In Praise of Slowness – by Carl Honoré
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This isn’t just about “taking the time to smell the roses” although yes, that too. Rather, it’s mostly about looking at what drives us to speed everything up in the first place, and correcting where appropriate.
If your ancestors had time to eat fruit and lie in the sun, then why, with all of modern technology now available, are you harangued 16+ hours a day by the pressures of universally synchronized timepieces?
Honoré places a lot of the blame squarely on the industrial revolution; whereas previously our work would be limited by craftsmen who take a year to complete something, or the pace of animals in a field, now humans had to keep up with the very machines that were supposed to serve us—and it’s only got worse from there.
This book takes a tour of many areas affected by this artificial “need for speed”, and how it harms not just our work-life balance, but also our eating habits, the medical attention we get, and even our love lives.
The prescription is deceptively simple, “slow down”. But Honoré dedicates the final three chapters of the book to the “how” of this, when of course there’s a lot the outside world will not accommodate—but where we can slow down, there’s good to be gained.
Bottom line: if you’ve ever felt that you could get all of your life into order if you could just pause the outside world for a week or two, this is the book for you.
Click here to check out In Praise of Slowness, and make time for what matters most!
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Eat to Your Heart’s Content – by Dr. Sat Bains
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Making food heart-healthy and tasty is a challenge that vexes many, but it doesn’t have to be so difficult.
Dr. Sat Bains, a professional chef with multiple Michelin stars to his name, is an expert on “tasty”, and after surviving a heart attack himself, he’s become an expert on “heart-healthy” since then.
The book contains not only the recipes (of which there are 68, by the way), but also large sections of explanation of what makes various ingredients or methods heart-healthy or heart-unhealthy.
There’s science in there too, and these sections were written under the guidance of Dr. Neil Williams, a lecturer in physiology and nutrition.
You may be wondering as to why the author himself has a doctorate too; in fact he has three, none of which are relevant:
- Doctor of Arts
- Doctor of Laws
- Doctor of Hospitality (Honorary)
…but we prefix “Dr.” when people are that and he is that. The expertise we’re getting here though is really his culinary skill and extracurricular heart-healthy learning, plus Dr. Williams’ actual professional health guidance.
Bottom line: if you’d like heart-healthy recipes with restaurant-level glamour, this book is a fine choice.
Click here to check out Eat To Your Heart’s Content, and look after yours!
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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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Is ADHD Being Over-Diagnosed For Cash?
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Is ADHD Being Systematically Overdiagnosed?
The BBC’s investigative “Panorama” program all so recently did a documentary in which one of their journalists—who does not have ADHD—went to three private clinics and got an ADHD diagnosis from each of them:
- The BBC documentary: Private ADHD Clinics Exposed (28 mins)
- Their “5 Minutes” version: ADHD Undercover: How I Was Misdiagnosed (6 mins)
So… Is it really a case of show up, pay up, and get a shiny new diagnosis?
The BBC Panorama producers cherry-picked 3 private providers, and during those clinical assessments, their journalist provided answers that would certainly lead to a diagnosis.
This was contrasted against a three-hour assessment with an NHS psychiatrist—something that rarely happens in the NHS. Which prompts the question…
How did he walk into a 3-hour psychiatrist assessment, when most people have to wait in long waiting lists for a much more cursory appointment first with assorted gatekeepers, before going on another long waiting list, for an also-much-shorter appointment with a psychiatrist?
That would be because the NHS psychiatrist was given advance notification that this was part of an investigation and would be filmed (the private clinics were not gifted the same transparency)
So, maybe just a tad unequal treatment!
In case you’re wondering, here’s what that very NHS psychiatrist had to say on the topic:
Is it really too easy to be diagnosed with ADHD?
(we’ll give you a hint—remember Betteridge’s Law!)
❝Since the documentary aired, I have heard from people concerned that GPs could now be more likely to question legitimate diagnoses.
But as an NHS psychiatrist it is clear to me that the root of this issue is not overdiagnosis.
Instead, we are facing the combined challenges of remedying decades of underdiagnosis and NHS services that were set up when there was little awareness of ADHD.❞
~ Dr. Mike Smith, Psychiatrist
The ADHD foundation, meanwhile, has issued its own response, saying:
❝We are disappointed that BBC Panorama has opted to broadcast a poorly researched, sensationalist piece of television journalism.❞
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What You Should Have Been Told About The Menopause Beforehand
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What You Should Have Been Told About Menopause Beforehand
This is Dr. Jen Gunter. She’s a gynecologist, specializing in chronic pain and vulvovaginal disorders. She’s also a woman on a mission to demystify things that popular culture, especially in the US, would rather not talk about.
When was the last time you remember the menopause being referenced in a movie or TV show? If you can think of one at all, was it just played for laughs?
And of course, the human body can be funny, so that’s not necessarily the problem, but it sure would be nice if that weren’t all that there is!
So, what does Dr. Gunter want us to know?
It’s a time of changes, not an end
The name “menopause” is misleading. It’s not a “pause”, and those menses aren’t coming back.
And yet, to call it a “menostop” would be differently misleading, because there’s a lot more going on than a simple cessation of menstruation.
Estrogen levels will drop a lot, testosterone levels may rise slightly, mood and sleep and appetite and sex drive will probably be affected (progesterone can improve all these things!) and
not to mention butwe’re going to mention: vaginal atrophy, which is very normal and very treatable with a topical estrogen cream. Untreated menopause can also bring a whole lot of increased health risks (for example, heart disease, osteoporosis, and, counterintuitively given the lower estrogen levels, breast cancer).However, with a little awareness and appropriate management, all these things can usually be navigated with minimal adverse health outcomes.
Dr Gunter, for this reason, refers to it interchangeably as “the menopausal transition”. She describes it as being less like a cliff edge we fall off, and more like a bridge we cross.
Bridges can be dangerous to cross! But they can also get us safely where we’re going.
Ok, so how do we manage those things?
Dr. Gunter is a big fan of evidence-based medicine, so we’ll not be seeing any yonic crystals or jade eggs. Or “goop”.
See also: Meet Goop’s Number One Enemy
For most people, she recommends Menopausal Hormone Therapy (MHT), which falls under the more general category of Hormone Replacement Therapy (HRT).
This is the most well-evidenced, science-based way to avoid most of the risks associated with menopause.
Nevertheless, there are scare-stories out there, ranging from painful recommencement of bleeding, to (once again) increased risk of breast cancer. However, most of these are either misunderstandings, or unrelated to menopause and MHT, and are rather signs of other problems that should not be ignored.
To get a good grounding in this, you might want to read her Hormone Therapy Guide, freely available as a standalone section on her website. This series of posts is dedicated to hormone therapy. It starts with some basics and builds on that knowledge with each post:
Dr. Gunter’s Guide To The Hormone Menoverse
What about natural therapies?
There are some non-hormonal things that work, but these are mostly things that:
- give a statistically significant reduction in symptoms
- give the same statistically significant reduction in symptoms as placebo
As Dr. Gunter puts it:
❝While most of the studies of prescription medications for hot flashes have an appropriate placebo arm, this is rarely the case with so-called alternative therapies.
In fact, the studies here are almost always low quality, so it’s often not possible to conclude much.
Many reviews that look at these studies often end with a line that goes something like, “Randomized trials with a placebo arm, a low risk of bias, and adequate sample sizes are urgently needed.”
You should interpret this kind of conclusion as the polite way of saying, “We need studies that aren’t BS to say something constructive.”❞
However, if it works, it works, whatever its mechanism. It’s just good, when making medical decisions, to do so with the full facts!
For that matter, even Dr. Gunter acknowledges that while MHT can be lifechanging (in a positive way) for many, it’s not for everyone:
Informed Decisions: When Menopause Hormone Therapy Isn’t Recommended
Want to know more?
Dr. Gunter also has an assortment of books available, including The Menopause Manifesto (which we’ve reviewed previously), and some others that we haven’t, such as “Blood” and “The Vagina Bible”.
Enjoy!
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Good (Or Bad) Health Starts With Your Blood
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Blood Should Be Only Slightly Thicker Than Water
This is Dr. Casey Means, a physician, lecturer (mostly at Stanford), and CMO of a metabolic health company, Levels, as well as being Associate Editor of the International Journal of Diabetes Reversal and Prevention, where she serves alongside such names as Dr. Colin Campbell, Dr. Joel Fuhrman, Dr. Michael Greger, Dr. William Li, Dr. Dean Ornish, and you get the idea: it’s a star-studded cast.
What does she want us to know?
The big blood problem:
❝We’re spending 3.8 trillion dollars a year on healthcare costs in the U.S., and the reality is that people are getting sicker, fatter, and more depressed.
Over 50% of Americans have pre-diabetes or type 2 diabetes; it’s insane, that number should be close to zero.❞
~ Dr. Casey Means
Indeed, pre-diabetes and especially type 2 diabetes should be very avoidable in any wealthy nation.
Unfortunately, the kind of diet that avoids it tends to rely on having at least 2/3 of the following:
- Money
- Time
- Knowledge
For example:
- if you have money and time, you can buy lots of fresh ingredients without undue worry, and take the time to carefully prep and cook them
- if you have money and knowledge you can have someone else shop and cook for you, or at least get meal kits delivered
- if you have time and knowledge, you can actually eat very healthily on a shoestring budget
If you have all three, then the world’s your oyster mushroom steak sautéed in extra virgin olive oil with garlic and cracked black pepper served on a bed of Swiss chard and lashed with Balsamic vinegar.
However, many Americans aren’t in the happy position of having at least 2/3, and a not-insignificant portion of the population don’t even have 1/3.
As an aside: there is a food scientist and chef who’s made it her mission to educate people about food that’s cheap, easy, and healthy:
…but today is about Dr. Means, so, what does she suggest?
Know
thyselfthy blood sugarsDr. Means argues (reasonably; this is well-backed up by general scientific consensus) that much of human disease stems from the diabetes and pre-diabetes that she mentioned above, and so we should focus on that most of all.
Our blood sugar levels being unhealthy will swiftly lead to other metabolic disorders:
Heart disease and non-alcoholic fatty liver disease are perhaps first in line, but waiting in the wings are inflammation-mediated autoimmune disorders, and even dementia, because neuroinflammation is at least as bad as inflammation anywhere else, arguably worse, and our brain can only be as healthy as the blood that feeds it and takes things that shouldn’t be there away.
Indeed,
❝Alzheimer’s dementia is now being called type 3 diabetes because it’s so related to blood sugar❞
~ Dr. Casey Means
…which sounds like a bold claim, but it’s true, even if the name is not “official” yet, it’s well-established in professional circulation:
❝We conclude that the term “type 3 diabetes” accurately reflects the fact that AD represents a form of diabetes that selectively involves the brain and has molecular and biochemical features that overlap with both T1DM and T2DM❞
~ Dr. Suzanne M. de la Monte & Dr. Jack Wands
Read in full: Alzheimer’s Disease Is Type 3 Diabetes–Evidence Reviewed ← this is from the very respectable Journal of Diabetes Science and Technology.
What to do about it
Dr. Means suggests we avoid the “glucose roller-coaster” that most Americans are on, meaning dramatic sugar spikes, or to put it in sciencese: high glycemic variability.
This leads to inflammation, oxidative stress, glycation (where sugar sticks to proteins and DNA), and metabolic dysfunction. Then there’s the flipside: reactive hypoglycemia, a result of a rapid drop in blood sugar after a spike, can cause anxiety, fatigue, weakness/trembling, brain fog, and of course cravings. And so the cycle repeats.
But it doesn’t have to!
By taking it upon ourselves to learn about what causes our blood sugars to rise suddenly or gently, we can manage our diet and other lifestyle factors accordingly.
And yes, it’s not just about diet, Dr. Means tells us. While added sugar and refined carbohydrates or indeed the main drivers of glycemic variability, our sleep, movement, stress management, and even toxin exposure play important parts too.
One way to do this, that Dr. Means recommends, is with a continuous glucose monitor:
Track Your Blood Sugars For Better Personalized Health
Another way is to just apply principles that work for almost everyone:
10 Ways To Balance Blood Sugars
Want to know more from Dr. Means?
You might like her book:
Good Energy – by Dr. Casey Means
…which goes into this in far more detail than we have room to today.
Enjoy!
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Brain Food? The Eyes Have It!
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Brain Food? The Eyes Have It!
This is Dr. Michael Greger, M.D. FACLM, of “Dr. Greger’s Daily Dozen” and “How Not To Die” fame, and he wants us to protect our brains (and while we’re at it, our eyesight).
And the secret is…
Lutein.
This is a carotenoid, which is super important for the eyes and brain. Not to be confused with carrots, which despite the name are usually not a good source of carotenoids!
They do however contain lots of beta-carotene, a form of vitamin A, but that (and the famous WW2-era myth born of deliberate disinformation by the British government) isn’t what we’re covering today.
We say “eyes and brain” but really, the eyes are just an extension of the brain in any case.
Pedantry aside, what Dr. Greger wants you to know about lutein is how important it is for the protection of your brain/eyes, both against cognitive decline and against age-related macular degeneration (the most common cause of eyesight loss in old age).
Important take-away info:
- Two things that hasten brain aging are inflammation and oxidative stress. Antioxidant and anti-inflammatory foods mitigate those.
- Researchers investigated eight different dietary antioxidants, including vitamins A and E. Only lutein was “significantly related to better cognition”.
- The macula in the middle of our retina is packed with lutein, and levels in the retina correspond to levels in the rest of our brain.
- Alzheimer’s patients have significantly less lutein in their eyes and in their blood, and a higher occurrence of macular degeneration.
- Dark green leafy vegetables are lutein superstars. A half cup of kale has 50 times more lutein than an egg.
Want to know more about the Dr. Greger’s Daily Dozen approach to health?
See the Website / Get the App (Android & iOS) / Get the Science Book / Get the Cookbook!
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