Grains: Bread Of Life, Or Cereal Killer?
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Going Against The Grain?
In Wednesday’s newsletter, we asked you for your health-related opinion of grains (aside from any gluten-specific concerns), and got the above-depicted, below-described, set of responses:
- About 69% said “They are an important cornerstone of a healthy balanced diet”
- About 22% said “They can be enjoyed in moderation, but watch out”
- About 8% said “They are terrible health-drainers that will kill us”
So, what does the science say?
They are terrible health-drainers that will kill us: True or False?
True or False depending on the manner of their consumption!
There is a big difference between the average pizza base and a bowl of oats, for instance. Or rather, there are a lot of differences, but what’s most critical here?
The key is: refined and ultraprocessed grains are so inferior to whole grains as to be actively negative for health in most cases for most people most of the time.
But! It’s not because processing is ontologically evil (in reality: some processed foods are healthy, and some unprocessed foods are poisonous). although it is a very good general rule of thumb.
So, we need to understand the “why” behind the “key” that we just gave above, and that’s mostly about the resultant glycemic index and associated metrics (glycemic load, insulin index, etc).
In the case of refined and ultraprocessed grains, our body gains sugar faster than it can process it, and stores it wherever and however it can, like someone who has just realised that they will be entertaining a houseguest in 10 minutes and must tidy up super-rapidly by hiding things wherever they’ll fit.
And when the body tries to do this with sugar from refined grains, the result is very bad for multiple organs (most notably the liver, but the pancreas takes quite a hit too) which in turn causes damage elsewhere in the body, not to mention that we now have urgently-produced fat stored in unfortunate places like our liver and abdominal cavity when it should have gone to subcutaneous fat stores instead.
In contrast, whole grains come with fiber that slows down the absorption of the sugars, such that the body can deal with them in an ideal fashion, which usually means:
- using them immediately, or
- storing them as muscle glycogen, or
- storing them as subcutaneous fat
👆 that’s an oversimplification, but we only have so much room here.
For more on this, see:
Glycemic Index vs Glycemic Load vs Insulin Index
And for why this matters, see:
Which Sugars Are Healthier, And Which Are Just The Same?
And for fixing it, see:
They can be enjoyed in moderation, but watch out: True or False?
Technically True but functionally False:
- Technically true: “in moderation” is doing a lot of heavy lifting here. One person’s “moderation” may be another person’s “abstemiousness” or “gluttony”.
- Functionally false: while of course extreme consumption of pretty much anything is going to be bad, unless you are Cereals Georg eating 10,000 cereals each day and being a statistical outlier, the issue is not the quantity so much as the quality.
Quality, we discussed above—and that is, as we say, paramount. As for quantity however, you might want to know a baseline for “getting enough”, so…
They are an important cornerstone of a healthy balanced diet: True or False?
True! This one’s quite straightforward.
3 servings (each being 90g, or about ½ cup) of whole grains per day is associated with a 22% reduction in risk of heart disease, 5% reduction in all-cause mortality, and a lot of benefits across a lot of disease risks:
❝This meta-analysis provides further evidence that whole grain intake is associated with a reduced risk of coronary heart disease, cardiovascular disease, and total cancer, and mortality from all causes, respiratory diseases, infectious diseases, diabetes, and all non-cardiovascular, non-cancer causes.
These findings support dietary guidelines that recommend increased intake of whole grain to reduce the risk of chronic diseases and premature mortality.❞
~ Dr. Dagfinn Aune et al.
We’d like to give a lot more sources for the same findings, as well as papers for all the individual claims, but frankly, there are so many that there isn’t room. Suffice it to say, this is neither controversial nor uncertain; these benefits are well-established.
Here’s a very informative pop-science article, that also covers some of the things we discussed earlier (it shows what happens during refinement of grains) before getting on to recommendations and more citations for claims than we can fit here:
Harvard School Of Public Health | Whole Grains
“That’s all great, but what if I am concerned about gluten?”
There certainly are reasons you might be, be it because of a sensitivity, allergy, or just because perhaps you’d like to know more.
Let’s first mention: not all grains contain gluten, so it’s perfectly possible to enjoy naturally gluten-free grains (such as oats and rice) as well as gluten-free pseudocereals, which are not actually grains but do the same job in culinary and nutritional terms (such as quinoa and buckwheat, despite the latter’s name).
Finally, if you’d like to know more about gluten’s health considerations, then check out our previous mythbusting special:
Enjoy!
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When Carbs, Proteins, & Fats Switch Metabolic Roles
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Strange Things Happening In The Islets Of Langerhans
It is generally known and widely accepted that carbs have the biggest effect on blood sugar levels (and thus insulin response), fats less so, and protein least of all.
And yet, there was a groundbreaking study published yesterday which found:
❝Glucose is the well-known driver of insulin, but we were surprised to see such high variability, with some individuals showing a strong response to proteins, and others to fats, which had never been characterized before.
Insulin plays a major role in human health, in everything from diabetes, where it is too low*, to obesity, weight gain and even some forms of cancer, where it is too high.
These findings lay the groundwork for personalized nutrition that could transform how we treat and manage a range of conditions.❞
*saying ”too low” here is potentially misleading without clarification; yes, Type 1 Diabetics will have too little [endogenous] insulin (because the pancreas is at war with itself and thus isn’t producing useful quantities of insulin, if any). Type 2, however, is more a case of acquired insulin insensitivity, because of having too much at once too often, thus the body stops listening to it, “boy who cried wolf”-style, and the pancreas also starts to get fatigued from producing so much insulin that’s often getting ignored, and does eventually produce less and less while needing more and more insulin to get the same response, so it can be legitimately said “there’s not enough”, but that’s more of a subjective outcome than an objective cause.
Back to the study itself, though…
What they found, and how they found it
Researchers took pancreatic islets from 140 heterogenous donors (varied in age and sex; ostensibly mostly non-diabetic donors, but they acknowledge type 2 diabetes could potentially have gone undiagnosed in some donors*) and tested cell cultures from each with various carbs, proteins, and fats.
They found the expected results in most of the cases, but around 9% responded more strongly to the fats than the carbs (even more strongly than to glucose specifically), and even more surprisingly 8% responded more strongly to the proteins.
*there were also some known type 2 diabetics amongst the donors; as expected, those had a poor insulin response to glucose, but their insulin response to proteins and fats were largely unaffected.
What this means
While this is, in essence, a pilot study (the researchers called for larger and more varied studies, as well as in vivo human studies), the implications so far are important:
It appears that, for a minority of people, a lot of (generally considered very good) antidiabetic advice may not be working in the way previously understood. They’re going to (for example) put fat on their carbs to reduce the blood sugar spike, which will technically still work, but the insulin response is going to be briefly spiked anyway, because of the fats, which very insulin response is what will lower the blood sugars.
In practical terms, there’s not a lot we can do about this at home just yet—even continuous glucose monitors won’t tell us precisely, because they’re monitoring glucose, not the insulin response. We could probably measure everything and do some math and work out what our insulin response has been like based on the pace of change in blood sugar levels (which won’t decrease without insulin to allow such), but even that is at best grounds for a hypothesis for now.
Hopefully, more publicly-available tests will be developed soon, enabling us all to know our “insulin response type” per the proteome predictors discovered in this study, rather than having to just blindly bet on it being “normal”.
Ironically, this very response may have hidden itself for a while—if taking fats raised insulin response without raising blood sugar levels, then if blood sugar levels are the only thing being measured, all we’ll see is “took fats at dinner; blood sugars returned to normal more quickly than when taking carbs without fats”.
You can read the study in full here:
Proteomic predictors of individualized nutrient-specific insulin secretion in health and disease
Want to know more about blood sugar management?
You might like to catch up on:
- 10 Ways To Balance Your Blood Sugars
- Track Your Blood Sugars For Better Personalized Health
- How To Turn Back The Clock On Insulin Resistance
Take care!
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Half Of Americans Over 50 Have Hemorrhoids, But They Can Be Prevented!
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
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
❝Hello. I was hoping you could give some useful tips about how to avoid a painful ailment that has affected Ernest Hemingway, Karl Marx, David Livingstone, Napoleon, Marilyn Monroe, King Alfred, and Martin Luther, and, I confess, me from time to time … namely, hemorrhoids. Help!❞
Firstly: that list could be a lot longer! We don’t have global stats, but in the US for example, half of adults over 50 have hemorrhoids.
So, you’re certainly not alone. People just don’t talk about it.
But, there are preventative things you can do:
Fiber, fiber, fiber. See also:
Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
Hydrate, hydrate, hydrate.
This one’s simple enough. If you are dehydrated, constipation is more likely, and with it, hemorrhoids.
Watch your meds…
Some medications can cause constipation—painkillers containing codeine are a common culprit, for example.
When you go, go!
Not only can prolonged straining promote hemorrhoids, but also (if you’ll pardon the phrasing—there’s only so delicately we can say this) simply sitting with things partway “open” down there is not good for its health; things can quickly become irritated, and that can lead to hemorrhoids.
So: when you go, go. Leave your phone in another room!
Wash—but carefully.
Beyond your normal showering/bathing routine, a bidet is a great option for keeping things happy down there, if you have that option available to you.
However, if you have hemorrhoids, don’t use soap, as this can cause irritation and make it worse.
Warm water is fine, as is a salt bath, and pat dry and/or use gentle wet-wipes rather than rougher paper.
You can follow up with a hemorrhoid cream of your choice (or hydrocortisone, unless that’s contraindicated by another condition you have)
Know when to seek help
Hemorrhoids will usually go away by themselves if not exacerbated. But if it’s getting unduly difficult, and/or you’re bleeding down there, it’s time to see a doctor.
Note on bleeding: even if you’re 100% sure you have hemorrhoids, there are still other reasons you could be bleeding, and so it needs checking out.
Hemorrhoid treatment, if needed, will vary depending on severity. Beyond creams and lotions, there are other options that are less fun but sometimes necessary, including injections, electrotherapy, banding, or surgery.
Take care!
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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:
- Mind resets, which are mostly CBT,
- 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!
- 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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Imposter Syndrome (and why almost everyone has it)
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Imposter Syndrome (and why almost everyone has it)
Imposter syndrome is the pervasive idea that we’re not actually good enough, people think we are better than we are, and at any moment we’re going to get found out and disappoint everyone.
Beyond the workplace
Imposter syndrome is most associated with professionals. It can range from a medical professional who feels like they’ve been projecting an image of confidence too much, to a writer or musician who is sure that their next piece will never live up to the acclaim of previous pieces and everyone will suddenly realize they don’t know what they’re doing, to a middle-manager who feels like nobody above or below them realizes how little they know how to do.
But! Less talked-about (but no less prevalent) is imposter syndrome in other areas of life. New parents tend to feel this strongly, as can the “elders” of a family that everyone looks to for advice and strength and support. Perhaps worst is when the person most responsible for the finances of a household feels like everyone just trusts them to keep everything running smoothly, and maybe they shouldn’t because it could all come crashing down at any moment and everyone will see them for the hopeless shambles of a human being that they really are.
Feelings are not facts
And yet (while everyone makes mistakes sometimes) the reality is that we’re all doing our best. Given that imposter syndrome affects up to 82% of people, let’s remember to have some perspective. Everyone feels like they’re winging it sometimes. Everyone feels the pressure.
Well, perhaps not everyone. There’s that other 18%. Some people are sure they’re the best thing ever. Then again, there’s probably some in that 18% that actually feel worse than the 82%—they just couldn’t admit it, even in an anonymized study.
But one thing’s for sure: it’s very, very common. Especially in high-performing women, by the way, and people of color. In other words, people who typically “have to do twice as much to get recognized as half as good”.
That said, the flipside of this is that people who are not in any of those categories may feel “everything is in my favor, so I really have no excuse to not achieve the most”, and can sometimes take very extreme actions to try to avoid perceived failure, and it can be their family that pays the price.
Things to remember
If you find imposter syndrome nagging at you, remember these things:
- There are people far less competent than you, doing the same thing
- Nobody knows how to do everything themselves, especially at first
- If you don’t know how to do something, you can usually find out
- There is always someone to ask for help, or at least advice, or at least support
At the end of the day, we evolved to eat fruit and enjoy the sun. None of us are fully equipped for all the challenges of the modern world, but if we do our reasonable best, and look after each other (and that means that you too, dear reader, deserve looking after as well), we can all do ok.
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Nature Valley Protein Granola vs Kellog’s All-Bran – Which is Healthier?
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Our Verdict
When comparing Nature Valley Protein Granola to Kellog’s All-Bran, we picked the All-Bran.
Why?
While the Protein Granola indeed contains more protein (13g/cup, compared to 5g/cup), it also contains three times as much sugar (18g/cup, compared to 9g/cup) and only ⅓ as much fiber (4g/cup, compared to 12g/cup)
Given that fiber is what helps our bodies to absorb sugar more gently (resulting in fewer spikes), this is extremely important, especially since 18g of sugar in one cup of Protein Granola is already most of the recommended daily allowance, all at once!
For reference: the AHA recommends no more than 25g added sugar for women, or 32g for men
Hence, we went for the option with 3x as much fiber and ⅓ of the sugar, the All-Bran.
For more about keeping blood sugars stable, see:
10 Ways To Balance Blood Sugars
Enjoy!
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From immunotherapy to mRNA vaccines – the latest science on melanoma treatment explained
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More than 16,000 Australians will be diagnosed with melanoma each year. Most of these will be caught early, and can be cured by surgery.
However, for patients with advanced or metastatic melanoma, which has spread from the skin to other organs, the outlook was bleak until the advent of targeted therapies (that attack specific cancer traits) and immune therapies (that leverage the immune system). Over the past decade, these treatments have seen a significant climb in the number of advanced melanoma patients surviving for at least five years after diagnosis, from less than 10% in 2011 to around 50% in 2021.
While this is great news, there are still many melanoma patients who cannot be treated effectively with current therapies. Researchers have developed two exciting new therapies that are being evaluated in clinical trials for advanced melanoma patients. Both involve the use of immunotherapy at different times and in different ways.
The first results from these trials are now being shared publicly, offering insight into the future of melanoma treatment.
Svitlana Hulko/Shutterstock Immunotherapy before surgery
Immunotherapy works by boosting the power of a patient’s immune system to help kill cancer cells. One type of immunotherapy uses something called “immune checkpoint inhibitors”.
Immune cells carry “immune checkpoint” proteins, which control their activity. Cancer cells can interact with these checkpoints to turn off immune cells and hide from the immune system. Immune checkpoint inhibitors block this interaction and help keep the immune system activated to fight the cancer.
Results from an ongoing phase 3 trial using immune checkpoint inhibitors were recently published in the New England Journal of Medicine.
This trial used two types of immune checkpoint inhibitors: nivolumab, which blocks an immune checkpoint called PD-1, and ipilimumab, which blocks CTLA-4.
More than 16,000 Australians are diagnosed with melanoma each year. Delovely Pics/Shutterstock Some 423 patients (including many from Australia) were enrolled in the trial, and participants were randomly assigned to one of two groups.
The first group had surgery to remove their melanoma, and were then given immunotherapy (nivolumab) to help kill any remaining cancer cells. Giving a systemic (whole body) therapy such as immunotherapy after surgery is a standard way of treating melanoma. The second group received immunotherapy first (nivolumab plus ipilimumab) and then underwent surgery. This is a new approach to treating these cancers.
Based on previous observations, the researchers had predicted that giving patients immunotherapy while the whole tumour was still present would activate the tumour-fighting abilities of the patient’s immune system much better than giving it once the tumour had been removed.
Sure enough, 12 months after starting therapy, 83.7% of patients who received immunotherapy before surgery remained cancer-free, compared to 57.2% in the control group who received immunotherapy after surgery.
Based on these results, Australian of the year Georgina Long – who co-led the trial with Christian Blank from The Netherlands Cancer Institute – has suggested this method of immunotherapy before surgery should be considered a new standard of treatment for higher risk stage 3 melanoma. She also said a similar strategy should be evaluated for other cancers.
The promising results of this phase 3 trial suggest we might see this combination treatment being used in Australian hospitals within the next few years.
mRNA vaccines
Another emerging form of melanoma therapy is the post-surgery combination of a different checkpoint inhibitor (pembrolizumab, which blocks PD-1), with a messenger RNA vaccine (mRNA-4157).
While checkpoint inhibitors like pembrolizumab have been around for more than a decade, mRNA vaccines like mRNA-4157 are a newer phenomenon. You might be familiar with mRNA vaccines though, as the biotechnology companies Pfizer-BioNTech and Moderna released COVID vaccines based on mRNA technology.
mRNA-4157 works basically the same way – the mRNA is injected into the patient and produces antigens, which are small proteins that train the body’s immune system to attack a disease (in this case, cancer, and for COVID, the virus).
However, mRNA-4157 is unique – literally. It’s a type of personalised medicine, where the mRNA is created specifically to match a patient’s cancer. First, the patient’s tumour is genetically sequenced to figure out what antigens will best help the immune system to recognise their cancer. Then a patient-specific version of mRNA-4157 is created that produces those antigens.
The latest results of a three-year, phase 2 clinical trial which combined pembrolizumab and mRNA-4157 were announced this past week. Overall, 2.5 years after starting the trial, 74.8% of patients treated with immunotherapy combined with mRNA-4157 post-surgery remained cancer-free, compared to 55.6% of those treated with immunotherapy alone. These were patients who were suffering from high-risk, late-stage forms of melanoma, who generally have poor outcomes.
It’s worth noting these results have not yet been published in peer-reviewed journals. They’re available as company announcements, and were also presented at some cancer conferences in the United States.
Based on the results of this trial, the combination of pembrolizumab and the vaccine progressed to a phase 3 trial in 2023, with the first patients being enrolled in Australia. But the final results of this trial are not expected until 2029.
It is hoped this mRNA-based anti-cancer vaccine will blaze a trail for vaccines targeting other types of cancer, not just melanoma, particularly in combination with checkpoint inhibitors to help stimulate the immune system.
Despite these ongoing advances in melanoma treatment, the best way to fight cancer is still prevention which, in the case of melanoma, means protecting yourself from UV exposure wherever possible.
Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, WEHI (Walter and Eliza Hall Institute of Medical Research) and John (Eddie) La Marca, Senior Research Officer, Blood Cells and Blood Cancer, WEHI (Walter and Eliza Hall Institute of Medical Research)
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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