not know how to do better and be afraid to ask. And for that matter, it’s also entirely possible for his partner to not know either.
Dr. Hargons lists the four main keys as:
- Communication
- Intimacy
- Passion
- Pleasure
And communication indeed comes first, so to speak. For example, she advises:
❝Begin by identifying what you like and don’t like sexually. An easy way to do this is to create a “Yes, No, Maybe So” list. You can use paper or a Notes app on your phone.
Create three columns: one for Yes, No, and Maybe So sections. In the Yes section, write all the things you enjoy and want to keep doing sexually, as well as things you have not tried yet that you want to try. In the No section, write all the things you don’t enjoy and do not want to do anymore. It can also include things you haven’t tried that you’re uninterested in trying. Finally, in your Maybe So list, write all the things you’re curious about and/or are only willing to try in specific settings or circumstances.
You can share this list with your partner, but even if you are not ready to do that, you will already have enhanced your sexual self-awareness and be better positioned to talk with your sexual partner about what you want.❞
This represents an important shift from “whatever” to taking an active role in your sex life at your own pace.
And from there, it’s just a matter of exploring, together, and learning as you go. Could anything be more exciting than that?
“What if I’m single?”
We talked about this a little previously, more relationally than sexually specifically, though:
Now, a single person can of course still have an active sex life if you so choose, in which case, the above advice still applies, just, it’ll be conversations with your partner-of-the-moment rather than with a life partner. And that’s important too! Just because something is casual, doesn’t mean it need not be entered into mindfully and with a sense of what you want out of it, and communicating that effectively (while encouraging the same from others, and of course actually listening to, and caring about, what they say too).
And if you are, perchance, single and decided on a life of celibacy now, you can and (if you are sexual at all) should still figure out what you like and don’t like sexually, because even if it’s going to be you-on-you action, it will be good for you to love yourself enough to do it right.
Seriously, treat yourself at least as well as you would any other lover.
On which note, corded wand-style vibrators like the famous “Magic Wand” kind are much more powerful than the battery kind, and you will feel the difference, in a good way.
And if you really want to invest in your sexual wellness and you like the idea, saddle-style vibrators like this one will rock your socks off in ways handheld vibrators couldn’t dream of.
Want to know more?
You might want to check out Dr. Hargons’ book:
Good Sex: Stories, Science, and Strategies for Sexual Liberation – by Dr. Candice Hargons ← this covers so many important areas, more than we have room to here. Just check out the table of contents, and you’ll see what we mean.
…which we haven’t reviewed yet, but here are some excellent related books that we have:
- Come Together: The Science (and Art) of Creating Lasting Sexual Connections – by Dr. Emily Nagoski
- Better Sex Through Mindfulness: How Women Can Cultivate Desire – by Dr. Lori Brotto
Enjoy!
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Long COVID is real—here’s how patients can get treatment and support
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.
What you need to know
- There is still no single, FDA-approved treatment for long COVID, but doctors can help patients manage individual symptoms.
- Long COVID patients may be eligible for government benefits that can ease financial burdens.
- Getting reinfected with COVID-19 can worsen existing long COVID symptoms, but patients can take steps to stay protected.
On March 15—Long COVID Awareness Day—patients shared their stories and demanded more funding for long COVID research. Nearly one in five U.S. adults who contract COVID-19 suffer from long COVID, and up to 5.8 million children have the disease.
Anyone who contracts COVID-19 is at risk of developing long-term illness. Long COVID has been deemed by some a “mass-disabling event,” as its symptoms can significantly disrupt patients’ lives.
Fortunately, there’s hope. New treatment options are in development, and there are resources available that may ease the physical, mental, and financial burdens that long COVID patients face.
Read on to learn more about resources for long COVID patients and how you can support the long COVID patients in your life.
What is long COVID, and who is at risk?
Long COVID is a cluster of symptoms that can occur after a COVID-19 infection and last for weeks, months, or years, potentially affecting almost every organ. Symptoms range from mild to debilitating and may include fatigue, chest pain, brain fog, dizziness, abdominal pain, joint pain, and changes in taste or smell.
Anyone who gets infected with COVID-19 is at risk of developing long COVID, but some groups are at greater risk, including unvaccinated people, women, people over 40, and people who face health inequities.
What types of support are available for long COVID patients?
Currently, there is still no single, FDA-approved treatment for long COVID, but doctors can help patients manage individual symptoms. Some options for long COVID treatment include therapies to improve lung function and retrain your sense of smell, as well as medications for pain and blood pressure regulation. Staying up to date on COVID-19 vaccines may also improve symptoms and reduce inflammation.
Long COVID patients are eligible for disability benefits under the Americans with Disabilities Act. The Pandemic Legal Assistance Network provides pro bono support for long COVID patients applying for these benefits.
Long COVID patients may also be eligible for other forms of government assistance, such as Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), Medicaid, and rental and utility assistance programs.
How can friends and family of long COVID patients provide support?
Getting reinfected with COVID-19 can worsen existing long COVID symptoms. Wearing a high-quality, well-fitting mask will reduce your risk of contracting COVID-19 and spreading it to long COVID patients and others. At indoor gatherings, improving ventilation by opening doors and windows, using high-efficiency particulate air (HEPA) filters, and building your own Corsi-Rosenthal box can also reduce the spread of the COVID-19 virus.
Long COVID patients may also benefit from emotional and financial support as they manage symptoms, navigate barriers to treatment, and go through the months-long process of applying for and receiving disability benefits.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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When Doctors Make House Calls, Modern-Style!
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In Tuesday’s newsletter, we asked you foryour opinion of telehealth for primary care consultations*, and got the above-depicted, below-described, set of responses:
- About 46% said “It is no substitute for an in-person meeting with a doctor; let’s keep the human touch”
- About 29% said “It means less waiting and more accessibility, while avoiding transmission of diseases”
- And 25 % said “I find that the pros and cons of telehealth vs in-person balance out, so: no preference”
*We specified that by “primary care” we mean the initial consultation with a non-specialist doctor, before receiving treatment or being referred to a specialist. By “telehealth” we mean by videocall or phonecall.
So, what does the science say?
A quick note first
Because telehealth was barely a thing (statistically speaking) before the first stages of the COVID pandemic, compared to how it is now, most of the science for this is young, and a lot of the science simply hasn’t been done yet, and/or has not been published yet, because the process can take years.
Because of this, some studies we do have aren’t specifically about primary care, and are sometimes about specialists. We think this should not affect the results much, but it bears highlighting.
Nevertheless, we’ll do what we can with the science we have!
Telehealth is more accessible than in-person consultations: True or False?
True, for most people. For example…
❝Data was found from a variety of emergency and non-emergency departments of primary, secondary, and specialised healthcare.
Satisfaction was high among recipients of healthcare, scoring 9-10 on a scale of 0-10 or ranging from 73.3% to 100%.
Convenience was rated high in every specialty examined. Satisfaction of clinicians was high throughout the specialities despite connection failure and concerns about confidentiality of information.❞
whereas…
❝Nonetheless, studies reported perception of increased barriers to accessing care and inequalities for vulnerable patients especially in older people❞
~ Ibid.
Source: Satisfaction with telemedicine use during COVID-19 pandemic in the UK: a systematic review
Now, perception of those things does necessarily equate to an actual increased barrier, but it is reasonable that someone who thinks something is inaccessible will be less inclined to try to access it.
The quality of care provided via telehealth is as good as in-person: True or False?
True, ostensibly, with caveats. The caveats are:
- We’re going offreported patient satisfaction, not objective patient health outcomes (we found little* science as yet for the relative incidence of misdiagnosis, for example—which kind of thing will take time to be revealed).
- We’re also therefore speaking (as statistics do) for the significant majority of people. However, if we happen to be (statistically speaking) an insignificant minority, well, that just sucks for us personally.
*we did find some, but it wasn’t very helpful yet. For example:
An electronic trigger to detect telemedicine-related diagnostic errors
this one does look at the incidence of diagnostic errors, but provides no control group (i.e. otherwise-comparable in-person consultations) for comparison.
While most oft-considered demographic groups reported comparable patient satisfaction (per race, gender, and socioeconomic status, for example), there was one outlier variable, which was age (as we quoted from that first study above).
However!
Looking under the hood of these stats, it seems that age is not the real culprit, so much as technological illiteracy, which is heavily correlated with age:
❝Lower eHealth literacy is associated with more negative attitudes towards I/C technology in healthcare. This trend is consistent across diverse demographics and regions. ❞
Source: Meta-analysis: eHealth literacy and attitudes towards internet/computer technology
There are things that can be done at an in-person consultation that can’t be done by telehealth: True or False?
True, of course. It is incredibly rare that we will cite “common sense”, (as sometimes “common sense” is actually “common mistakes” and is simply and verifiably wrong), but in this case, as one 10almonds subscriber put it:
❝The doctor uses his five senses to assess. This cannot be attained over the phone❞
~ 10almonds subscriber
A quick note first: if your doctor is using their sense of taste to diagnose you, please get a different doctor, because they should definitely not be doing that!
Not in this century, anyway… Once upon a time, diabetes was diagnosed by urine-tasting (and yes, that was a fairly reliable method).
However, nowadays indeed a doctor will use sight, sound, touch, and sometimes even smell.
In a videocall we’re down to two of those senses (sight and sound), and in a phonecall, down to one (sound) and even that is hampered. Your doctor cannot, for example, use a stethoscope over the phone.
With this in mind, it really comes down to what you need from your doctor in that consultation.
- If you’re 99% sure that what you need is to be prescribed an antidepressant, that probably doesn’t need a full physical.
- If you’re 99% sure that what you need is a referral, chances are that’ll be fine by telehealth too.
- If your doctor is 99% sure that what you need is a verbal check-up (e.g. “How’s it been going for you, with the medication that I prescribed for you a month ago?”, then again, a call is probably fine.
If you have a worrying lump, or an unhappy bodily discharge, or an unexplained mysterious pain? These things, more likely an in-person check-up is in order.
Take care!
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What you need to know about FLiRT, an emerging group of COVID-19 variants
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What you need to know
- COVID-19 wastewater levels are currently low, but a recent group of variants called FLiRT is making headlines.
- KP.2 is one of several FLiRT variants, and early lab tests suggest that it’s more infectious than JN.1.
- Getting infected with any COVID-19 variant can cause severe illness, heart problems, and death.
KP.2, a new COVID-19 variant, is now dominant in the United States. Lab tests suggest that it may be more infectious than JN.1, the variant that was dominant earlier this year.
Fortunately, there’s good news: Current wastewater data shows that COVID-19 infection rates are low. Still, experts are closely watching KP.2 to see if it will lead to an uptick in infections.
Read on to learn more about KP.2 and how to stay informed about COVID-19 cases in your area.
Where can I find data on COVID-19 cases in my area?
Hospitals are no longer required to report COVID-19 hospital admissions or hospital capacity to the Department of Health and Human Services. However, wastewater-based epidemiology (WBE) estimates the number of COVID-19 infections in a community based on the amount of COVID-19 viral particles detected in local wastewater.
View this map of wastewater data from the CDC to visualize COVID-19 infection rates throughout the U.S., or look up COVID-19 wastewater trends in your state.
What do we know so far about the new variant?
Early lab tests suggest that KP.2—one of a group of emerging variants called FLiRT—is similar to the previously dominant variant, JN.1, but it may be more infectious. If you had JN.1, you may still get reinfected with KP.2, especially if it’s been several months or longer since your last COVID-19 infection.
A CDC spokesperson said they have no reason to believe that KP.2 causes more severe illness than other variants. Experts are closely watching KP.2 to see if it will lead to an uptick in COVID-19 cases.
How can I protect myself from COVID-19 variants?
Staying up to date on COVID-19 vaccines reduces your risk of severe illness, long COVID, heart problems, and death. The CDC recommends that people 65 and older and immunocompromised people receive an additional dose of the updated COVID-19 vaccine this spring.
Wearing a high-quality, well-fitting mask reduces your risk of contracting COVID-19 and spreading it to others. At indoor gatherings, improving ventilation by opening doors and windows, using high-efficiency particulate air (HEPA) filters, and building your own Corsi-Rosenthal box can also reduce the spread of COVID-19.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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