Generation M – by Dr. Jessica Shepherd
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Menopause is something that very few people are adequately prepared for despite its predictability, and also something that very many people then neglect to take seriously enough.
Dr. Shepherd encourages a more proactive approach throughout all stages of menopause and beyond; she discusses “the preseason, the main event, and the after-party” (perimenopause, menopause, and postmenopause), which is important, because typically people take up an interest in perimenopause, are treating it like a marathon by menopause, and when it comes to postmenopause, it’s easy to think “well, that’s behind me now”, and it’s not, because untreated menopause will continue to have (mostly deleterious) cumulative effects until death.
As for HRT, there’s a chapter on that of course, going into quite some detail. There is also plenty of attention given to popular concerns such as managing weight changes and libido changes, as well as oft-neglected topics such as brain changes, as well as things considered more cosmetic but that can have a big impact on mental health, such as skin and hair.
The style throughout is pop-science; friendly without skimping on detail and including plenty of good science.
Bottom line: if you’d like a fairly comprehensive overview of the changes that occur from perimenopause all the way to menopause and well beyond, then this is a great book for that.
Click here to check out Generation M, and live well at every stage of life!
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Running or yoga can help beat depression, research shows – even if exercise is the last thing you feel like
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At least one in ten people have depression at some point in their lives, with some estimates closer to one in four. It’s one of the worst things for someone’s wellbeing – worse than debt, divorce or diabetes.
One in seven Australians take antidepressants. Psychologists are in high demand. Still, only half of people with depression in high-income countries get treatment.
Our new research shows that exercise should be considered alongside therapy and antidepressants. It can be just as impactful in treating depression as therapy, but it matters what type of exercise you do and how you do it.
Walk, run, lift, or dance away depression
We found 218 randomised trials on exercise for depression, with 14,170 participants. We analysed them using a method called a network meta-analysis. This allowed us to see how different types of exercise compared, instead of lumping all types together.
We found walking, running, strength training, yoga and mixed aerobic exercise were about as effective as cognitive behaviour therapy – one of the gold-standard treatments for depression. The effects of dancing were also powerful. However, this came from analysing just five studies, mostly involving young women. Other exercise types had more evidence to back them.
Walking, running, strength training, yoga and mixed aerobic exercise seemed more effective than antidepressant medication alone, and were about as effective as exercise alongside antidepressants.
But of these exercises, people were most likely to stick with strength training and yoga.
Antidepressants certainly help some people. And of course, anyone getting treatment for depression should talk to their doctor before changing what they are doing.
Still, our evidence shows that if you have depression, you should get a psychologist and an exercise plan, whether or not you’re taking antidepressants.
Join a program and go hard (with support)
Before we analysed the data, we thought people with depression might need to “ease into it” with generic advice, such as “some physical activity is better than doing none.”
But we found it was far better to have a clear program that aimed to push you, at least a little. Programs with clear structure worked better, compared with those that gave people lots of freedom. Exercising by yourself might also make it hard to set the bar at the right level, given low self-esteem is a symptom of depression.
We also found it didn’t matter how much people exercised, in terms of sessions or minutes a week. It also didn’t really matter how long the exercise program lasted. What mattered was the intensity of the exercise: the higher the intensity, the better the results.
Yes, it’s hard to keep motivated
We should exercise caution in interpreting the findings. Unlike drug trials, participants in exercise trials know which “treatment” they’ve been randomised to receive, so this may skew the results.
Many people with depression have physical, psychological or social barriers to participating in formal exercise programs. And getting support to exercise isn’t free.
We also still don’t know the best way to stay motivated to exercise, which can be even harder if you have depression.
Our study tried to find out whether things like setting exercise goals helped, but we couldn’t get a clear result.
Other reviews found it’s important to have a clear action plan (for example, putting exercise in your calendar) and to track your progress (for example, using an app or smartwatch). But predicting which of these interventions work is notoriously difficult.
A 2021 mega-study of more than 60,000 gym-goers found experts struggled to predict which strategies might get people into the gym more often. Even making workouts fun didn’t seem to motivate people. However, listening to audiobooks while exercising helped a lot, which no experts predicted.
Still, we can be confident that people benefit from personalised support and accountability. The support helps overcome the hurdles they’re sure to hit. The accountability keeps people going even when their brains are telling them to avoid it.
So, when starting out, it seems wise to avoid going it alone. Instead:
- join a fitness group or yoga studio
get a trainer or an exercise physiologist
- ask a friend or family member to go for a walk with you.
Taking a few steps towards getting that support makes it more likely you’ll keep exercising.
Let’s make this official
Some countries see exercise as a backup plan for treating depression. For example, the American Psychological Association only conditionally recommends exercise as a “complementary and alternative treatment” when “psychotherapy or pharmacotherapy is either ineffective or unacceptable”.
Based on our research, this recommendation is withholding a potent treatment from many people who need it.
In contrast, The Royal Australian and New Zealand College of Psychiatrists recommends vigorous aerobic activity at least two to three times a week for all people with depression.
Given how common depression is, and the number failing to receive care, other countries should follow suit and recommend exercise alongside front-line treatments for depression.
I would like to acknowledge my colleagues Taren Sanders, Chris Lonsdale and the rest of the coauthors of the paper on which this article is based.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.
Michael Noetel, Senior Lecturer in Psychology, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Milk Thistle For The Brain, Bones, & More
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“Thistle Do Nicely”
Milk thistle is a popular supplement; it comes from the milk thistle plant (Silybum marianum), commonly just called thistles. There are other kinds of thistle too, but these are one of the most common.
So, what does it do?
Liver health
Milk thistle enjoys popular use to support liver health; the liver is a remarkably self-regenerative organ if given the chance, but sometimes it can use a helping hand.
See for example: How To Undo Liver Damage
As for milk thistle’s beneficence, it is very well established:
- Milk thistle in liver diseases: past, present, future
- Hepatoprotective effect of silymarin
- Silybum Marianum and Chronic Liver Disease: A Marriage of Many Years
Brain health
For this one the science is less well-established, as studies so far have been on non-human animals, or have been in vitro studies.
Nevertheless, the results so far are promising, and the mechanism of action seems to be a combination of reducing oxidative stress and neuroinflammation, as well as suppressing amyloid β-protein (Aβ) fibril formation, in other words, reducing amyloid plaques.
General overview: A Mini Review on the Chemistry and Neuroprotective Effects of Silymarin
All about the plaques, but these are non-human animal studies:
- Mouse model: Silymarin attenuated the amyloid β plaque burden and improved behavioral abnormalities in an Alzheimer’s disease mouse model
- Rat model: Silymarin effect on amyloid-β plaque accumulation and gene expression of APP in an Alzheimer’s disease rat model
Against diabetes
Milk thistle improves insulin sensitivity, and reduces fasting blood sugar levels and HbA1c levels. The research so far is mostly in type 2 diabetes, however (at least, so far as we could find). For example:
Studies we could find for T1D were very far from translatable to human usefulness, for example, “we poisoned these rats with streptozotocin then gave them megadoses of silymarin (10–15 times the dose usually recommended for humans) and found very small benefits to the lenses of their eyes” (source).
Against osteoporosis
In this case, milk thistle’s estrogenic effects may be of merit to those at risk of menopause-induced osteoporosis:
If you’d like a quick primer about such things as what antiosteoclastic activity is, here’s a quick recap:
Which Osteoporosis Medication, If Any, Is Right For You?
Is it safe?
It is “Generally Recognized As Safe”, and even when taken at high doses for long periods, side effects are very rare.
Contraindications include if you’re pregnant, nursing, or allergic.
Potential reasons for caution (but not necessarily contraindication) include if you’re diabetic (its blood-sugar lowering effects will decrease the risk of hyperglycemia while increasing the risk of hypoglycemia), or have a condition that could be exacerbated by its estrogenic effects—including if you are on HRT, because it’s an estrogen receptor agonist in some ways (for example those bone benefits we mentioned before) but an estrogen antagonist in others (for example, in the uterus, if you have one, or in nearby flat muscles, if you don’t).
As ever, speak with your doctor/pharmacist to be sure.
Want to try it?
We don’t sell it, but here for your convenience is an example product on Amazon
Enjoy!
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Aspirin vs Cancer Metastasis
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Aspirin is a bit of a mixed bag.
In the category of things in its favor, it’s a modest analgesic with few side effects from occasional use, so it’s a good option if you have a headache, for example.
Unless you’re already on blood thinners or having a bleeding disorder, in which case, aspirin is not the thing to reach for.
About aspirin and heart disease
This is actually a complicated one, and we covered it at length in a dedicated main feature. If you want a one-line summary, it’s “chronic low-dose aspirin use can lower overall CVD risk, but does not reduce CVD mortality or all-cause mortality, and you may pay for it with gastrointestinal bleeding, and increased risk of ulcers“.
For a more nuanced explanation, see: Aspirin, CVD Risk, & Potential Counter-Risks
On the other hand, if you are having a heart attack and are waiting for the ambulance that you already called, and have aspirin to hand that you don’t have to go looking for, then it can be good to take a dose then.
For more on that, see: How To Survive A Heart Attack When You’re Alone
There are more problems
In the case of chronic use of low-dose aspirin, not only does it increase the risks of bleeding, especially gastrointestinal bleeding, and ulcers, but also it increases the risk of anemia. Given that anemia also gives the symptom “dizziness”, this is also a significant threat for increasing the incidence of falls in the older population, too, which can of course lead to serious complications and ultimately death.
For the science about this, see: Low-Dose Aspirin & Anemia
Now, about aspirin and cancer metastasis
This one’s a point in aspirin’s favor.
Cancer is, in and of itself, obviously a big problem. In terms of when it’s most likely to kill someone, that is usually when the cancer becomes metastatic, that is to say, it has spread.
So, while preventing cancer and, failing that, killing cancer are very important goals, there is a third axis to cancer care, which is preventing metastasis in someone who has cancer.
And that’s what aspirin does. How, you ask?
Scientists found this one out by accident!
They were doing genetic research in mice, to find genes that had an effect on metastasis. In the process, they found a certain gene that instructs the creation of a certain protein, and mice that lacked that gene (and thus its associated protein) had less metastasis.
The protein in question suppresses T-cells, which are programmed to recognize and kill metastatic cancer cells (amongst having other great jobs; they are an important part of the immune system in general, and one that declines with aging; most people in their 60s or older are producing very few T-cells).
About that, see: Focusing On Health In Our Sixties
Tracing the cell signaling, the researchers found that the protein is activated when T-cells are exposed to thromboxane A2 (or TXA2 to its friends).
And TXA2? That’s produced by platelets, and aspirin works by inhibiting TXA2 production, effectively making platelets (and thus the blood as a whole) less sticky.
So, that’s quite a few steps in the process, but ultimately:
- Aspirin inhibits TXA2 production
- Lower TXA2 levels mean ARHGEF1 (that’s the protein) isn’t activated
- ARHGEF1 not being activated means T-cells are free to do their thing
- T-cells are now free to kill metastatic cancer cells
You can read the paper here:
Aspirin prevents metastasis by limiting platelet TXA2 suppression of T cell immunity
Take care!
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Mango vs Pineapple – Which is Healthier?
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Our Verdict
When comparing mango to pineapple, we picked the pineapple.
Why?
It was close! Both of these tropical fruits have almost identical macros, and when it comes to vitamins and minerals, mango has slightly more vitamins while pineapple has slightly more minerals, so that balances out too. Their glycemic loads are 11 and 13 respectively, so: very low, and very similar.
See also: Which Sugars Are Healthier, And Which Are Just The Same?
In terms of what sets them apart:
Mango has a lot of vitamin A, to the point that it can interfere with blood-thinners if you take those.
Pineapple has bromelain, an enzyme with unique anti-inflammatory properties that we must devote a Research Review Monday to one of these days, because there’s a lot to say, but the short version is, it’s very powerful.
Since bromelain is found only in pineapples, whereas vitamin A is easy to find in abundance in many foods, we went with the pineapple.
Enjoy!
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Get Well, Stay Well – by Dr. Gemma Newman
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Dr. Gemma Newman is a GP (British equivalent of what in America is called a “family doctor”) who realized she was functioning great as a diagnostic flowchart interpreter and pill dispensary, but not actually doing much of what she got into the job to do: helping people.
Her patients were getting plenty of treatments, but not getting better. Often, they were getting worse. And she knew why: they come in for treatment for one medical problem, when they have six and a half medical problems probably a stack of non-medical problems that contributed to them,
So, this book sets out to do what she tries to do in her office, but often doesn’t have the time: treat the whole person.
In it, she details what areas of life to look at, what things are most likely to contribute to wellness/unwellness (be those things completely in your power or not), and how to—bit by bit—make all the parts better, and keep them that way.
The writing style is conversational, and while it’s heavily informed by her professional competence, there’s no arcane science here; it’s more about the system of bringing everything together harmoniously.
Bottom line: if you think there’s more to wellness than can be represented on an annual physicals chart, then this is the book to help you get/keep on top of things.
Click here to check out Get Well, Stay Well, and do just that!
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The Five Pillars Of Longevity
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The Five Pillars Of Longevity
This is Dr. Mark Hyman. He’s a medical doctor, and he’s the board president of clinical affairs of the Institute for Functional Medicine. He’s also the founder and medical director of the UltraWellness Center!
What he’d like you to know about is what he calls the “Five Pillars of Longevity”.
Now, here at 10almonds, we often talk about certain things that science finds to be good for almost any health condition, and have made a habit of referencing what we call “The Usual Five Things™” (not really a trademark, by the way—just a figure of speech), which are:
- Have a good diet
- Get good exercise
- Get good sleep
- Reduce (or eliminate) alcohol consumption
- Don’t smoke
…and when we’re talking about a specific health consideration, we usually provide sources as to why each of them are particularly relevant, and pointers as to the what/how associated with them (ie what diet is good, how to get good sleep, etc).
Dr. Hyman’s “Five Pillars of Longevity” are based on observations from the world’s “Blue Zones”, the popular name for areas with an unusually high concentration of supercentenarians—Sardinia and Okinawa being famous examples, with a particular village in each being especially exemplary.
These Five Pillars of Longevity partially overlap with ours for three out of five, and they are:
- Good nutrition
- Optimized workouts
- Reduce stress
- Get quality sleep
- Find (and live) your purpose
We won’t argue against those! But what does he have to say, for each of them?
Good nutrition
Dr. Hyman advocates for a diet he calls “pegan”, which he considers to combine the paleo and vegan diets. Here at 10almonds, we generally advocate for the Mediterranean Diet because of the mountains of evidence for it, but his approach may be similar in some ways, since it looks to consume a majority plant diet, with some unprocessed meats/fish, limited dairy, and no grains.
By the science, honestly, we stand by the Mediterranean (which includes whole grains), but if for example your body may have issues of some kind with grains, his approach may be a worthy consideration.
Optimized workouts
For Dr. Hyman, this means getting in three kinds of exercise regularly:
- Aerobic/cardio, to look after your heart health
- Resistance training (e.g. weights or bodyweight strength-training) to look after your skeletal and muscular health
- Yoga or similar suppleness training, to look after your joint health
Can’t argue with that, and it can be all too easy to fall into the trap of thinking “I’m healthy because I do x” while forgetting y and/or z! Thus, a three-pronged approach definitely has its merits.
Reduce stress
Acute stress (say, a cold shower) is can confer some health benefits, but chronic stress is ruinous to our health and it ages us. So, reducing this is critical. Dr. Hyman advocates for the practice of mindfulness and meditation, as well as journaling.
Get quality sleep
Quality here, not just quantity. As well as the usual “sleep hygiene” advices, he has some more unorthodox methods, such as the use of binaural beats to increase theta-wave activity in the brain (and thus induce more restful sleep), and the practice of turning off Wi-Fi, on the grounds that Wi-Fi signals interfere with our sleep.
We were curious about these recommendations, so we checked out what the science had to say! Here’s what we found:
- Minimal Effects of Binaural Auditory Beats for Subclinical Insomnia: A Randomized Double-Blind Controlled Study
- Spending the night next to a router – Results from the first human experimental study investigating the impact of Wi-Fi exposure on sleep
In short: probably not too much to worry about in those regards. On the other hand, worrying less, unlike those two things, is a well-established way improve sleep!
(Surprised we disagreed with our featured expert on a piece of advice? Please know: you can always rely on us to stand by what the science says; we pride ourselves on being as reliable as possible!)
Find (and live!) your purpose
This one’s an ikigai thing, to borrow a word from Japanese, or finding one’s raison d’être, as we say in English using French, because English is like that. It’s about having purpose.
Dr. Hyman’s advice here is consistent with what many write on the subject, and it’d be an interesting to have more science on, but meanwhile, it definitely seems consistent with commonalities in the Blue Zone longevity hotspots, where people foster community, have a sense of belonging, know what they are doing for others and keep doing it because they want to, and trying to make the world—or even just their little part of it—better for those who will follow.
Being bitter, resentful, and self-absorbed is not, it seems a path to longevity. But a life of purpose, or even just random acts of kindness, may well be.
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