A Surprisingly Powerful Tool: Eye Movement Desensitization & Reprocessing
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Eye Movement Desensitization & Reprocessing (EMDR)
What skeletons are in your closet? As life goes on, most of accumulate bad experiences as well as good ones, to a greater or lesser degree. From clear cases of classic PTSD, to the widely underexamined many-headed beast that is C-PTSD*, our past does affect our present. Is there, then, any chance for our future being different?
*PTSD is typically associated with military veterans, for example, or sexual assault survivors. There was a clear, indisputable, Bad Thing™ that was experienced, and it left a psychological scar. When something happens to remind us of that—say, there are fireworks, or somebody touches us a certain way—it’ll trigger an immediate strong response of some kind.
These days the word “triggered” has been popularly misappropriated to mean any adverse emotional reaction, often to something trivial.
But, not all trauma is so clear. If PTSD refers to the result of that one time you were smashed with a sledgehammer, C-PTSD (Complex PTSD) refers to the result of having been hit with a rolled-up newspaper every few days for fifteen years, say.
This might have been…
- childhood emotional neglect
- a parent with a hair-trigger temper
- bullying at school
- extended financial hardship as a young adult
- “just” being told or shown all too often that your best was never good enough
- the persistent threat (real or imagined) of doom of some kind
- the often-reinforced idea that you might lose everything at any moment
If you’re reading this list and thinking “that’s just life though”, you might be in the estimated 1 in 5 people with (often undiagnosed) C-PTSD.
For more on C-PTSD, see our previous main feature:
So, what does eye movement have to do with this?
Eye Movement Desensitization & Reprocessing (EMDR) is a therapeutic technique whereby a traumatic experience (however small or large; it could be the memory of that one time you said something very regrettable, or it could be some horror we couldn’t describe here) is recalled, and then “detoothed” by doing a bit of neurological jiggery-pokery.
How the neurological jiggery-pokery works:
By engaging the brain in what’s called bilateral stimulation (which can be achieved in various ways, but a common one is moving the eyes rapidly from side to side, hence the name), the event can be re-processed, in much the same way that we do when dreaming, and relegated safely to the past.
This doesn’t mean you’ll forget the event; you’d need to do different exercises for that.
See also our previous main feature:
The Dark Side Of Memory (And How To Make Your Life Better)
That’s not the only aspect of EMDR, though…
EMDR is not just about recalling traumatic events while moving your eyes from side-to-side. What an easy fix that would be! There’s a little more to it.
The process also involves (ideally with the help of a trained professional) examining what other memories, thoughts, feelings, come to mind while doing that. Sometimes, a response we have today associated with, for example, a feeling of helplessness, or rage in conflict, or shame, or anything really, can be connected to previous instances of feeling the same thing. And, each of those events will reinforce—and be reinforced by—the others.
An example of this could be an adult who struggles with substance abuse (perhaps alcohol, say), using it as a crutch to avoid feelings of [insert static here; we don’t know what the feelings are because they’re being avoided], that were first created by, and gradually snowballed from, some adverse reaction to something they did long ago as a child, then reinforced at various times later in life, until finally this adult doesn’t know what to do, but they do know they must hide it at all costs, or suffer the adverse reaction again. Which obviously isn’t a way to actually overcome anything.
EMDR, therefore, seeks to not just “detooth” a singular traumatic memory, but rather, render harmless the whole thread of memories.
Needless to say, this kind of therapy can be quite an emotionally taxing experience, so again, we recommend trying it only under the guidance of a professional.
Is this an evidence-based approach?
Yes! It’s not without its controversy, but that’s how it is in the dog-eat-dog world of academia in general and perhaps psychotherapy in particular. To give a note to some of why it has some controversy, here’s a great freely-available paper that presents “both sides” (it’s more than two sides, really); the premises and claims, the criticisms, and explanations for why the criticisms aren’t necessarily actually problems—all by a wide variety of independent research teams:
Research on Eye Movement Desensitization & Reprocessing (EMDR) as a Treatment for PTSD
To give an idea of the breadth of applications for EMDR, and the evidence of the effectiveness of same, here are a few additional studies/reviews (there are many):
- An Eye Movement Desensitization and Reprocessing (EMDR) Group Intervention for Syrian Refugees With Post-traumatic Stress Symptoms: Results of a Randomized Controlled Trial
- Cognitive Behavioral Therapy vs. Eye Movement Desensitization and Reprocessing for Treating Panic Disorder: A Randomized Controlled Trial
- Eye movement desensitization and reprocessing (EMDR) therapy in the treatment of depression: a matched pairs study in an inpatient setting
- Emergency room intervention to prevent post concussion-like symptoms and post-traumatic stress disorder. A pilot randomized controlled study of a brief eye movement desensitization and reprocessing intervention versus reassurance or usual care
As for what the American Psychiatric Association says about it:
❝After assessing the 120 outcome studies pertaining to the focus areas, we conclude that for two of the areas (i.e., PTSD in children and adolescents and EMDR early interventions research) the strength of the evidence is rated at the highest level, whereas the other areas obtain the second highest level.❞
Source: The current status of EMDR therapy, specific target areas, and goals for the future
Want to learn more?
To learn a lot more than we could include here, check out the APA’s treatment guidelines (they are written in a fashion that is very accessible to a layperson):
APA | Eye Movement Desensitization and Reprocessing (EMDR) Therapy
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Do you have knee pain from osteoarthritis? You might not need surgery. Here’s what to try instead
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Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to updated treatment guidelines from the Australian Commission on Safety and Quality in Health Care.
So what is knee osteoarthritis and what are the best ways to manage it?
More than 2 million Australians have osteoarthritis
Osteoarthritis is the most common joint disease, affecting 2.1 million Australians. It costs the economy A$4.3 billion each year.
Osteoarthritis commonly affects the knees, but can also affect the hips, spine, hands and feet. It impacts the whole joint including bone, cartilage, ligaments and muscles.
Most people with osteoarthritis have persistent pain and find it difficult to perform simple daily tasks, such as walking and climbing stairs.
Is it caused by ‘wear and tear’?
Knee osteoarthritis is most likely to affect older people, those who are overweight or obese, and those with previous knee injuries. But contrary to popular belief, knee osteoarthritis is not caused by “wear and tear”.
Research shows the degree of structural wear and tear visible in the knee joint on an X-ray does not correlate with the level of pain or disability a person experiences. Some people have a low degree of structural wear and tear and very bad symptoms, while others have a high degree of structural wear and tear and minimal symptoms. So X-rays are not required to diagnose knee osteoarthritis or guide treatment decisions.
Telling people they have wear and tear can make them worried about their condition and afraid of damaging their joint. It can also encourage them to try invasive and potentially unnecessary treatments such as surgery. We have shown this in people with osteoarthritis, and other common pain conditions such as back and shoulder pain.
This has led to a global call for a change in the way we think and communicate about osteoarthritis.
What’s the best way to manage osteoarthritis?
Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms. These include education and self-management, exercise and physical activity, weight management and nutrition, and certain pain medicines.
Education is important to dispel misconceptions about knee osteoarthritis. This includes information about what osteoarthritis is, how it is diagnosed, its prognosis, and the most effective ways to self-manage symptoms.
Health professionals who use positive and reassuring language can improve people’s knowledge and beliefs about osteoarthritis and its management.
Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as paracetamol and anti-inflammatories and can prevent or delay the need for joint replacement surgery in the future.
Many types of exercise are effective for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi. So you can do whatever type of exercise best suits you.
Increasing general physical activity is also important, such as taking more steps throughout the day and reducing sedentary time.
Weight management is important for those who are overweight or obese. Weight loss can reduce knee pain and disability, particularly when combined with exercise. Losing as little as 5–10% of your body weight can be beneficial.
Pain medicines should not replace treatments such as exercise and weight management but can be used alongside these treatments to help manage pain. Recommended medicines include paracetamol and non-steroidal anti-inflammatory drugs.
Opioids are not recommended. The risk of harm outweighs any potential benefits.
What about surgery?
People with knee osteoarthritis commonly undergo two types of surgery: knee arthroscopy and knee replacement.
Knee arthroscopy is a type of keyhole surgery used to remove or repair damaged pieces of bone or cartilage that are thought to cause pain.
However, high-quality research has shown arthroscopy is not effective. Arthroscopy should therefore not be used in the management of knee osteoarthritis.
Joint replacement involves replacing the joint surfaces with artificial parts. In 2021–22, 53,500 Australians had a knee replacement for their osteoarthritis.
Joint replacement is often seen as being inevitable and “necessary”. But most people can effectively manage their symptoms through exercise, physical activity and weight management.
The new guidelines (known as “care standard”) recommend joint replacement surgery only be considered for those with severe symptoms who have already tried non-surgical treatments.
I have knee osteoarthritis. What should I do?
The care standard links to free evidence-based resources to support people with osteoarthritis. These include:
- education, such as a decision aid and four-week online course
- self-directed online exercise and yoga programs
- weight management support
- pain management strategies, such as MyJointPain and painTRAINER.
If you have osteoarthritis, you can use the care standard to inform discussions with your health-care provider, and to make informed decisions about your care.
Belinda Lawford, Postdoctoral research fellow in physiotherapy, The University of Melbourne; Giovanni E. Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney; Joshua Zadro, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, University of Sydney, and Rana Hinman, Professor in Physiotherapy, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How To Rebuild Your Neurons’ Myelin Sheaths
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PS: We Love You
Phosphatidylserine, or “PS” for short, is a phospholipid found in the brain. In other words, a kind of fatty compound that is such stuff as our brains are made of.
In particular, it’s required for healthy nerve cell membranes and myelin (the protective sheath that neurons live in—basically, myelin sheaths do for neurons what telomere caps do for DNA).
For an overview that’s more comprehensive than we have room for here, check out:
Phosphatidylserine and the human brain
Many people take it as a supplement.
Does taking it as a supplement work?
This is a valid question, as a lot of supplements can’t be absorbed well, and/or can’t pass the blood-brain barrier. But, as the above-linked study notes:
❝Exogenous PS (300-800 mg/d) is absorbed efficiently in humans, crosses the blood-brain barrier, and safely slows, halts, or reverses biochemical alterations and structural deterioration in nerve cells. It supports human cognitive functions, including the formation of short-term memory, the consolidation of long-term memory, the ability to create new memories, the ability to retrieve memories, the ability to learn and recall information, the ability to focus attention and concentrate, the ability to reason and solve problems, language skills, and the ability to communicate. It also supports locomotor functions, especially rapid reactions and reflexes.❞
(“Exogenous” means “coming from outside of the body”, as opposed to “endogenous”, meaning “made inside the body”. Effectively, in this context “exogenous” means “taken as a supplement”.)
Why do people take it?
The health claims for phosphatidylserine fall into two main categories:
- Neuroprotection (helping your brain to avoid age-related decline in the long term)
- Cognitive enhancement (helping your brain work better in the short term)
What does the science say?
There’s a lot of science that’s been done on the neuroprotective properties of PS, and there are thousands of studies we could draw from here. The upshot is that regular phosphatidylserine supplementation (most often 300mg/day, but studies are also found for 100–500mg/day) is strongly associated with a reduction in cognitive decline over the course of 12 weeks (a common study duration). Here are a some spotlight studies showing this:
- Effects of phosphatidylserine in Alzheimer’s disease
- Double-blind cross-over study of phosphatidylserine vs. placebo in patients with early dementia of the Alzheimer type
- Effect of Phosphatidylserine on Cerebral Glucose Metabolism in Alzheimer’s Disease
- The effect of soybean-derived phosphatidylserine on cognitive performance in elderly with subjective memory complaints
Note: PS can be derived from various sources, with the two most common forms being bovine (i.e., from cow brains) or soy-derived.
There is no established difference in the efficacy of these.
There have been some concerns raised about the risk of CJD (the human form of BSE, as in “mad cow disease”) from consuming brain matter from cows, but studies have not found any evidence of this actually happening.
There is also some evidence that phosphatidyserine significantly boosts cognitive performance, even in young people with no extant cognitive decline, for example:
(as the title suggests, they did also test for its effect on mood and endocrine response, but found it made no difference to those, just the cognitive function—which enjoyed a boost before exercise, as well as after it, meaning that the boost wasn’t dependent on the exercise)
PS for cognitive enhancement in the young and healthy is not nearly so well-explored as its use as a later-life guard against age-related cognitive decline. However, just because the studies in younger people are dwarfed in number by the studies in older people, doesn’t detract from the validity of the studies in younger people.
Basically: its use in older people has been studied the most, but all available evidence points to it being beneficial to brain health at all ages.
Where can we get it?
We don’t sell it (or anything else), but for your convenience, here’s an example product on Amazon.
Enjoy!
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The 5 Love Languages Gone Wrong
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Levelling up the 5 love languages
The saying “happy wife; happy life” certainly goes regardless of gender, and if we’re partnered, it’s difficult to thrive in our individual lives if we’re not thriving as a couple. So, with the usual note that mental health is also just health, let’s take a look at getting beyond the basics of a well-known, often clumsily-applied model:
The 5 love languages
You’re probably familiar with “the 5 love languages”, as developed by Dr. Gary Chapman. If not, they are:
- Acts of Service
- Gift-Giving
- Physical Touch
- Quality Time
- Words of Affirmation
The idea is that we each weight these differently, and problems can arise when a couple are “speaking a different language”.
So, is this a basic compatibility test?
It doesn’t have to be!
We can, if we’re aware of each other’s primary love languages, make an effort to do a thing we wouldn’t necessarily do automatically, to ensure they’re loved the way they need to be.
But…
What a lot of people overlook is that we can also have different primary love languages for giving and for receiving. And, missing that can mean that even taking each other’s primarily love languages into account, efforts to make a partner feel loved, or to feel loved oneself, can miss 50% of the time.
For example, I (your writer here today, hi) could be asked my primary love language and respond without hesitation “Acts of Service!” because that’s my go-to for expressing love.
I’m the person who’ll run around bringing drinks, do all the housework, and without being indelicate, will tend towards giving in the bedroom. But…
A partner trying to act on that information to make me feel loved by giving Acts of Service would be doomed to catastrophic failure, because my knee-jerk reaction would be “No, here, let me do that for you!”
So it’s important for partners to ask each other…
- Not: “what’s your primary love language?” ❌
- But: “what’s your primary way of expressing love?” ✅
- And: “which love language makes you feel most loved?” ✅
For what it’s worth, I thrive on Words of Affirmation, so thanks again to everyone who leaves kind feedback on our articles! It lets me know I provided a good Act of Service
So far, so simple, right? You and your partner (or: other person! Because as we’ve just seen, these go for all kinds of dynamics, not just romantic partnerships) need to be aware of each other’s preferred love languages for giving and receiving.
But…
There’s another pitfall that many fall into, and that’s assuming that the other person has the same idea about what a given love language means, when there’s more to clarify.
For example:
- Acts of Service: is it more important that the service be useful, or that it took effort?
- Gift-Giving: is it better that a gift be more expensive, or more thoughtful and personal?
- Physical Touch: what counts here? If we’re shoulder-to-shoulder on the couch, is that physical touch or is something more active needed?
- Quality Time: does it count if we’re both doing our own thing but together in the same room, comfortable in silence together? Or does it need to be a more active and involved activity together? And is it quality time if we’re at a social event together, or does it need to be just us?
- Words of Affirmation: what, exactly, do we need to hear? For romantic partners, “I love you” can often be important, but is there something else we need to hear? Perhaps a “because…”, or perhaps a “so much that…”, or perhaps something else entirely? Does it no longer count if we have to put the words in our partner’s mouth, or is that just good two-way communication?
Bottom line:
There’s a lot more to this than a “What’s your love language?” click-through quiz, but with a little application and good communication, this model can really resolve a lot of would-be problems that can grow from feeling unappreciated or such. And, the same principles go just the same for friends and others as they do for romantic partners.
In short, it’s one of the keys to good interpersonal relationships in general—something critical for our overall well-being!
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Flax Seeds vs Pumpkin Seeds – Which is Healthier?
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Our Verdict
When comparing flax seeds to pumpkin seeds, we picked the flax.
Why?
Looking at the macros first, they are equal on protein, and flax seeds have a lot more fiber while pumpkin seeds have a lot more carbs. We’re going to prioritise fiber over carbs and call this a win for flax.
In terms of vitamins, flax seeds have a lot more of vitamins B1, B2, B3, B5, B6, B7, B9, C, E, K, and choline, while pumpkin seeds have a tiny bit more vitamin A. An easy win for flax here.
When it comes to minerals, flax has multiples more calcium, copper, iron, magnesium, manganese, phosphorus, and selenium, while pumpkin seeds have more zinc. Another win for flax.
Adding up the sections makes for a clear overall win for flax, but by all means enjoy either or both; diversity is good!
Want to learn more?
You might like to read:
What’s Your Plant Diversity Score? ← seeds count as plants!
Enjoy!
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What is type 1.5 diabetes? It’s a bit like type 1 and a bit like type 2 – but it’s often misdiagnosed
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While you’re likely familiar with type 1 and type 2 diabetes, you’ve probably heard less about type 1.5 diabetes.
Also known as latent autoimmune diabetes in adults (LADA), type 1.5 diabetes has features of both type 1 and type 2 diabetes.
More people became aware of this condition after Lance Bass, best known for his role in the iconic American pop band NSYNC, recently revealed he has it.
So, what is type 1.5 diabetes? And how is it diagnosed and treated?
There are several types of diabetes
Diabetes mellitus is a group of conditions that arise when the levels of glucose (sugar) in our blood are higher than normal. There are actually more than ten types of diabetes, but the most common are type 1 and type 2.
Type 1 diabetes is an autoimmune condition where the body’s immune system attacks and destroys the cells in the pancreas that make the hormone insulin. This leads to very little or no insulin production.
Insulin is important for moving glucose from the blood into our cells to be used for energy, which is why people with type 1 diabetes need insulin medication daily. Type 1 diabetes usually appears in children or young adults.
Type 2 diabetes is not an autoimmune condition. Rather, it happens when the body’s cells become resistant to insulin over time, and the pancreas is no longer able to make enough insulin to overcome this resistance. Unlike type 1 diabetes, people with type 2 diabetes still produce some insulin.
Type 2 is more common in adults but is increasingly seen in children and young people. Management can include behavioural changes such as nutrition and physical activity, as well as oral medications and insulin therapy.
How does type 1.5 diabetes differ from types 1 and 2?
Like type 1 diabetes, type 1.5 occurs when the immune system attacks the pancreas cells that make insulin. But people with type 1.5 often don’t need insulin immediately because their condition develops more slowly. Most people with type 1.5 diabetes will need to use insulin within five years of diagnosis, while those with type 1 typically require it from diagnosis.
Type 1.5 diabetes is usually diagnosed in people over 30, likely due to the slow progressing nature of the condition. This is older than the typical age for type 1 diabetes but younger than the usual diagnosis age for type 2.
Type 1.5 diabetes shares genetic and autoimmune risk factors with type 1 diabetes such as specific gene variants. However, evidence has also shown it may be influenced by lifestyle factors such as obesity and physical inactivity which are more commonly associated with type 2 diabetes.
What are the symptoms, and how is it treated?
The symptoms of type 1.5 diabetes are highly variable between people. Some have no symptoms at all. But generally, people may experience the following symptoms:
- increased thirst
- frequent urination
- fatigue
- blurred vision
- unintentional weight loss.
Typically, type 1.5 diabetes is initially treated with oral medications to keep blood glucose levels in normal range. Depending on their glucose control and the medication they are using, people with type 1.5 diabetes may need to monitor their blood glucose levels regularly throughout the day.
When average blood glucose levels increase beyond normal range even with oral medications, treatment may progress to insulin. However, there are no universally accepted management or treatment strategies for type 1.5 diabetes.
Type 1.5 diabetes is often misdiagnosed
Lance Bass said he was initially diagnosed with type 2 diabetes, but later learned he actually has type 1.5 diabetes. This is not entirely uncommon. Estimates suggest type 1.5 diabetes is misdiagnosed as type 2 diabetes 5–10% of the time.
There are a few possible reasons for this.
First, accurately diagnosing type 1.5 diabetes, and distinguishing it from other types of diabetes, requires special antibody tests (a type of blood test) to detect autoimmune markers. Not all health-care professionals necessarily order these tests routinely, either due to cost concerns or because they may not consider them.
Second, type 1.5 diabetes is commonly found in adults, so doctors might wrongly assume a person has developed type 2 diabetes, which is more common in this age group (whereas type 1 diabetes usually affects children and young adults).
Third, people with type 1.5 diabetes often initially make enough insulin in the body to manage their blood glucose levels without needing to start insulin medication. This can make their condition appear like type 2 diabetes, where people also produce some insulin.
Finally, because type 1.5 diabetes has symptoms that are similar to type 2 diabetes, it may initially be treated as type 2.
We’re still learning about type 1.5
Compared with type 1 and type 2 diabetes, there has been much less research on how common type 1.5 diabetes is, especially in non-European populations. In 2023, it was estimated type 1.5 diabetes represented 8.9% of all diabetes cases, which is similar to type 1. However, we need more research to get accurate numbers.
Overall, there has been a limited awareness of type 1.5 diabetes and unclear diagnostic criteria which have slowed down our understanding of this condition.
A misdiagnosis can be stressful and confusing. For people with type 1.5 diabetes, being misdiagnosed with type 2 diabetes might mean they don’t get the insulin they need in a timely manner. This can lead to worsening health and a greater likelihood of complications down the road.
Getting the right diagnosis helps people receive the most appropriate treatment, save money, and reduce diabetes distress. If you’re experiencing symptoms you think may indicate diabetes, or feel unsure about a diagnosis you’ve already received, monitor your symptoms and chat with your doctor.
Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University and Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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An Apple (Cider Vinegar) A Day…
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An Apple (Cider Vinegar) A Day…
You’ve probably heard of people drinking apple cider vinegar for its health benefits. It’s not very intuitive, so today we’re going to see what the science has to say…
Apple cider vinegar for managing blood sugars
Whether diabetic, prediabetic, or not at all, blood sugar spikes aren’t good for us, so anything that evens that out is worth checking out. As for apple cider vinegar…
Diabetes Control: Is Vinegar a Promising Candidate to Help Achieve Targets?
…the answer found by this study was “yes”, but their study was small, and they concluded that more research would be worthwhile. So…
…was also a small study, with the same (positive) results.
But! We then found a much larger systematic review was conducted, examining 744 previously-published papers, adding in another 14 they found via those. After removing 47 duplicates, and removing another 15 for not having a clinical trial or not having an adequate control, they concluded:
❝In this systematic review and meta-analyses, the effect of vinegar consumption on postprandial glucose and insulin responses were evaluated through pooled analysis of glucose and insulin AUC in clinical trials. Vinegar consumption was associated with a statistically significant reduction in postprandial glucose and insulin responses in both healthy participants and participants with glucose disorder.❞
~ Sishehbor, Mansoori, & Shirani
Check it out:
Apple cider vinegar for weight loss?
Yep! It appears to be an appetite suppressant, probably moderating ghrelin and leptin levels.
But…
As a bonus, it also lowers triglycerides and total cholesterol, while raising HDL (good cholesterol), and that’s in addition to doubling the weight loss compared to control:
How much to take?
Most of these studies were done with 1–2 tbsp of apple cider vinegar in a glass of water, at mealtime.
Obviously, if you want to enjoy the appetite-suppressant effects, take it before the meal! If you forget and/or choose to take it after though, it’ll still help keep your blood sugars even and still give you the cholesterol-moderating benefits.
Where to get it?
Your local supermarket will surely have it. Or if you buy it online, you can even get it in capsule form!
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