Your Health Audit, From Head To Toe

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Health Audit Time

Here at 10almonds, we often cover quite specific things, ranging from “the effect of sodium on organs other than your heart” to “make this one small change to save your knees while driving”.

But, we’re each a whole person, and we need to take care of the whole organism that makes up the wonderful being that we each are. If we let one part of it drop in health too much, the others will soon follow suit because of the knock-on effects.

So, let’s do a quick self-check-up, and see what can be done for each! How’s your…

Mental Health

We’re doing this audit head-to-to, so let’s start it here, because mental health is also just health, and it’s difficult to tackle the others without having this one at least under control!

Are you experiencing chronic stress? Anxiety? Depression? Joy?

If you answered “no” to “joy” but also “no” to “depression”, you might want to rethink your answer to “depression”, by the way. Life should be a joyous thing!

Some resources to address your mental health:

Brain Health

Your brain is a big, powerful organ. It uses more of your daily energy (in the physiological sense of the word, we’re talking calories and mitochondria and ATP) than any other organ, by far.

And when it comes to organ failure, if your brain fails, then having the best joints in the world won’t help you, for example.

Some resources to address your brain health:

Heart Health

Everything depends on your heart, head to toe. Tirelessly pumping blood with oxygen, nutrients, and agents of your immune system all around your body, all day every day for your entire life.

What’s your resting heart rate like? How about your blood pressure? And while we’re on the topic of blood… how’s your blood sugar health?

These are all important things to a) know about and b) keep on top of!

Some resources to address your heart health:

Gut Health

By cell count, we’re about 10% human and 90% bacteria. By gene count, also. Pretty important, therefore, that we look after our trillions of tiny friends that keep our organism working.

Most people in N. America, for example, get vastly under the recommended daily amount of fiber, and that’s just the most basic courtesy we could do for these bugs that keep us alive (they need that fiber to live, and their process of consuming it is beneficial to us in a stack of ways).

Some resources to address your gut health:

Hormonal Health

Hormones are weird and wonderful and affect so much more than the obvious sex-related functions (but yes, those too). A lot of people don’t realize it, but having our hormones in good order or not can make the difference between abject misery and a happy, fulfilling life.

Some resources to address your hormonal health:

Bone/Joint Health

Fear nothing! For you are a ghost operating a skeleton clad in flesh. But also, you know, look after that skeleton; you only get one! Being animals, we’re all about movement, and being humans, we’ve ended up with some lifestyle situations that aren’t great for that mobility. We sit too much; we walk too little; we cramp ourselves into weird positions (driving, anyone?), and we forget the range of motion we’re supposed to have. But let’s remember…

Some resources to address your bone/joint health:

Lastly…

While it’s good to do a little self-audit like this every now and again, it’s even better to get a professional check-up!

As engineers say: if you don’t schedule time for maintenance, your equipment will schedule it for you.

Don’t Forget…

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  • The Bare-Bones Truth About Osteoporosis

    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.

    In yesterday’s issue of 10almonds, we asked you “at what age do you think it’s important to start worrying about osteoporosis?”, and here’s the spread of answers you gave us:

    The Bare-bones Truth About Osteoporosis

    In yesterday’s issue of 10almonds, we asked you “at what age do you think it’s important to start worrying about osteoporosis?”, and here’s the spread of answers you gave us:

    At first glance it may seem shocking that a majority of respondents to a poll in a health-focused newsletter think it’ll never be an issue worth worrying about, but in fact this is partly a statistical quirk, because the vote of the strongest “early prevention” crowd was divided between “as a child” and “as a young adult”.

    This poll also gave you the option to add a comment with your vote. Many subscribers chose to do so, explaining your choices… But, interestingly, not one single person who voted for “never” had any additional thoughts to add.

    We loved reading your replies, by the way, and wish we had room to include them here, because they were very interesting and thought-provoking.

    Let’s get to the myths and facts:

    Top myth: “you will never need to worry about it; drink a glass of milk and you’ll be fine!”

    The body is constantly repairing itself. Its ability to do that declines with age. Until about 35 on average, we can replace bone mineral as quickly as it is lost. After that, we lose it by up to 1% per year, and that rate climbs after 50, and climbs even more steeply for those who go through (untreated) menopause.

    Losing 1% per year might not seem like a lot, but if you want to live to 100, there are some unfortunate implications!

    About that menopause, by the way… Because declining estrogen levels late in life contribute significantly to osteoporosis, hormone replacement therapy (HRT) may be of value to many for the sake of bone health, never mind the more obvious and commonly-sought benefits.

    Learn more: Management of osteoporosis in postmenopausal women: the 2021 position statement of The North American Menopause Society

    On the topic of that glass of milk…

    • Milk is a great source of calcium, which is useless to the body if you don’t also have good levels of vitamin D and magnesium.
    • People’s vitamin D levels tend to directly correlate to the level of sun where they live, if supplementation isn’t undertaken.
    • Plant-based milks are usually fortified with vitamin D (and calcium), by the way.
    • Most people are deficient in magnesium, because green leafy things don’t form as big a part of most people’s diets as they should.

    See also: An update on magnesium and bone health

    Next most common myth: “bone health is all about calcium”

    We spoke a little above about the importance of vitamin D and magnesium for being able to properly use that. But potassium is also critical:

    Read more: The effects of potassium on bone health

    While we’re on the topic…

    People think of collagen as being for skin health. And it is important for that, but collagen’s benefits (and the negative effects of its absence) go much deeper, to include bone health. We’ve written about this before, so rather than take more space today, we’ll just drop the link:

    We Are Such Stuff As Fish Are Made Of

    Want to really maximize your bone health?

    You might want to check out this well-sourced LiveStrong article:

    Bone Health: Best and Worst Foods

    (Teaser: leafy greens are in 2nd place, topped by sardines at #1—where do you think milk ranks?)

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  • Tribulus Terrestris For Testosterone?

    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.

    (Clinical) Trials and Tribul-ations

    In the category of supplements that have enjoyed use as aphrodisiacs, Tribulus terrestris (also called caltrop, goat’s head, gokshura, or puncture vine) has a long history, having seen wide use in both Traditional Chinese Medicine and in Ayurveda.

    It’s been used for other purposes too, and has been considered a “general wellness” plant.

    So, what does the science say?

    Good news: very conclusive evidence!

    Bad news: the conclusion is not favorable…

    Scientists are known for their careful use of clinical language, and it’s very rare for a study/review to claim something as proven (scientists leave journalists to do that part), and in this case, when it comes to Tribulus’s usefulness as a testosterone-enhancing libido-boosting supplement…

    ❝analysis of empirical evidence from a comprehensive review of available literature proved this hypothesis wrong❞

    ~ Drs. Neychev & Mitev

    Strong words! You can read it in full here; they do make some concessions along the way (e.g. mentioning unclear or contradictory findings, suggesting that it may have some effect, but by an as-yet unknown mechanism if it does—although some potential effect on nitric oxide levels has been hypothesized, which is reasonable if so, as NO does feature in arousal-signalling), but the general conclusion is “no, this doesn’t have androgen-enhancing properties”:

    Pro-sexual and androgen enhancing effects of Tribulus terrestris L.: Fact or Fiction

    That’s a review though, what about taking a look at a representative RCT? Here we go:

    ❝Tribulus terrestris was not more effective than placebo on improving symptoms of erectile dysfunction or serum total testosterone❞

    ~ Dr. Santos et al.

    Read more: Tribulus terrestris versus placebo in the treatment of erectile dysfunction: A prospective, randomized, double-blind study

    As a performance-enhancer in sport

    We’ll be brief here: it doesn’t seem to work and it may not be safe:

    Insights into Supplements with Tribulus Terrestris used by Athletes

    From sport, into general wellness?

    Finally, a study that finds it may be useful for something!

    ❝Overall, participants supplemented with TT displayed significant improvements in lipid profile. Inflammatory and hematological biomarkers showed moderate beneficial effects with no significant changes on renal biomarkers. No positive effects were observed on the immune system response. Additionally, no TT-induced toxicity was reported.

    In conclusion, there was no clear evidence of the beneficial effects of TT supplementation on muscle damage markers and hormonal behavior.❞

    ~ Dr. Fernández-Lázaro et al.

    Read more: Effects of Tribulus terrestris L. on Sport and Health Biomarkers in Physically Active Adult Males: A Systematic Review

    About those lipids…

    Animal studies have shown that it may not only improve lipid profiles, but also may partially repair the endothelial dysfunction resulting from hyperlipidemia:

    Influence of Tribulus terrestris extract on lipid profile and endothelial structure in developing atherosclerotic lesions in the aorta of rabbits on a high-cholesterol diet

    Want to try some?

    In the unlikely event that today’s research review has inspired you with an urge to try Tribulus terrestris, here’s an example product on Amazon

    If on the other hand you’d like to actually increase testosterone levels, then we suggest:

    Topping Up Testosterone? ← a previous main feature did earlier this year

    Take care!

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  • Good Energy – by Dr. Casey Means

    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.

    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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  • A short history of sunscreen, from basting like a chook to preventing skin cancer

    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.

    Australians have used commercial creams, lotions or gels to manage our skin’s sun exposure for nearly a century.

    But why we do it, the preparations themselves, and whether they work, has changed over time.

    In this short history of sunscreen in Australia, we look at how we’ve slathered, slopped and spritzed our skin for sometimes surprising reasons.

    At first, suncreams helped you ‘tan with ease’

    Advertisement for Hamilton's Sunburn Vanishing Cream
    This early sunscreen claimed you could ‘tan with ease’.
    Trove/NLA

    Sunscreens have been available in Australia since the 30s. Chemist Milton Blake made one of the first.

    He used a kerosene heater to cook batches of “sunburn vanishing cream”, scented with French perfume.

    His backyard business became H.A. Milton (Hamilton) Laboratories, which still makes sunscreens today.

    Hamilton’s first cream claimed you could “
    Sunbathe in Comfort and TAN with ease”. According to modern standards, it would have had an SPF (or sun protection factor) of 2.

    The mirage of ‘safe tanning’

    A tan was considered a “modern complexion” and for most of the 20th century, you might put something on your skin to help gain one. That’s when “safe tanning” (without burning) was thought possible.

    Coppertone advertisement showing tanned woman in bikini
    This 1967 Coppertone advertisement urged you to ‘tan, not burn’.
    SenseiAlan/Flickr, CC BY-SA

    Sunburn was known to be caused by the UVB component of ultraviolet (UV) light. UVA, however, was thought not to be involved in burning; it was just thought to darken the skin pigment melanin. So, medical authorities advised that by using a sunscreen that filtered out UVB, you could “safely tan” without burning.

    But that was wrong.

    From the 70s, medical research suggested UVA penetrated damagingly deep into the skin, causing ageing effects such as sunspots and wrinkles. And both UVA and UVB could cause skin cancer.

    Sunscreens from the 80s sought to be “broad spectrum” – they filtered both UVB and UVA.

    Researchers consequently recommended sunscreens for all skin tones, including for preventing sun damage in people with dark skin.

    Delaying burning … or encouraging it?

    Up to the 80s, sun preparations ranged from something that claimed to delay burning, to preparations that actively encouraged it to get that desirable tan – think, baby oil or coconut oil. Sun-worshippers even raided the kitchen cabinet, slicking olive oil on their skin.

    One manufacturer’s “sun lotion” might effectively filter UVB; another’s merely basted you like a roast chicken.

    Since labelling laws before the 80s didn’t require manufacturers to list the ingredients, it was often hard for consumers to tell which was which.

    At last, SPF arrives to guide consumers

    In the 70s, two Queensland researchers, Gordon Groves and Don Robertson, developed tests for sunscreens – sometimes experimenting on students or colleagues. They printed their ranking in the newspaper, which the public could use to choose a product.

    An Australian sunscreen manufacturer then asked the federal health department to regulate the industry. The company wanted standard definitions to market their products, backed up by consistent lab testing methods.

    In 1986, after years of consultation with manufacturers, researchers and consumers, Australian Standard AS2604 gave a specified a testing method, based on the Queensland researchers’ work. We also had a way of expressing how well sunscreens worked – the sun protection factor or SPF.

    This is the ratio of how long it takes a fair-skinned person to burn using the product compared with how long it takes to burn without it. So a cream that protects the skin sufficiently so it takes 40 minutes to burn instead of 20 minutes has an SPF of 2.

    Manufacturers liked SPF because businesses that invested in clever chemistry could distinguish themselves in marketing. Consumers liked SPF because it was easy to understand – the higher the number, the better the protection.

    Australians, encouraged from 1981 by the Slip! Slop! Slap! nationwide skin cancer campaign, could now “slop” on a sunscreen knowing the degree of protection it offered.

    How about skin cancer?

    It wasn’t until 1999 that research proved that using sunscreen prevents skin cancer. Again, we have Queensland to thank, specifically the residents of Nambour. They took part in a trial for nearly five years, carried out by a research team led by Adele Green of the Queensland Institute of Medical Research. Using sunscreen daily over that time reduced rates of squamous cell carcinoma (a common form of skin cancer) by about 60%.

    Follow-up studies in 2011 and 2013 showed regular sunscreen use almost halved the rate of melanoma and slowed skin ageing. But there was no impact on rates of basal cell carcinoma, another common skin cancer.

    By then, researchers had shown sunscreen stopped sunburn, and stopping sunburn would prevent at least some types of skin cancer.

    What’s in sunscreen today?

    An effective sunscreen uses one or more active ingredients in a cream, lotion or gel. The active ingredient either works:

    • “chemically” by absorbing UV and converting it to heat. Examples include PABA (para-aminobenzoic acid) and benzyl salicylate, or

    • “physically” by blocking the UV, such as zinc oxide or titanium dioxide.

    Physical blockers at first had limited cosmetic appeal because they were opaque pastes. (Think cricketers with zinc smeared on their noses.)

    With microfine particle technology from the 90s, sunscreen manufacturers could then use a combination of chemical absorbers and physical blockers to achieve high degrees of sun protection in a cosmetically acceptable formulation.

    Where now?

    Australians have embraced sunscreen, but they still don’t apply enough or reapply often enough.

    Although some people are concerned sunscreen will block the skin’s ability to make vitamin D this is unlikely. That’s because even SPF50 sunscreen doesn’t filter out all UVB.

    There’s also concern about the active ingredients in sunscreen getting into the environment and whether their absorption by our bodies is a problem.

    Sunscreens have evolved from something that at best offered mild protection to effective, easy-to-use products that stave off the harmful effects of UV. They’ve evolved from something only people with fair skin used to a product for anyone.

    Remember, slopping on sunscreen is just one part of sun protection. Don’t forget to also slip (protective clothing), slap (hat), seek (shade) and slide (sunglasses).The Conversation

    Laura Dawes, Research Fellow in Medico-Legal History, Australian National University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Increase in online ADHD diagnoses for kids poses ethical questions

    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.

    In 2020, in the midst of a pandemic, clinical protocols were altered for Ontario health clinics, allowing them to perform more types of care virtually. This included ADHD assessments and ADHD prescriptions for children – services that previously had been restricted to in-person appointments. But while other restrictions on virtual care are back, clinics are still allowed to virtually assess children for ADHD.

    This shift has allowed for more and quicker diagnoses – though not covered by provincial insurance (OHIP) – via a host of newly emerging private, for-profit clinics. However, it also has raised significant ethical questions.

    It solves an equity issue in terms of rural access to timely assessments, but does it also create new equity issues as a privatized service?

    Is it even feasible to diagnose a child for a condition like ADHD without meeting that child in person?

    And as rates of ADHD diagnosis continue to rise, should health regulators re-examine the virtual care approach?

    Ontario: More prescriptions, less regulation

    There are numerous for-profit clinics offering virtual diagnoses and prescriptions for childhood ADHD in Ontario. These include KixCare, which does not offer the option of an in-person assessment. Another clinic, Springboard, makes virtual appointments available within days, charging around $2,600 for assessments, which take three to four hours. The clinic offers coaching and therapy at an additional cost, also not covered by OHIP. Families can choose to continue to visit the clinic virtually during a trial stage with medications, prescribed by a doctor in the clinic who then sends prescribing information back to the child’s primary care provider.

    For-profit clinics like these are departing from Canada’s traditional single-payer health care model. By charging patients out-of-pocket fees for services, the clinics are able to generate more revenue because they are working outside of the billing standards for OHIP, standards that set limits on the maximum amount doctors can earn for providing specific services. Instead many services are provided by non-physician providers, who are not limited by OHIP in the same way.

    Need for safeguards

    ADHD prescriptions rose during the pandemic in Ontario, with women, people of higher income and those aged 20 to 24 receiving the most new diagnoses, according to research published in January 2024 by a team including researchers from the Centre for Addictions and Mental Health and Holland Bloorview Children’s Hospital. There may be numerous reasons for this increase but could the move to virtual care have been a factor?

    Ontario psychiatrist Javeed Sukhera, who treats both children and adults in Canada and the U.S., says virtual assessments can work for youth with ADHD, who may receive treatment quicker if they live in remote areas. However, he is concerned that as health care becomes more privatized, it will lead to exploitation and over-diagnosis of certain conditions.

    “There have been a lot of profiteers who have tried to capitalize on people’s needs and I think this is very dangerous,” he said. “In some settings, profiteering companies have set up systems to offer ADHD assessments that are almost always substandard. This is different from not-for-profit setups that adhere to quality standards and regulatory mechanisms.”

    Sukhera’s concerns recall the case of Cerebral Inc., a New York state-based virtual care company founded in 2020 that marketed on social media platforms including Instagram and TikTok. Cerebral offered online prescriptions for ADHD drugs among other services and boasted more than 200,000 patients. But as Dani Blum reported in the New York Times, Cerebral was accused in 2023 of pressuring doctors on staff to prescribe stimulants and faced an investigation by state prosecutors into whether it violated the U.S. Controlled Substances Act.

    “At the start of the pandemic, regulators relaxed rules around medical prescription of controlled substances,” wrote Blum. “Those changes opened the door for companies to prescribe and market drugs without the protocols that can accompany an in-person visit.”

    Access increased – but is it equitable?

    Virtual care has been a necessity in rural areas in Ontario since well before the pandemic, although ADHD assessments for children were restricted to in-person appointments prior to 2020.

    But ADHD assessment clinics that charge families out-of-pocket for services are only accessible to people with higher incomes. Rural families, many of whom are low income, are unable to afford thousands for private assessments, let alone the other services upsold by providers. If the private clinic/virtual care trend continues to grow unchecked, it may also attract doctors away from the public model of care since they can bill more for services. This could further aggravate the gap in care that lower income people already experience.

    This could further aggravate the gap in care that lower income people already experience.

    Sukhera says some risks could be addressed by instituting OHIP coverage for services at private clinics (similar to private surgical facilities that offer mixed private/public coverage), but also with safeguards to ensure that profits are reinvested back into the health-care system.

    “This would be especially useful for folks who do not have the income, the means to pay out of pocket,” he said.

    Concerns of misdiagnosis and over-prescription

    Some for-profit companies also benefit financially from diagnosing and issuing prescriptions, as has been suggested in the Cerebral case. If it is cheaper for a clinic to do shorter, virtual appointments and they are also motivated to diagnose and prescribe more, then controls need to be put in place to prevent misdiagnosis.

    The problem of misdiagnosis may also be related to the nature of ADHD assessments themselves. University of Strathclyde professor Matthew Smith, author of Hyperactive: The Controversial History of ADHD, notes that since the publication of Diagnostic and Statistical Manual of Mental Disorders in 1980, assessment has typically involved a few hours of parents and patients providing their subjective perspectives on how they experience time, tasks and the world around them.

    “It’s often a box-ticking exercise, rather than really learning about the context in which these behaviours exist,” Smith said. “The tendency has been to use a list of yes/no questions which – if enough are answered in the affirmative – lead to a diagnosis. When this is done online or via Zoom, there is even less opportunity to understand the context surrounding behaviour.”

    Smith cited a 2023 BBC investigation in which reporter Rory Carson booked an in-person ADHD assessment at a clinic and was found not to have the condition, then had a private online assessment – from a provider on her couch in a tracksuit – and was diagnosed with ADHD after just 45 minutes, for a fee of £685.

    What do patients want?

    If Canadian regulators can effectively tackle the issue of privatization and the risk of misdiagnosis, there is still another hurdle: not every youth is willing to take part in virtual care.

    Jennifer Reesman, a therapist and Training Director for Neuropsychology at the Chesapeake Center for ADHD, Learning & Behavioural Health in Maryland, echoed Sukhera’s concerns about substandard care, cautioning that virtual care is not suitable for some of her young clients who had poor experiences with online education and resist online health care. It can be an emotional issue for pediatric patients who are managing their feelings about the pandemic experience.

    “We need to respect what their needs are, not just the needs of the provider,” says Reesman.

    In 2020, Ontario opted for virtual care based on the capacity of our health system in a pandemic. Today, with a shortage of doctors, we are still in a crisis of capacity. The success of virtual care may rest on how engaged regulators are with equity issues, such as waitlists and access to care for rural dwellers, and how they resolve ethical problems around standards of care.

    Children and youth are a distinct category, which is why we had restrictions on virtual ADHD diagnosis prior to the pandemic. A question remains, then: If we could snap our fingers and have the capacity to provide in-person ADHD care for all children, would we? If the answer to that question is yes, then how can we begin to build our capacity?

    This article is republished from healthydebate under a Creative Commons license. Read the original article.

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  • Anti-Inflammatory Piña Colada Baked Oats

    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.

    If you like piña coladas and getting songs stuck in your head, then enjoy this very anti-inflammatory, gut-healthy, blood-sugar-balancing, and frankly delicious dish:

    You will need

    • 9 oz pineapple, diced
    • 7 oz rolled oats
    • 3 oz desiccated coconut
    • 14 fl oz coconut milk (full fat, the kind from a can)
    • 14 fl oz milk (your choice what kind, but we recommend coconut, the kind for drinking)
    • Optional: some kind of drizzling sugar such as honey or maple syrup

    Method

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

    1) Preheat the oven to 350℉ / 180℃.

    2) Mix all the ingredients (except the drizzling sugar, if using) well, and put them in an ovenproof dish, compacting the mixture down gently so that the surface is flat.

    3) Drizzle the drizzling sugar, if drizzling.

    4) Bake in the oven for 30–40 minutes, until lightly golden-brown.

    5) Serve hot or cold:

    Enjoy!

    Want to learn more?

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

    Take care!

    Don’t Forget…

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