Feminist narratives are being hijacked to market medical tests not backed by evidence
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Corporations have used feminist language to promote their products for decades. In the 1980s, companies co-opted messaging about female autonomy to encourage women’s consumption of unhealthy commodities, such as tobacco and alcohol.
Today, feminist narratives around empowerment and women’s rights are being co-opted to market interventions that are not backed by evidence across many areas of women’s health. This includes by commercial companies, industry, mass media and well-intentioned advocacy groups.
Some of these health technologies, tests and treatments are useful in certain situations and can be very beneficial to some women.
However, promoting them to a large group of asymptomatic healthy women that are unlikely to benefit, or without being transparent about the limitations, runs the risk of causing more harm than good. This includes inappropriate medicalisation, overdiagnosis and overtreatment.
In our analysis published today in the BMJ, we examine this phenomenon in two current examples: the anti-mullerian hormone (AMH) test and breast density notification.
The AMH test
The AMH test is a blood test associated with the number of eggs in a woman’s ovaries and is sometimes referred to as the “egg timer” test.
Although often used in fertility treatment, the AMH test cannot reliably predict the likelihood of pregnancy, timing to pregnancy or specific age of menopause. The American College of Obstetricians and Gynaecologists therefore strongly discourages testing for women not seeking fertility treatment.
Despite this, several fertility clinics and online companies market the AMH test to women not even trying to get pregnant. Some use feminist rhetoric promising empowerment, selling the test as a way to gain personalised insights into your fertility. For example, “you deserve to know your reproductive potential”, “be proactive about your fertility” and “knowing your numbers will empower you to make the best decisions when family planning”.
The use of feminist marketing makes these companies appear socially progressive and champions of female health. But they are selling a test that has no proven benefit outside of IVF and cannot inform women about their current or future fertility.
Our recent study found around 30% of women having an AMH test in Australia may be having it for these reasons.
Misleading women to believe that the test can reliably predict fertility can create a false sense of security about delaying pregnancy. It can also create unnecessary anxiety, pressure to freeze eggs, conceive earlier than desired, or start fertility treatment when it may not be needed.
While some companies mention the test’s limitations if you read on, they are glossed over and contradicted by the calls to be proactive and messages of empowerment.
Breast density notification
Breast density is one of several independent risk factors for breast cancer. It’s also harder to see cancer on a mammogram image of breasts with high amounts of dense tissue than breasts with a greater proportion of fatty tissue.
While estimates vary, approximately 25–50% of women in the breast screening population have dense breasts.
Stemming from valid concerns about the increased risk of cancer, advocacy efforts have used feminist language around women’s right to know such as “women need to know the truth” and “women can handle the truth” to argue for widespread breast density notification.
However, this simplistic messaging overlooks that this is a complex issue and that more data is still needed on whether the benefits of notifying and providing additional screening or tests to women with dense breasts outweigh the harms.
Additional tests (ultrasound or MRI) are now being recommended for women with dense breasts as they have the ability to detect more cancer. Yet, there is no or little mention of the lack of robust evidence showing that it prevents breast cancer deaths. These extra tests also have out-of-pocket costs and high rates of false-positive results.
Large international advocacy groups are also sponsored by companies that will financially benefit from women being notified.
While stronger patient autonomy is vital, campaigning for breast density notification without stating the limitations or unclear evidence of benefit may go against the empowerment being sought.
Ensuring feminism isn’t hijacked
Increased awareness and advocacy in women’s health are key to overcoming sex inequalities in health care.
But we need to ensure the goals of feminist health advocacy aren’t undermined through commercially driven use of feminist language pushing care that isn’t based on evidence. This includes more transparency about the risks and uncertainties of health technologies, tests and treatments and greater scrutiny of conflicts of interests.
Health professionals and governments must also ensure that easily understood, balanced information based on high quality scientific evidence is available. This will enable women to make more informed decisions about their health.
Brooke Nickel, NHMRC Emerging Leader Research Fellow, University of Sydney and Tessa Copp, NHMRC Emerging Leader Research Fellow, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Beat Osteoporosis with Exercise – by Dr. Karl Knopf
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There are a lot of books about beating osteoporosis, and yet when it comes to osteoporosis exercises, it took us some work to find a good one. But, this one’s it!
A lot of books give general principles and a few sample exercises. This one, in contrast, gives:
- An overview of osteopenia and osteoporosis, first
- A brief overview of non-exercise osteoporosis considerations
- Principles for exercising a) to reduce one’s risk of osteoporosis b) if one has osteoporosis
- Clear explanations of about 150 exercises that fit both categories
This last item’s important, because a lot of popular advice is exercises that are only good for one or the other (given that a lot of things that strengthen a healthy person’s bones can break the bones of someone with osteoporosis), so having 150 exercises that are safe and effective in both cases, is a real boon.
That doesn’t mean you have to do all 150! If you want to, great. But even just picking and choosing and putting together a little program is good.
Bottom line: if you’d like a comprehensive guide to exercise to keep you strong in the face of osteoporosis, this is a great one.
Click here to check out Beat Osteoporosis With Exercise, and stay strong!
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Fasting Without Crashing?
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Intermittent Fasting: What’s the truth?
Before we get to facts and fictions, let’s quickly cover:
What is Intermittent Fasting?
Intermittent Fasting (IF) is an umbrella term for various kinds of time-restricted fasting, based on a schedule. Types include:
Time-restricted IF, for example:
- 16:8—Fast for 16 hours, eat during an 8-hour window
- 18:6–Fast for 18 hours, eat during a 6-hour window
- 20:4—Fast for 20 hours, eat during a 4-hour window
24hr fasting, including:
- Eat Stop Eat—basically, take a day off from eating once a week
- Alternate Day Fasting—a more extreme version of the above; it is what it sounds like; eat one day, fast the next, repeat
Non-fast fasting, e.g:
- 5:2—Eat normally for 5 days, have a very reduced calorie intake (⅓ of normal intake) for the other 2 days
- Fruit Fasting—have a small amount of fruit on “fast” days, but no other food
- The Warrior Diet—as above, but include a small amount of non-starchy vegetables
Why IF?
While IF is perhaps most commonly undertaken as a means of fat loss or fat management (i.e., keeping fat down when it is already low), others cite different reasons, such as short term cognitive performance or long-term longevity.
But… Does it work?
Here we get into the myth-busting bit!
“IF promotes weight loss”
Mix of True and False. It can! But it also doesn’t have to. If you’re a bodybuilder who downs 4,000 calories in your 4hr eating window, you’re probably not going to lose weight! For such people, this is of course “a feature, not a bug” of IF—especially as it has been found that, in an acute study, IF did not adversely impact muscle protein synthesis.
“IF promotes fat loss, without eating less”
Broadly True. IF was found to be potentially equal to, but not necessarily better than, eating less.
“IF provides metabolic benefits for general health”
Broadly True. IF (perhaps counterintuitively) decreases the risk of insulin resistance, and also has anti-inflammatory effects, benefits a healthy gut microbiome, and promotes healthy autophagy (which as we noted in a previous edition of 10almonds, is important against both aging and cancer)
However, results vary according to which protocol you’re observing…
For what it’s worth, 16:8 is perhaps the most-studied protocol. Because such studies tend to have the eating window from midday to 8pm, this means that—going against popular wisdom—part of the advice here is basically “skip breakfast”.
“Unlike caloric restriction, IF is sustainable and healthy as a long-term protocol”
Broadly True. Of course, there’s a slight loophole here in that IF is loosely defined—technically everyone fasts while they’re sleeping, at the very least!
However, for the most commonly-studied IF method (16:8), this is generally very sustainable and healthy and for most people.
On the other hand, a more extreme method such as Alternate Day Fasting, may be trickier to sustain (even if it remains healthy to do so), because it’s been found that hunger does not decrease on fasting days—ie, the body does not “get used to it”.
The American Journal of Clinical Nutrition wrote:
❝Alternate-day fasting was feasible in nonobese subjects, and fat oxidation increased. However, hunger on fasting days did not decrease, perhaps indicating the unlikelihood of continuing this diet for extended periods of time. Adding one small meal on a fasting day may make this approach to dietary restriction more acceptable.❞
“IF improves mood and cognition”
Mix of True and False (plus an honest “We Don’t Know” from researchers).
Many studies have found benefits to both mood and cognition, but in the short-term, fasting can make people “hangry” (or: “experience irritability due to low blood sugar levels”, as the scientists put it), and in the long term, it can worsen symptoms of depression for those who already experience such—although some studies have found it can help alleviate depressive symptoms.
Basically this is one where researchers typically append the words “more research is needed” to their summaries.
“Anyone can do IF”
Definitely False, unless going by the absolute broadest possible interpretation of what constitutes “Intermittent Fasting” to the point of disingenuity.
For example, if you are Type 1 Diabetic, and your blood sugars are hypo, and you wait until tomorrow to correct that, you will stand a good chance of going into a coma instead. So please don’t.
(On the other hand, IF may help achieve remission of type 2 diabetes)
Lastly, IF is broadly not recommend to children and adolescents, anyone pregnant or breastfeeding, and certain underlying health conditions not mentioned above (we’re not going to try to give an exhaustive list here, but basically, if you have a chronic health condition, we recommend you check with your doctor first).
WHICH APP?
Choosing a fasting app
Thinking of giving IF a try and would like a little extra help? We’ve got you covered!
Check out: Livewire’s 7 Best Intermittent Fasting Apps of 2023
Prefer to just trust us with a recommendation?
We like BodyFast—it’s #2 on Lifewire’s list, but it has an array of pre-set plans to choose from (unlike Lifewire’s #1, Zero), and plenty of clear tracking, scheduling help, and motivational features.
Both are available on both iOS and Android:
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Peace Is Every Step – by Thích Nhất Hạnh
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Mindfulness is one of the few practices to make its way from religion (in this case, Buddhism) into hard science. We’ve written before about its many evidence-based benefits, and many national health information outlets recommend it. So, what does this book have to add?
Thích Nhất Hạnh spent most of his 95 years devoted to the practice and teaching of mindfulness and compassion. In this book, the focus is on bringing mindfulness off the meditation mat and into general life.
After all, what if we could extend that “unflappability” into situations that pressure and antagonize us? That would be some superpower!
The author offers techniques to do just that, simple exercises to transform negative emotions, and to make us more likely to remember to do so.
After all, “in the heat of the moment” is rarely when many of us are at our best, this book gives way to allow those moments themselves to serve as immediate triggers to be our best.
The title “Peace Is Every Step” is not a random collection of words; the goal of this book is to enable to reader to indeed carry peace with us as we go.
Not just “peace is always available to us”, but if we do it right: “we have now arranged for our own peace to automatically step in and help us when we need it most”.
Bottom line: if you’d like to practice mindfulness, or practice it more consistently, this book offers some powerful tools.
Click here to check out Peace Is Every Step, and carry yours with you!
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Built from Broken – by Scott Hogan, CPT, COES
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So many exercise programs come with the caveat “consult your doctor before engaging in any new activity”, and the safe-but-simple “do not try to train through an injury”.
Which is all very well and good for someone in fabulous health who sprained an ankle while running and can just wait a bit, but what about those of us carrying…
- long-term injuries
- recurring injuries
- or just plain unfixable physical disabilities?
That’s where physiotherapist Scott Hogan comes in. The subtitle line goes:
❝A Science-Based Guide to Healing Painful Joints, Preventing Injuries, and Rebuilding Your Body❞
…but he does also recognize that there are some things that won’t bounce back.
On the other hand… There are a lot of things that get written off by doctors as “here’s some ibuprofen” that, with consistent mindful training, could actually be fixed.
Hogan delivers again and again in this latter category! You’ll see on Amazon that the book has thousands of 4- and 5-star ratings and many glowing reviews, and it’s for a reason or three:
- The book first lays a foundational knowledge of the most common injuries likely to impede us from training
- It goes on to give step-by-step corrective exercises to guide your body through healing itself. Your body is trying to heal itself anyway; you might as well help it accomplish that!
- It finishes up with a comprehensive (and essential) guide to train for the strength and mobility that will help you avoid future problems.
In short: a potentially life-changing book if you have some (likely back- or joint-related) problem that needs overcoming!
And if you don’t? An excellent pre-emptive guide all the same. This is definitely one of those “an ounce of prevention is better than a pound of cure” things.
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Lifespan vs Healthspan, And The Spice Of Life
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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
❝Great newsletter. Am taking turmeric for inflammation of hips and feet. Works like magic. Would like to know how it works, and what tumeric is best combined with – also whether there any risks in longterm use.❞
Glad you’re enjoying! As for turmeric, it sure is great, isn’t it? To answer your questions in a brief fashion:
- How it works: it does a lot of things, but perhaps its most key feature is its autoxidative metabolites that mediate its anti-inflammatory effect. This, it slows or inhibits oxidative stress that would otherwise cause inflammation, increase cancer risk, and advance aging.
- Best combined with: black pepper
- Any risks in long-term use: there are no known risks in long-term use ← that’s just one study, but there are lots. Some studies were prompted by reported hepatotoxicity of curcumin supplements, but a) the reports themselves seem to be without evidence b) the reported hepatoxicity was in relation to contaminants in the supplements, not the curcumin itself c) clinical trials were unable to find any hepatotoxicity (or other) risks anyway. Here’s an example of such a study.
You might also like our previous main feature: Why Curcumin (Turmeric) Is Worth Its Weight In Gold
❝This push for longevity is appealing but watching my mother in her nineties is a life I’m not looking forward to. Healthy longevity, yes, but longevity for the sake of a longer life? No thank you.❞
Yes, you’re quite right, that’s exactly the point! Assuming we live to die of age-related conditions (i.e., we do not suffer a fatal accident or incident in our younger years), those unfun last years are coming whether they come at 75 or 95. Or earlier or later, because that can absolutely happen too!
For example: nearly 10% of Americans over 65 have difficulty with self-care
As a rule, and we’ve covered some of the science of this previously, having at least 4 out of 5 of the “big 5” lifestyle factors (diet, exercise, sleep, low-or-zero alcohol, not smoking) not only extends life, but specifically extends the healthspan, i.e. the count of healthy life-years that precedes final age-related decline.
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Yoga Safety: Simple Guidelines
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.
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
❝I was wondering whether there were very simple, clear bullet points or instructions on things to be wary of in Yoga.❞
That’s quite a large topic, and not one that lends itself well to being conveyed in bullet points, but first we’ll share the article you sent us when sending this question:
Tips for Avoiding Yoga Injuries
…and next we’ll recommend the YouTube channel @livinleggings, whose videos we feature here from time to time. She (Liv) has a lot of good videos on problems/mistakes/injuries to avoid.
Here’s a great one to get you started:
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