Good Energy – by Dr. Casey Means

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For a book with a title like “Good Energy” and chapters such as “Bad Energy Is the Root of Disease”, this is actually a very science-based book (and there are a flock of well-known doctors saying so in the “praise for” section, too).

The premise is simple: most of our health is a matter of what our metabolism is (or isn’t) doing, and it’s not just a case of “doing more” or “doing less”. Indeed, a lot of “our” energy is expended doing bad things (such as chronic inflammation, to give an obvious example).

Dr. Means outlines about a dozen things many people do wrong, and about a dozen things we can do right, to get our body’s energy system working for us, rather than against us.

The style here is pop-science throughout, and in the category of criticism, the bibliography is offloaded to her website (we prefer to have things in our hands). However, the information here is good, clearly-presented, and usefully actionable.

Bottom line: if you ever find yourself feeling run-down and like your body is using your resources against you rather than for you, this is the book to get you out of that slump!

Click here to check out Good Energy, and get your metabolism working for you!

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  • Stress Resets – by Dr. Jennifer Taitz

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    You may be thinking: “that’s a bold claim in the subtitle; does the book deliver?”

    And yes, yes it does.

    The “resets” themselves are divided into categories:

    1. Mind resets, which are mostly CBT,
    2. Body resets, which include assorted somatic therapies such as vagus nerve resets, the judicious use of ice-water, what 1-minute sprints of exercise can do for your mental state, and why not to use the wrong somatic therapy for the wrong situation!
    3. Behavior resets, which are more about the big picture, and not falling into common traps.

    What common traps, you ask? This is about how we often have maladaptive responses to stress, e.g. we’re short of money so we overspend, we have an important deadline so we over-research and procrastinate, we’re anxious so we hyperfixate on the problem, we’re grieving so we look to substances to try to cope, we’re exhausted so we stay up late to try to claw back some lost time. Things where our attempt to cope actually makes things worse for us.

    Instead, Dr. Taitz advises us of how to get ourselves from “knowing we shouldn’t do that” to actually not doing that, and how to respond more healthily to stress, how to turn general stress into eustress, or as she puts it, how to “turn your knots into bows”.

    The style is… “Academic light”, perhaps we could say. It’s a step above pop-science, but a step below pure academic literature, which does make it a very pleasant read as well as informative. There are often footnotes at the bottom of each page to bridge any knowledge-gap, and for those who want to know the evidence of these evidence-based approaches, she does provide 35 pages of hard science sources to back up her claims.

    Bottom line: if you’d like to learn how better to manage stress from an evidence-based perspective that’s not just “do minfdulness meditation”, then this book gives a lot of ways.

    Click here to check out Stress Resets, and indeed soothe your body and mind in minutes!

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  • Healthy Brain, Happy Life – by Dr. Wendy Suzuki

    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.

    We talked about Dr. Wendy Suzuki’s research in the category of exercise and brain-benefits in our main feature the other day. But she has more to say than we can fit into an article!

    This book chronicles her discoveries, through her work in memory and neuroplasticity, to her discoveries about exercise, and her dive into broader neurology-based mental health. So what does neurology-based mental health look like?

    The answer is: mitigating brain-busters such as stress and anxiety, revitalizing a fatigued brain, boosting creativity, and other such benefits.

    Does she argue that exercise is a cure-all? No, not quite. Sometimes there are other things she’s recommending (such as in her chapter on challenging the neurobiology of the stress response, or her chapter on meditation and the brain).

    The writing style is mostly casual, interspersed with occasional mini-lectures (complete with diagrams and other illustrations), and is very readable and informative throughout.

    Bottom line: if you’d like the more in-depth details of Dr. Suzuki’s work, this book is a very accessible way to get 320 pages of that!

    Click here to check out Healthy Brain, Happy Life, and give yours the best!

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  • Anti-Inflammatory Brownies

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    Brownies are usually full of sugar, butter, and flour. These ones aren’t! Instead, they’re full of fiber (good against inflammation), healthy fats, and anti-inflammatory polyphenols:

    You will need

    • 1 can chickpeas (keep half the chickpea water, also called aquafaba, as we’ll be using it)
    • 4 oz of your favorite nut butter (substitute with tahini if you’re allergic to nuts)
    • 3 oz rolled oats
    • 2 oz dark chocolate chips (or if you want the best quality: dark chocolate, chopped into very small pieces)
    • 3 tbsp of your preferred plant milk (this is an anti-inflammatory recipe and unfermented dairy is inflammatory)
    • 2 tbsp cocoa powder (pure cacao is best)
    • 1 tbsp glycine (if unavailable, use 2 tbsp maple syrup, and skip the aquafaba)
    • 2 tsp vanilla extract
    • ½ tsp baking powder
    • ¼ tsp low-sodium salt

    Method

    (we suggest you read everything at least once before doing anything)

    1) Preheat the oven to 350℉ / 180℃, and line a 7″ cake tin with baking paper.

    2) Blend the oats in a food processor, until you have oat flour.

    3) Add all the remaining ingredients except the dark chocolate chips, and process until the mixture resembles cookie dough.

    3) Transfer to a bowl, and fold in the dark chocolate chips, distributing evenly.

    4) Add the mixture to the cake tin, and smooth the surface down so that it’s flat and even. Bake for about 25 minutes, and let them cool in the tin for at least 10 minutes, but longer is better, as they will firm up while they cool. Cut into cubes when ready to serve:

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • Six Ways To Eat For Healthier Skin

    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.

    Sadia Badiei, the nutritionist-chef of “Pick Up Limes” fame, has advice:

    More than skin-deep:

    We’ll not keep them a mystery; here are the six points of focus:

    1. Collagen and skin elasticity

    Collagen is the structural protein that provides firmness and elasticity to the skin, but its production decreases with age, resulting in about a 1% annual loss starting at age 20. To support collagen, a diet rich in protein is essential, including foods like beans, lentils, tofu, tempeh, nuts, and seeds. They can’t do their work alone though; vitamins C and E play a critical role in collagen production and repair, protecting against damage from sun exposure, pollution, and free radicals. Vitamin E can be found in almonds, sunflower seeds, leafy greens, peanuts, and avocados, while vitamin C is abundant in citrus fruits, bell peppers, and broccoli.

    2. Skin healing and zinc

    Zinc is critical for wound healing and reducing inflammation, making it particularly helpful in managing skin conditions such as acne, eczema, psoriasis, and rosacea. Great dietary sources of zinc include nutritional yeast, pumpkin, sesame, and hemp seeds, as well as legumes and whole grains. However, zinc absorption can be hindered by phytate levels in some foods. Soaking, sprouting, or fermenting foods where possible can correct for that and improve zinc absorption.

    3. Dry skin and hydration

    Dry skin can result from many things, including dry air, hot water, abrasive soaps, and certain medications. While moisturizers provide external hydration, dietary omega-3 fats are essential for improving the skin’s barrier function, helping it retain moisture. Plant-based sources of omega-3s include walnuts, hemp seeds, chia seeds, flax seeds, and algae-based supplements. Staying adequately hydrated also supports overall health of course (everything runs on water in one way or another, after all), which indirectly benefits skin hydration, although drinking additional water only helps if dehydration is present.

    4. Sebum regulation

    Sebum, an oily substance that lubricates the skin, can cause issues like acne and blackheads when overproduced. Hormonal fluctuations and diet both influence sebum levels (in either direction). High glycemic index foods, such as sweetened beverages, refined grains, and sugary snacks, can lead to spikes in insulin, which in turn stimulates excess sebum production. In contrast, low glycemic index foods like vegetables, whole grains, tofu, nuts, and seeds regulate blood sugar and help manage sebum production, promoting clearer skin without an excess or a shortage of sebum.

    5. Gut health and skin

    The gut-skin connection means that imbalances in gut bacteria can contribute to skin issues like acne, eczema, and psoriasis. Supporting gut health involves increasing the diversity of beneficial bacteria through probiotic-rich foods. Fermented options like plant-based yogurts, kimchi, miso, sauerkraut, and kombucha not only improve gut microbiome health but also positively impact skin health by reducing inflammation and improving overall skin conditions.

    6. Inflammation and skin health

    Chronic inflammation is associated with so many health issues, and when it comes to skin, that includes acne, rosacea, and even wrinkles. Anti-inflammatory foods, especially those rich in antioxidants, can mitigate these effects and improve skin elasticity, smoothness, and color. Diets centered around fruits, vegetables, and other plant-based foods provide the necessary nutrients to combat inflammation, showcasing the significant role of nutrition in promoting radiant, healthy skin.

    For more on each of these, enjoy:

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

    Want to learn more?

    You might also like to read:

    Undo The Sun’s Damage To Your Skin

    Take care!

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  • What Menopause Does To The Heart

    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.

    World Menopause Day: Menopause & Cardiovascular Disease Risk

    Today, the 18th of October, is World Menopause Day.

    The theme for this year is cardiovascular disease (CVD), and if your first reaction is to wonder what that has to do with the menopause, then this is the reason why it’s being featured. Much of the menopause and its effects are shrouded in mystery; not because of a lack of science (though sometimes a bit of that too), but rather, because it is popularly considered an unimportant, semi-taboo topic.

    So, let’s be the change we want to see, and try to fix that!

    What does CVD have to do with the menopause?

    To quote Dr. Anjana Nair:

    ❝The metabolic and clinical factors secondary to menopause, such as dyslipidemia, insulin resistance, fat redistribution and systemic hypertension, contribute to the accelerated risk for cardiovascular aging and disease.

    Atherosclerosis appears to be the end result of the interaction between cardiovascular risk factors and their accentuation during the perimenopausal period.

    The increased cardiovascular risk in menopause stems from the exaggerated effects of changing physiology on the cardiovascular system.❞

    Source: Cardiovascular Changes in Menopause

    See also: Menopause-associated risk of cardiovascular disease

    Can we do anything about it?

    Yes, we can! Here be science:

    This (in few words: get your hormone levels checked, and consider HRT if appropriate) is consistent with the advice from gynecologist Dr. Jen Gunter, whom we featured back in August:

    What You Should Have Been Told About The Menopause Beforehand

    What about lifestyle changes?

    We definitely can do some good things; here’s what the science has to say:

    For a full low-down on all of these:

    Revealing the evidence-based lifestyle solutions to managing your menopause symptoms

    Want to know more?

    You can get the International Menopause Society’s free downloadable booklet here:

    Menopause & Cardiovascular Disease: What Women Need To Know

    You may also like our previous main feature:

    What Does “Balance Your Hormones” Even Mean?

    Take care!

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  • The push for Medicare to cover weight-loss drugs: An explainer

    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 largest U.S. insurer, Medicare, does not cover weight-loss drugs, making it tougher for older people to get access to promising new medications.

    If you cover stories about drug costs in the U.S., it’s important to understand why Medicare’s Part D pharmacy program, which covers people aged 65 and older and people with certain disabilities, doesn’t cover weight-loss drugs today. It’s also important to consider what would happen if Medicare did start covering weight loss drugs. This explainer will give you a brief overview of the issues and then summarize some recent publications the benefits and costs of drugs like semaglutide and tirzepatide.

    First, what are these new and newsy weight loss drugs?

    Semaglutide is a medication used for both the treatment of type 2 diabetes and for long-term weight management in adults with obesity. It debuted in the United States in 2017 as an injectable diabetes drug called Ozempic, manufactured by Novo Nordisk. It’s part of a class of drugs that mimics the action of glucagon, a substance that the human body makes to aid digestion. 

    Glucagon-like peptide-1 (GLP-1) drugs like semaglutide help prompt the body to release insulin. But they also cause a minor delay in the pace of digestion, helping people feel sated after eating.

    That second effect turned Ozempic into a widely used weight-loss drug, even before the Food and Drug Administration (FDA) gave its okay for this use. Doctors in the United States can prescribe medicines for uses beyond those approved by the FDA. This is known as off-label use.

    In writing about her own experience in using the medicine to help her shed 40 pounds, Washington Post columnist Ruth Marcus in June noted that Novo Nordisk mentioned the potential for weight loss in its “ubiquitous cable ads (‘Oh-oh-oh, Ozempic!’)” 

    The American Society of Health-System Pharmacists has reported shortages of semaglutide due to demand, leaving some people with diabetes struggling to find supply of the medicine.

    Novo Nordisk won Food and Drug Administration (FDA) approval in 2021 to market semaglutide as an injectable weight loss drug under the name Wegovy, but with a different dosing regimen than Ozempic. Rival Eli Lilly first won FDA approval of its similar GLP-1 diabetes drug, tirzepatide, in the United States in 2022 and sells it under the brand name Mounjaro.

    In November of 2023, Eli Lilly won FDA approval to sell tirzepatide as a weight-loss drug, soon-to-be marketed under the brand name Zepbound. The company said it will set a monthly list price for a month’s supply of the drug at $1,059.87, which the company described as 20% discount to the cost of rival Novo Nordisk’s Wegovy. Wegovy has a list price of $1,349.02, according to the Novo Nordisk website. 

    Even when their insurance plans officially cover costs for weight loss drugs, consumers may face barriers in seeking that coverage for these drugs. Commercial health plans have in place prior authorization requirements to try to limit coverage of new weight-loss shots to those who qualify for these treatments. The Wegovy shot, for example, is intended for people whose weight reaches a certain benchmark for obesity or who are overweight and have a condition related to excess weight, such as diabetes, high blood pressure or high cholesterol.

    State Medicaid programs, meanwhile, have taken approaches that vary by state. For example, the most populous U.S. state, California, provides some coverage to new weight-loss injections through its Medicaid program, but many others, including Texas, the No. 2 state in terms of population,  do not, according to an online tool that Novo Nordisk created to help people check on coverage. 

    Medicare does cover semaglutide for treatment of diabetes, and the insurer reported $3 billion in 2021 spending on the drug under Medicare Part D. Congress last year gave Medicare new tools that might help it try to lower the cost of semaglutide.

    Medicare is in the midst of implementing new authority it gained through the Inflation Reduction Act (IRA) of 2022 to negotiate with companies about the cost of certain medicines.

    This legislation gave Medicare, for the first time, tools to directly negotiate with pharmaceutical companies on the cost of some medicines. Congress tailored this program to spare drug makers from negotiations for the first few years they put new medicines on the market, allowing them to recoup investment in these products.

    Why doesn’t Medicare cover weight-loss drugs?

    Congress created the Medicare Part D pharmacy program in 2003 to address a gap in coverage that had existed since the creation of Medicare in 1965. The program long covered the costs of drugs administered by doctors and those given in hospitals, but not the kinds of medicines people took on their own, like Wegovy shots.

    In 2003, there seemed to be good reasons to leave weight-loss drugs out of the benefit, write Inmaculada Hernandez of the University of California, San Diego, and coauthors in their September 2023 editorial in the Journal of General Internal Medicine, “Medicare Part D Coverage of Anti-obesity Medications: a Call for Forward-Looking Policy Reform.”

    When members of Congress worked on the Part D benefit, the drugs available on the market were known to have limited effectiveness and unpleasant side effects. And those members of Congress were aware of how a drug combination called fen-phen, once touted as a weight-loss miracle medicine, turned out in rare cases to cause fatal heart valve damage. In 1997, American Home Products, which later became Wyeth, took its fen-phen product off the market.

    But today GLP-1 drugs like semaglutide appear to offer significant benefits, with far less risk and milder side effects, write Hernandez and coauthors.

    “Other than budget impact, it is hard to find a reason to justify the historical statutory exclusion of weight loss drugs from coverage other than the stigma of the condition itself,” they write.

    What’s happening today that could lead Medicare to start covering weight loss drugs?

    Novo Nordisk and Eli Lilly both have hired lobbyists to try to persuade lawmakers to reverse this stance, according to Senate records.  Pro tip: You can use the Senate’s lobbying disclosure database to track this and other issues. Type in the name of the company of interest and then read through the forms. 

    Some members of Congress already have been trying for years to strike the Medicare Part D restriction on weight-loss drugs. Over the past decade, senators Tom Carper (D-DE) and Bill Cassidy, MD, (R-LA) have repeatedly introduced bills that would do that. They introduced the current version, the Treat and Reduce Obesity Act of 2023, in July. It has the support of 10 other Republican senators and seven Democratic ones, as of Dec. 19. The companion House measure has the support of 41 Democrats and 23 Republicans in that chamber, which has 435 seats.

    The influential nonprofit Institute for Clinical and Economic Review conducts in-depth analyses of drugs and medical treatments in the United States. ICER last year recommended passage of a law allowing Medicare Part D to cover weight-loss medications. ICER also called for broader coverage of weight-loss medications in state Medicaid programs. Insurers, including Medicare, consider ICER’s analyses in deciding whether to cover treatments.

    While offering these calls for broader coverage as part of a broad assessment of obesity management, ICER also urged companies to reduce the costs of weight-loss medicines.

    Most people with obesity can’t achieve sustained weight loss through diet and exercise alone, said David Rind, ICER’s chief medical officer in an August 2022 statement. The development of newer obesity treatments represents the achievement of a long-standing goal of medical research, but prices of these new products must be reasonable to allow broad access to them, he noted.

    After an extensive process of reviewing studies, engaging in public debate and processing feedback, ICER concluded that semaglutide for weight loss should have an annual cost of $7,500 to $9,800, based on its potential benefits.

    What does academic research say about the benefits and the potential costs of new obesity drugs?

    Here are a couple of studies to consider when covering the ongoing story of weight-loss drug costs:

    Medicare Part D Coverage of Antiobesity Medications — Challenges and Uncertainty Ahead
    Khrysta Baig, Stacie B. Dusetzina, David D. Kim and Ashley A. Leech. New England Journal of Medicine, March 2023

    In this Perspective piece, researchers at Vanderbilt University create a series of estimates about how much Medicare may have to spend annually on weight-loss drugs if the program eventually covers these drugs.

    These include a high estimate — $268 billion — based on an extreme calculation, one reflecting the potential cost if virtually all people on Medicare who have obesity used semaglutide. In an announcement of the study on the Vanderbilt website, lead author Khrysta Baig described this as a “purely hypothetical scenario,” but one that “ underscores that at current prices, these medications cannot be the only way – or even the main way – we address obesity as a society.”

    In a more conservative estimate, Bhaig and coauthors consider a case where only about 10% of those eligible for obesity treatment opted for semaglutide, which would result in $27 billion in new costs.

     (To put these numbers in context, consider that the federal government now spends about $145 billion a year on the entire Part D program.)

    It’s likely that all people enrolled in Part D would have to pay higher monthly premiums if Medicare were to cover weight-loss injections, Baig and coauthors write.

    Baig and coauthors note that the recent ICER review of weight-loss drugs focused on patients younger than the Medicare population. The balance of benefits and risks associated with weight-loss drugs may be less favorable for older people than the younger ones, making it necessary to study further how these drugs work for people aged 65 and older, they write. For example, research has shown older adults with a high blood sugar level called prediabetes are less likely to develop diabetes than younger adults with this condition.

    SELECTing Treatments for Cardiovascular Disease — Obesity in the Spotlight
    Amit Khera and Tiffany M. Powell-Wiley. New England Journal of Medicine, Dec. 14, 2023
    Semaglutide and Cardiovascular Outcomes in Patients Without Diabetes
    A Michael Lincoff, et. al. New England Journal of Medicine, Dec. 14, 2023.

    An editorial accompanies the publication of a semaglutide study that drew a lot of coverage in the media. The Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (SELECT) study was a randomized controlled trial, conducted by Novo Nordisk, which looked at rates of cardiovascular events in people who already had known heart risk and were overweight, but not diabetic. Patients were randomly assigned to receive a once-weekly dose of semaglutide (Wegovy) or a placebo.

    In the study, the authors report that of the 8,803 patients who took Wegovy in the trial, 569 (6.5%)  had a heart attack or another cardiovascular event, compared with 701 of the 8801 patients (8.0%) in the placebo group. The mean duration of exposure to semaglutide or placebo in the study was 34.2 months.

    The study also reports a mean 9.4% reduction in body weight among patients taking Wegovy, while those on placebo had a mean loss of 0.88%.

    The findings suggest Wegovy may be a welcome new treatment option for many people who have coronary disease and are overweight, but are not diabetic, write Khera and Powell-Wiley in their editorial. 

    But the duo, both of whom focus on disease prevention in their research, also call for more focus on the prevention and root causes of obesity and on the use of proven treatment approaches other than medication.

    “Socioeconomic, environmental, and psychosocial factors contribute to incident obesity, and therefore equity-focused obesity prevention and treatment efforts must target multiple levels,” they write. “For instance, public policy targeting built environment features that limit healthy behaviors can be coupled with clinical care interventions that provide for social needs and access to treatments like semaglutide.”

    Additional information:

    The nonprofit KFF, formerly known as the Kaiser Family Foundation, has done recent reports looking at the potential for expanded coverage of semaglutide:

    Medicaid Utilization and Spending on New Drugs Used for Weight Loss, Sept. 8, 2023

    What Could New Anti-Obesity Drugs Mean for Medicare? May 18, 2023

    And KFF held an Aug. 4 webinar, New Weight Loss Drugs Raise Issues of Coverage, Cost, Access and Equity, for which the recording is posted here.

    This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.

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