Healthiest-Three-Nut Butter
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We’re often telling you to “diversify your nuts”, so here’s a great way to get in three at once with no added sugar, palm oil, or preservatives, and only the salt you choose to put in. We’ve picked three of the healthiest nuts around, but if you happen to be allergic, don’t worry, we’ve got you covered too.
You will need
- 1 cup almonds (if allergic, substitute a seed, e.g. chia, and make it ½ cup)
- 1 cup walnuts (if allergic, substitute a seed, e.g. pumpkin, and make it ½ cup)
- 1 cup pistachios (if allergic, substitute a seed, e.g. poppy, and make it ½ cup)
- 1 tbsp almond oil (if allergic, substitute extra virgin olive oil) (if you prefer sweet nut butter, substitute 1 tbsp maple syrup; the role here is to emulsify the nuts, and this will do the same job)
- Optional: ¼ tsp MSG or ½ tsp low-sodium salt
Method
(we suggest you read everything at least once before doing anything)
1a) If using nuts, heat your oven to 350℉ / 180℃. Place the nuts on a baking tray lined with baking paper, and bake/roast for about 10 minutes, but keep an eye on it to ensure the nuts don’t burn, and jiggle them if necessary to ensure they toast evenly. Once done, allow to cool.
1b) If using seeds, you can either omit that step, or do the same for 5 minutes if you want to, but really it’s not necessary.
2) Blend all ingredients (nuts/seeds, oil, MSG/salt) in a high-speed blender. Note: this will take about 10 minutes in total, and we recommend you do it in 30-second bursts so as to not overheat the motor. You also may need to periodically scrape the mixture down the side of the blender, to ensure a smooth consistency.
3) Transfer to a clean jar, and enjoy at your leisure:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Why You Should Diversify Your Nuts!
- Sesame Seeds vs Poppy Seeds – Which is Healthier?
- If You’re Not Taking Chia, You’re Missing Out
- Sea Salt vs MSG – Which is Healthier?
Take care!
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Ouch. That ‘Free’ Annual Checkup Might Cost You. Here’s Why.
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When Kristy Uddin, 49, went in for her annual mammogram in Washington state last year, she assumed she would not incur a bill because the test is one of the many preventive measures guaranteed to be free to patients under the 2010 Affordable Care Act. The ACA’s provision made medical and economic sense, encouraging Americans to use screening tools that could nip medical problems in the bud and keep patients healthy.
So when a bill for $236 arrived, Uddin — an occupational therapist familiar with the health care industry’s workings — complained to her insurer and the hospital. She even requested an independent review.
“I’m like, ‘Tell me why am I getting this bill?’” Uddin recalled in an interview. The unsatisfying explanation: The mammogram itself was covered, per the ACA’s rules, but the fee for the equipment and the facility was not.
That answer was particularly galling, she said, because, a year earlier, her “free” mammogram at the same health system had generated a bill of about $1,000 for the radiologist’s reading. Though she fought that charge (and won), this time she threw in the towel and wrote the $236 check. But then she dashed off a submission to the KFF Health News-NPR “Bill of the Month” project:
“I was really mad — it’s ridiculous,” she later recalled. “This is not how the law is supposed to work.”
The ACA’s designers might have assumed that they had spelled out with sufficient clarity that millions of Americans would no longer have to pay for certain types of preventive care, including mammograms, colonoscopies, and recommended vaccines, in addition to doctor visits to screen for disease. But the law’s authors didn’t reckon with America’s ever-creative medical billing juggernaut.
Over the past several years, the medical industry has eroded the ACA’s guarantees, finding ways to bill patients in gray zones of the law. Patients going in for preventive care, expecting that it will be fully covered by insurance, are being blindsided by bills, big and small.
The problem comes down to deciding exactly what components of a medical encounter are covered by the ACA guarantee. For example, when do conversations between doctor and patient during an annual visit for preventive services veer into the treatment sphere? What screenings are needed for a patient’s annual visit?
A healthy 30-year-old visiting a primary care provider might get a few basic blood tests, while a 50-year-old who is overweight would merit additional screening for Type 2 diabetes.
Making matters more confusing, the annual checkup itself is guaranteed to be “no cost” for women and people age 65 and older, but the guarantee doesn’t apply for men in the 18-64 age range — though many preventive services that require a medical visit (such as checks of blood pressure or cholesterol and screens for substance abuse) are covered.
No wonder what’s covered under the umbrella of prevention can look very different to medical providers (trying to be thorough) and billers (intent on squeezing more dollars out of every medical encounter) than it does to insurers (who profit from narrower definitions).
For patients, the gray zone has become a billing minefield. Here are a few more examples, gleaned from the Bill of the Month project in just the past six months:
Peter Opaskar, 46, of Texas, went to his primary care doctor last year for his preventive care visit — as he’d done before, at no cost. This time, his insurer paid $130.81 for the visit, but he also received a perplexing bill for $111.81. Opaskar learned that he had incurred the additional charge because when his doctor asked if he had any health concerns, he mentioned that he was having digestive problems but had already made an appointment with his gastroenterologist. So, the office explained, his visit was billed as both a preventive physical and a consultation. “Next year,” Opasker said in an interview, if he’s asked about health concerns, “I’ll say ‘no,’ even if I have a gunshot wound.”
Kevin Lin, a technology specialist in Virginia in his 30s, went to a new primary care provider to take advantage of the preventive care benefit when he got insurance; he had no physical complaints. He said he was assured at check-in that he wouldn’t be charged. His insurer paid $174 for the checkup, but he was billed an additional $132.29 for a “new patient visit.” He said he has made many calls to fight the bill, so far with no luck.
Finally, there’s Yoori Lee, 46, of Minnesota, herself a colorectal surgeon, who was shocked when her first screening colonoscopy yielded a bill for $450 for a biopsy of a polyp — a bill she knew was illegal. Federal regulations issued in 2022 to clarify the matter are very clear that biopsies during screening colonoscopies are included in the no-cost promise. “I mean, the whole point of screening is to find things,” she said, stating, perhaps, the obvious.
Though these patient bills defy common sense, room for creative exploitation has been provided by the complex regulatory language surrounding the ACA. Consider this from Ellen Montz, deputy administrator and director of the Center for Consumer Information and Insurance Oversight at the Centers for Medicare & Medicaid Services, in an emailed response to queries and an interview request on this subject: “If a preventive service is not billed separately or is not tracked as individual encounter data separately from an office visit and the primary purpose of the office visit is not the delivery of the preventive item or service, then the plan issuer may impose cost sharing for the office visit.”
So, if the doctor decides that a patient’s mention of stomach pain does not fall under the umbrella of preventive care, then that aspect of the visit can be billed separately, and the patient must pay?
And then there’s this, also from Montz: “Whether a facility fee is permitted to be charged to a consumer would depend on whether the facility usage is an integral part of performing the mammogram or an integral part of any other preventive service that is required to be covered without cost sharing under federal law.”
But wait, how can you do a mammogram or colonoscopy without a facility?
Unfortunately, there is no federal enforcement mechanism to catch individual billing abuses. And agencies’ remedies are weak — simply directing insurers to reprocess claims or notifying patients they can resubmit them.
In the absence of stronger enforcement or remedies, CMS could likely curtail these practices and give patients the tools to fight back by offering the sort of clarity the agency provided a few years ago regarding polyp biopsies — spelling out more clearly what comes under the rubric of preventive care, what can be billed, and what cannot.
The stories KFF Health News and NPR receive are likely just the tip of an iceberg. And while each bill might be relatively small compared with the stunning $10,000 hospital bills that have become all too familiar in the United States, the sorry consequences are manifold. Patients pay bills they do not owe, depriving them of cash they could use elsewhere. If they can’t pay, those bills might end up with debt-collection agencies and, ultimately, harm their credit score.
Perhaps most disturbing: These unexpected bills might discourage people from seeking preventive screenings that could be lifesaving, which is why the ACA deemed them “essential health benefits” that should be free.
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.
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Thinking, Fast and Slow – by Dr. Daniel Kahneman
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We all try to make the best decisions we can with the information available… Don’t we?
Yet, somehow, a survival chance of 90% seems better than a mortality rate of 10%, and as it turns out, we as fallible humans are prey to all manner of dubious heuristics.
Nobel Prize winner Dr. Daniel Kahneman lays out for us two sytems of thought process:
- Fast, intuitive, emotional
- Slow, deliberate, logical
He makes the case for how and why we do need both, but often end up using the wrong one. He notes how the first is required for efficiency, or we would spend all day deciding what socks to wear… The second, meanwhile, is required for high-stakes decisions, but is lazy by nature, and often we don’t engage it when we ought to.
Over the course of many diverse examples, Dr. Kahneman shows how again and again, the second system is slowly cogitating at the back of the class, while the first system is bouncing up and down with its hand in the air saying “I know! I know!”, even when, in fact, it does not know.
For a book largely founded in economics (it’s a massive takedown of the notion of the rational consumer), it is not at all dry, and is very readable in style. It’s engaging throughout, and readers far removed from Wall Street will find plenty of ways it relates to our everyday lives.
Bottom line: if you’d like to avoid making many mistakes in what you’d assumed to be rational decisions, this book is critical reading.
Click here to check out “Thinking, Fast And Slow”, and enjoy the results of better decisions!
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Stop Overthinking – by Nick Trenton
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This book is exactly what it says on the tin. We are given twenty-three techniques to relieve stress, stop negative spirals, declutter your mind, and focus on the present, in the calm pursuit of good mental health and productivity.
The techniques are things like the RAIN technique above, so if you liked that, you’ll love this. Being a book rather than a newsletter, it also takes the liberty of going into much more detail—hence the 200 pages for 23 techniques. Unlike many books, it’s not packed in fluff either. It’s that perfect combination of “to the point” and “very readable”.
If you’ve read this far into the review and you’re of two minds about whether or not this book could be useful to you, then you just might be overthinking it
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Mediterranean Diet… In A Pill?
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Does It Come In A Pill?
For any as yet unfamiliar with the Mediterranean diet, you may be wondering what it involves, beyond a general expectation that it’s a diet popularly enjoyed in the Mediterranean. What image comes to mind?
We’re willing to bet that tomatoes feature (great source of lycopene, by the way, and if you’re not getting lycopene, you’re missing out), but what else?
- Salads, perhaps? Vegetables, olives? Olive oil, yea or nay?
- Bread? Pasta? Prosciutto, salami? Cheese?
- Pizza but only if it’s Romana style, not Chicago?
- Pan-seared liver, with some fava beans and a nice Chianti?
In fact, the Mediterranean diet is quite clear on all these questions, so to read about these and more (including a “this yes, that no” list), see:
What Is The Mediterranean Diet, And What Is It Good For?
So, how do we get that in a pill?
A plucky band of researchers, Dr. Chiara de Lucia et al. (quite a lot of “et al.”; nine listed authors on the study), wondered to what extent the benefits of the Mediterranean diet come from the fact that the Mediterranean diet is very rich in polyphenols, and set about testing that, by putting the same polyphenols in capsule form, and running a randomized, double-blind, placebo-controlled, crossover clinical intervention trial.
Now, polyphenols are not the only reason the Mediterranean diet is great; there are also other considerations, such as:
- a great macronutrient balance with lots of fiber, healthy fats, moderate carbs, and protein from select sources
- the absence or at least very low presence of a lot of harmful substances such as refined seed oils, added sugars, refined carbohydrates, and the like (“but pasta” yes pasta; in moderation and wholegrain and served with extra sources of fiber and healthy fats, all of which slow down the absorption of the carbs)
…but polyphenols are admittedly very important too; we wrote about some common aspects of them here:
Tasty Polyphenols: Enjoy Bitter Foods For Your Heart & Brain
As for what Dr. de Lucia et al. put into the capsule, behold…
The ingredients:
- Apple Extract 10.0%
- Pomegranate Extract 10.0%
- Tomato Powder 2.5%
- Beet, Spray Dried 2.5%
- Olive Extract 7.5%
- Rosemary Extract 7.5%
- Green Coffee Bean Extract (CA) 7.5%
- Kale, Freeze Dried 2.5%
- Onion Extract 10.0%
- Ginger Extract 10.0%
- Grapefruit Extract 2.5%
- Carrot, Air Dried 2.5%
- Grape Skin Extract 17.5%
- Blueberry Extract 2.5%
- Currant, Freeze Dried 2.5%
- Elderberry, Freeze Dried 2.5%
And the relevant phytochemicals they contain:
- Quercetin
- Luteolin
- Catechins
- Punicalagins
- Phloretin
- Ellagic Acid
- Naringin
- Apigenin
- Isorhamnetin
- Chlorogenic Acids
- Rosmarinic Acid
- Anthocyanins
- Kaempferol
- Proanthocyanidins
- Myricetin
- Betanin
And what, you may wonder, did they find? Well, first let’s briefly summarise the setup of the study:
They took volunteers (n=30), average age 67, BMI >25, without serious health complaints, not taking other supplements, not vegetarian or vegan, not consuming >5 cups of coffee per day, and various other stipulations like that, to create a fairly homogenous study group who were expected to respond well to the intervention. In contrast, someone who takes antioxidant supplements, already eats many different color plants per day, and drinks 10 cups of coffee, probably already has a lot of antioxidant activity going on, and someone with a lower BMI will generally have lower resting levels of inflammatory markers, so it’s harder to see a change, proportionally.
About those inflammatory markers: that’s what they were testing, to see whether the intervention “worked”; essentially, did the levels of inflammatory markers go up or down (up is bad; down is good).
For more on inflammation, by the way, see:
How to Prevent (or Reduce) Inflammation
…which also explains what it actually is, and some important nuances about it.
Back to the study…
They gave half the participants the supplement for a week and the other half placebo; had a week’s gap as a “washout”, then repeated it, switching the groups, taking blood samples before and after each stage.
What they found:
The group taking the supplement had lower inflammatory markers after a week of taking it, while the group taking the placebo had relatively higher inflammatory markers after a week of taking it; this trend was preserved across both groups (i.e., when they switched roles for the second half).
The results were very significant (p=0.01 or thereabouts), and yet at the same time, quite modest (i.e. the supplement made a very reliable, very small difference), probably because of the small dose (150mg) and small intervention period (1 week).
What the researchers concluded from this
The researchers concluded that this was a success; the study had been primarily to provide proof of principle, not to rock the world. Now they want the experiment to be repeated with larger sample sizes, greater heterogeneity, larger doses, and longer intervention periods.
This is all very reasonable and good science.
What we conclude from this
That ingredients list makes for a good shopping list!
Well, not the extracts they listed, necessarily, but rather those actual fruits, vegetables, etc.
If nine top scientists (anti-aging specialists, neurobiologists, pharmacologists, and at least one professor of applied statistics) came to the conclusion that to get the absolute most bang-for-buck possible, those are the plants to get the phytochemicals from, then we’re not going to ignore that.
So, take another list above and ask yourself: how many of those 16 foods do you eat regularly, and could you work the others in?
Want to make your Mediterranean diet even better?
While the Mediterranean diet is a top-tier catch-all, it can be tweaked for specific areas of health, for example giving it an extra focus on heart health, or brain health, or being anti-inflammatory, or being especially gut healthy:
Four Ways To Upgrade The Mediterranean
Enjoy!
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21 Most Beneficial Polyphenols & What Foods Have Them
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We often write about polyphenols here at 10almonds; sometimes mentioning that a certain food is good because it has them, or else occasionally an entire article about a particular polyphenol. But what about a birds-eye view of polyphenols as a whole?
Well, there are many, but we’ve picked 21 particularly beneficial for human health, and what foods contain them.
We’ll be working from this fantastic database, by the way:
❝Phenol-Explorer is the first comprehensive database on polyphenol content in foods. The database contains more than 35,000 content values for 500 different polyphenols in over 400 foods. These data are derived from the systematic collection of more than 60,000 original content values found in more than 1,300 scientific publications. Each of these publications has been critically evaluated before inclusion in the database. The whole data on the polyphenol composition of foods is available for download.❞
Source: Phenol-Explorer.EU | Database on polyphenol content in foods
We use this database at least several times per week while writing 10almonds; it’s a truly invaluable resource!
However, 500 is a lot, so here’s a rundown of 21 especially impactful ones; we’ve sorted them per the categories used in the explorer, and in some cases we’ve aggregated several very similar polyphenols typically found together in the same foods, into one item (so for example we just list “quercetin” instead of quercetin 3-O-rutinoside + quercetin 4′-O-glucoside + quercetin 3,4′-O-diglucoside, etc etc). We’ve also broadly grouped some particularly populous ones such as “anthocyanins”, “catechins”, and so forth.
Without further ado, here’s what you ideally want to be getting plenty of in your diet:
Flavonoids
- Quercetin
- Foods: onions, apples, berries, kale, broccoli, capers.
- Benefits: anti-inflammatory, reduces allergy symptoms, supports heart and brain health, and may lower blood pressure.
- See also: Fight Inflammation & Protect Your Brain, With Quercetin
- Kaempferol
- Foods: spinach, kale, tea (green and black), capers, brussels sprouts.
- Benefits: antioxidant, may reduce the risk of cancer, supports cardiovascular health, and has anti-inflammatory properties.
- Epigallocatechin gallate (EGCG)
- Foods: green tea, matcha.
- Benefits: potent antioxidant, promotes weight loss, supports brain health, and may reduce the risk of heart disease.
- Anthocyanins
- Foods: blueberries, blackberries, raspberries, red cabbage, cherries.
- Benefits: improve brain health, support eye health, and reduce the risk of cardiovascular diseases.
- Apigenin
- Foods: parsley, celery, chamomile tea.
- Benefits: anti-inflammatory, reduces anxiety, and supports brain and immune system health.
- Luteolin
- Foods: peppers, thyme, celery, carrots.
- Benefits: anti-inflammatory, supports brain health, and may help reduce the growth of cancer cells.
- Catechins (aside from EGCG)
- Foods: green tea, dark chocolate, apples
- Benefits: boosts metabolism, supports cardiovascular health, and reduces oxidative stress.
- Hesperidin
- Foods: oranges, lemons, limes, grapefruits.
- Benefits: supports vascular health, reduces inflammation, and may help manage diabetes.
- Naringenin
- Foods: oranges, grapefruits, tomatoes.
- Benefits: antioxidant, supports liver health, and may improve cholesterol levels.
For more on epigallocatechin gallate and other catechins, see: Which Tea Is Best, By Science?
Phenolic Acids
- Chlorogenic acid
- Foods: coffee, artichokes, apples, pears.
- Benefits: supports weight management, improves blood sugar regulation, and reduces inflammation.
- See also: Green Coffee Bean Extract: Coffee Benefits Without The Coffee?
- Caffeic acid
- Foods: coffee, thyme, sage, basil.
- Benefits: antioxidant, anti-inflammatory, and supports skin health.
- See also: The Bitter Truth About Coffee (or is it?)
- Ferulic acid
- Foods: whole grains, rice bran, oats, flaxseeds, spinach.
- Benefits: protects skin from UV damage, reduces inflammation, and supports cardiovascular health.
- Gallic acid
- Foods: green tea, grapes, berries, walnuts.
- Benefits: antioxidant, may reduce the risk of cancer, and supports brain health.
Stilbenes
- Resveratrol
- Foods: red grapes, blueberries, peanuts.
- Benefits: anti-aging properties, supports heart health, and reduces inflammation.
- See also: Resveratrol & Healthy Aging ← and no, you can’t usefully get it from red wine; here’s why!
Lignans
- Secoisolariciresinol
- Foods: flaxseeds, sesame seeds, whole grains.
- Benefits: supports hormone balance, reduces the risk of hormone-related cancers, and promotes gut health.
- Matairesinol
- Foods: rye, oats, barley, sesame seeds.
- Benefits: hormonal support, antioxidant, and may reduce the risk of cardiovascular diseases.
See also: Sprout Your Seeds, Grains, Beans, Etc ← for maximum nutritional availability!
Tannins
- Ellagic acid
- Foods: pomegranates, raspberries, walnuts.
- Benefits: anti-cancer properties, supports skin health, and reduces inflammation.
- Proanthocyanidins
- Foods: cranberries, apples, grapes, dark chocolate.
- Benefits: supports urinary tract health, reduces inflammation, and improves blood vessel health.
See also: Enjoy Bitter Foods For Your Heart & Brain
Curcuminoids
- Curcumin
- Foods: turmeric.
- Benefits: potent anti-inflammatory, supports joint health, and may reduce the risk of chronic diseases.
- See also: Why Curcumin (Turmeric) Is Worth Its Weight In Gold
Isoflavones
- Genistein
- Foods: soybeans, chickpeas.
- Benefits: supports bone health, reduces the risk of hormone-related cancers, and promotes heart health.
- Daidzein
- Foods: soybeans, legumes.
- Benefits: hormonal balance, supports bone health, and may help alleviate menopausal symptoms.
See also: What Does “Balance Your Hormones” Even Mean?
Well, that’s a lot of things to remember!
If you want to make it easier for yourself, you can simply make sure to get at least 30 different kinds of plant into your diet per week, and by doing so, statistically, you should cover most of these!
Read more: What’s Your Plant Diversity Score?
Alternatively, for a middle-ground approach of targetting 16 most polyphenol delivering foods, check out this super-dense arrangement:
Mediterranean Diet… In A Pill? ← it’s about plant extracts from 16 specific foods, and the polyphenols they deliver
Enjoy!
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- Quercetin
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Bacopa Monnieri: A Well-Evidenced Cognitive Enhancer
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Bacopa monnieri: a powerful nootropic
Bacopa monnieri is one of those “from traditional use” herbs that has made its way into science.
It’s been used for at least 1,400 years in Ayurvedic medicine, for cognitive enhancement, against anxiety, and some disease-specific treatments.
See: Pharmacological attributes of Bacopa monnieri extract: current updates and clinical manifestation
What are its claimed health benefits?
Bacopa monnieri is these days mostly sold and bought as a nootropic, and that’s what the science supports best.
Nootropic benefits claimed:
- Improves attention, learning, and memory
- Reduces depression, anxiety, and stress
- Reduces restlessness and impulsivity
Other benefits claimed:
- Antioxidant properties
- Anti-inflammatory properties
- Anticancer properties
What does the science say?
Those last three, the antioxidant / anti-inflammatory / anticancer properties, when something has one of those qualities it often has all three, because there are overlapping systems at hand when it comes to oxidative stress, inflammation, and cellular damage.
Bacopa monnieri is no exception to this “rule of thumb”, and/but studies to support these benefits have mostly been animal studies and/or in vitro studies (i.e., cell cultures in a petri dish in lab conditions).
For example:
- Inhibition of lipoxygenases and cyclooxygenase-2 enzymes by extracts isolated from Bacopa monnieri
- Assessing the anti-inflammatory effects of Bacopa-derived bioactive compounds using network pharmacology and in vitro studies
- The evolving roles of Bacopa monnieri as potential anticancer agent: a review
In the category of antioxidant and anti-inflammatory effects in the brain, sometimes results differ depending on the test population, for example:
- Neuroprotective effects of Bacopa monnieri in experimental model of dementia (it worked for rats)
- Use of Bacopa monnieri in the treatment of dementia due to Alzheimer’s disease: systematic review of randomized controlled trials (it didn’t work for humans)
Anything more promising than that?
Yes! The nootropic effects have been much better-studied in humans, and with much better results.
For example, in this 12-week study in healthy adults, taking 300mg/day significantly improved visual information processing, learning, and memory (tested against placebo):
The chronic effects of an extract of Bacopa monnieri on cognitive function in healthy human subjects
Another 12-week study showed older adults enjoyed the same cognitive enhancement benefits as their younger peers:
Children taking 225mg/day, meanwhile, saw a significant reduction in ADHD symptoms, such as restlessness and impulsivity:
And as for the mood benefits, 300mg/day significantly reduced anxiety and depression in elderly adults:
In summary
Bacopa monnieri, taken at 300mg/day (studies ranged from 225mg/day to 600mg/day, but 300mg is most common) has well-evidenced cognitive benefits, including:
- Improved attention, learning, and memory
- Reduced depression, anxiety, and stress
- Reduced restlessness and impulsivity
It may also have other benefits, including against oxidative stress, inflammation, and cancer, but the research is thinner and/or not as conclusive for those.
Where to get it
As ever, we don’t sell it (or anything else), but for your convenience, here is an example product on Amazon.
Enjoy!
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