Keep Inflammation At Bay
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How to Prevent (or Reduce) Inflammation
You asked us to do a main feature on inflammation, so here we go!
Before we start, it’s worth noting an important difference between acute and chronic inflammation:
- Acute inflammation is generally when the body detects some invader, and goes to war against it. This (except in cases such as allergic responses) is usually helpful.
- Chronic inflammation is generally when the body does a civil war. This is almost never helpful.
We’ll be tackling the latter, which frees up your body’s resources to do better at the former.
First, the obvious…
These five things are as important for this as they are for most things:
- Get a good diet—the Mediterranean diet is once again a top-scorer
- Exercise—move and stretch your body; don’t overdo it, but do what you reasonably can, or the inflammation will get worse.
- Reduce (or ideally eliminate) alcohol consumption. When in pain, it’s easy to turn to the bottle, and say “isn’t this one of red wine’s benefits?” (it isn’t, functionally*). Alcohol will cause your inflammation to flare up like little else.
- Don’t smoke—it’s bad for everything, and that goes for inflammation too.
- Get good sleep. Obviously this can be difficult with chronic pain, but do take your sleep seriously. For example, invest in a good mattress, nice bedding, a good bedtime routine, etc.
*Resveratrol (which is a polyphenol, by the way), famously found in red wine, does have anti-inflammatory properties. However, to get enough resveratrol to be of benefit would require drinking far more wine than will be good for your inflammation or, indeed, the rest of you. So if you’d like resveratrol benefits, consider taking it as a supplement. Superficially it doesn’t seem as much fun as drinking red wine, but we assure you that the results will be much more fun than the inflammation flare-up after drinking.
About the Mediterranean Diet for this…
There are many causes of chronic inflammation, but here are some studies done with some of the most common ones:
- Beneficial effect of Mediterranean diet in systemic lupus erythematosus patients
- How the Mediterranean diet and some of its components modulate inflammatory pathways in arthritis
- The effects of the Mediterranean diet on biomarkers of vascular wall inflammation and plaque vulnerability in subjects with high risk for cardiovascular disease
- Adherence to Mediterranean diet and 10-year incidence of diabetes: correlations with inflammatory and oxidative stress biomarkers*
*Type 1 diabetes is a congenital autoimmune disorder, as the pancreas goes to war with itself. Type 2 diabetes is different, being a) acquired and b) primarily about insulin resistance, and/but this is related to chronic inflammation regardless. It is also possible to have T1D and go on to develop insulin resistance, and that’s very bad, and/but beyond the scope of today’s newsletter, in which we are focusing on the inflammation aspects.
Some specific foods to eat or avoid…
Eat these:
- Leafy greens
- Cruciferous vegetables
- Tomatoes
- Fruits in general (berries in particular)
- Healthy fats, e.g. olives and olive oil
- Almonds and other nuts
- Dark chocolate (choose high cocoa, low sugar)
Avoid these:
- Processed meats (absolute worst offenders are hot dogs, followed by sausages in general)
- Red meats
- Sugar (includes most fruit juices, but not most actual fruits—the difference with actual fruits is they still contain plenty of fiber, and in many cases, antioxidants/polyphenols that reduce inflammation)
- Dairy products (unless fermented, in which case it seems to be at worst neutral, sometimes even a benefit, in moderation)
- White flour (and white flour products, e.g. white bread, white pasta, etc)
- Processed vegetable oils
See also: 9 Best Drinks To Reduce Inflammation, Says Science
Supplements?
Some supplements that have been found to reduce inflammation include:
(links are to studies showing their efficacy)
Consider Intermittent Fasting
Remember when we talked about the difference between acute and chronic inflammation? It’s fair to wonder “if I reduce my inflammatory response, will I be weakening my immune system?”, and the answer is: generally, no.
Often, as with the above supplements and dietary considerations, reducing inflammation actually results in a better immune response when it’s actually needed! This is because your immune system works better when it hasn’t been working in overdrive constantly.
Here’s another good example: intermittent fasting reduces the number of circulating monocytes (a way of measuring inflammation) in healthy humans—but doesn‘t compromise antimicrobial (e.g. against bacteria and viruses) immune response.
See for yourself: Dietary Intake Regulates the Circulating Inflammatory Monocyte Pool ← the study is about the anti-inflammatory effects of fasting
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The Many Faces Of Cosmetic Surgery
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Cosmetic Surgery: What’s The Truth?
In Tuesday’s newsletter, we asked you your opinion on elective cosmetic surgeries, and got the above-depicted, below-described, set of responses:
- About 48% said “Everyone should be able to get what they want, assuming informed consent”
- About 28% said “It can ease discomfort to bring features more in line with normalcy”
- 15% said “They should be available in the case of extreme disfigurement only”
- 10% said “No elective cosmetic surgery should ever be performed; needless danger”
Well, there was a clear gradient of responses there! Not so polarizing as we might have expected, but still enough dissent for discussion
So what does the science say?
The risks of cosmetic surgery outweigh the benefits: True or False?
False, subjectively (but this is important).
You may be wondering: how is science subjective?
And the answer is: the science is not subjective, but people’s cost:worth calculations are. What’s worth it to one person absolutely may not be worth it to another. Which means: for those for whom it wouldn’t be worth it, they are usually the people who will not choose the elective surgery.
Let’s look at some numbers (specifically, regret rates for various surgeries, elective/cosmetic or otherwise):
- Regret rate for elective cosmetic surgery in general: 20%
- Regret rate for knee replacement (i.e., not cosmetic): 17.1%
- Regret rate for hip replacement (i.e., not cosmetic): 4.8%
- Regret rate for gender-affirming surgeries (for transgender patients): 1%
So we can see, elective surgeries have an 80–99% satisfaction rate, depending on what they are. In comparison, the two joint replacements we mentioned have a 82.9–95.2% satisfaction rate. Not too dissimilar, taken in aggregate!
In other words: if a person has studied the risks and benefits of a surgery and decides to go ahead, they’re probably going to be happy with the results, and for them, the benefits will have outweighed the risks.
Sources for the above numbers, by the way:
- What is the regret rate for plastic surgery?
- Decision regret after primary hip and knee replacement surgery
- A systematic review of patient regret after surgery—a common phenomenon in many specialties but rare within gender-affirmation surgery
But it’s just a vanity; therapy is what’s needed instead: True or False?
False, generally. True, sometimes. Whatever the reasons for why someone feels the way they do about their appearance—whether their face got burned in a fire or they just have triple-J cups that they’d like reduced, it’s generally something they’ve already done a lot of thinking about. Nevertheless, it does also sometimes happen that it’s a case of someone hoping it’ll be the magical solution, when in reality something else is also needed.
How to know the difference? One factor is whether the surgery is “type change” or “restorative”, and both have their pros and cons.
- In “type change” (e.g. rhinoplasty), more psychological adjustment is needed, but when it’s all over, the person has a new nose and, statistically speaking, is usually happy with it.
- In “restorative” (e.g. facelift), less psychological adjustment is needed (as it’s just a return to a previous state), so a person will usually be happy quickly, but ultimately it is merely “kicking the can down the road” if the underlying problem is “fear of aging”, for example. In such a case, likely talking therapy would be beneficial—whether in place of, or alongside, cosmetic surgery.
Here’s an interesting paper on that; the sample sizes are small, but the discussion about the ideas at hand is a worthwhile read:
Does cosmetic surgery improve psychosocial wellbeing?
Some people will never be happy no matter how many surgeries they get: True or False?
True! We’re going to refer to the above paper again for this one. In particular, here’s what it said about one group for whom surgeries will not usually be helpful:
❝There is a particular subgroup of people who appear to respond poorly to cosmetic procedures. These are people with the psychiatric disorder known as “body dysmorphic disorder” (BDD). BDD is characterised by a preoccupation with an objectively absent or minimal deformity that causes clinically significant distress or impairment in social, occupational, or other areas of functioning.
For several reasons, it is important to recognise BDD in cosmetic surgery settings:
Firstly, it appears that cosmetic procedures are rarely beneficial for these people. Most patients with BDD who have had a cosmetic procedure report that it was unsatisfactory and did not diminish concerns about their appearance.
Secondly, BDD is a treatable disorder. Serotonin-reuptake inhibitors and cognitive behaviour therapy have been shown to be effective in about two-thirds of patients with BDD❞
~ Dr. David Castle et al. (lightly edited for brevity)
Which is a big difference compared to, for example, someone having triple-J breasts that need reducing, or the wrong genitals for their gender, or a face whose features are distinct outliers.
Whether that’s a reason people with BDD shouldn’t be able to get it is an ethical question rather than a scientific one, so we’ll not try to address that with science.
After all, many people (in general) will try to fix their woes with a haircut, a tattoo, or even a new sportscar, and those might sometimes be bad decisions, but they are still the person’s decision to make.
And even so, there can be protectionist laws/regulations that may provide a speed-bump, for example:
Take care!
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Exercising With Less Soreness!
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An Ancient Sports Drink & Healing Potion, Now With Modern Science?
Ginseng has many health benefits, we talked about 8 of them in this previous edition of 10almonds:
…but we’ve somehow never yet done a Monday’s Research Review for it! We must do one, one of these days. For now though, it’s Saturday’s Life Hacks, and we’re here with…
Speeding up recovery after muscle damage
We talked about this topic before too:
Overdone It? How To Speed Up Recovery After Exercise
…which gives very good advice (including some supplements that help), but was published before the latest science that we’re going to talk about today:
A team of researchers all so very recently found that ginseng also reduces muscular fatigue and, importantly, hastens recovery of muscle damage caused by exercise.
And that’s not all…
❝It should also be noted that, by reducing fatigue, taking ginseng on a regular basis may also help reduce the risk of injury, particularly in the case of muscles or ligaments, which can in turn improve athletic performance.❞
This means that it can be taken regularly and prophylactically, as they found:
❝taking ginseng systematically for a long time can mitigate the response of the biological markers, mainly creatine kinase (CK) and interleukin 6 (IL-6), responsible for exercise-induced muscle damage and inflammation.❞
You may be thinking “isn’t creatine good?” and yes, yes it is:
Creatine: Very Different For Young & Old People
…however, creatine kinase is not creatine. Creatine kinase (CK) is an enzyme that affects the creatine (to put it in few words, without getting into the fascinating biochemistry of this). Now, it’s necessary for us to have some CK (or else we wouldn’t be able to do what we need to with the creatine), but elevated levels often indicate some sort of problem going on:
Approach to asymptomatic creatine kinase elevation
…so ginseng keeping those things balanced is a good thing.
The study
We’ve talked a lot about the findings and what they mean, but if you’d like to read the paper for yourself, you can read it here:
Effect of Ginseng Intake on Muscle Damage Induced by Exercise in Healthy Adults
Where to get ginseng
If you’d like to take ginseng as a supplement, then there are many ways to do so, with the most common being capsules or ginseng tea, which has an interesting and distinctive taste, and is very refreshing. Here are examples on Amazon, for your convenience:
Enjoy!
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The China Study – by Dr. T Colin Campbell and Dr. Thomas M. Campbell
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This is not the newest book we’ve reviewed (originally published 2005; this revised and expanded edition 2016), but it is a seminal one.
You’ve probably heard it referenced, and maybe you’ve wondered what the fuss is about. Now you can know!
The titular study itself was huge. We tend to think “oh there was one study” and look to discount it, but it literally looked at the population of China. That’s a large study.
And because China is relatively ethnically homogenous, especially per region, it was easier to isolate what dietary factors made what differences to health. Of course, that did also create a limitation: follow-up studies would be needed to see if the results were the same for non-Chinese people. But even for the rest of us (this reviewer is not Chinese), it already pointed science in the right direction. And sure enough, smaller follow-up studies elsewhere found the same.
But enough about the research; what about the book? This is a book review, not a research review, after all.
The book itself is easy for a lay reader to understand. It explains how the study was conducted (no small feat), and how the data was examined. It also discusses the results, and the conclusions drawn from those results.
In light of all this, it also offers simple actionable advices, on how to eat to avoid disease in general, and cancer in particular. In especially that latter case, one take-home conclusion was: get more of your protein from plants for a big reduction in cancer risk, for example.
Bottom line: this book is an incredible blend of “comprehensive” and “readable” that we don’t often find in the same book! It contains not just a lot of science, but also an insight into how the science works, on a research level. And, of course, its results and conclusions have strong implications for all our lives.
Click here to check out The China Study, to know more about it!
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Cleaning Up Your Mental Mess – by Dr. Caroline Leaf
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First of all, what mental mess is this? Well, that depends on you, but common items include:
- Anxiety
- Depression
- Stress
- Trauma
Dr. Caroline Leaf also includes the more nebulous item “toxic thoughts”, but this is mostly a catch-all term.
Given that it says “5 simple scientifically proven steps”, it would be fair if you are wondering:
“Is this going to be just basic CBT stuff?”
And… First, let’s not knock basic CBT stuff. It’s not a panacea, but it’s a great tool for a lot of things. However… Also, no, this book is not about just basic CBT stuff.
In fact, this book’s methods are presented in such a novel way that this reviewer was taken aback by how unlike it was to anything she’d read before.
And, it’s not that the components themselves are new—it’s just that they’re put together differently, in a much more organized comprehensive and systematic way, so that a lot less stuff falls through the cracks (a common problem with standalone psychological tools and techniques).
Bottom line: if you buy one mental health self-help book this year, we recommend that it be this one
Click here to check out Cleaning Up Your Mental Mess, and take a load off your mind!
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How & Why Non-Sleep Deep Rest Works (And What Activities Trigger The Same State)
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Stress is a natural response that evolved over thousands of years to help humans meet challenges by priming the body and mind for action. However, chronic stress is harmful, as it diverts energy away from essential processes like cell maintenance and repair, leading to deterioration of health (physical and mental).
Counteracting this requires intentional periods of deep rest… But how?
Parasympathetic Response
Practices as diverse as mindfulness meditation, yoga, prayer, tai chi, qigong, knitting, painting, gardening, and sound baths can help induce states of deep rest—these days often called “Non-Sleep Deep Rest” (NSDR), to differentiate it from deep sleep.
How it works: these activities send signals to the brain that the body is safe, initiating biological changes that…
- protect chromosomes from DNA damage
- promote cellular repair, and
- enhance mitochondrial function.
If we then (reasonably!) conclude from this: “so, we must embrace moments of stillness and mindfulness, and allow ourselves to experience the ease and safety of the present”, that may sound a little wishy-washy, but the neurology of it is clear, the consequences of that neurological response on every living cell in the body are also clear, so by doing NSDR (whether by yoga nidra or knitting or something else) we can significantly improve our overall well-being.
Note: the list of activities above is far from exhaustive, but do be aware that this doesn‘t mean any activity you enjoy and do to unwind will trigger NSDR. On the contrary, many activities you enjoy and do to unwind may trigger the opposite, a sympathetic nervous system response—watching television is a common example of this “wrong choice for NSDR”. Sure, it can be absorbing and a distraction from your daily stressors, but it also can be exciting (both cognitively and neurologically and thus also physiologically), which is the opposite of what we want.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Non-Sleep Deep Rest: A Neurobiologist’s Take
Take care!
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This Is Your Brain on Music – by Dr. Daniel Levitin
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Music has sometimes been touted as having cognitive benefits, by its practice and even by the passive experience of it. But what’s the actual science of it?
Dr. Levitin, an accomplished musician and neuroscientist, explores and explains.
We learn about how music in all likelihood allowed our ancestors to develop speech, something that set us apart (and ahead!) as a species. How music was naturally-selected-for in accordance with its relationship with health. How processing music involves almost every part of the brain. How music pertains specifically to memory. And more.
As a bonus, as well as explaining a lot about our brain, this book offers those of us with limited knowledge of music theory a valuable overview of the seven main dimensions of music, too.
Bottom line: if you’d like to know more about the many-faceted relationship between music and cognitive function, this is a top-tier book about such.
Click here to check out “This Is Your Brain On Music”, and learn more about yours!
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Learn to Age Gracefully
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