Eat To Avoid (Or Beat) PCOS
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Polycystic ovary syndrome, PCOS, affects very many people; around 1 in 5 women. It can show up unexpectedly, and usually the first-identified sign is irregular vaginal bleeding. We say “vaginal” rather than “menstrual” as it’s not technically menses, although it’ll look (and can feel) the same.
Like many “affects mostly women” conditions, science’s general position is “we don’t know what causes it or how to cure it”.
Quick book recommendation before we continue:
Unwell Women: Misdiagnosis and Myth in a Man-Made World – by Dr. Elinor Cleghorn
…is a top-tier book about medical misogyny. We’d say more here, but well, you can read our review there 🙂
What doesn’t work
Since PCOS is characterized by excessive androgen production, it is reasonable to expect that foods containing phytoestrogens (such as soy) may help. They won’t. The human body can’t use those as estrogen, and in fact, consuming unusually large quantities of phytoestrogens can actually get in the way of your own (or bioidentical) estrogen, by competing for the same receptors but not really doing the job.
But, you won’t get that problem from moderate consumption of soy; the warning is more for those tempted to self-medicate with megadoses, or are opting for dubious supplements such as Pueraria mirifica ← will have to do a research review on that one of these days, but suffice it to say meanwhile, it has some serious drawbacks
See also: What Does “Balance Your Hormones” Even Mean?
What can work
There are some supplement-based approaches that actually can help, and those are the ones that rather than trying to manufacture estrogen out of thin air, work to reduce testosterone and/or reduce the conversion of free testosterone to its more potent form, dihydrogen testosterone (DHT); here are two examples:
- Licorice, Digestion, & Hormones
- One Man’s Saw Palmetto Is Another Woman’s Serenoa Repens ← this one has the most evidence of the two
What will work
…or at least, barring additional confounding factors, what the evidence strongly supports working. Here’s where we get into diet properly, and there are three main dietary approaches:
Low-GI diet: focus on high-fiber, low-carb foods (e.g. whole grains, legumes, berries, leafy greens). Eating this way results in improved insulin sensitivity, lower fasting insulin, cholesterol, triglycerides, waist circumference, and (for women) yes, lower testosterone levels.
See: What Do The Different Kinds Of Fiber Do? 30 Foods That Rank Highest
High antioxidant diet: focus on foods rich in antioxidants (e.g. vitamin A, α-tocopherol specifically, vitamins C and D, and polyphenols) as these lower PCOS incidence.
See: 21 Most Beneficial Polyphenols & What Foods Have Them
Ketogenic diet: focus on high-fat, very low-carb foods (e.g. fatty fish, dairy, leafy greens). This significantly reduces androgen levels, improves insulin sensitivity, and regulates hormones. But… It’s recommended for short-term use only due to its negative health impacts from poor (i.e. narrow) nutritional coverage:
See: Ketogenic Diet: Burning Fat, Or Burning Out?
It is also reasonable to supplement, for example:
❝Omega-3 fatty acids and vitamin D have powerful anti-inflammatory and antioxidant properties that significantly improve insulin sensitivity and reduce androgen levels in metabolic syndromes like PCOS. A higher intake of omega-3 and vitamin E also alleviates mental health parameters and gene expression of PPAR-γ, IL-8, and TNF-α in women with PCOS.
Dietary supplements, such as antioxidants like N-acetylcysteine (NAC), vitamin D, inositol, and omega-3 fatty acids, and mineral supplements (zinc, magnesium selenium, and chromium) help in reducing insulin resistance. These supplements also enhance ovulatory function and decrease inflammation in PCOS patients.
Omega-3 fatty acid supplements improve biochemical parameters LH, LH/FSH, lipid profiles, and adiponectin levels and regularize the menstrual cycle in women with PCOS. A recent RCT also indicated that probiotic/symbiotic supplementation significantly improves triglyceride, insulin, and HDL levels in women with PCOS.❞
Source: The Role of Lifestyle Interventions in PCOS Management: A Systematic Review
Want to know more?
You might like this book that we reviewed a little while back:
PCOS Repair Protocol – by Tamika Woods
Take care!
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Sleeping on Your Back after 50; Yay or Nay?
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Sleeping Differently After 50
Sleeping is one of those things that, at any age, can be hard to master. Some of our most popular articles have been on getting better sleep, and effective sleep aids, and we’ve had a range of specific sleep-related questions, like whether air purifiers actually improve your sleep.
But perhaps there’s an underlying truth hidden in our opening sentence…is sleeping consistently difficult because the way we sleep should change according to our age?
Inspired by Brad and Mike’s video below (which was published to their 5 million+ subscribers!), there are 4 main elements to consider when sleeping on your back after you’ve hit the 50-year mark:
- Degenerative Disk Disease: As you age, your spine may start to show signs of wear and tear, which directly affects comfort while lying on your back.
- Sleep Apnea and Snoring: Sleep Apnea and snoring become more of an issue with age, and sleeping on your back can exacerbate these problems; when you sleep on your back, the soft tissues in your throat, as well as your tongue, “fall back” and partly obstruct your the airway.
- Spinal Stenosis: Spinal Stenosis–the often-age-related narrowing of your spinal canal–can put pressure on the nerves that travel through the spine, which equally makes back-sleeping harder.
- GERD: The all-too-familiar gastroesophageal reflux disease can be more problematic when lying flat on your back, as doing so can allow easy access for stomach acid to move upwards.
Alternatives to Back Sleeping
Referencing the Mayo Clinic’s Sleep Facility’s director, Dr. Virend Somers, today’s video suggests a simple solution: sleeping on your side. The video goes into a bit more detail but, as you know, here at 10almonds we like to cut to the chase.
Modifications for Back Sleeping
If you’re a lifelong back-sleeping and cannot bear the idea of changing to your side, or your stomach, then there are a few modifications that you can make to ease any pain and discomfort.
Most solutions revolve around either leg wedges or pillow adjustments. For instance, if you’re suffering from back pain, try propping your knees up. Or if GERD is your worst enemy, a wedge pillow could help keep that acid down.
As can be expected, the video dives into more detail:
How was the video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!
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What’s behind rising heart attack rates in younger adults
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Deaths from heart attacks have been in decline for decades, thanks to improved diagnosis and treatments. But, among younger adults under 50 and those from communities that have been marginalized, the trend has reversed.
More young people have suffered heart attacks each year since the 2000s—and the reasons why aren’t always clear.
Here’s what you need to know about heart attack trends in younger adults.
Heart attack deaths began declining in the 1980s
Heart disease has been a leading cause of death in the United States for more than a century, but rates have declined for decades as diagnosis and treatments improved. In the 1950s, half of all Americans who had heart attacks died, compared to one in eight today.
A 2023 study found that heart attack deaths declined 4 percent a year between 1999 and 2020.
The downward trend plateaued in the 2000s as heart attacks in young adults rose
In 2012, the decline in heart disease deaths in the U.S. began to slow. A 2018 study revealed that a growing number of younger adults were suffering heart attacks, with women more affected than men. Additionally, younger adults made up one-third of heart attack hospitalizations, with one in five heart attack patients being under 40.
The following year, data showed that heart attack rates among adults under 40 had increased steadily since 2006. Even more troubling, young patients were just as likely to die from heart attacks as patients more than a decade older.
Why are more younger adults having heart attacks?
Heart attacks have historically been viewed as a condition that primarily affects older adults. So, what has changed in recent decades that puts younger adults at higher risk?
Higher rates of obesity, diabetes, and high blood pressure
Several leading risk factors for heart attacks are rising among younger adults.
Between 2009 and 2020, diabetes and obesity rates increased in Americans ages 20 to 44.During the same period, hypertension, or high blood pressure, rates did not improve in younger adults overall and worsened in young Hispanic people. Notably, young Black adults had hypertension rates nearly twice as high as the general population.
Hypertension significantly increases the risk of heart attack and cardiovascular death in young adults.
Increased substance use
Substance use of all kinds increases the risk of cardiovascular issues, including heart attacks. A recent study found that cardiovascular deaths associated with substance use increased by 4 percent annually between 1999 and 2019.
The rise in substance use-related deaths has accelerated since 2012 and was particularly pronounced among women, younger adults (25-39), American Indians and Alaska Natives, and those in rural areas.
Alcohol was linked to 65 percent of the deaths, but stimulants (like methamphetamine) and cannabis were the substances associated with the greatest increase in cardiovascular deaths during the study period.
Poor mental health
Depression and poor mental health have been linked to cardiovascular issues in young adults. A 2023 study of nearly 600,000 adults under 50 found that depression and self-reported poor mental health are a risk factor for heart disease, regardless of socioeconomic or other cardiovascular risk factors.
Adults under 50 years consistently report mental health conditions at around twice the rate of older adults. Additionally, U.S. depression rates have trended up and reached an all-time high in 2023, when 17.8 percent of adults reported having depression.
Depression rates are rising fastest among women, adults under 44, and Black and Hispanic populations.
COVID-19
COVID-19 can cause real, lasting damage to the heart, increasing the risk of certain cardiovascular diseases for up to a year after infection. Vaccination reduces the risk of heart attack and other cardiovascular events caused by COVID-19 infection.
The first year of the pandemic marked the largest single-year spike in heart-related deaths in five years, including a 14 percent increase in heart attacks. In the second year of the pandemic, heart attacks in young adults increased by 30 percent.
Heart attack prevention
Not every heart attack is preventable, but everyone can take steps to reduce their risks. The American Heart Association recommends managing health conditions that increase heart disease risk, including diabetes, obesity, and high blood pressure.
Lifestyle changes like improving diet, reducing substance use, and increasing physical activity can also help reduce heart attack risk.
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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Is “Extra Virgin” Worth It?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
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
❝I was wondering, is the health difference important between extra virgin olive oil and regular?❞
Assuming that by “regular” you mean “virgin and still sold as a food product”, then there are health differences, but they’re not huge. Or at least: not nearly so big as the differences between those and other oils.
Virgin olive oil (sometimes simply sold as “olive oil”, with no claims of virginity) has been extracted by the same means as extra virgin olive oil, that is to say: purely mechanical.
The difference is that extra virgin olive oil comes from the first pressing*, so the free fatty acid content is slightly lower (later checked and validated and having to score under a 0.8% limit for “extra virgin” instead of 2% limit for a mere “virgin”).
*Fun fact: in Arabic, extra virgin is called “البكر الممتاز“, literally “the amazing first-born”, because of this feature!
It’s also slightly higher in mono-unsaturated fatty acids, which is a commensurately slight health improvement.
It’s very slightly lower in saturated fats, which is an especially slight health improvement, as the saturated fats in olive oil are amongst the healthiest saturated fats one can consume.
On which fats are which:
The truth about fats: the good, the bad, and the in-between
And our own previous discussion of saturated fats in particular:
Can Saturated Fats Be Healthy?
Probably the strongest extra health-benefit of extra virgin is that while that first pressing squeezes out oil with the lowest free fatty acid content, it squeezes out oil with the highest polyphenol content, along with other phytonutrients:
If you enjoy olive oil, then springing for extra virgin is worth it if that’s not financially onerous, both for health reasons and taste.
However, if mere “virgin” is what’s available, it’s no big deal to have that instead; it still has a very similar nutritional profile, and most of the same benefits.
Don’t settle for less than “virgin”, though.
While some virgin olive oils aren’t marked as such, if it says “refined” or “blended”, then skip it. These will have been extracted by chemical means and/or blended with completely different oils (e.g. canola, which has a very different nutritional profile), and sometimes with a dash of virgin or extra virgin, for the taste and/or so that they can claim in big writing on the label something like:
a blend of
EXTRA VIRGIN OLIVE OIL
and other oils…despite having only a tiny amount of extra virgin olive oil in it.
Different places have different regulations about what labels can claim.
The main countries that produce olives (and the EU, which contains and/or directly trades with those) have this set of rules:
International Olive Council: Designations and definitions of Olive Oils
…which must be abided by or marketers face heavy fines and sanctions.
In the US, the USDA has its own set of rules based on the above:
USDA | Olive Oil and Olive-Pomace Oil Grades and Standards
…which are voluntary (not protected by law), and marketers can pay to have their goods certified if they want.
So if you’re in the US, look for the USDA certification or it really could be:
- What the USDA calls “US virgin olive oil not fit for human consumption”, which in the IOC is called “lamp oil”*
- crude pomace-oil (oil made from the last bit of olive paste and then chemically treated)
- canola oil with a dash of olive oil
- anything yellow and oily, really
*This technically is virgin olive oil insofar as it was mechanically extracted, but with defects that prevent it from being sold as such, such as having a free fatty acid content above the cut-off, or just a bad taste/smell, or some sort of contamination.
See also: Potential Health Benefits of Olive Oil and Plant Polyphenols
(the above paper has a handy infographic if you scroll down just a little)
Where can I get some?
Your local supermarket, probably, but if you’d like to get some online, here’s an example product on Amazon for your convenience
Enjoy!
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Super Joints – by Pavel Tsatsouline
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For those of us for whom mobility and pain-free movement are top priorities, this book has us covered. So what’s different here, compared to your average stretching book?
It’s about functional strength with the stretches. The author’s background as a special forces soldier means that his interest was not in doing arcane yoga positions so much as being able to change direction quickly without losing speed or balance, get thrown down and get back up without injury, twist suddenly without unpleasantly wrenching anything (of one’s own, at least), and generally be able to take knocks without taking damage.
While we are hopefully not having to deal with such violence in our everyday lives, the robustness of body that results from these exercises is one that certainly can go a long way to keep us injury-free.
The exercises themselves are well-described, clearly and succinctly, with equally clear illustrations.
Note: the paperback version is currently expensive, probably due to supply and demand, but if you select the Kindle version, it’s much cheaper with no loss of quality (because the illustrations are black-on-white line-drawings and very clear; perfect for Kindle e-ink)
The style of the book is very casual and conversational, yet somehow doesn’t let that distract it from being incredibly information dense; there is no fluff here, just valuable guidance.
Bottom line: if you would like to be more robust with non-nonsense exercises, then this book is a fine choice.
Click here to check out Super Joints, and make yours flexible and strong!
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Pasteurization: What It Does And Doesn’t Do
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Pasteurization’s Effect On Risks & Nutrients
In Wednesday’s newsletter, we asked you for your health-related opinions of raw (cow’s) milk, and got the above-depicted, below-described, set of responses:
- About 47% said “raw milk is dangerous to consume, whereas pasteurization makes it safer”
- About 31% said “raw milk is a good source of vital nutrients which pasteurization would destroy”
- About 14% said “both raw milk and pasteurized milk are equally unhealthy”
- About 9% said “both raw milk and pasteurized milk are equally healthy”
Quite polarizing! So, what does the science say?
“Raw milk is dangerous to consume, whereas pasteurization makes it safer: True or False?”
True! Coincidentally, the 47% who voted for this are mirrored by the 47% of the general US population in a similar poll, deciding between the options of whether raw milk is less safe to drink (47%), just as safe to drink (15%), safer to drink (9%), or not sure (30%):
Public Fails to Appreciate Risk of Consuming Raw Milk, Survey Finds
As for what those risks are, by the way, unpasteurized dairy products are estimated to cause 840x more illness and 45x more hospitalizations than pasteurized products.
This is because unpasteurized milk can (and often does) contain E. coli, Listeria, Salmonella, Cryptosporidium, and other such unpleasantries, which pasteurization kills.
Source for both of the above claims:
(we know the title sounds vague, but all this information is easily visible in the abstract, specifically, the first two paragraphs)
Raw milk is a good source of vital nutrients which pasteurization would destroy: True or False?
False! Whether it’s a “good” source can be debated depending on other factors (e.g., if we considered milk’s inflammatory qualities against its positive nutritional content), but it’s undeniably a rich source. However, pasteurization doesn’t destroy or damage those nutrients.
Incidentally, in the same survey we linked up top, 16% of the general US public believed that pasteurization destroys nutrients, while 41% were not sure (and 43% knew that it doesn’t).
Note: for our confidence here, we are skipping over studies published by, for example, dairy farming lobbies and so forth. Those do agree, by the way, but nevertheless we like sources to be as unbiased as possible. The FDA, which is not completely unbiased, has produced a good list of references for this, about half of which we would consider biased, and half unbiased; the clue is generally in the journal names. For example, Food Chemistry and the Journal of Food Science and Journal of Nutrition are probably less biased than the International Dairy Association and the Journal of Dairy Science:
FDA | Raw Milk Misconceptions and the Danger of Raw Milk Consumption
this page covers a lot of other myths too, more than we have room to “bust” here, but it’s very interesting reading and we recommend to check it out!
Notably, we also weren’t able to find any refutation by counterexample on PubMed, with the very slight exception that some studies sometimes found that in the case of milks that were of low quality, pasteurization can reduce the vitamin E content while increasing the vitamin A content. For most milks however, no significant change was found, and in all cases we looked at, B-vitamins were comparable and vitamin D, popularly touted as a benefit of cow’s milk, is actually added later in any case. And, importantly, because this is a common argument, no change in lipid profiles appears to be findable either.
In science, when something has been well-studied and there aren’t clear refutations by counterexample, and the weight of evidence is clearly very much tipped into one camp, that usually means that camp has it right.
Milk generally is good/bad for the health: True or False?
True or False, depending on what we want to look at. It’s definitely not good for inflammation, but the whole it seems to be cancer-neutral and only increases heart disease risk very slightly:
- Keep Inflammation At Bay ← short version is milk is bad, fermented milk products are fine in moderation
- Is Dairy Scary? ← short version is that milk is neither good nor terrible; fermented dairy products however are health-positive in numerous ways when consumed in moderation
You may be wondering…
…how this goes for the safety of dairy products when it comes to the bird flu currently affecting dairy cows, so:
Take care!
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At The Heart Of Women’s Health
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A woman’s heart is a particular thing
For the longest time (and still to a large degree now), “women’s health” is assumed to refer to the health of organs found under a bikini. But there’s a lot more to it than that. We are whole people, with such things as brains and hearts and more.
Today (Valentine’s Day!) we’re focusing on the heart.
A quick recap:
We’ve talked previously about some of these sex differences when it comes to the heart, for example:
Heart Attack: His & Hers (Be Prepared!)
…but that’s fairly common knowledge at least amongst those who are attentive to such things, whereas…
…is much less common knowledge, especially with the ways statins are more likely to make things worse for a lot of women (not all though; see the article for some nuance about that).
We also talked about:
What Menopause Does To The Heart
…which is well worth reading too!
A question:
Why are women twice as likely to die from a heart attack as their age-equivalent male peers? Women develop heart disease later, but die from it sooner. Why is that?
That’s been a question scientists have been asking (and tentatively answering, as scientists do—hypotheses, theories, conclusions even sometimes) for 20 years now. Likely contributing factors include:
- A lack of public knowledge of the different symptoms
- A lack of confidence of bystanders to perform CPR on a woman
- A lack of public knowledge (including amongst prescribers) about the sex-related differences for statins
- A lack of women in cardiology, comparatively.
- A lack of attention to it, simply. Men get heart disease earlier, so it’s thought of as a “man thing”, by health providers as much as by individuals. Men get more regular cardiovascular check-ups, women get a mammogram and go.
Statistically, women are much more likely to die from heart disease than breast cancer:
- Breast cancer kills around 0.02% of us.
- Heart disease kills one in three.
And yet…
❝In a nationwide survey, only 22% of primary care doctors and 42% of cardiologists said they feel extremely well prepared to assess cardiovascular risks in women.
We are lagging in implementing risk prevention guidelines for women.
A lot of women are being told to just watch their cholesterol levels and see their doctor in a year. That’s a year of delayed care.❞
Source: The slowly evolving truth about heart disease and women
(there’s a lot more in that article than we have room for in ours, so do check it out!)
Some good news:
The “bystanders less likely to feel confident performing CPR on a woman” aspect may be helped by the deployment of new automatic external defibrillator, that works from four sides instead of one.
It’s called “double sequential external defibrillation”, and you can learn about it here:
A new emergency procedure for cardiac arrests aims to save more lives—here’s how it works
(it’s in use already in Canada and Aotearoa)
Gentlemen-readers, thank you for your attention to this one even if it was mostly not about you! Maybe someone you love will benefit from being aware of this
On a lighter note…
Since it’s Valentine’s Day, a little more on affairs of the heart…
Is chocolate good for the heart? And is it really an aphrodisiac?
We answered these questions and more in our previous main feature:
Chocolate & Health: Fact or Fiction?
Enjoy!
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