Hospitals worldwide are short of saline. We can’t just switch to other IV fluids – here’s why

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Last week, the Australian Therapeutic Goods Administration added intravenous (IV) fluids to the growing list of medicines in short supply. The shortage is due to higher-than-expected demand and manufacturing issues.

Two particular IV fluids are affected: saline and compound sodium lactate (also called Hartmann’s solution). Both fluids are made with salts.

There are IV fluids that use other components, such as sugar, rather than salt. But instead of switching patients to those fluids, the government has chosen to approve salt-based solutions by other overseas brands.

So why do IV fluids contain different chemicals? And why can’t they just be interchanged when one runs low?

Pavel Kosolapov/Shutterstock

We can’t just inject water into a vein

Drugs are always injected into veins in a water-based solution. But we can’t do this with pure water, we need to add other chemicals. That’s because of a scientific principle called osmosis.

Osmosis occurs when water moves rapidly in and out of the cells in the blood stream, in response to changes to the concentration of chemicals dissolved in the blood plasma. Think salts, sugars, nutrients, drugs and proteins.

Too high a concentration of chemicals and protein in your blood stream leads it to being in a “hypertonic” state, which causes your blood cells to shrink. Not enough chemicals and proteins in your blood stream causes your blood cells to expand. Just the right amount is called “isotonic”.

Mixing the drug with the right amount of chemicals, via an injection or infusion, ensures the concentration inside the syringe or IV bag remains close to isotonic.

A woman connected to an IV drip looks out a hospital window.
Australia is currently short on two salt-based IV fluids. sirnength88/Shutterstock

What are the different types of IV fluids?

There are a range of IV fluids available to administer drugs. The two most popular are:

  • 0.9% saline, which is an isotonic solution of table salt. This is one of the IV fluids in short supply
  • a 5% solution of the sugar glucose/dextrose. This fluid is not in short supply.

There are also IV fluids that combine both saline and glucose, and IV fluids that have other salts:

  • Ringer’s solution is an IV fluid which has sodium, potassium and calcium salts
  • Plasma-Lyte has different sodium salts, as well as magnesium
  • Hartmann’s solution (compound sodium lactate) contains a range of different salts. It is generally used to treat a condition called metabolic acidosis, where patients have increased acid in their blood stream. This is in short supply.

What if you use the wrong solution?

Some drugs are only stable in specific IV fluids, for instance, only in salt-based IV fluids or only in glucose.

Putting a drug into the wrong IV fluid can potentially cause the drug to “crash out” of the solution, meaning patients won’t get the full dose.

Or it could cause the drug to decompose: not only will it not work, but it could also cause serious side effects.

An example of where a drug can be transformed into something toxic is the cancer chemotherapy drug cisplatin. When administered in saline it is safe, but administration in pure glucose can cause life-threatening damage to a patients’ kidneys.

What can hospitals use instead?

The IV fluids in short supply are saline and Hartmann’s solution. They are provided by three approved Australian suppliers: Baxter Healthcare, B.Braun and Fresenius Kabi.

The government’s solution to this is to approve multiple overseas-registered alternative saline brands, which they are allowed to do under current legislation without it going through the normal Australian quality checks and approval process. They will have received approval in their country of manufacture.

The government is taking this approach because it may not be effective or safe to formulate medicines that are meant to be in saline into different IV fluids. And we don’t have sufficient capacity to manufacture saline IV fluids here in Australia.

The Australian Society of Hospital Pharmacists provides guidance to other health staff about what drugs have to go with which IV fluids in their Australian Injectable Drugs Handbook. If there is a shortage of saline or Hartmann’s solution, and shipments of other overseas brands have not arrived, this guidance can be used to select another appropriate IV fluid.

Why don’t we make it locally?

The current shortage of IV fluids is just another example of the problems Australia faces when it is almost completely reliant on its critical medicines from overseas manufacturers.

Fortunately, we have workarounds to address the current shortage. But Australia is likely to face ongoing shortages, not only for IV fluids but for any medicines that we rely on overseas manufacturers to produce. Shortages like this put Australian lives at risk.

In the past both myself, and others, have called for the federal government to develop or back the development of medicines manufacturing in Australia. This could involve manufacturing off-patent medicines with an emphasis on those medicines most used in Australia.

Not only would this create stable, high technology jobs in Australia, it would also contribute to our economy and make us less susceptible to future global drug supply problems.

Nial Wheate, Professor and Director Academic Excellence, Macquarie University and Shoohb Alassadi, Casual academic, pharmaceutical sciences, University of Sydney

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

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  • Hope: A research-based explainer

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    This year, more than 60 countries, representing more than 4 billion people, will hold major elections. News headlines already are reporting that voters are hanging on to hope. When things get tough or don’t go our way, we’re told to hang on to hope. HOPE was the only word printed on President Barack Obama’s iconic campaign poster in 2008.

    Research on hope has flourished only in recent decades. There’s now a growing recognition that hope has a role in physical, social, and mental health outcomes, including promoting resilience. As we embark on a challenging year of news, it’s important for journalists to learn about hope.

    So what is hope? And what does the research say about it?

    Merriam-Webster defines hope as a “desire accompanied by expectation of or belief in fulfillment.” This definition highlights the two basic dimensions of hope: a desire and a belief in the possibility of attaining that desire.

    Hope is not Pollyannaish optimism, writes psychologist Everett Worthington in a 2020 article for The Conversation. “Instead, hope is a motivation to persevere toward a goal or end state, even if we’re skeptical that a positive outcome is likely.”

    There are several scientific theories about hope.

    One of the first, and most well-known, theories on hope was introduced in 1991 by American psychologist Charles R. Snyder.

    In a paper published in the Journal of Personality and Social Psychology, Snyder defined hope as a cognitive trait centered on the pursuit of goals and built on two components: a sense of agency in achieving a goal, and a perceived ability to create pathways to achieve that goal. He defined hope as something individualistic.

    Snyder also introduced the Hope Scale, which continues to be used today, as a way to measure hope. He suggested that some people have higher levels of hope than others and there seem to be benefits to being more hopeful.

    “For example, we would expect that higher as compared with lower hope people are more likely to have a healthy lifestyle, to avoid life crises, and to cope better with stressors when they are encountered,” they write.

    Others have suggested broader definitions.

    In 1992, Kaye Herth, a professor of nursing and a scholar on hope, defined hope as “a multidimensional dynamic life force characterized by a confident yet uncertain expectation of achieving good, which to the hoping person, is realistically possible and personally significant.” Herth also developed the Herth Hope Index, which is used in various settings, including clinical practice and research.

    More recently, others have offered an even broader definition of hope.

    Anthony Scioli, a clinical psychologist and author of several books on hope, defines hope “as an emotion with spiritual dimensions,” in a 2023 review published in Current Opinion in Psychology. “Hope is best viewed as an ameliorating emotion, designed to fill the liminal space between need and reality.”

    Hope is also nuanced.

    “Our hopes may be active or passive, patient or critical, private or collective, grounded in the evidence or resolute in spite of it, socially conservative or socially transformative,” writes Darren Webb in a 2007 study published in History of the Human Sciences. “We all hope, but we experience this most human of all mental feelings in a variety of modes.”

    To be sure, a few studies have shown that hope can have negative outcomes in certain populations and situations. For example, one study highlighted in the research roundup below finds that Black college students who had higher levels of hope experienced more stress due to racial discrimination compared with Black students who had lower levels of hope.

    Today, hope is one of the most well-studied constructs within the field of positive psychology, according to the journal Current Opinion in Psychology, which dedicated its August 2023 issue to the subject. (Positive psychology is a branch of psychology focused on characters and behaviors that allow people to flourish.)

    We’ve gathered several studies below to help you think more deeply about hope and recognize its role in your everyday lives.

    Research roundup

    The Role of Hope in Subsequent Health and Well-Being For Older Adults: An Outcome-Wide Longitudinal Approach
    Katelyn N.G. Long, et al. Global Epidemiology, November 2020.

    The study: To explore the potential public health implications of hope, researchers examine the relationship between hope and physical, behavioral and psychosocial outcomes in 12,998 older adults in the U.S. with a mean age of 66.

    Researchers note that most investigations on hope have focused on psychological and social well-being outcomes and less attention has been paid to its impact on physical and behavioral health, particularly among older adults.

    The findings: Results show a positive association between an increased sense of hope and a variety of behavioral and psychosocial outcomes, such as fewer sleep problems, more physical activity, optimism and satisfaction with life. However, there wasn’t a clear association between hope and all physical health outcomes. For instance, hope was associated with a reduced number of chronic conditions, but not with stroke, diabetes and hypertension.

    The takeaway: “The later stages of life are often defined by loss: the loss of health, loved ones, social support networks, independence, and (eventually) loss of life itself,” the authors write. “Our results suggest that standard public health promotion activities, which often focus solely on physical health, might be expanded to include a wider range of factors that may lead to gains in hope. For example, alongside community-based health and nutrition programs aimed at reducing chronic conditions like hypertension, programs that help strengthen marital relations (e.g., closeness with a spouse), provide opportunities to volunteer, help lower anxiety, or increase connection with friends may potentially increase levels of hope, which in turn, may improve levels of health and well-being in a variety of domains.”

    Associated Factors of Hope in Cancer Patients During Treatment: A Systematic Literature Review
    Corine Nierop-van Baalen, Maria Grypdonck, Ann van Hecke and Sofie Verhaeghe. Journal of Advanced Nursing, March 2020.

    The study: The authors review 33 studies, written in English or Dutch and published in the past decade, on the relationship between hope and the quality of life and well-being of patients with cancer. Studies have shown that many cancer patients respond to their diagnosis by nurturing hope, while many health professionals feel uneasy when patients’ hopes go far beyond their prognosis, the authors write.

    The findings: Quality of life, social support and spiritual well-being were positively associated with hope, as measured with various scales. Whereas symptoms, psychological distress and depression had a negative association with hope. Hope didn’t seem to be affected by the type or stage of cancer or the patient’s demographics.

    The takeaway: “Hope seems to be a process that is determined by a person’s inner being rather than influenced from the outside,” the authors write. “These factors are typically given meaning by the patients themselves. Social support, for example, is not about how many patients experience support, but that this support has real meaning for them.”

    Characterizing Hope: An Interdisciplinary Overview of the Characteristics of Hope
    Emma Pleeging, Job van Exel and Martijn Burger. Applied Research in Quality of Life, September 2021.

    The study: This systematic review provides an overview of the concept of hope based on 66 academic papers in ten academic fields, including economics and business studies, environmental studies, health studies, history, humanities, philosophy, political science, psychology, social science, theology and youth studies, resulting in seven themes and 41 sub-themes.

    The findings: The authors boil down their findings to seven components: internal and external sources, the individual and social experience of hope, internal and external effects, and the object of hope, which can be “just about anything we can imagine,” the authors write.

    The takeaway: “An important implication of these results lies in the way hope is measured in applied and scientific research,” researchers write. “When measuring hope or developing instruments to measure it, researchers could be well-advised to take note of the broader understanding of the topic, to prevent that important characteristics might be overlooked.”

    Revisiting the Paradox of Hope: The Role of Discrimination Among First-Year Black College Students
    Ryon C. McDermott, et al. Journal of Counseling Psychology, March 2020.

    The study: Researchers examine the moderating effects of hope on the association between experiencing racial discrimination, stress and academic well-being among 203 first-year U.S. Black college students. They build on a small body of evidence that suggests high levels of hope might have a negative effect on Black college students who experience racial discrimination.

    The authors use data gathered as part of an annual paper-and-pencil survey of first-year college students at a university on the Gulf Coast, which the study doesn’t identify.

    The findings: Researchers find that Black students who had higher levels of hope experienced more stress due to racial discrimination compared with students who had lower levels of hope. On the other hand, Black students with low levels of hope may be less likely to experience stress when they encounter discrimination.

    Meanwhile, Black students who had high levels of hope were more successful in academic integration — which researchers define as satisfaction with and integration into the academic aspects of college life — despite facing discrimination. But low levels of hope had a negative impact on students’ academic well-being.

    “The present study found evidence that a core construct in positive psychology, hope, may not always protect Black students from experiencing the psychological sting of discrimination, but it was still beneficial to their academic well-being,” the authors write.

    The takeaway: “Our findings also highlight an urgent need to reduce discrimination on college campuses,” the researchers write. “Reducing discrimination could help Black students (and other racial minorities) avoid additional stress, as well as help them realize the full psychological and academic benefits of having high levels of hope.”

    Additional reading

    Hope Across Cultural Groups Lisa M. Edwards and Kat McConnell. Current Opinion in Psychology, February 2023.

    The Psychology of Hope: A Diagnostic and Prescriptive Account Anthony Scioli. “Historical and Multidisciplinary Perspectives on Hope,” July 2020.

    Hope Theory: Rainbows in the Mind C.R. Snyder. Psychological Inquiry, 2002

    This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.

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  • How White Is Your Tongue?

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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

    ❝So its normal to develop a white sort of coating on the tongue, right? It develops when I eat, and is able to (somewhat) easily be brushed off❞

    If (and only if) there is no soreness and the coverage of the whiteness is not extreme, then, yes, that is normal and fine.

    Your mouth has a microbiome, and it’s supposed to have one (helps keep the conditions in your mouth correct, so that food is broken down and/but your gums and teeth aren’t).

    Read more: The oral microbiome: Role of key organisms and complex networks in oral health and disease

    The whiteness you often see on a healthy tongue is, for the most part, bacteria and dead cells—harmless.

    Cleaning the whiteness off with your brush is fine. You can also scrape off with floss is similar if you prefer. Or a tongue-scraper! Those can be especially good for people for whom brushing the tongue is an unpleasant sensation. Or you can just leave it, if it doesn’t bother you.

    By the way, that microbiome is a reason it can be good to go easy on the mouthwash. Moderate use of mouthwash is usually fine, but you don’t want to wipe out your microbiome then have it taken over by unpleasantries that the mouthwash didn’t kill (unpleasantries like C. albicans).

    There are other mouthwash-related considerations too:

    Toothpastes and mouthwashes: which kinds help, and which kinds harm?

    If you start to get soreness, that probably means the papillae (little villi-like things) are inflamed. If there is soreness, and/or the whiteness is extreme, then it could be a fungal infection (usually C. albicans, also called Thrush), in which case, antifungal medications will be needed, which you can probably get over the counter from your pharmacist.

    Do not try to self-treat with antibiotics.

    Antibiotics will make a fungal infection worse (indeed, antibiotic usage is often the reason for getting fungal growth in the first place) by wiping out the bacteria that normally keep it in check.

    Other risk factors include a sugary diet, smoking, and medications that have “dry mouth” as a side effect.

    Read more: Can oral thrush be prevented?

    If you have any symptoms more exciting than the above, then definitely see a doctor.

    Take care!

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  • Do We Simply Not Care About Old People?

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    The covid-19 pandemic would be a wake-up call for America, advocates for the elderly predicted: incontrovertible proof that the nation wasn’t doing enough to care for vulnerable older adults.

    The death toll was shocking, as were reports of chaos in nursing homes and seniors suffering from isolation, depression, untreated illness, and neglect. Around 900,000 older adults have died of covid-19 to date, accounting for 3 of every 4 Americans who have perished in the pandemic.

    But decisive actions that advocates had hoped for haven’t materialized. Today, most people — and government officials — appear to accept covid as a part of ordinary life. Many seniors at high risk aren’t getting antiviral therapies for covid, and most older adults in nursing homes aren’t getting updated vaccines. Efforts to strengthen care quality in nursing homes and assisted living centers have stalled amid debate over costs and the availability of staff. And only a small percentage of people are masking or taking other precautions in public despite a new wave of covid, flu, and respiratory syncytial virus infections hospitalizing and killing seniors.

    In the last week of 2023 and the first two weeks of 2024 alone, 4,810 people 65 and older lost their lives to covid — a group that would fill more than 10 large airliners — according to data provided by the CDC. But the alarm that would attend plane crashes is notably absent. (During the same period, the flu killed an additional 1,201 seniors, and RSV killed 126.)

    “It boggles my mind that there isn’t more outrage,” said Alice Bonner, 66, senior adviser for aging at the Institute for Healthcare Improvement. “I’m at the point where I want to say, ‘What the heck? Why aren’t people responding and doing more for older adults?’”

    It’s a good question. Do we simply not care?

    I put this big-picture question, which rarely gets asked amid debates over budgets and policies, to health care professionals, researchers, and policymakers who are older themselves and have spent many years working in the aging field. Here are some of their responses.

    The pandemic made things worse. Prejudice against older adults is nothing new, but “it feels more intense, more hostile” now than previously, said Karl Pillemer, 69, a professor of psychology and gerontology at Cornell University.

    “I think the pandemic helped reinforce images of older people as sick, frail, and isolated — as people who aren’t like the rest of us,” he said. “And human nature being what it is, we tend to like people who are similar to us and be less well disposed to ‘the others.’”

    “A lot of us felt isolated and threatened during the pandemic. It made us sit there and think, ‘What I really care about is protecting myself, my wife, my brother, my kids, and screw everybody else,’” said W. Andrew Achenbaum, 76, the author of nine books on aging and a professor emeritus at Texas Medical Center in Houston.

    In an environment of “us against them,” where everybody wants to blame somebody, Achenbaum continued, “who’s expendable? Older people who aren’t seen as productive, who consume resources believed to be in short supply. It’s really hard to give old people their due when you’re terrified about your own existence.”

    Although covid continues to circulate, disproportionately affecting older adults, “people now think the crisis is over, and we have a deep desire to return to normal,” said Edwin Walker, 67, who leads the Administration on Aging at the Department of Health and Human Services. He spoke as an individual, not a government representative.

    The upshot is “we didn’t learn the lessons we should have,” and the ageism that surfaced during the pandemic hasn’t abated, he observed.

    Ageism is pervasive. “Everyone loves their own parents. But as a society, we don’t value older adults or the people who care for them,” said Robert Kramer, 74, co-founder and strategic adviser at the National Investment Center for Seniors Housing & Care.

    Kramer thinks boomers are reaping what they have sown. “We have chased youth and glorified youth. When you spend billions of dollars trying to stay young, look young, act young, you build in an automatic fear and prejudice of the opposite.”

    Combine the fear of diminishment, decline, and death that can accompany growing older with the trauma and fear that arose during the pandemic, and “I think covid has pushed us back in whatever progress we were making in addressing the needs of our rapidly aging society. It has further stigmatized aging,” said John Rowe, 79, professor of health policy and aging at Columbia University’s Mailman School of Public Health.

    “The message to older adults is: ‘Your time has passed, give up your seat at the table, stop consuming resources, fall in line,’” said Anne Montgomery, 65, a health policy expert at the National Committee to Preserve Social Security and Medicare. She believes, however, that baby boomers can “rewrite and flip that script if we want to and if we work to change systems that embody the values of a deeply ageist society.”

    Integration, not separation, is needed. The best way to overcome stigma is “to get to know the people you are stigmatizing,” said G. Allen Power, 70, a geriatrician and the chair in aging and dementia innovation at the Schlegel-University of Waterloo Research Institute for Aging in Canada. “But we separate ourselves from older people so we don’t have to think about our own aging and our own mortality.”

    The solution: “We have to find ways to better integrate older adults in the community as opposed to moving them to campuses where they are apart from the rest of us,” Power said. “We need to stop seeing older people only through the lens of what services they might need and think instead of all they have to offer society.”

    That point is a core precept of the National Academy of Medicine’s 2022 report Global Roadmap for Healthy Longevity. Older people are a “natural resource” who “make substantial contributions to their families and communities,” the report’s authors write in introducing their findings.

    Those contributions include financial support to families, caregiving assistance, volunteering, and ongoing participation in the workforce, among other things.

    “When older people thrive, all people thrive,” the report concludes.

    Future generations will get their turn. That’s a message Kramer conveys in classes he teaches at the University of Southern California, Cornell, and other institutions. “You have far more at stake in changing the way we approach aging than I do,” he tells his students. “You are far more likely, statistically, to live past 100 than I am. If you don’t change society’s attitudes about aging, you will be condemned to lead the last third of your life in social, economic, and cultural irrelevance.”

    As for himself and the baby boom generation, Kramer thinks it’s “too late” to effect the meaningful changes he hopes the future will bring.

    “I suspect things for people in my generation could get a lot worse in the years ahead,” Pillemer said. “People are greatly underestimating what the cost of caring for the older population is going to be over the next 10 to 20 years, and I think that’s going to cause increased conflict.”

    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.

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  • The Princess of Wales wants to stay cancer-free. What does this mean?
  • 10 Great Exercises to Improve Your Eyesight

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    If your eyesight has been declining a bit, all is not lost. Just like many other muscles in the body, the muscles of the eye—including those responsible for changing the focal length of your vision—can atrophy without exercise. So, without further ado, here are the exercises recommended:

    The eyes (still) have it

    1. Blink for a minute: blink rapidly for 30–60 seconds to regulate blood circulation, lubricate your eyes, and prevent dryness.
    2. Rotate your head while staring ahead: turn your head in a circular motion while keeping your gaze straight ahead. This improves blood circulation to your eyes.
    3. Look to your right and left: slowly move your gaze from right to left while breathing. This one relaxes and stretches the eye muscles.
    4. Close your eyes and relax: close your eyes for at least 30 seconds to relax and strengthen your photoreceptor cells.
    5. Move your gaze in different directions: shift your gaze right-left, up-down, in circular motions, and trace a figure 8 with your eyes. This improves visual perception for both near- and far-sightedness.
    6. Close and open your eyes: tighten your eyes shut for 3–5 seconds, then open them. Repeat seven times to improve blood circulation and relax your eye muscles. ← 10almonds note: the duration makes this different from #4, so do try both!
    7. Push against your temples with your fingers: gently press your temples with your fingers for two seconds, then release. Repeat 4–5 times to improve fluid circulation in your eyes.
    8. Draw geometric figures with your gaze: use your eyes to trace shapes such as triangles, squares, and circles to enhance your eye coordination and muscle strength.
    9. Move your eyeballs up and down: close your eyes and slowly move your eyeballs up and down five times to stretch and relax the muscles ← 10almonds note: this seems to be the same as part of #5 and has a considerable overlap with #8, but we’re listing it anyway, or else everyone will wonder where #9 went!
    10. Strengthen near and far focusing: focus on your thumb 10 inches away for 10–15 seconds, then switch focus to an object 10–20 feet away. Repeat five times to improve focus adjustment ability.

    By practicing these exercises daily, we are told that you can improve eye health and vision within a week.

    For more on all these, plus visual demonstrations, enjoy:

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

    Want to learn more?

    You might also like to read:

    Vision for Life, Revised Edition – by Dr. Meir Schneider

    Take care!

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  • The Secret to Mental Health – by George Pransky

    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.

    This book (and its author) have a sizeable popular following, so it definitely can be said that it has been well-received by many people. The premise in this book is that there is fundamentally nothing wrong with anybody’s brain, and rather everything can be broken down into:

    • Mind (the energy and intelligence that animates all life)
    • Consciousness (the capacity to be aware of one’s life and experiences)
    • Thought (the ability to think, allowing individuals to create their personal experience of reality)

    The author explains, over the course of 145 pages, that where anyone with any perceived mental health issue is going wrong is by either lacking self-awareness (Consciousness) or erring by creating an undesirable personal experience of reality (Thought).

    In terms of the science of this, frequent references are made to “there is evidence that shows”, “new discoveries about mental health suggest…”, etc, but this claimed evidence is never actually presented, just alluded to. Where many books would have a bibliography, this one has simply a collection of what the author has titled “interesting case studies, conversations, papers, and discussions” (there are no actual case studies or papers; it is just a collection of anecdotes).

    The style is… Honestly, in this reviewer’s opinion, barely readable. But, apparently lots of people love it, so your mileage may vary.

    We don’t usually delve too far into claimed credentials, but because of the interesting writing style and the bold claims without evidence, we were curious as to where this PhD came from, and apparently it came from a now-shut-down diploma mill that was described by the court as “a complete scam”.

    Bottom line: we can’t recommend this one, but we read it so that you don’t have to, and we hope that publishing this review will help reassure you that when we do recommend a book, we mean it!

    Click here to check out The Secret To Mental Health, and see lots of glowing reviews from people who praise the author’s charisma!

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  • Kimchi Fried Rice

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    Fried rice is not something that leaps to many people’s minds when one says “health food”. But it can be! Today’s recipe is great for many aspects of health, but especially the gut, because of its star ingredient, the kimchi—as well as the fiber in the rest of the dish, which is mostly a variety of vegetables, as well as the rice, which we are assuming you got wholegrain. An optional egg per person adds more healthy fats too!

    You will need

    • Avocado oil, for frying. We picked avocado oil for its healthy fats profile, neutral taste, and high smoke point (we’ll be working at very high temperatures today that might make olive oil or coconut oil smoke). We also recommend against seed oils (e.g. sunflower or canola) for health reasons.
    • 1lb cooked and cooled rice—here’s our recipe for Tasty Versatile Rice if you don’t have leftovers you want to use
    • 7oz kimchi, roughly chopped
    • 4 spring onions, finely chopped
    • 4oz white cabbage, finely shredded
    • 3oz frozen peas, defrosted
    • 1 bulb garlic, thinly sliced
    • 1 carrot, grated
    • ½ red pepper, finely diced
    • 2 tbsp chili oil (or 2 tbsp extra virgin olive oil and 1 red chili, very finely chopped) ← don’t worry about the smoke point of this; it’s going to be for drizzling
    • 1 tbsp dark soy sauce
    • 2 tsp black pepper, coarse ground
    • Optional: 1 egg per person
    • Note: we didn’t forget to include salt; there’s simply enough already in the dish because of the kimchi and soy sauce.

    Method

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

    1) Lightly oil a wok (or similar) and crank up the heat as high as your stove can muster. Add the garlic and spring onions; keep them moving. When they’re turning golden, add the cabbage, carrot, and red pepper. Add them one by one, giving the wok a chance to get back to temperature each time before adding the next ingredient.

    2) When the vegetables are beginning to caramelize (if the temperature is good, this should only be a couple of minutes at most), add the rice, as well as the kimchi, peas, soy sauce, and black pepper. Toss everything ensure it’s all well-combined and evenly cooked. When it’s done (probably only another minute or two), take it off the heat.

    3) Optional: if you’re adding eggs, fry them now. Serve a bowl of kimchi-fried rice per person, adding 1 fried egg on top of each.

    4) Drizzle the chili oil as a colorful, tasty garnish that’s full of healthful polyphenols too.

    Enjoy!

    Want to learn more?

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

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