Hormones & Health, Beyond The Obvious

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Wholesome Health

This is Dr. Sara Gottfried, who some decades ago got her MD from Harvard and specialized as an OB/GYN at MIT. She’s since then spent the more recent part of her career educating people (mostly: women) about hormonal health, precision, functional, & integrative medicine, and the importance of lifestyle medicine in general.

What does she want us to know?

Beyond “bikini zone health”

Dr. Gottfried urges us to pay attention to our whole health, in context.

“Women’s health” is often thought of as what lies beneath a bikini, and if it’s not in those places, then we can basically treat a woman like a man.

And that’s often not actually true—because hormones affect every living cell in our body, and as a result, while prepubescent girls and postmenopausal women (specifically, those who are not on HRT) may share a few more similarities with boys and men of similar respective ages, for most people at most ages, men and women are by default quite different metabolically—which is what counts for a lot of diseases! And note, that difference is not just “faster” or “slower””, but is often very different in manner also.

That’s why, even in cases where incidence of disease is approximately similar in men and women when other factors are controlled for (age, lifestyle, medical history, etc), the disease course and response to treatment may vary considerable. For a strong example of this, see for example:

  • The well-known: Heart Attack: His & Hers ← most people know these differences exist, but it’s always good to brush up on what they actually are
  • The less-known: Statins: His & Hers ← most people don’t know these differences exist, and it pays to know, especially if you are a woman or care about one

Nor are brains exempt from his…

The female brain (kinda)

While the notion of an anatomically different brain for men and women has long since been thrown out as unscientific phrenology, and the idea of a genetically different brain is… Well, it’s an unreliable indicator, because technically the cells will have DNA and that DNA will usually (but not always; there are other options) have XX or XY chromosomes, which will usually (but again, not always) match apparent sex (in about 1/2000 cases there’s a mismatch, which is more common than, say, red hair; sometimes people find out about a chromosomal mismatch only later in life when getting a DNA test for some unrelated reason), and in any case, even for most of us, the chromosomal differences don’t count for much outside of antenatal development (telling the default genital materials which genitals to develop into, though this too can get diverted, per many intersex possibilities, which is also a lot more common than people think) or chromosome-specific conditions like colorblindness…

The notion of a hormonally different brain is, in contrast to all of the above, a reliable and easily verifiable thing.

See for example:

Alzheimer’s Sex Differences May Not Be What They Appear

Dr. Gottfried urges us to take the above seriously!

Because, if women get Alzheimer’s much more commonly than men, and the disease progresses much more quickly in women than men, but that’s based on postmenopausal women not on HRT, then that’s saying “Women, without women’s usual hormones, don’t do so well as men with men’s usual hormones”.

She does, by the way, advocate for bioidentical HRT for menopausal women, unless contraindicated for some important reason that your doctor/endocrinologist knows about. See also:

Menopausal HRT: A Tale Of Two Approaches (Bioidentical vs Animal)

The other very relevant hormone

…that Dr. Gottfried wants us to pay attention to is insulin.

Or rather, its scrubbing enzyme, the prosaically-named “insulin-degrading enzyme”, but it doesn’t only scrub insulin. It also scrubs amyloid beta—yes, the same that produces the amyloid beta plaques in the brain associated with Alzheimer’s. And, there’s only so much insulin-degrading enzyme to go around, and if it’s all busy breaking down excess insulin, there’s not enough left to do the other job too, and thus can’t break down amyloid beta.

In other words: to fight neurodegeneration, keep your blood sugars healthy.

This may actually work by multiple mechanisms besides the amyloid hypothesis, by the way:

The Surprising Link Between Type 2 Diabetes & Alzheimer’s

Want more from Dr. Gottfried?

You might like this interview with Dr. Gottfried by Dr. Benson at the IMCJ:

Integrative Medicine: A Clinician’s Journal | Conversations with Sara Gottfried, MD

…in which she discusses some of the things we talked about today, and also about her shift from a pharmaceutical-heavy approach to a predominantly lifestyle medicine approach.

Enjoy!

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  • Tips for Improving Memory

    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.

    Q&A with 10almonds Subscribers!

    Q: Any tips, other than supplements, for improving memory?

    A: So many tips! Certainly enough to do a main feature on, so again maybe we’ll do that in another issue soon. Meanwhile, here are the absolute most critical things for you to know, understand, and apply:

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    • Your memory is the product of countless connections in your brain. The more connections lead to a given memory, the more memorable it will be. What use is this knowledge to you? It means that if you want to remember something, try to make as many connections to it as possible, so:
      • Involve as many senses as possible.
      • When you learn things, try to learn them in context. Then when your mind has reason to think about the context, it’ll be more likely to remember the thing itself too.
    • Rehearsal matters. A lot. This means repeatedly going over something in your head. This brings about the neural equivalent of “muscle memory”.
    • Enjoy yourself if you can. The more fun something is, the more you will mentally rehearse it, and the more mental connections you’ll make to it.

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  • The Better Brain – by Dr. Bonnie Kaplan and Dr. Julia Rucklidge

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  • To-Do List Formula – by Damon Zahariades

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    The first part of this book is given to reviewing popular to-do list methods that are already widely “out there”. This treatment is practical and exploratory, looking at the pros and cons of each.

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    Matt Gutman is not a doctor or a psychologist. He’s a journalist, accustomed to asking questions and then asking more probing questions, unrelenting until he gets the answers he’s looking for.

    This book is the result of what happened when he needed to overcome his own anxiety and panic attacks, and went on an incisive investigative journey.

    The style is as clear and accessible as you’d expect of a journalist, and presents a very human exploration, nonetheless organized in a way that will be useful to the reader.

    It’s said that “experience is a great teacher, but she sends hefty bills”. In this case as in many, it’s good to learn from someone else’s experience!

    By the end of the book, you’ll have a good grounding in most approaches to dealing with anxiety and panic attacks, and an idea of efficacy/applicability, and what to expect.

    Bottom line: without claiming any magic bullet, this book presents six key strategies that Gutman found to work, along with his experiences of what didn’t. Valuable reading if you want to curb your own anxiety, or want to be able to help/support someone else with theirs.

    Click here to check out No Time To Panic, and find the peace you deserve!

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  • Meditation That You’ll Actually Enjoy

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    Meditation That You’ll Actually Enjoy

    We previously wrote about…

    No-Frills, Evidence-Based Mindfulness

    this is a great primer, by the way, for the science and simplicity of mindfulness, along with the simplest mindfulness meditation to get you going.

    Today, we’re going to have some fun with meditation.

    First: The Problem

    Once the usefulness and health benefits of meditation have been established, often people want to meditate, but complain they don’t have the time.

    But that’s not the real reason, though, is it?

    Let’s face it, a basic meditation can give benefits within two minutes. Or within two breaths, for that matter. So, it’s not really for a lack of time.

    The real reason is because it doesn’t feel productive, and it’s not fun. For us to feel motivated to do a thing, usually we need at least one or the other. And even if we know it really is productive, it not feeling that way will hobble us.

    So instead, let us make things a little more fun, with…

    Meditation games!

    As it turns out, there are good kinds of meditation with which one can have a little fun.

    Catch the next thought

    A common feature of many meditative practices is the experience of having fewer, or ideally no, thoughts.

    But it’s hard to enact a negative, and thoughts keep coming.

    So instead, make yourself comfortable, settle in, and lie in wait for thoughts. When one comes along, pounce on it in your mind. And then release it, and wait for the next.

    At first, your thoughts may be coming thick and fast, but soon, you’ll find the pauses between them lengthening, and you have moments of contented not-knowing of what the next thought will be before it comes along.

    This state of relaxed, ready alertness, calm and receptive, is exactly what we’re hoping to find here. But don’t worry about that while you’re busy lying in wait for the next wild thought to come along

    Counting breaths

    Many meditative practices involve focus on one’s breath. But it’s easy for attention to wander!

    This game is a simple one. Count your breaths, not trying to change your rate of breathing at all, just letting it be, and see how high you can get before you lose count.

    Breathing in and out, once, counts as one breath, by the way.

    You may find that your rate of breathing naturally slows while you’re doing this. That’s fine; let it. It’ll add to the challenge of the game, because before long there will be lengthy pauses between each number.

    If you lose count, just start again, and see if you can beat your high score.

    This meditation game is an excellent exercise to build for sustained focus, while also improving the quality of breathing (as a side-effect of merely paying attention to it).

    Hot spot, cold spot

    The above two meditation games were drawn from Japanese and Chinese meditative practices, zen and qigong respectively; this one’s from an Indian meditative practice, yoga nidra. But for now, just approach it with a sense of playful curiosity, for best results.

    Make yourself comfortable, lying on your back, arms by your sides.

    Take a moment first to pay attention to each part of your body from head to toe, and release any tension that you may be holding along the way.

    First part: mentally scan your body for where it feels warmest, or most active, or most wanting of attention (for example if there is pain, or an itch, or some other sensation); that’s your “hot spot” for the moment.

    Second part: mentally scan your body for where it feels coolest, or most inert, or almost like it’s not a part of your body at all; that’s your “cold spot” for the moment.

    Now, see if you can flip them. Whether you can or can’t, notice if your “hot spot” or “cold spot” moves, or if you can move them consciously.

    This meditation game is a great exercise to strengthen interoception and somatic awareness in general—essential for being able to “listen to your body”!

    Closing thoughts

    All three practices above have very serious reasons and great benefits, but make sure you don’t skip enjoyment of the fun aspects!

    Being “young at heart” is, in part, to do with the ability to enjoy—literally, to take joy in—the little things in life.

    With that in mind, all we have left to say here is…

    Enjoy!

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  • Our ‘food environments’ affect what we eat. Here’s how you can change yours to support healthier eating

    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 January, many people are setting new year’s resolutions around healthy eating. Achieving these is often challenging – it can be difficult to change our eating habits. But healthy diets can enhance physical and mental health, so improving what we eat is a worthwhile goal.

    One reason it’s difficult to change our eating habits relates to our “food environments”. This term describes:

    The collective physical, economic, policy and sociocultural surroundings, opportunities and conditions that influence people’s food and beverage choices and nutritional status.

    Our current food environments are designed in ways that often make it easier to choose unhealthy foods than healthy ones. But it’s possible to change certain aspects of our personal food environments, making eating healthier a little easier.

    Unhealthy food environments

    It’s not difficult to find fast-food restaurants in Australian cities. Meanwhile, there are junk foods at supermarket checkouts, service stations and sporting venues. Takeaway and packaged foods and drinks routinely come in large portion sizes and are often considered tastier than healthy options.

    Our food environments also provide us with various prompts to eat unhealthy foods via the media and advertising, alongside health and nutrition claims and appealing marketing images on food packaging.

    At the supermarket, unhealthy foods are often promoted through prominent displays and price discounts.

    We’re also exposed to various situations in our everyday lives that can make healthy eating challenging. For example, social occasions or work functions might see large amounts of unhealthy food on offer.

    Not everyone is affected in the same way

    People differ in the degree to which their food consumption is influenced by their food environments.

    This can be due to biological factors (for example, genetics and hormones), psychological characteristics (such as decision making processes or personality traits) and prior experiences with food (for example, learned associations between foods and particular situations or emotions).

    People who are more susceptible will likely eat more and eat more unhealthy foods than those who are more immune to the effects of food environments and situations.

    Those who are more susceptible may pay greater attention to food cues such as advertisements and cooking smells, and feel a stronger desire to eat when exposed to these cues. Meanwhile, they may pay less attention to internal cues signalling hunger and fullness. These differences are due to a combination of biological and psychological characteristics.

    These people might also be more likely to experience physiological reactions to food cues including changes in heart rate and increased salivation.

    Two young women sitting on a couch eating chips.
    It’s common to eat junk food in front of the TV.
    PR Image Factory/Shutterstock

    Other situational cues can also prompt eating for some people, depending on what they’ve learned about eating. Some of us tend to eat when we’re tired or in a bad mood, having learned over time eating provides comfort in these situations.

    Other people will tend to eat in situations such as in the car during the commute home from work (possibly passing multiple fast-food outlets along the way), or at certain times of day such as after dinner, or when others around them are eating, having learned associations between these situations and eating.

    Being in front of a TV or other screen can also prompt people to eat, eat unhealthy foods, or eat more than intended.

    Making changes

    While it’s not possible to change wider food environments or individual characteristics that affect susceptibility to food cues, you can try to tune into how and when you’re affected by food cues. Then you can restructure some aspects of your personal food environments, which can help if you’re working towards healthier eating goals.

    Although both meals and snacks are important for overall diet quality, snacks are often unplanned, which means food environments and situations may have a greater impact on what we snack on.

    Foods consumed as snacks are often sugary drinks, confectionery, chips and cakes. However, snacks can also be healthy (for example, fruits, nuts and seeds).

    Try removing unhealthy foods, particularly packaged snacks, from the house, or not buying them in the first place. This means temptations are removed, which can be especially helpful for those who may be more susceptible to their food environment.

    Planning social events around non-food activities can help reduce social influences on eating. For example, why not catch up with friends for a walk instead of lunch at a fast-food restaurant.

    Creating certain rules and habits can reduce cues for eating. For example, not eating at your desk, in the car, or in front of the TV will, over time, lessen the effects of these situations as cues for eating.

    You could also try keeping a food diary to identify what moods and emotions trigger eating. Once you’ve identified these triggers, develop a plan to help break these habits. Strategies may include doing another activity you enjoy such as going for a short walk or listening to music – anything that can help manage the mood or emotion where you would have typically reached for the fridge.

    Write (and stick to) a grocery list and avoid shopping for food when hungry. Plan and prepare meals and snacks ahead of time so eating decisions are made in advance of situations where you might feel especially hungry or tired or be influenced by your food environment.The Conversation

    Georgie Russell, Senior Lecturer, Institute for Physical Activity and Nutrition (IPAN), Deakin University and Rebecca Leech, NHMRC Emerging Leadership Fellow, School of Exercise and Nutrition Sciences, Deakin University

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

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