Hormone Replacement
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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 cant believe 10 Almonds addresses questions. Thanks. I see the word symptoms for menopause. I don’t know what word should replace it but maybe one should be used or is symptom accurate? And I recently read that there was a great disservice for women in my era as they were denied/scared of hormones replacement. Unnecessarily❞
You’d better believe it! In fact we love questions; they give us things to research and write about.
“Symptom” is indeed an entirely justified word to use, being:
- General: any phenomenon or circumstance accompanying something and serving as evidence of it.
- Medical: any phenomenon that arises from and accompanies a particular disease or disorder and serves as an indication of it.
If the question is more whether the menopause can be considered a disease/disorder, well, it’s a naturally occurring and ultimately inevitable change, yes, but then, so is cancer (it’s in the simple mathematics of DNA replication and mutation that, unless a cure for cancer is found, we will always eventually get cancer, if nothing else kills us first).
So, something being natural/inevitable isn’t a reason to not consider it a disease/disorder, nor a reason to not treat it as appropriate if it is causing us harm/discomfort that can be safely alleviated.
Moreover, and semantics aside, it is medical convention to consider menopause to be a medical condition, that has symptoms. Indeed, for example, the US’s NIH (and its constituent NIA, the National Institute of Aging) and the UK’s NHS, both list the menopause’s symptoms, using that word:
- NIA (NIH): What are the signs and symptoms of menopause?
- NHS: Common symptoms of menopause and perimenopause
With regard to fearmongering around HRT, certainly that has been rife, and there were some very flawed (and later soundly refuted) studies a while back that prompted this—and even those flawed studies were not about the same (bioidentical) hormones available today, in any case. So even if they had been correct (they weren’t), it still wouldn’t be a reason to not get treatment nowadays, if appropriate!
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Lower Cholesterol Naturally
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Lower Cholesterol, Without Statins
We’ll start this off by saying that lowering cholesterol might not, in fact, be critical or even especially helpful for everyone, especially in the case of women. We covered this more in our article about statins:
…which was largely informed by the wealth of data in this book:
The Truth About Statins – by Dr. Barbara H. Roberts
…which in turn, may in fact put a lot of people off statins. We’re not here to tell you don’t use them—they may indeed be useful or even critical for some people, as Dr. Roberts herself also makes makes clear. But rather, we always recommend learning as much as possible about what’s going on, to be able to make the most informed choices when it comes to what often might be literally life-and-death decisions.
On which note, if anyone would like a quick refresher on cholesterol, what it actually is (in its various forms) and what it does, why we need it, the problems it can cause anyway, then here you go:
Now, with all that in mind, we’re going to assume that you, dear reader, would like to know:
- how to lower your LDL cholesterol, and/or
- how to maintain a safe LDL cholesterol level
Because, while the jury’s out on the dangers of high LDL levels for women in particular, it’s clear that for pretty much everyone, maintaining them within well-established safe zones won’t hurt.
Here’s how:
Relax
Or rather, manage your stress. This doesn’t just reduce your acute risk of a heart attack, it also improves your blood metrics along the way, and yes, that includes not just blood pressure and blood sugars, but even triglycerides! Here’s the science for that, complete with numbers:
What are the effects of psychological stress and physical work on blood lipid profiles?
With that in mind, here’s…
How To Manage Chronic Stress (Even While Chronically Stressed)
Not chemically “relaxed”, though
While relaxing is important, drinking alcohol and smoking are unequivocally bad for pretty much everything, and this includes cholesterol levels:
Can We Drink To Good Health? ← this also covers popular beliefs about red wine and heart health, and the answer is no, we cannot
As for smoking, it is good to quit as soon as possible, unless your doctor specifically advises you otherwise (there are occasional situations where something else needs to be dealt with first, but not as many some might like to believe):
Addiction Myths That Are Hard To Quit
If you’re wondering about cannabis (CBD and/or THC), then we’d love to tell you about the effect these things have on heart health in general and cholesterol levels in particular, but the science is far too young (mostly because of the historic, and in some places contemporary, illegality cramping the research), and we could only find small, dubious, mutually contradictory studies so far. So the honest answer is: science doesn’t know this one, yet.
Exercise… But don’t worry, you can still stay relaxed
When it comes to heart health, the most important thing is keeping moving, so getting in those famous 150 minutes per week of moderate exercise is critical, and getting more is ideal.
240 minutes per week is a neat 40 minutes per day, by the way and is very attainable (this writer lives a 20-minute walk away from where she does her daily grocery shopping, thus making for a daily 40-minute round trip, not counting the actual shopping).
See: The Doctor Who Wants Us To Exercise Less, And Move More
If walking is for some reason not practical for you, here’s a whole list of fun options that don’t feel like exercise but are:
Manage your hormones
This one is mostly for menopausal women, though some people with atypical hormonal situations may find it applicable too.
Estrogen protects the heart… Until it doesn’t:
See also: World Menopause Day: Menopause & Cardiovascular Disease Risk
Here’s a great introduction to sorting it out, if necessary:
Dr. Jen Gunter: What You Should Have Been Told About Menopause Beforehand
Eat a heart-healthy diet
Shocking nobody, but it has to be said, for the sake of being methodical. So, what does that look like?
What Matters Most For Your Heart? Eat More (Of This) For Lower Blood Pressure
(it’s fiber in the #1 spot, but there’s a list of most important things there, that’s worth checking out and comparing it to what you habitually eat)
You can also check out the DASH (Dietary Approaches to Stop Hypertension) edition of the Mediterranean diet, here:
Four Ways To Upgrade The Mediterranean Diet
As for saturated fat (and especially trans-fats), the basic answer is to keep them to minimal, but there is room for nuance with saturated fats at least:
Can Saturated Fats Be Healthy?
And lastly, do make sure to get enough omega 3 fatty-acids:
What Omega-3s Really Do For Us
And enjoy plant sterols and stanols! This would need a whole list of their own, so here you go:
Take These To Lower Cholesterol! (Statin Alternatives)
Take care!
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As The Summer Gets Hotter Still…
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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 would love to see an article about heat dehydrated illness….so much of the US is under hot conditions. I had an fainting sweating episode and now trying to recoup from it. What should we do? Drink water,rest…???❞
We have done some of this, but it’s always a good one to revisit! Last summer (N. Hemisphere summer), we wrote this:
Stay Safe From Heat Exhaustion & Heatstroke!
…and this year, it’s getting hotter still (and is already the hottest summer on record), with certainly much of the US seriously affected, as you say. Next year, it will probably be worse again; climate change is getting predictable like that, and likely will continue until fixed. We are but a health science publication, so we can’t fix the world’s climate, but we can reiterate the above advice, and urge everyone to take it seriously.
Note: heat exhaustion and heatstroke kill. Yes, we’re including heat exhaustion in that, because by the time you get heat exhaustion, you’re often not in the best state of mind to take the correct steps to avoid the heatstroke that follows.
To think otherwise would be akin to thinking “falling never killed anyone; it’s only when you stop falling that it’s dangerous”.
This summer, we did also write this more niche article:
…whose advice won’t apply to everyone, but will be helpful to some, and honestly, some of that advice does go for everyone.
One thing we didn’t write about in those articles that we’ll add here:
Humidity is dangerous:
- Dry heat: you sweat, the sweat evaporates, cooling you. As well as losing heat, you’ve also now lost water and salts, which you’ll need to replenish, but your body is operating correctly.
- Humid heat: you sweat, and now you are just sweaty until further notice. It doesn’t evaporate because the surrounding humidity doesn’t provide the physics for that. Not only are you not losing heat through evaporating sweat, but also, if you’re wearing clothes, that’s now an insulating layer you’re wearing.
…so that means, watch the humidity as carefully as you watch the temperature, and when it’s high, get extra serious about finding ways to keep yourself cool (e.g. shade, rest, cooling showers etc if you can, that kind of thing).
Take care!
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Pistachios vs Peanuts – Which is Healthier?
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Our Verdict
When comparing pistachios to peanuts, we picked the peanuts.
Why?
The choice might be surprising; after all, peanuts are usually the cheapest and most readily available nuts, popularly associated with calories and not much else. However! This one was super-close, and peanuts won very marginally, as you’ll see.
In terms of macros, pistachios have slightly more fiber and nearly 2x the carbs, while peanuts have slightly more protein and fats. What we all as individuals might prioritize more there is subjective, but this could arguably be considered a tie. About the fiber and carbs: peanuts have the lower glycemic index, but not by much. And about those fats: yes, they are healthy, and the fat breakdown for each is almost identical: pistachios have 53% monounsaturated, 33% polyunsaturated, and 14% saturated, while peanuts have 53% monounsaturated, 34% polyunsaturated, and 14% saturated. Yes, that adds up to 101% in the case of peanuts, but that’s what happens with rounding things to integers. However, the point is clear: both of these nuts have almost identical fats.
In the category of vitamins, pistachios have more of vitamins A, B1, B2, B6, and C, while peanuts have more of vitamins B3, B5, B9, E, and choline, So, a 5:5 tie on vitamins.
When it comes to minerals, pistachios have more calcium, copper, phosphorus, and potassium, while peanuts have more iron, magnesium, manganese, selenium, and zinc. So, a marginal victory for peanuts (and yes, the margins of difference were similar in each case).
Adding up the tie, the other tie, and the marginal victory for peanuts, means a marginal victory for peanuts in total.
A quick note in closing though: this was comparing raw unsalted nuts in both cases, so do take that into account when buying nuts, and at the very least, skip the salted, unless you are deficient in sodium. Or if you’re using them for cooking, then buying salted nuts because they’re usually cheaper is fine; just soak and rinse them to remove the salt.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Take care!
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Plant-Based Healthy Cream Cheese
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Cream cheese is a delicious food, and having a plant-based diet isn’t a reason to miss out. Here we have a protein-forward nuts-based cream cheese that we’re sure you’ll love (unless you’re allergic to nuts, in which case, maybe skip this one).
You will need
- 1½ cups raw cashews, soaked in warm water and then drained
- ½ cup water
- ½ cup coconut cream
- Juice of ½ lemon
- 3 tbsp nutritional yeast
- ½ tsp onion powder
- ½ tsp garlic powder
- ½ tsp black pepper
- ½ tsp cayenne pepper
- ¼ tsp MSG, or ½ tsp low-sodium salt
- Optional: ⅓ cup fresh basil
Method
(we suggest you read everything at least once before doing anything)
1) Blend all of the ingredients until creamy.
2) Optional: leave on the countertop, covered, for 1–2 hours, if you want a more fermented (effectively: cheesy) taste.
3) Refrigerate, ideally overnight, before serving. Serving on bagels is a classic, but you can also enjoy with the Healthy Homemade Flatbreads we made yesterday
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Pistachios vs Cashews – Which is Healthier? ← Pistachios actually won here, but cashews are also great and are better (from a culinary perspective) for making cream cheese
- Why You Should Diversify Your Nuts!
- Our Top 5 Spices: How Much Is Enough For Benefits?
Take care!
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How To Prevent And Reverse Type 2 Diabetes
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Turn back the clock on insulin resistance
This is Dr. Jason Fung. He’s a world-leading expert on intermittent fasting and low carbohydrate approaches to diet. He also co-founded the Intensive Dietary Management Program, later rebranded to the snappier title: The Fasting Method, a program to help people lose weight and reverse type 2 diabetes. Dr. Fung is certified with the Institute for Functional Medicine, for providing functional medicine certification along with educational programs directly accredited by the Accreditation Council for Continuing Medical Education (ACCME).
Why Intermittent Fasting?
Intermittent fasting is a well-established, well-evidenced, healthful practice for most people. In the case of diabetes, it becomes complicated, because if one’s blood sugars are too low during a fasting period, it will need correcting, thus breaking the fast.
Note: this is about preventing and reversing type 2 diabetes. Type 1 is very different, and sadly cannot be prevented or reversed in this fashion.
However, these ideas may still be useful if you have T1D, as you have an even greater need to avoid developing insulin resistance; you obviously don’t want your exogenous insulin to stop working.
Nevertheless, please do confer with your endocrinologist before changing your dietary habits, as they will know your personal physiology and circumstances in ways that we (and Dr. Fung) don’t.
In the case of having type 2 diabetes, again, please still check with your doctor, but the stakes are a lot lower for you, and you will probably be able to fast without incident, depending on your diet itself (more on this later).
Intermittent Fasting can be extra helpful for the body in the case of type 2 diabetes, as it helps give the body a rest from high insulin levels, thus allowing the body to become gradually re-sensitised to insulin.
Why low carbohydrate?
Carbohydrates, especially sugars, especially fructose*, cause excess sugar to be quickly processed by the liver and stored there. When the body’s ability to store glycogen is exceeded, the liver stores energy as fat instead. The resultant fatty liver is a major contributor to insulin resistance, when the liver can’t keep up with the demand; the blood becomes spiked full of unprocessed sugars, and the pancreas must work overtime to produce more and more insulin to deal with that—until the body starts becoming desensitized to insulin. In other words, type 2 diabetes.
There are other factors that affect whether we get type 2 diabetes, for example a genetic predisposition. But, our carb intake is something we can control, so it’s something that Dr. Fung focuses on.
*A word on fructose: actual fruits are usually diabetes-neutral or a net positive due to their fiber and polyphenols.
Fructose as an added ingredient, however, not so much. That stuff zips straight into your veins with nothing to slow it down and nothing to mitigate it.
The advice from Dr. Fung is simple here: cut the carbs. If you are already diabetic and do this with no preparation, you will probably simply suffer hypoglycemia, so instead:
- Enjoy a fibrous starter (a salad, some fruit, or perhaps some nuts)
- Load up with protein first, during your main meal—this will start to trigger your feelings of satedness
- Eat carbs last (preferably whole, unprocessed carbohydrates), and stop eating when 80% full.
Adapting Intermittent Fasting to diabetes
Dr. Fung advocates for starting small, and gradually increasing your fasting period, until, ideally, fasting 16 hours per day. You probably won’t be able to do this immediately, and that’s fine.
You also probably won’t be able to do this, if you don’t also make the dietary adjustments that help to give your liver a break, and thus by knock-on-effect, give your pancreas a break too.
With the dietary adjustments too, however, your insulin production-and-response will start to return to its pre-diabetic state, and finally its healthy state, after which, it’s just a matter of maintenance.
Want to hear more from Dr. Fung?
You may enjoy his blog, and for those who like videos, here is his YouTube channel:
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Prevention Is Better Than Cure
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Preventative healthcare is the theme this week:
New year, new risks
The start of a new year is a great time to update adult vaccinations, including the flu shot, any COVID-19 boosters, and vaccines for pneumonia, shingles, and tetanus—when was your last booster, after all? Vaccination recommendations vary by age and health conditions, so do check what’s appropriate in your case. Key vaccines include the pneumonia vaccine for those 65 and older, the shingles vaccine for adults over 50, and the Tdap vaccine every 10 years to protect against tetanus, diphtheria, and pertussis (whooping cough), especially for new parents and grandparents, to protect infants:
Read in full: Why it’s important to update adult vaccinations for a new year
Related: The Truth About Vaccines
The heart-healthiest swap you can do
Based on a large (n=202,863, of which 160,123 women and 42,740 men) dataset, a higher plant-to-animal protein ratio is associated with significantly lower risks of cardiovascular disease (CVD) and coronary artery disease (CAD), with diets lower in meat (especially if lower in red meat) and instead rich in plant-based proteins like legumes, nuts, and whole grains reducing CVD risk by 19% and coronary artery disease risk by 27%. Which is quite considerable.
Substituting even small amounts of animal protein (especially if it’s red meat) with plant protein further enhances heart health:
Read in full: Higher plant-to-animal protein ratio linked to lower risk for CVD, CAD among U.S. adults
Related: Plant vs Animal Protein: Head to Head
Let’s keep pan-resistant superbugs at bay
Researchers want to warn us about the threat of pan-resistant bacteria, which could render all known antibiotics ineffective, leading to a sharp rise in global infection-related deaths.
To be clear, we don’t have anything pan-resistant yet, but antibiotic-resistant superbugs are getting close, and in the long term, are likely to win the evolutionary arms race if we don’t change things to diverge considerably from our current path. Modeling a hypothetical pan-resistant E. coli strain, researchers predicted U.S. sepsis deaths could increase 18- to 46-fold within five years of its emergence.
The study calls for urgent action, including stricter antibiotic stewardship, new drug development, and monitoring technologies, emphasizing that without intervention, the global impact could be catastrophic:
Read in full: A public health emergency is waiting at the bottom of the antibiotic resistance cliff
Related: Stop Sabotaging Your Immune System ← see also (linked therein), 4 ways antibiotics can kill you
Take care!
Don’t Forget…
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