Fat’s Real Barriers To Health
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Fat Justice In Healthcare
This is Aubrey Gordon, an author, podcaster, and fat justice activist. What does that mean?
When it comes to healthcare, we previously covered some ideas very similar to her work, such as how…
There’s a lot of discrimination in healthcare settings
In this case, it often happens that a thin person goes in with a medical problem and gets treated for that, while a fat person can go in with the same medical problem and be told “you should try losing some weight”.
Top tip if this happens to you… Ask: “what would you advise/prescribe to a thin person with my same symptoms?”
Other things may be more systemic, for example:
When a thin person goes to get their blood pressure taken, and that goes smoothly, while a fat person goes to get their blood pressure taken, and there’s not a blood pressure cuff to fit them, is the problem the size of the person or the size of the cuff? It all depends on perspective, in a world built around thin people.
That’s a trivial-seeming example, but the same principle has far-reaching (and harmful) implications in healthcare in general, e.g:
- Surgeons being untrained (and/or unwilling) to operate on fat people
- Getting a one-size-fits-all dose that was calculated using average weight, and now doesn’t work
- MRI machines are famously claustrophobia-inducing for thin people; now try not fitting in it in the first place
…and so forth. So oftentimes, obesity will be correlated with a poor healthcare outcome, where the problem is not actually the obesity itself, but rather the system having been set up with thin people in mind.
It would be like saying “Having O- blood type results in higher risks when receiving blood transfusions”, while omitting to add “…because we didn’t stock O- blood”.
Read more on this topic: Shedding Some Obesity Myths
Does she have practical advice about this?
If she could have you understand one thing, it would be:
You deserve better.
Or if you are not fat: your fat friends deserve better.
How this becomes useful is: do not accept being treated as the problem!
Demand better!
If you meekly accept that you “just need to lose weight” and that thus you are the problem, you take away any responsibility from your healthcare provider(s) to actually do their jobs and provide healthcare.
See also Gordon’s book, which we’ve not reviewed yet but probably will one of these days:
“You Just Need to Lose Weight”: And 19 Other Myths About Fat People – by Aubrey Gordon
Are you saying fat people don’t need to lose weight?
That’s a little like asking “would you say office workers don’t need to exercise more?”; there are implicit assumptions built into the question that are going unaddressed.
Rather: some people might benefit healthwise from losing weight, some might not.
In fact, over the age of 65, being what is nominally considered “overweight” reduces all-cause mortality risk.
For details of that and more, see: When BMI Doesn’t Measure Up
But what if I do want/need to lose weight?
Gordon’s not interested in helping with that, but we at 10almonds are, so…
Check out: Lose Weight, But Healthily
Where can I find more from Aubrey Gordon?
You might enjoy her blog:
Aubrey Gordon | Your Fat Friend
Or her other book, which we reviewed previously:
What We Don’t Talk About When We Talk About Fat – by Aubrey Gordon
Enjoy!
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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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A Cold Shower A Day Keeps The Doctor Away?
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A Cold Shower A Day Keeps The Doctor Away?
This is Dutch extreme athlete Wim Hof, also known as “The Iceman”! He’s broken many world records mostly relating to the enduring the cold, for example:
- climbing Mount Kilimanjaro in shorts
- running a half-marathon above the Arctic Circle barefoot
- standing in a container completely covered with ice cubes for more than 112 minutes
You might not want to do yoga in your pyjamas on an iceberg, but you might like…
- better circulatory health
- reduced risk of stroke
- a boosted immune system
- healthier skin
- more energy and alertness
…and things like that. Wim Hof’s method is not just about extreme athletic achievements; most of what he does, the stuff that can benefit the rest of us, is much more prosaic.
The Wim Hof Method
For Wim Hof, three things are key:
- Breathing (See: Wim Hof Method Breathing Exercises)
- Commitment (See: How to Increase Willpower)
- Cold therapy (See: Benefits of Cold Therapy)
Today, we’re going to be focusing on the last one there.
What are the benefits of Cold Therapy?
Once upon a time, we didn’t have central heating, electric blankets, thermal underwear, and hot showers. In fact, once upon a time, we didn’t have houses or clothes. We used to be a lot more used to the elements! And while it’s all well and good to enjoy modern comforts, it has left our bodies lacking practice.
Practice at what? Most notably: vasodilation and vasoconstriction, in response to temperature changes. Either:
- vasodilation, because part of our body needs more blood to keep it warm and nourished, or
- vasoconstriction, because part of our body needs less blood running through it to get cooled down.
Switching between the two gives the blood vessels practice at doing it, and improves vascular muscle tone. If your body doesn’t get that practice, your blood vessels will be sluggish at making the change. This can cause circulation problems, which in turn have a big impact in many other areas of health, including:
- cardiovascular disease
- stroke risk
- mood instability
- nerve damage in extremities
On the flipside, if the blood vessels do get regular practice at dilating and constricting, you might enjoy lower risk of those things, and instead:
- improved immune response
- healthier skin
- better quality sleep
- more energy and alertness
- improved sexual performance/responsiveness
So, how to get that, without getting extreme?
As today’s title suggests, “a cold shower a day” is a great practice.
You don’t have to jump straight in, especially if you think your circulation and vascular responses might be a bit sluggish in the first instance. In fact, Wim Hof recommends:
- Week 1: Thirty seconds of cold water at the end of a warm shower each morning
- Week 2: One minute of cold water at the end of a warm shower each morning
- Week 3: A minute and a half of cold water at the end of a warm shower each morning
- Week 4: Two minutes of cold water at the end of a warm shower each morning
How cold is cold?
The benefits of cold exposure begin at around 16ºC / 60ºF, so in most places, water from the cold water mains is sufficiently cold.
As your body becomes more used to making the quick-change on a vascular level, the cold water will seem less shocking to your system. In other words, on day 30 it won’t hit you like it did on day one.
At that point, you can either continue with your two-minutes daily cold shower, and reap the benefits, or if you’re curious to push it further, that’s where ice baths come in!
Can anyone do it, or are any conditions contraindicated?
As ever, we’re a health and productivity newsletter, not doctors, let alone your doctors. Nothing here is medical advice. However, Wim Hof himself says:
❝Listen to your body, and never force the practices. We advise against doing Wim Hof Method if you are dealing with any of the following:
- Epilepsy
- High blood pressure
- Coronary heart disease
- A history of serious healthy issues like heart failure or stroke
- Pregnancy*
- Childhood*❞
*There is simply not enough science regarding the effects of cold exposure on people who are pregnant, or children. Obviously, we don’t expect this to be remedied anytime soon, because the study insitutions’ ethics boards would (rightly!) hold up the study.
As for the other conditions, and just generally if unsure, consult a doctor.
As you can see, this does mean that a limitation of Cold Therapy is that it appears to be far better as a preventative, since it helps guard against the very conditions that could otherwise become contraindications.
We haven’t peppered today’s main feature with study papers, partly because Wim Hof’s own website has kindly collated a collection of them (with links and summaries!) onto one page:
Further reading: The Science Behind The Wim Hof Method
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Natto, Taurine + Black Pepper, And Other Game-Changers
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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
❝Loved the info on nuts; of course I always eat pecans, which didn’t make the list of healthy nuts!❞
Dear subscriber, pardon the paraphrase of your comment—somehow it got deleted and now exists only in this writer’s memory. However, to address it:
Pecans are great too! We can’t include everything in every article (indeed, we got another feedback the same day saying the article was too long), but we love when you come to us with stuff for us to look at and write about (seriously, writer here: the more you ask, the easier it makes my job), so let’s talk pecans for a moment:
Pecans would have been number six on our list if we’d have written more!
Like many nuts, they’ve an abundance of healthy fats, fiber, vitamins, and minerals.
They’re particularly good for zinc, which is vital for immune function, healing (including normal recovery after normal exercise), and DNA synthesis (so: anti-aging).
Pecans are also great for reducing LDL (“bad” cholesterol) and triglycerides (which are also bad for heart health); check it out:
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Hearty Healthy Ukrainian Borscht
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In the West, borscht is often thought of as Russian, but it is Ukrainian in origin and popular throughout much of Eastern Europe, with many local variations. Today’s borscht is a vegetarian (and vegan, depending on your choice of cooking fat) borscht from Kyiv, and it’s especially good for the gut, heart, and blood sugars.
You will need
- 1 quart vegetable stock; ideally you made this yourself from vegetable offcuts you kept in the freezer, but failing that, your supermarket should have low-sodium stock cubes
- 4 large beets, peeled and cut into matchsticks
- 1 can white beans (cannellini beans are ideal), drained and rinsed
- 1 cup sauerkraut
- 1 large onion, finely chopped
- 1 green bell pepper, roughly chopped
- 1 large russet potato, peeled and cut into large chunks
- 3 small carrots, tops removed and cut into large chunks
- 1 tbsp tomato paste
- ½ bulb garlic, finely chopped
- 2 tsp black pepper, coarse ground
- 1 bunch fresh dill, chopped. If you cannot get fresh, substitute with parsley (1 bunch fresh, chopped, or 1 tbsp dried). Do not use dried dill; it won’t work.
- A little fat for cooking; this one’s a tricky and personal decision. Butter is traditional, but would make this recipe impossible to cook without going over the recommended limit for saturated fat. Avocado oil is healthy, relatively neutral in taste, and has a high smoke point, though that latter shouldn’t be necessary here if you are attentive with the stirring. Extra virgin olive oil is also a healthy choice, but not as neutral in flavor and does have a lower smoke point. Coconut oil has arguably too strong a taste and a low smoke point. Seed oils are very heart-unhealthy. All in all, avocado oil is a respectable choice from all angles except tradition.
- On standby: a little vinegar (your preference what kind)
Salt is conspicuous by its absence, but there should be enough already from the other ingredients, especially the sauerkraut.
Method
(we suggest you read everything at least once before doing anything)
1) Heat some oil in a large sauté pan (cast iron is perfect if you have it), add the onion and pepper, and stir until the onion is becoming soft.
2) Add the carrots and beets and stir until they are becoming soft. If you need to add a little more oil, that’s fine.
3) Add the tomato paste, and stir in well.
4) Add a little (about ½ cup) of the vegetable stock and stir in well until you get a consistent texture with the tomato paste.
5) Add the sauerkraut and the rest of the broth, and cook for about 20 minutes.
6) Add the potatoes and cook for another 10 minutes.
7) Add the beans and cook for another 5 minutes.
8) Add the garlic, black pepper, and herbs. Check that everything is cooked (poke a chunk of potato with a fork) and that the seasoning is to your liking. The taste should be moderately sour from the sauerkraut; if it is sweet, you can stir in a little vinegar now to correct that.
9) Serve! Ukrainian borscht is most often served hot (unlike Lithuanian borscht, which is almost always served cold), but if the weather’s warm, it can certainly be enjoyed cold too:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Making Friends With Your Gut (You Can Thank Us Later)
- Eat More (Of This) For Lower Blood Pressure
- No, Beetroot Isn’t Vegetable Viagra. But Here’s What It Can Do
- The Many Health Benefits Of Garlic
- Black Pepper’s Impressive Anti-Cancer Arsenal
Take care!
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What’s the difference between physical and chemical sunscreens? And which one should you choose?
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Sun exposure can accelerate ageing, cause skin burns, erythema (a skin reaction), skin cancer, melasmas (or sun spots) and other forms of hyperpigmentation – all triggered by solar ultraviolet radiation.
Approximately 80% of skin cancer cases in people engaged in outdoor activities are preventable by decreasing sun exposure. This can be done in lots of ways including wearing protective clothing or sunscreens.
But not all sunscreens work in the same way. You might have heard of “physical” and “chemical” sunscreens. What’s the difference and which one is right for you?
How sunscreens are classified
Sunscreens are grouped by their use of active inorganic and organic ultraviolet (UV) filters. Chemical sunscreens use organic filters such as cinnamates (chemically related to cinnamon oil) and benzophenones. Physical sunscreens (sometimes called mineral sunscreens) use inorganic filters such as titanium and zinc oxide.
These filters prevent the effects of UV radiation on the skin.
Organic UV filters are known as chemical filters because the molecules in them change to stop UV radiation reaching the skin. Inorganic UV filters are known as physical filters, because they work through physical means, such as blocking, scattering and reflection of UV radiation to prevent skin damage.
Nano versus micro
The effectiveness of the filters in physical sunscreen depends on factors including the size of the particle, how it’s mixed into the cream or lotion, the amount used and the refraction index (the speed light travels through a substance) of each filter.
When the particle size in physical sunscreens is large, it causes the light to be scattered and reflected more. That means physical sunscreens can be more obvious on the skin, which can reduce their cosmetic appeal.
Nanoparticulate forms of physical sunscreens (with tiny particles smaller than 100 nanometers) can improve the cosmetic appearance of creams on the skin and UV protection, because the particles in this size range absorb more radiation than they reflect. These are sometimes labelled as “invisible” zinc or mineral formulations and are considered safe.
So how do chemical sunscreens work?
Chemical UV filters work by absorbing high-energy UV rays. This leads to the filter molecules interacting with sunlight and changing chemically.
When molecules return to their ground (or lower energy) state, they release energy as heat, distributed all over the skin. This may lead to uncomfortable reactions for people with skin sensitivity.
Generally, UV filters are meant to stay on the epidermis (the first skin layer) surface to protect it from UV radiation. When they enter into the dermis (the connective tissue layer) and bloodstream, this can lead to skin sensitivity and increase the risk of toxicity. The safety profile of chemical UV filters may depend on whether their small molecular size allows them to penetrate the skin.
Chemical sunscreens, compared to physical ones, cause more adverse reactions in the skin because of chemical changes in their molecules. In addition, some chemical filters, such as dibenzoylmethane tend to break down after UV exposure. These degraded products can no longer protect the skin against UV and, if they penetrate the skin, can cause cell damage.
Due to their stability – that is, how well they retain product integrity and effectiveness when exposed to sunlight – physical sunscreens may be more suitable for children and people with skin allergies.
Although sunscreen filter ingredients can rarely cause true allergic dermatitis, patients with photodermatoses (where the skin reacts to light) and eczema have higher risk and should take care and seek advice.
What to look for
The best way to check if you’ll have a reaction to a physical or chemical sunscreen is to patch test it on a small area of skin.
And the best sunscreen to choose is one that provides broad-spectrum protection, is water and sweat-resistant, has a high sun protection factor (SPF), is easy to apply and has a low allergy risk.
Health authorities recommend sunscreen to prevent sun damage and cancer. Chemical sunscreens have the potential to penetrate the skin and may cause irritation for some people. Physical sunscreens are considered safe and effective and nanoparticulate formulations can increase their appeal and ease of use.
Yousuf Mohammed, Dermatology researcher, The University of Queensland and Khanh Phan, Postdoctoral research associate, Frazer Institute, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Getting to Neutral – by Trevor Moawad
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We all know that a pessimistic outlook is self-defeating… And yet, toxic positivity can also be a set-up for failure! At some point, reckless faith in the kindly nature of the universe will get crushed, badly. Sometimes that point is a low point in life… sometimes it’s six times a day. But one thing’s for sure: we can’t “just decide everything will go great!” because the world just doesn’t work that way.
That’s where Trevor Moawad comes in. “Getting to neutral” is not a popular selling point. Everyone wants joy, abundance, and high after high. And neutrality itself is often associated with boredom and soullessness. But, Moawad argues, it doesn’t have to be that way.
This book’s goal—which it accomplishes well—is to provide a framework for being a genuine realist. What does that mean?
“I’m not a pessimist; I’m a realist” – every pessimist ever.
^Not that. That’s not what it means. What it means instead is:
- Hope for the best
- Prepare for the worst
- Adapt as you go
…taking care to use past experiences to inform future decisions, but without falling into the trap of thinking that because something happened a certain way before, it always will in the future.
To be rational, in short. Consciously and actively rational.
Feel the highs! Feel the lows! But keep your baseline when actually making decisions.
Bottom line: this book is as much an antidote to pessimism and self-defeat, as it is to reckless optimism and resultant fragility. Highly recommendable.
Click here to check out “Getting to Neutral” and start creating your best, most reason-based life!
PS: in this book, Moawad draws heavily from his own experiences of battling adversity in the form of cancer—of which he died, before this book’s publication. A poignant reminder that he was right: we won’t always get the most positive outcome of any given situation, so what matters the most is making the best use of the time we have.
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