
HBD: The Human Being Diet – by Petronella Ravenshear
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We don’t often review diet books, so why did this one catch our attention? The answer lies in its comprehensive nature without being excessively long and complex.
Ravenshear (a nutritionist) brings a focus on metabolic balance, and what will and won’t work for keeping it healthy.
The first part of the book is mostly informational; covering such things as blood sugar balance, gut health, hormones, and circadian rhythm considerations, amongst others.
The second, larger part of the book is mostly instructional; do this and that, don’t do the other, guidelines on quantities and timings, and what things may be different for some people, and what to do about those.
The style is conversational and light, but well-grounded in good science.
Bottom line: if you’d like a “one-stop shop” for giving your diet an overhaul, this book is a fine choice.
Click here to check out the Human Being Diet, and enjoy the best of health!
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Vitamin B6 is essential – but too much can be toxic. Here’s what to know to stay safe
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In recent weeks, reports have been circulating about severe reactions in people who’ve taken over-the-counter vitamin B6 supplements.
Vitamin B6 poisoning can injure nerves and lead to symptoms including numbness, tingling and even trouble walking and moving.
In some cases, those affected didn’t know the product contained any vitamin B6.
So what is vitamin B6, where is it found and how much is too much? Here’s what you need to know about this essential nutrient.
Kim Kuperkova/Shutterstock What is vitamin B6?
Vitamin B6 (also known as pyridoxine) is a group of six compounds that share a similar chemical structure.
It is an essential nutrient, meaning we need it for normal body functions, but we can’t produce it ourselves.
Adults aged 19–50 need 1.3mg of vitamin B6 per day. The recommended dose is lower for teens and children, and higher for those aged 51 and over (1.7mg for men and 1.5mg for women) and people who are breastfeeding or pregnant (1.9mg).
Most of us get this in our diet – largely from animal products, including meat, dairy and eggs.
The vitamin is also available in a range of different plant foods, including spinach, kale, bananas and potatoes, so deficiency is rare, even for vegetarians and vegans.
The vitamin B6 we consume in the diet is inactive, meaning the body can’t use it. To activate B6, the liver transforms it into a compound called pyridoxal-5’-phosphate (PLP).
In this form, vitamin B6 helps the body with more than 140 cellular functions, including building and breaking down proteins, producing red blood cells, regulating blood sugar and supporting brain function.
Vitamin B6 is important for overall health and has also been associated with reduced cancer risk and inflammation.
Despite being readily available in the diet, vitamin B6 is also widely included in various supplements, multivitamins and other products, such as Berocca and energy drinks.
Most people get enough vitamin B6 from their diet. Tatjana Baibakova/Shutterstock Should we be worried about toxicity?
Vitamin B6 toxicity is extremely rare. It almost never occurs from dietary intake alone, unless there is a genetic disorders or disease that stops nutrient absorption (such as coeliac disease).
This is because all eight vitamins in the B group are water-soluble. If you consume more of the vitamin than your body needs, it can be excreted readily and harmlessly in your urine.
However, in some rare cases, excessive vitamin B6 accumulates in the blood, resulting in a condition called peripheral neuropathy. We’re still not sure why this occurs in some people but not others.
Peripheral neuropathy occurs when the sensory nerves – those outside our brain and spinal cord that send information to the central nervous system – are damaged and unable to function. This can be caused by a wide range of diseases (and is most well known in type 2 diabetes).
The most common symptoms are numbness and tingling, though in some cases patients may experience difficulty with balance or walking.
We don’t know exactly how excess vitamin B6 causes peripheral neuropathy, but it is thought to interfere with how the neurotransmitter GABA sends signals to the sensory nerves.
Vitamin B6 can cause permanent damage to nerves. Studies have shown symptoms improved when the person stopped taking the supplement, although they didn’t completely resolve.
What is considered excessive? And has this changed?
Toxicity usually occurs only when people take supplements with high doses of B6.
Until 2022, only products with more than 50mg of vitamin B6 were required to display a warning about peripheral neuropathy. But the Therapeutic Goods Administration lowered this and now requires any product containing more than 10mg of vitamin B6 to carry a warning.
The Therapeutic Goods Administration has also halved the daily upper limit of vitamin B6 a product can provide – from 200mg to 100mg.
These changes followed a review by the administration, after receiving 32 reports of peripheral neuropathy in people taking supplements. Two thirds of these people were taking less than 50mg of vitamin B6.
The Therapeutic Goods Administration acknowledges the risk varies between individuals and a lot is unknown. Its review could not identify a minimum dose, duration of use or patient risk factors.
But I thought B vitamins were good for me?
Too much of anything can cause problems.
The updated guidelines are likely to significantly lower the risk of toxicity. They also make consumers more aware of which products contain B6, and the risks.
The Therapeutic Goods Administration will continue to monitor evidence and revise guidelines if necessary.
While vitamin B6 toxicity remains very rare, there are still many questions about why some people get peripheral neuropathy with lower dose supplements.
It could be that some specific vitamin B compounds have a stronger effect, or some people may have genetic vulnerabilities or diseases which put them at higher risk.
So what should I do?
Most people don’t need to actively seek vitamin B6 in supplements.
However, many reports to the Therapeutic Goods Administration were of vitamin B6 being added to supplements labelled as magnesium or zinc – and some weren’t aware they were consuming it.
It is important to always check the label if you are taking a new medicine or supplement, especially if it hasn’t been explicitly prescribed by a health-care professional.
Be particularly cautious if you are taking multiple supplements. While one multivitamin is unlikely to cause an issue, adding a magnesium supplement for cramping, or a zinc supplement for cold and flu symptoms, may cause an excessive vitamin B6 dose over time, and increase your risk.
Importantly, pay attention to symptoms that may indicate peripheral neuropathy, such as pins and needles, numbness, or pain in the feet or hands, if you do change or add a supplement.
Most importantly, if you need advice, you should talk to your doctor, dietitian or pharmacist.
Vasso Apostolopoulos, Distinguished Professor, Professor of Immunology, RMIT University and Jack Feehan, Vice Chancellors Senior Research Fellow in Immunology, RMIT University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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DVT Risk Management Beyond The Socks
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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
❝I know I am at higher risk of DVT after having hip surgery, any advice beside compression stockings?❞
First of all, a swift and easy recovery to you!
Surgery indeed increases the risk of deep vein thrombosis (henceforth: DVT), and hip or knee surgery especially so, for obvious reasons.
There are other risk factors you can’t control, like genetics (family history of DVT as an indicator) and age, but there are some that you can, including:
- smoking (so, ideally don’t; do speak to your doctor before quitting though, in case withdrawal might be temporarily worse for you than smoking)
- obesity (so, losing weight is good if overweight, but if this is going to happen, it’ll mostly happen in the kitchen not the gym, which may be a relief as you’re probably not the very most up for exercise at present)
- See also: Lose Weight, But Healthily
- sedentariness (so, while you’re probably not running marathons right now, please do try to keep moving, even if only gently)
Beyond that, yes compression socks, but also frequent gentle massage can help a lot to avoid clots forming.
Also, no surprises, a healthy diet will help, especially one that’s good for general heart health. Check out for example the Mediterranean DASH diet:
Four Ways To Upgrade The Mediterranean Diet
Also, obviously, speak with your doctor/pharmacist if you haven’t already about possible medications, including checking whether any of your current medications increase the risk and could be swapped for something that doesn’t.
Take care!
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Syringe Exchange Fears Hobble Fight Against West Virginia HIV Outbreak
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CHARLESTON, http://w.va/. — More than three years have passed since federal health officials arrived in central Appalachia to assess an alarming outbreak of HIV spread mostly between people who inject opioids or methamphetamine.
Infectious disease experts from the Centers for Disease Control and Prevention made a list of recommendations following their visit, including one to launch syringe service programs to stop the spread at its source. But those who’ve spent years striving to protect people who use drugs from overdose and illness say the situation likely hasn’t improved, in part because of politicians who contend that such programs encourage illegal drug use.
Joe Solomon is a Charleston City Council member and co-director of SOAR WV, a group that works to address the health needs of people who use drugs. He’s proud of how his close-knit community has risen to this challenge but frustrated with the restraints on its efforts.
“You see a city and a county willing to get to work at a scale that’s bigger than ever before,” Solomon said, “but we still have one hand tied behind our back.”
The hand he references is easier access to clean syringes.
In April 2021, the CDC came to Charleston — the seat of Kanawha County and the state capital, tucked into the confluence of the Kanawha and Elk rivers — to investigate dozens of newly detected HIV infections. The CDC’s HIV intervention chief called it “the most concerning HIV outbreak in the United States” and warned that the number of reported diagnoses could be just “the tip of the iceberg.”
Now, despite attention and resources directed toward the outbreak, researchers and health workers say HIV continues to spread. In large part, they say, the outbreak lingers because of restrictions state and local policymakers have placed on syringe exchange efforts.
Research indicates that syringe service programs are associated with an estimated 50% reduction in HIV and hepatitis C, and the CDC issued recommendations to steer a response to the outbreak that emphasized the need for improved access to those services.
That advice has thus far gone unheeded by local officials.
In late 2015, the Kanawha-Charleston Health Department launched a syringe service program but shuttered it in 2018 under pressure, with then-Mayor Danny Jones calling it a “mini-mall for junkies and drug dealers.”
SOAR stepped in, hosting health fairs at which it distributed naloxone, an opioid overdose reversal drug; offered treatment and referrals; provided HIV testing; and exchanged clean syringes for used ones.
But in April 2021, the state legislature passed a bill limiting the number of syringes people could exchange and made it mandatory to present a West Virginia ID. The Charleston City Council subsequently added guidelines of its own, including requiring individual labeling of syringes.
As a result of these restrictions, SOAR ceased exchanging syringes. West Virginia Health Right now operates an exchange program in the city under the restrictions.
Robin Pollini is a West Virginia University epidemiologist who conducts community-based research on injection drug use. “Anyone I’ve talked to who’s used that program only used it once,” she said. “And the numbers they report to the state bear that out.”
A syringe exchange run by the health department in nearby Cabell County — home to Huntington, the state’s largest city after Charleston — isn’t so constrained. As Solomon notes, that program exchanges more than 200 syringes for every one exchanged in Kanawha.
A common complaint about syringe programs is that they result in discarded syringes in public spaces. Jan Rader, director of Huntington’s Mayor’s Office of Public Health and Drug Control Policy, is regularly out on the streets and said she seldom encounters discarded syringes, pointing out that it’s necessary to exchange a used syringe for a new one.
In August 2023, the Charleston City Council voted down a proposal from the Women’s Health Center of West Virginia to operate a syringe exchange in the city’s West Side community, with opponents expressing fears of an increase in drug use and crime.
Pollini said it’s difficult to estimate the number of people in West Virginia with HIV because there’s no coordinated strategy for testing; all efforts are localized.
“You would think that in a state that had the worst HIV outbreak in the country,” she said, “by this time we would have a statewide testing strategy.”
In addition to the testing SOAR conducted in 2021 at its health fairs, there was extensive testing during the CDC’s investigation. Since then, the reported number of HIV cases in Kanawha County has dropped, Pollini said, but it’s difficult to know if that’s the result of getting the problem under control or the result of limited testing in high-risk groups.
“My inclination is the latter,” she said, “because never in history has there been an outbreak of injection-related HIV among people who use drugs that was solved without expanding syringe services programs.”
“If you go out and look for infections,” Pollini said, “you will find them.”
Solomon and Pollini praised the ongoing outreach efforts — through riverside encampments, in abandoned houses, down county roads — of the Ryan White HIV/AIDS Program to test those at highest risk: people known to be injecting drugs.
“It’s miracle-level work,” Solomon said.
But Christine Teague, Ryan White Program director at the Charleston Area Medical Center, acknowledged it hasn’t been enough. In addition to HIV, her concerns include the high incidence of hepatitis C and endocarditis, a life-threatening inflammation of the lining of the heart’s chambers and valves, and the cost of hospital resources needed to address them.
“We’ve presented that data to the legislature,” she said, “that it’s not just HIV, it’s all these other lengthy hospital admissions that, essentially, Medicaid is paying for. And nothing seems to penetrate.”
Frank Annie is a researcher at CAMC specializing in cardiovascular diseases, a member of the Charleston City Council, and a proponent of syringe service programs. Research he co-authored found 462 cases of endocarditis in southern West Virginia associated with injection drug use, at a cost to federal, state, and private insurers of more than $17 million, of which less than $4 million was recovered.
Teague is further concerned for West Virginia’s rural counties, most of which don’t have a syringe service program.
Tasha Withrow, a harm reduction advocate in bordering rural Putnam County, said her sense is that HIV numbers aren’t alarmingly high there but said that, with little testing and heightened stigma in a rural community, it’s difficult to know.
In a January 2022 follow-up report, the CDC recommended increasing access to harm reduction services such as syringe service programs through expansion of mobile services, street outreach, and telehealth, using “patient-trusted” individuals, to improve the delivery of essential services to people who use drugs.
Teague would like every rural county to have a mobile unit, like the one operated by her organization, offering harm reduction supplies, medication, behavioral health care, counseling, referrals, and more. That’s an expensive undertaking. She suggested opioid settlement money through the West Virginia First Foundation could pay for it.
Pollini said she hopes state and local officials allow the experts to do their jobs.
“I would like to see them allow us to follow the science and operate these programs the way they’re supposed to be run, and in a broader geography,” she said. “Which means that it shouldn’t be a political decision; it should be a public health decision.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
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Overdone It? How To Speed Up Recovery After Exercise
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How To Speed Up Recovery After A Workout (According To Actual Science)
Has your enthusiasm ever been greater than your ability, when it comes to exercise?
Perhaps you leapt excitedly into a new kind of exercise, or maybe you made a reprise of something you used to do, and found out the hard way you’re not in the same condition you used to be?
If you’ve ever done an exercise session and then spent the next three days recovering, this one’s for you. And if you’ve never done that? Well, prevention is better than cure!
Post-exercise stretching probably won’t do much to help
If you like to stretch after a workout, great, don’t let us stop you. Stretching is, generally speaking, good.
But: don’t rely on it to hasten recovery. Here’s what scientists Afonso et al. had to say recently, after doing a big review of a lot of available data:
❝There wasn’t sufficient statistical evidence to reject the null hypothesis that stretching and passive recovery have equivalent influence on recovery.
Data is scarce, heterogeneous, and confidence in cumulative evidence is very low. Future research should address the limitations highlighted in our review, to allow for more informed recommendations.
For now, evidence-based recommendations on whether post-exercise stretching should be applied for the purposes of recovery should be avoided, as the (insufficient) data that is available does not support related claims.❞
…and breath! What a title.
Hot and Cold
Contrast bath therapy (alternating hot and cold, which notwithstanding the name, can also be done in a shower) can help reduce muscle soreness after workout, because of how the change in temperature stimulates vasodilation and vasoconstriction, reducing inflammation while speeding up healing:
Contrast Water Therapy and Exercise Induced Muscle Damage: A Systematic Review and Meta-Analysis
If doing this in the shower isn’t practical for you, and you (like most people) have only one bathtub, then cold is the way to go for the most evidence-based benefits:
Whole-Body Cryotherapy in Athletes: From Therapy to Stimulation. An Updated Review of the Literature
Eat protein whenever, carbs after
Eating protein before a workout can boost muscle protein synthesis. Be aware that even if you’re not bodybuilding, your body will still need to do cell replacement and repair, including in any muscle tissue that got damaged* during the workout
If you don’t like eating before a workout, eating protein after is fine too:
Pre- versus post-exercise protein intake has similar effects on muscular adaptations
*Note: muscle tissue is supposed to get damaged (slightly!) during many kinds of workout.
From lactic acid (that “burn” you feel when exercising) to microtears, the body’s post-workout job is to make the muscle stronger than before, and to do that, it needs you to have found the weak spots for it.
That’s what exercise-to-exhaustion does.
Eating carbs after a workout helps replace lost muscle glycogen.
For a lot more details on optimal nutrition timing in the context of exercise (carbs, proteins, micronutrients, different kinds of exercise, etc), check out this very clear guide:
International society of sports nutrition position stand: nutrient timing
Alcohol is not the post-workout carb you want
Shocking, right? But of course, it’s very common for casual sportspeople to hit the bar for a social drink after their activity of choice.
However, consuming alcohol after exercise doesn’t merely fail to help, it actively inhibits glycogen replacement and protein synthesis:
Also, if you’re tempted to take alcohol “to relax”, please be aware that alcohol only feels relaxing because of what it does to the brain; to the rest of the body, it is anything but, and also raises blood pressure and cortisol levels.
As to what to drink instead…
Hydrate, and consider creatine and tart cherry supplementation
Hydration is a no-brainer, but when you’re dehydrated, it’s easy to forget!
Creatine is a very well-studied supplement, that helps recovery from intense exercise:
Tart cherry juice has been found to reduce muscle damage, soreness, and inflammation after exercise:
Wondering where you can get tart cherry powder? We don’t sell it (or anything else), but here’s an example product on Amazon.
And of course, actually rest
That includes good sleep, please. Otherwise…
Effects of Sleep Deprivation on Acute Skeletal Muscle Recovery after Exercise
Rest well!
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The Five Invitations – by Frank Ostaseski
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This book covers exactly what its subtitle promises, and encourages the reader to truly live life fully, something that Ostaseski believes cannot be done in ignorance of death.
Instead, he argues from his experience of decades working at a hospice, we must be mindful of death not only to appreciate life, but also to make the right decisions in life—which means responding well to what he calls, as per the title of this book, “the five invitations”.
We will not keep them a mystery; they are:
- Don’t wait; do the important things now
- Welcome everything; push away nothing
- Bring your whole self to the experience
- Find a place in the middle of things
- Cultivate a “don’t know” mind
Note, for example, that “do the important things now” requires knowing what is important. For example, ensuring a loved one knows how you feel about them, might be more important than scratching some item off a bucket list. And “push away nothing” does mean bad things too; rather, of course try to make life better rather than worse, but accept the lessons and learnings of the bad too, and see the beauty that can be found in contrast to it. Enjoying the fullness of life without getting lost in it; carrying consciousness through the highs and lows. And yes, approaching the unknown (which means not only death, but also the large majority of life) with open-minded curiosity and wonder.
The style of the book is narrative and personal, without feeling like a collection of anecdotes, but rather, taking the reader on a journey, prompting reflection and introspection along the way.
Bottom line: if you’d like to minimize the regrets you have in life, this book is a fine choice.
Click here to check out The Five Invitations, and answer with a “yes” to the call of life!
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The Calorie Myth – by Jonathan Bailor
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First we’ll mention: the author is not a doctor, but the book is endorsed by assorted well-known doctors in the field, and the science described is consistent with current scientific consensus (and, for that matter, consistent with what we wrote in our mythbusting feature: Are You A Calorie-Burning Machine?).
It’s often (correctly) said that “not all calories are created equal”, but how should we quantify them? He proposes his “SANE solution”, which is based around the ideas of:
- Satiety: how quickly calories fill us up
- Aggression: how likely calories are to be stored as fat
- Nutrition: how many micronutrients calories bring with them, and how much
- Efficiency: how easily calories are converted
To this end, he recommends a diet high in foods that score well on his “SANE” factors, and provides such things as recipes, meal plans etc to help, as well principles for exercising more usefully in the context of metabolic base rate, and moving (rather than fighting) one’s “set point”, which is usually associated with one’s weight but it really has more to do with metabolic base rate. In fact, Bailor recommends throwing out the bathroom scale and focusing on pursuing good health itself, rather than obsessing over changing one’s relationship with the Earth’s gravitational field.
Yes, it says “lose weight” in the subtitle, but the idea is that this will be a by-product rather than the thing actively pursued. After all, we can control our actions, so that input variable is where we should put our focus, not the output variable of the numbers on the scale which can often be misleading (muscle weighing more than fat, tendency to water weight fluctuations, etc).
The style is a little flashy and salesy for this reviewer’s personal taste (a lot of references to his own businesses and neologisms associated with such), but it doesn’t take away from the quality of the content, and in terms of science, study references come at a rate of about one per page on average.
Bottom line: if you’d like to rethink your relationship with calories, then this book can help give you a much more practical angle.
Click here to check out The Calorie Myth, and take control of your metabolic base rate!
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