Feel-Good Productivity – by Dr. Ali Abdaal

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“Rise and grind” is not a sustainable way to live. Yet for most of us, there are things we do have to do every day that we don’t necessarily do for fun. So, how to be productive with those things, and not feel like we are constantly compromising and sacrificing our time on this earth for some intrinsically trivial but extrinsically required activity that’ll be forgotten tomorrow?

And most of us do also have dreams and ambitions (and if you don’t, then what were they before life snatched them away from you?), things to work towards. So there is “carrot” for us as well as “stick”. But how to break the cycle and get more carrot and less stick, while being more productive than before?

Dr. Abdaal frames this principally in terms of neurology first, psychology next.

That when we are bored, we simply do not have the neurochemicals required to work well anyway, so addressing that first needs to be a priority. He lays out many ways of doing this, gives lots of practical tips, and brings attention to the ways it’s easy to go wrong (and how to fix those too).

The writing style isdeceptively relaxed and casual, leading the reader smoothly into understanding of each topic before moving on.

Bottom line: if you want to get more done while feeling better about it (not a tired wreck), then this is the book for you!

Click here to check out Feel-Good Productivity, and thrive!

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  • Pine Nuts vs Pecans – Which is Healthier?

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    Our Verdict

    When comparing pine nuts to pecans, we picked the pine nuts.

    Why?

    Both have their merits!

    In terms of macros, pine nuts have more protein while pecans have more fiber. They’re about equal on fats, although pine nuts have more polyunsaturated fat and pecans have more monounsaturated fat, of which, both are healthy. They’re also about equal on carbs. So really it comes down to the subjective choice between prioritizing protein and prioritizing fiber. On principle, we pick fiber, which gives the win to pecans, but your preference in this regard may differ; prioritizing the protein would give the win to pine nuts.

    In the category of vitamins, pine nuts have more of vitamins B2, B3, B9, E, K, and choline, while pecans have more of vitamins A, B1, B5, B6, and C. Thus, a 6:5 marginal win for pine nuts.

    Looking at the minerals, pine nuts have more copper, iron, magnesium, manganese, phosphorus, potassium, and zinc, while pecans have more calcium and selenium. An easy win for pine nuts this time.

    Adding up the sections makes for a win for pine nuts, but of course, enjoy either or (preferably) both; diversity is good!

    Want to learn more?

    You might like to read:

    Why You Should Diversify Your Nuts

    Enjoy!

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  • 3 signs your diet is causing too much muscle loss – and what to do about it

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    When trying to lose weight, it’s natural to want to see quick results. So when the number on the scales drops rapidly, it seems like we’re on the right track.

    But as with many things related to weight loss, there’s a flip side: rapid weight loss can result in a significant loss of muscle mass, as well as fat.

    So how you can tell if you’re losing too much muscle and what can you do to prevent it?

    EvMedvedeva/Shutterstock

    Why does muscle mass matter?

    Muscle is an important factor in determining our metabolic rate: how much energy we burn at rest. This is determined by how much muscle and fat we have. Muscle is more metabolically active than fat, meaning it burns more calories.

    When we diet to lose weight, we create a calorie deficit, where our bodies don’t get enough energy from the food we eat to meet our energy needs. Our bodies start breaking down our fat and muscle tissue for fuel.

    A decrease in calorie-burning muscle mass slows our metabolism. This quickly slows the rate at which we lose weight and impacts our ability to maintain our weight long term.

    How to tell you’re losing too much muscle

    Unfortunately, measuring changes in muscle mass is not easy.

    The most accurate tool is an enhanced form of X-ray called a dual-energy X-ray absorptiometry (DXA) scan. The scan is primarily used in medicine and research to capture data on weight, body fat, muscle mass and bone density.

    But while DEXA is becoming more readily available at weight-loss clinics and gyms, it’s not cheap.

    There are also many “smart” scales available for at home use that promise to provide an accurate reading of muscle mass percentage.

    Woman stands on scales
    Some scales promise to tell us our muscle mass. Lee Charlie/Shutterstock

    However, the accuracy of these scales is questionable. Researchers found the scales tested massively over- or under-estimated fat and muscle mass.

    Fortunately, there are three free but scientifically backed signs you may be losing too much muscle mass when you’re dieting.

    1. You’re losing much more weight than expected each week

    Losing a lot of weight rapidly is one of the early signs that your diet is too extreme and you’re losing too much muscle.

    Rapid weight loss (of more than 1 kilogram per week) results in greater muscle mass loss than slow weight loss.

    Slow weight loss better preserves muscle mass and often has the added benefit of greater fat mass loss.

    One study compared people in the obese weight category who followed either a very low-calorie diet (500 calories per day) for five weeks or a low-calorie diet (1,250 calories per day) for 12 weeks. While both groups lost similar amounts of weight, participants following the very low-calorie diet (500 calories per day) for five weeks lost significantly more muscle mass.

    2. You’re feeling tired and things feel more difficult

    It sounds obvious, but feeling tired, sluggish and finding it hard to complete physical activities, such as working out or doing jobs around the house, is another strong signal you’re losing muscle.

    Research shows a decrease in muscle mass may negatively impact your body’s physical performance.

    3. You’re feeling moody

    Mood swings and feeling anxious, stressed or depressed may also be signs you’re losing muscle mass.

    Research on muscle loss due to ageing suggests low levels of muscle mass can negatively impact mental health and mood. This seems to stem from the relationship between low muscle mass and proteins called neurotrophins, which help regulate mood and feelings of wellbeing.

    So how you can do to maintain muscle during weight loss?

    Fortunately, there are also three actions you can take to maintain muscle mass when you’re following a calorie-restricted diet to lose weight.

    1. Incorporate strength training into your exercise plan

    While a broad exercise program is important to support overall weight loss, strength-building exercises are a surefire way to help prevent the loss of muscle mass. A meta-analysis of studies of older people with obesity found resistance training was able to prevent almost 100% of muscle loss from calorie restriction.

    Relying on diet alone to lose weight will reduce muscle along with body fat, slowing your metabolism. So it’s essential to make sure you’ve incorporated sufficient and appropriate exercise into your weight-loss plan to hold onto your muscle mass stores.

    Woman uses weights at the gym
    Strength-building exercises help you retain muscle. BearFotos/Shutterstock

    But you don’t need to hit the gym. Exercises using body weight – such as push-ups, pull-ups, planks and air squats – are just as effective as lifting weights and using strength-building equipment.

    Encouragingly, moderate-volume resistance training (three sets of ten repetitions for eight exercises) can be as effective as high-volume training (five sets of ten repetitions for eight exercises) for maintaining muscle when you’re following a calorie-restricted diet.

    2. Eat more protein

    Foods high in protein play an essential role in building and maintaining muscle mass, but research also shows these foods help prevent muscle loss when you’re following a calorie-restricted diet.

    But this doesn’t mean just eating foods with protein. Meals need to be balanced and include a source of protein, wholegrain carb and healthy fat to meet our dietary needs. For example, eggs on wholegrain toast with avocado.

    3. Slow your weight loss plan down

    When we change our diet to lose weight, we take our body out of its comfort zone and trigger its survival response. It then counteracts weight loss, triggering several physiological responses to defend our body weight and “survive” starvation.

    Our body’s survival mechanisms want us to regain lost weight to ensure we survive the next period of famine (dieting). Research shows that more than half of the weight lost by participants is regained within two years, and more than 80% of lost weight is regained within five years.

    However, a slow and steady, stepped approach to weight loss, prevents our bodies from activating defence mechanisms to defend our weight when we try to lose weight.

    Ultimately, losing weight long-term comes down to making gradual changes to your lifestyle to ensure you form habits that last a lifetime.

    At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can register here to express your interest.

    Nick Fuller, Charles Perkins Centre Research Program Leader, University of Sydney

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

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  • Walk Like You’re 20 Years Younger Again

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    How fit, healthy, strong, and mobile were you 20 years ago? For most people, the answer is “better than now”. Physiotherapist Dr. Doug Weiss has advice on turning back the clock:

    The exercises

    If you already have no problems walking, this one is probably not for you. However, if you’re not so able to comfortably walk as you used to be, then Dr. Weiss recommends:

    • Pillow squat: putting pillow on a chair, crossing hands on chest, standing up and sitting down. Similar to the very important “getting up off the floor without using your hands” exercise, but easier.
    • Wall leaning: standing against a wall with heels 4″ away from it, crossing arms over chest again, and pulling the body off the wall using the muscles in the front of the shin. Note, this means not cheating by using other muscles, leveraging the upper body, pushing off with the buttocks, or anything else like that.
    • Stepping forward: well, this certainly is making good on the promise of walking like we did 20 years ago; there sure was a lot of stepping forward involved. More seriously, this is actually about stepping over some object, first with support, and then without.
    • Heel raise: is what it sounds like, raising up on toes and back down again; first with support, then without.
    • Side stepping: step sideways 2–3 steps in each direction. First with support, then without. Bonus: if your support is your partner, then congratulations, you are now dancing bachata.

    For more details (and visual demonstration) of these exercises and more, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like:

    4 Tips To Stand Without Using Hands

    Take care!

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  • How does the drug abemaciclib treat breast cancer?

    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.

    The anti-cancer drug abemaciclib (also known as Vernezio) has this month been added to the Australian Pharmaceutical Benefits Scheme (PBS) to treat certain types of breast cancer.

    This significantly reduces the cost of the drug. A patient can now expect to pay A$31.60 for a 28-day supply ($7.70 with a health care concession card). The price of abemaciclib without government subsidy is $4,250.

    So what is abemaciclib, and how did we get to this point?

    It stops cells dividing

    Researchers at the pharmaceutical company Eli Lilly developed abemaciclib and published the first study on the drug (then known as LY2835219) in 2014.

    Abemaciclib is a type of drug known as a “cyclin-dependent kinase inhibitor”. It’s taken as a pill twice a day.

    To maintain our health, many of the cells in our bodies need to grow and divide to produce new cells. Cancers develop when cells grow and divide out of control. Therefore, stopping cells from dividing into new cells is one way that cancer can be fought.

    When cells divide, they have to make a copy of their DNA to pass onto the new cell. “Cyclin-dependent kinases” (CDKs for short) are essential for this process. So, if you stop the CDKs, you stop the DNA copying, you stop cells dividing, and you fight the cancer.

    However, there are different types of CDKs, and not all cancers need them all to grow. Abemaciclib specifically targets CDK4 and CDK6. Thankfully, a lot of cancers do need these CDKs, including some breast cancers.

    Woman checks her breast
    The drug targets CDK4 and CDK6. Photoroyalty/Shutterstock

    But abemaciclib will only be effective against cancers that rely on CDK4 and CDK6 for continued growth. This specificity also means abemaciclib is fairly unique, so it can’t easily be replaced with a different drug.

    Two other CDK4/6 inhibitors were developed around the same time as abemaciclib, and are called ribociclib and palbociclib. Both of these drugs are also on the PBS for specific types of breast cancer. As the drugs differ in their chemical structures, they have slight differences in the way they are taken up and processed by the body. The preferred drug given to a breast cancer patient will depend on their unique circumstances.

    What are the side effects?

    Research is still ongoing into the differences between each of these CDK4/6 inhibitors, but it is known that the side effects are largely similar, but can differ in severity.

    The most common side effects of abemaciclib are fatigue, diarrhoea and neutropenia (reduced white blood cells). The gastrointestinal issues are generally more severe with abemaciclib.

    If these side effects are too severe, abemaciclib treatment can be stopped.

    What types of cancer has abemaciclib been approved for?

    In 2017, the United States Food and Drug Administration (FDA) approved abemaciclib for the treatment of patients with metastatic HR+/HER2- (hormone receptor-positive and human epidermal growth factor receptor 2-negative) breast cancer who did not respond to standard endocrine therapy.

    Australia’s Therapeutic Goods Administration (TGA) similarly approved abemaciclib in 2022 as an “adjuvant” therapy (after the initial surgery to remove the tumour) for patients with HR+/HER2- invasive early breast cancer which had spread to lymph nodes and was at high risk of returning.

    Doctor looks at laptop
    The drug is approved for people with early breast cancer which is at high risk of returning. PeopleImages.com – Yuri A/Shutterstock

    As of May 1 2024, the PBS covers this use of abemaciclib in combination with endocrine therapy such as fulvestrant, which is also listed on the PBS. Endocrine therapy, also known as hormonal therapy, blocks hormone receptor positive (HR+) cancers from receiving the hormones they need to survive.

    Could abemaciclib be used for other cancers in the future?

    Abemaciclib is of great interest to scientists and medical practitioners, and testing is ongoing to assess the effectiveness of abemaciclib in treating a range of other cancers, including gastrointestinal cancers and blood cancers.

    Abemaciclib may even be usable in brain cancers, as it has long been known to be capable of crossing the blood-brain barrier, a common stumbling block for potential anti-cancer drugs.

    Time will tell whether the role of abemaciclib in health care will be expanded. But for now, its inclusion on the PBS is sure to bring some relief to breast cancer patients nationwide.

    Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute and John (Eddie) La Marca, Senior Resarch Officer, Walter and Eliza Hall Institute

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

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  • Fast Burn – by Dr. Ian K. Smith

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    Intermittent fasting seems simple enough: how complicated can “stop eating for a bit” be? Well, there are nuances and tweaks and hacks and “if you do this bit wrong it will sabotage your benefits” things to know about, too.

    Dr. Smith takes us through the basic essentials first, and covers each of the main kinds of intermittent fasting, for example:

    • Time-restricted eating; 12:12, 16:8, etc, with those being hours fasting vs hours eating
    • Caloric restriction models; for example 5:2, where one eats “normally” for 5 days a week, and on two non-consecutive days, eats only 500 calories
    • Day off models and more; for example, “no eating on Sundays” that can, depending on your schedule, be anything from a 24-hour fast to 36 hours or more.

    …and, most notably, what they each do metabolically.

    Then, the real meat of the book is his program. Taking into account the benefits of each form of fasting, he weaves together a 9-week program to first ease us gently into intermittent fasting, and then enjoy the maximum benefits with minimum self-sabotage.

    Which is the biggest stumbling-block for many trying intermittent fasting for the first time, so it’s a huge help that he takes care of this here.

    He also includes meal plans and recipes; readers can use those or not; the fasting plan stands on its own two feet without them too.

    Bottom line: if you’ve been thinking of trying intermittent fasting but have been put off by all the kinds or have had trouble sticking to it, this book may be just what you need.

    Click here to check out Fast Burn on Amazon and see what you can achieve!

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  • Palliative care as a true art form

    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.

    How do you ease the pain from an ailment amidst lost words? How can you serve the afflicted when lines start to blur? When the foundation of communication begins to crumble, what will be the pillar health-care professionals can lean on to support patients afflicted with dementia during their final days?

    The practice of medicine is both highly analytical and evidence based in nature. However, it is considered a “practice” because at the highest level, it resembles a musician navigating an instrument. It resembles art. Between lab values, imaging techniques and treatment options, the nuances for individualized patient care so often become threatened.

    Dementia, a non-malignant terminal illness, involves the progressive cognitive and social decline in those afflicted. Though there is no cure, dementia is commonly met in the setting of end-of-life care. During this final stage of life, the importance of comfort via symptomatic management and communication usually is a priority in patient care. But what about the care of a patient suffering from dementia? While communication serves as the vehicle to deliver care at a high level, medical professionals are suddenly met with a roadblock. And there … behind the pieces of shattered communication and a dampened map of ethical guidelines, health-care providers are at a standstill.

    It’s 4:37 a.m. You receive a text message from the overnight nurse at a care facility regarding a current seizure. After lorazepam is ordered and administered, Mr. H, a quick-witted 76-year-old, stabilizes. Phenobarbital 15mg SC qhs was also added to prevent future similar events. You exhale a sigh of relief.

    Mr. H. has been admitted to the floor 36 hours earlier after having a seizure while playing poker with colleagues. Since he became your patient, he’s shared many stories from professional and family life with you, along with as many jokes as he could fit in between. However, over the course of the next seven days, Mr. H. would develop aspiration pneumonia, progressing to ventilator dependency and, ultimately, multi-organ failure with rapid cognitive decline.

    What strategies and tools would you use to maximize the well-being of your patient during his decline? How would you bridge the gap of understanding between the patient’s family and health-care team to provide the standard of care that all patients are owed?

    To give Mr. H. the type of care he would have wanted, upon his hospital admission, he should have been questioned about his understanding of illness along with the goals of care of the medical team. The patient should have been informed that it is imperative to adhere to the medical regimen implemented by his team along with the risks of not doing so. In the event disease-related complications arose, advanced directives should have been documented to avoid any unnecessary measures.

    It is important to note, that with each change in status of the patient’s health status, the goal of treatment must be reassessed. The patient or surrogate decision-maker’s understanding of these goals is paramount in maintaining the patient’s autonomy. It is often said that effective communication is the bedrock of a healthy relationship. This is true regardless of type of relationship.

    This is why I and Megan Vierhout wrote Integrated End of Life Care in Dementia: A Comprehensive Guide, a book targeted at providing a much-needed road map to navigate the many challenges involved in end-of-life care for individuals with dementia. Ultimately, our aim is to provide a compass for both health-care professionals and the families of those affected by the progressive effects of dementia. We provide practical advice on optimizing communication with individuals with dementia while taking their cognitive limitations, preferences and needs into account.

    I invite you to explore the unpredictable terrain of end-of-life care for patients with dementia. Together, we can pave a smoother, sturdier path toward the practice of medicine as a true art form.

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

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