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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  • Vibration Plate, Review After 6 Months: Is It Worth It?

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    Is it push-button exercise, or an expensive fad, or something else entirely? Robin, from “The Science of Self-Care”, has insights:

    Science & Experience

    According to the science (studies cited in the video and linked-to in the video description, underneath it on YouTube), vibration therapy does have some clear benefits, namely:

    • Bone health (helps with bone density, particularly beneficial for postmenopausal women)
    • Muscle recovery (reduces lactate levels, aiding faster recovery)
    • Joint health (reduces pain and improves function in osteoarthritis patients)
    • Muscle stimulation (helps older adults maintain muscle mass)
    • Cognitive function (due to increased blood flow to the brain)

    And from her personal experience, the benefits included:

    • Improved recovery after exercise, reducing muscle soreness and stiffness
    • Reduced back pain and improved posture (not surprising, given the need for stabilizing muscles when using one of these)
    • Better circulation and (likely resulting from same) skin clarity

    She did not, however, notice:

    • Any reduction in cellulite
    • Any change in body composition (fat loss or muscle gain)

    For a deeper look into these things and more, plus a demonstration of how the machine actually operates, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

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  • Eat to Beat Depression and Anxiety – by Dr. Drew Ramsey

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    Most of us could use a little mood boost sometimes, and some of us could definitely stand to have our baseline neurochemistry elevated a bit. We’ve probably Googled “foods to increase dopamine”, and similar phrases. So, why is this a book, and not just an article saying to eat cashews and dark chocolate?

    Dr. Drew Ramsey takes a holistic approach to health. By this we mean that to have good health, the whole body and mind must be kept healthy. Let a part slip, and the others will soon follow. Improve a part, and the others will soon follow, too.

    Of course, there is only so much that diet can do. Jut as no diet will replace a Type 1 Diabetic’s pancreas with a working one, no diet will treat the causes of some kinds of depression and anxiety.

    For this reason, Dr. Ramsey, himself a psychiatrist (and a farmer!) recommends a combination of talking therapy and diet, with medications as a “third leg” to be included when necessary. The goal, for him, is to reduce dependence on medications, while still recognizing when they can be useful or even necessary.

    As for the practical, actionable advices in the book, he does (unsurprisingly) recommend a Mediterranean diet. Heavy on the greens and beans, plenty of colorful fruit and veg, small amounts of fish and seafood, even smaller amounts of grass-fed beef and fermented dairy. He also discusses a bunch of “superfoods” he particularly recommends.

    Nor does he just hand-wave the process; he talks about the science of how and why each of these things helps.

    And in practical terms, he even devotes some time to helping the reader get our kitchen set up, if we’re not already ready-to-go in that department. He also caters to any “can’t cook / won’t cook” readers and how to work around that too.

    Bottom line: if you’d like to get rewiring your brain (leveraging neuroplasticity is a key component of the book), this will get you on track. A particular strength is how the author “thinks of everything” in terms of common problems that people (especially: depressed and anxious people!) might have in implementing his advices.

    Click here to check out “Eat to Beat Depression and Anxiety” and get rebuilding your brain for a happier future!

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  • Time Smart – by Dr. Ashley Whillans

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    First, what this is not: it’s not a productivity book.

    What is rather: a book of better wellbeing.

    There is a little overlap, insofar as getting “time smart” in the ways that Dr. Whillans recommends will give you more ability to also be more productive—if that’s what you want.

    She talks us through time traps and the “time poverty epidemic”, as well as steps to finding time and funding time. Perhaps most critical idea-wise is the chapter on building a “time-affluence habit”, making decisions that prioritize your time-freedom where you can—which in turn will allow you to build yet more. Kind of like compound interest really, but for time.

    The writing style is a conversational tone, but peppered with bullet-point lists and charts and the like from time to time, and often with citations to back up claims. It makes for a very readable book, and yet one that’s also inspiring of the confidence that it’s more than just one person’s opinion.

    Bottom line: if you sometimes feel like you could do everything you want to if you could just find the time, this book can help you get there.

    Click here to check out Time Smart, and live your most satisfying life!

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  • Is Cutting Calories The Key To Healthy Long Life?

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    Caloric Restriction with Optimal Nutrition

    Yesterday, we asked you “What is your opinion of caloric restriction as a health practice?” and got the above-depicted, below-described spread of responses:

    • 48% said “It is a robust, scientifically proven way to live longer and healthier”
    • 23% said “It may help us to live longer, but at the cost of enjoying it fully”
    • 17% said “It’s a dangerous fad that makes people weak, tired, sick, and unhealthy”
    • 12% said “Counting calories is irrelevant to good health; the body compensates”

    So… What does the science say?

    A note on terms, first

    “Caloric restriction” (henceforth: CR), as a term, sees scientific use to mean anything from a 25% reduction to a 50% reduction, compared to metabolic base rate.

    This can also be expressed the other way around, “dropping to 60% of the metabolic base rate” (i.e., a 40% reduction).

    Here we don’t have the space to go into much depth, so our policy will be: if research papers consider it CR, then so will we.

    A quick spoiler, first

    The above statements about CR are all to at least some degree True in one way or another.

    However, there are very important distinctions, so let’s press on…

    CR is a robust, scientifically proven way to live longer and healthier: True or False?

    True! This has been well-studied and well-documented. There’s more science for this than we could possibly list here, but here’s a good starting point:

    ❝Calorie restriction (CR), a nutritional intervention of reduced energy intake but with adequate nutrition, has been shown to extend healthspan and lifespan in rodent and primate models.

    Accumulating data from observational and randomized clinical trials indicate that CR in humans results in some of the same metabolic and molecular adaptations that have been shown to improve health and retard the accumulation of molecular damage in animal models of longevity.

    In particular, moderate CR in humans ameliorates multiple metabolic and hormonal factors that are implicated in the pathogenesis of type 2 diabetes, cardiovascular diseases, and cancer, the leading causes of morbidity, disability and mortality❞

    Source: Ageing Research Reviews | Calorie restriction in humans: an update

    See also: Caloric restriction in humans reveals immunometabolic regulators of health span

    We could devote a whole article (or a whole book, really) to this, but the super-short version is that it lowers the metabolic “tax” on the body and allows the body to function better for longer.

    CR may help us to live longer, but at the cost of enjoying it fully: True or False?

    True or False, contingently, depending on what’s important to you. And that depends on psychology as much as physiology, but it’s worth noting that there is often a selection bias in the research papers; people ill-suited to CR drop out of the studies and are not counted in the final data.

    Also, relevant for a lot of our readers, most (human-based) studies recruit people over 18 and under 60. So while it is reasonable to assume the same benefits will be carried over that age, there is not nearly as much data for it.

    Studies into CR and Health-Related Quality of Life (HRQoL) have been promising, and/but have caveats:

    ❝In non-obese adults, CR had some positive effects and no negative effects on HRQoL.❞

    Source: Effect of Calorie Restriction on Mood, Quality of Life, Sleep, and Sexual Function in Healthy Non-obese Adults

    ❝We do not know what degree of CR is needed to achieve improvements in HRQoL, but we do know it requires an extraordinary amount of support.

    Therefore, the incentive to offer this intervention to a low-risk, normal or overweight individual is lacking and likely not sustainable in practice.❞

    Source: Caloric restriction improves health-related quality of life in healthy normal weight and overweight individuals

    CR a dangerous fad that makes people weak, tired, sick, and unhealthy: True or False?

    True if it is undertaken improperly, and/or without sufficient support. Many people will try CR and forget that the idea is to reduce metabolic load while still getting good nutrition, and focus solely on the calorie-counting.

    So for example, if a person “saves” their calories for the day to have a night out in a bar where they drink their calories as alcohol, then this is going to be abysmal for their health.

    That’s an extreme example, but lesser versions are seen a lot. If you save your calories for a pizza instead of a night of alcoholic drinks, then it’s not quite so woeful, but for example the nutrition-to-calorie ratio of pizza is typically not great. Multiply that by doing it as often as not, and yes, someone’s health is going to be in ruins quite soon.

    Counting calories is irrelevant to good health; the body compensates: True or False?

    True if by “good health” you mean weight loss—which is rarely, if ever, what we mean by “good health” here at 10almonds (unless we clarify such), but it’s a very common association and indeed, for some people it’s a health goal. You cannot sustainably and healthily lose weight by CR alone, especially if you’re not getting optimal nutrition.

    Your body will notice that you are starving, and try to save you by storing as much fat as it can, amongst other measures that will similarly backfire (cortisol running high, energy running low, etc).

    For short term weight loss though, yes, it’ll work. At a cost. That we don’t recommend.

    ❝By itself, decreasing calorie intake will have a limited short-term influence.❞

    Source: Reducing Calorie Intake May Not Help You Lose Body Weight

    See also…

    ❝Caloric restriction is a commonly recommended weight-loss method, yet it may result in short-term weight loss and subsequent weight regain, known as “weight cycling”, which has recently been shown to be associated with both poor sleep and worse cardiovascular health❞

    Source: Dieting Behavior Characterized by Caloric Restriction

    In summary…

    Caloric restriction is a well-studied area of health science. We know:

    • Practised well, it can extend not only lifespan, but also healthspan
    • Practised well, it can improve mood, energy, sexual function, and the other things people fear losing
    • Practised badly, it can be ruinous to the health—it is critical to practise caloric restriction with optimal nutrition.
    • Practised badly, it can lead to unhealthy weight loss and weight regain

    One final note…

    If you’ve tried CR and hated it, and you practised it well (e.g., with optimal nutrition), then we recommend just not doing it.

    You could also try intermittent fasting instead, for similar potential benefits. If that doesn’t work out either, then don’t do that either!

    Sometimes, we’re just weird. It can often be because of a genetic or epigenetic quirk. There are usually workarounds, and/but not everything that’s right for most people will be right for all of us.

    Take care!

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  • Cherries’ Very Healthy Wealth Of Benefits!

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    Cherry’s Health Benefits Simply Pop

    We wrote recently about some of the health benefits of cherries, in our “This or That” challenge, pitting them against strawberries:

    Strawberries vs Cherries – Which is Healthier?

    We said there that we’d do a main feature on cherries sometime soon, so here it is!

    Sweet & Sour

    Cherries can be divided into sweet vs sour. These are mostly nutritionally similar, though sour ones do have some extra benefits.

    Sweet and sour cherries are closely related but botanically different plants; it’s not simply a matter of ripeness (or preparation).

    These can mostly be sorted into varieties of Prunus avium and Prunus cerasus, respectively:

    Cherry Antioxidants: From Farm to Table

    Sour cherry varieties include morello and montmorency, so look out for those names in particular when doing your grocery-shopping.

    You may remember that it’s a good rule of thumb that foods that are more “bitter, astringent, or pungent” will tend to have a higher polyphenol content (that’s good):

    Enjoy Bitter Foods For Your Heart & Brain

    Juiced up

    Almost certainly for reasons of budget and convenience, as much as for standardization, most studies into the benefits of cherries have been conducted using concentrated cherry juice as a supplement.

    At home, we need not worry so much about standardization, and our budget and convenience are ours to manage. To this end, as a general rule of thumb, whole fruits are pretty much always better than juice:

    Which Sugars Are Healthier, And Which Are Just The Same?

    Antioxidant & anti-inflammatory!

    Cherries are a very good source of antioxidants, and as such they also reduce inflammation, which in turn means ameliorating autoimmune diseases, from common things like arthritis…

    Efficacy of Tart Cherry Juice to Reduce Inflammation Biomarkers among Women with Inflammatory Osteoarthritis (OA)

    …to less common things like gout:

    Cherry Consumption and the Risk of Recurrent Gout Attacks

    This can also be measured by monitoring uric acid metabolites:

    Consumption of cherries lowers plasma urate in healthy women

    Anti-diabetic effect

    Most of the studies on this have been rat studies, and the human studies have been less “the effect of cherry consumption on diabetes” and more a matter of separate studies adding up to this conclusion in, the manner of “cherries have this substance, this substance has this effect, therefore cherries will have this effect”. You can see an example of this discussed over the course of 15 studies, here:

    A Review of the Health Benefits of Cherries ← skip to section 2.2.1: “Cherry Intake And Diabetes”

    In short, the jury is out on cherry juice, but eating cherries themselves (much like getting plenty of fruit in general) is considered good against diabetes.

    Good for healthy sleep

    For this one, the juice suffices (actual cherries are still recommended, but the juice gave clear significant positive results):

    Pilot Study of the Tart Cherry Juice for the Treatment of Insomnia and Investigation of Mechanisms ← this was specifically in people over the age of 50

    Importantly, it’s not that cherries have a sedative effect, but rather they support the body’s ability to produce melatonin adequately when the time comes:

    Effect of tart cherry juice (Prunus cerasus) on melatonin levels and enhanced sleep quality

    Post-exercise recovery

    Cherries are well-known for boosting post-exercise recovery, though they may actually improve performance during exercise too, if eaten beforehand/

    For example, these marathon-runners who averaged 13% compared to placebo control:

    Effects of powdered Montmorency tart cherry supplementation on acute endurance exercise performance in aerobically trained individuals

    As for its recovery benefits, we wrote about this before:

    How To Speed Up Recovery After A Workout (According To Actual Science)

    Want to get some?

    We recommend your local supermarket (or farmer’s market!), but if for any reason you prefer to take a supplement, here’s an example product on Amazon

    Enjoy!

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  • Broccoli vs Asparagus – Which is Healthier?

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    Our Verdict

    When comparing broccoli to asparagus, we picked the broccoli.

    Why?

    Both are great! But broccoli does distinguish itself:

    In terms of macros, broccoli has slightly more protein, carbs, and fiber. The two vegetables have the same glycemic index. We’ll call this a slight win for broccoli based mainly on the higher fiber, but it’s not by a huge amount.

    When it comes to vitamins, broccoli has more of vitamins B5, B6, B9, C, K, and choline, whereas asparagus has more of vitamins A, B1, B2, B3, and E. This would already be a 6:5 marginal win for broccoli, but it’s worth bearing in mind that broccoli’s margins are greater, especially with broccoli having around 15x the amount of vitamin C. So, a clear win for broccoli, respectable as asparagus may be.

    In the category of minerals, broccoli has more calcium, magnesium, manganese, phosphorus, potassium, and selenium, while asparagus boasts more copper, iron, and zinc. A 6:3 win for broccoli here.

    Both vegetables also contain generous amounts of antioxidant polyphenols and other beneficial phytochemicals, often a little different from each other, so that’s a case for enjoying both.

    Still, if you’re going to pick just one, we recommend the broccoli!

    Want to learn more?

    You might like to read:

    Take care!

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