Insights into Osteoporosis
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.
It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I would like to see some articles on osteoporosis❞
You might enjoy this mythbusting main feature we did a few weeks ago!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Surgery is the default treatment for ACL injuries in Australia. But it’s not the only way
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.
The anterior cruciate ligament (ACL) is an important ligament in the knee. It runs from the thigh bone (femur) to the shin bone (tibia) and helps stabilise the knee joint.
Injuries to the ACL, often called a “tear” or a “rupture”, are common in sport. While a ruptured ACL has just sidelined another Matildas star, people who play sport recreationally are also at risk of this injury.
For decades, surgical repair of an ACL injury, called a reconstruction, has been the primary treatment in Australia. In fact, Australia has among the highest rates of ACL surgery in the world. Reports indicate 90% of people who rupture their ACL go under the knife.
Although surgery is common – around one million are performed worldwide each year – and seems to be the default treatment for ACL injuries in Australia, it may not be required for everyone.
PeopleImages.com – Yuri A/Shutterstock What does the research say?
We know ACL ruptures can be treated using reconstructive surgery, but research continues to suggest they can also be treated with rehabilitation alone for many people.
Almost 15 years ago a randomised clinical trial published in the New England Journal of Medicine compared early surgery to rehabilitation with the option of delayed surgery in young active adults with an ACL injury. Over half of people in the rehabilitation group did not end up having surgery. After five years, knee function did not differ between treatment groups.
The findings of this initial trial have been supported by more research since. A review of three trials published in 2022 found delaying surgery and trialling rehabilitation leads to similar outcomes to early surgery.
A 2023 study followed up patients who received rehabilitation without surgery. It showed one in three had evidence of ACL healing on an MRI after two years. There was also evidence of improved knee-related quality of life in those with signs of ACL healing compared to those whose ACL did not show signs of healing.
Experts used to think an ACL tear couldn’t heal without surgery – now there’s evidence it can. SKYKIDKID/Shutterstock Regardless of treatment choice the rehabilitation process following ACL rupture is lengthy. It usually involves a minimum of nine months of progressive rehabilitation performed a few days per week. The length of time for rehabilitation may be slightly shorter in those not undergoing surgery, but more research is needed in this area.
Rehabilitation starts with a physiotherapist overseeing simple exercises right through to resistance exercises and dynamic movements such as jumping, hopping and agility drills.
A person can start rehabilitation with the option of having surgery later if the knee remains unstable. A common sign of instability is the knee giving way when changing direction while running or playing sports.
To rehab and wait, or to go straight under the knife?
There are a number of reasons patients and clinicians may opt for early surgical reconstruction.
For elite athletes, a key consideration is returning to sport as soon as possible. As surgery is a well established method, athletes (such as Matilda Sam Kerr) often opt for early surgical reconstruction as this gives them a more predictable timeline for recovery.
At the same time, there are risks to consider when rushing back to sport after ACL reconstruction. Re-injury of the ACL is very common. For every month return to sport is delayed until nine months after ACL reconstruction, the rate of knee re-injury is reduced by 51%.
For people who opt to try rehabilitation, the option of having surgery later is still there. PeopleImages.com – Yuri A/Shutterstock Historically, another reason for having early surgical reconstruction was to reduce the risk of future knee osteoarthritis, which increases following an ACL injury. But a review showed ACL reconstruction doesn’t reduce the risk of knee osteoarthritis in the long term compared with non-surgical treatment.
That said, there’s a need for more high-quality, long-term studies to give us a better understanding of how knee osteoarthritis risk is influenced by different treatments.
Rehab may not be the only non-surgical option
Last year, a study looking at 80 people fitted with a specialised knee brace for 12 weeks found 90% had evidence of ACL healing on their follow-up MRI.
People with more ACL healing on the three-month MRI reported better outcomes at 12 months, including higher rates of returning to their pre-injury level of sport and better knee function. Although promising, we now need comparative research to evaluate whether this method can achieve similar results to surgery.
What to do if you rupture your ACL
First, it’s important to seek a comprehensive medical assessment from either a sports physiotherapist, sports physician or orthopaedic surgeon. ACL injuries can also have associated injuries to surrounding ligaments and cartilage which may influence treatment decisions.
In terms of treatment, discuss with your clinician the pros and cons of management options and whether surgery is necessary. Often, patients don’t know not having surgery is an option.
Surgery appears to be necessary for some people to achieve a stable knee. But it may not be necessary in every case, so many patients may wish to try rehabilitation in the first instance where appropriate.
As always, prevention is key. Research has shown more than half of ACL injuries can be prevented by incorporating prevention strategies. This involves performing specific exercises to strengthen muscles in the legs, and improve movement control and landing technique.
Anthony Nasser, Senior Lecturer in Physiotherapy, University of Technology Sydney; Joshua Pate, Senior Lecturer in Physiotherapy, University of Technology Sydney, and Peter Stubbs, Senior Lecturer in Physiotherapy, University of Technology Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Share This Post
-
Intermittent Fasting for Women Over 50 – by Emma Sanchez
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.
Intermittent fasting is promoted as a very healthful (evidence-based!) way to trim the fat and slow aging, along with other health benefits. But, physiologically and especially metabolically, the average woman is quite different from the average man! And most resources are aimed at men. So, what’s the difference?
Emma Sanchez gives an overview not just of intermittent fasting, but also, how it goes with specifically female physiology. From hormonal cycles, to different body composition and fat distribution, to how we simply retain energy better—which can be a mixed blessing!
We’re given advice about how to optimize all those things and more.
She also covers issues that many writers on the topic of intermittent fasting will tend to shy away from, such as:
- mood swings
- risk of eating disorder
- impact on cognitive thinking
…and she does this evenly and fairly, making the case for intermittent fasting while acknowledging potential pitfalls that need to be recognized in order to be managed.
Lastly, the “over 50” thing. This is covered in detail quite late in the book, but there are a lot of changes that occur (beyond the obvious!), and once again, Sanchez has tips and tricks for holding back the clock where possible, and working with it rather than against it, when appropriate.
All in all, a great book for any woman over 50, or really also for women under 50, especially if that particular milestone is on the horizon.
Get your copy of Intermittent Fasting for Women over 50 from Amazon today!
Share This Post
-
The Alzheimer’s Gut-Brain Connection—Caught On X-Ray!
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.
We’ve written before about Alzheimer’s disease (a lot), and if you’re just joining us, then a great place to start is here:
How To Reduce Your Alzheimer’s Risk
We’ve also written about gut health (a lot), and if you’re just joining us, then a great place to start is here:
Make Friends With Your Gut! (Here’s Why & How)
And as a hat trick, yes, we’ve also written (admittedly not as much) about the gut-brain connection; here’s a primer:
The Brain-Gut Highway: A Two-Way Street
Because of how gut microbes influence brain function, behavior, and cognition, scientists wondered whether one’s microbiome might play a role in Alzheimer’s development. Recently, scientists from Italy’s Institute of Nanotechnology, working with the European Synchrotron Radiation Facility (ESRF), found some concrete answers:
How gut health affects Alzheimer’s
When the gut loses its healthy balance of bacteria, harmful bacteria (and fungi, like C. albicans, also popularly called by its first name, “Candida”) take the wheel. This problem (called “dysbiosis”) allows harmful microbes to produce toxic substances, leading to inflammation and weakening the protective barriers between the gut and brain.
In some cases, like the aforementioned C. albicans, they’ll even put roots through your gut wall (and interact with your nervous system, and they are a common reason for sugar and alcohol cravings—your CNS has literally been hacked by a fungal colony that wants sugar (including the sugar that occurs when alcohol is broken down—and that’s without considering the fact that alcohol also kills several of C. albicans competitors that rank amongst the “good bacteria”). Suffice it to say, the holes it puts in your gut wall aren’t great for the health either.
In any case, once the gut barrier is breached, it’s been hypothesized that harmful bacteria may even travel to the brain, triggering Alzheimer’s.
How the x-rays helped
To better understand gut changes in Alzheimer’s, scientists used a technique called nano- and micro- x-ray phase-contrast tomography (XPCT) at the aforementioned ESRF. That very fancy string of words refers to a commensurately powerful imaging method, which allows researchers to see detailed structures inside the gut without damaging tissue, or even adding contrast agents (like those unpleasant drinks that are sometimes required to be taken before soft-tissue x-rays).
The study examined gut samples from mice with Alzheimer’s (so yes, this does need to be repeated with humans, but in this case there’s no obvious reason why it shouldn’t be the same).
The scans revealed important changes in gut structures, including:
- The tiny finger-like villi and corresponding crypts in the gut lining
- Important cells* that help with digestion and protection
- Neurons involved in gut function
*e.g. Paneth cells, goblet cells, telocytes, and erythrocytes, all of whom would take more explanation than we have room for here, but suffice it to say they’re important to both digestion and correct mucus production (bearing in mind, mucus membranes are one of the main physical barriers to harmful bacteria—as humans, our conscious interactions with mucus are usually only the nuisance that occurs when we get a cold or something, but rest assured, mucus keeps us alive).
In short, all these findings suggest (we’d say “show”, but technically cause and effect have not been proven) gut health indeed plays a crucial role in Alzheimer’s disease pathogenesis and pathology (i.e., how the disease begins and progresses, respectively).
Why it matters
To quote Dr. Alessia Cedola,
❝This technique represents a real breakthrough for the thorough analysis of the gut, and it could be pivotal in early detection and prognosis of the disease.
By gaining a deeper understanding of these processes, we hope to identify new therapeutic targets and develop innovative treatments for this devastating disease.❞
In short: the technology can be used as a super-early diagnostic tool, and ultimately, improve prevention (by encouraging people to focus on gut health) as well as, hopefully, leading to new treatments, too.
Want to see it?
Here’s the paper itself, where there are also abundant very clear images:
Are you on top of your gut health already?
If not, do refer back to that first link we dropped about gut health, up top!
If you are already sure you’re looking after your gut and want to do something else to avoid Alzheimer’s coming to call, you might want to consider:
How To Clean Your Brain (Glymphatic Health Primer) ← your glymphatic system, something many people neglect, is the brain’s cleanup crew, and removes things like the beta-amyloid proteins that are implicated in Alzheimer’s pathogenesis. So, it’s worth knowing how to keep it in working order!
Take care!
Share This Post
Related Posts
-
Healing The Modern Brain – by Dr. Drew Ramsey
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.
We previously reviewed Dr. Ramsey’s Eat To Beat Depression & Anxiety, and this time [it briefly covers that ground again, and then] it’s more about comprehensive brain health and mental fitness.
He tackles this in a methodical fashion, first briefly covering the need for mental fitness, and the obstacles to same, before the main part of the book—which covers the “how”.
The “how” in question is multifaceted, and the “nine tenets” mentioned in the subtitle cover very obvious things like diet, exercise, sleep, etc, as well as less obvious yet very important things like connection, engagement, purpose, and so forth, and some things that don’t get talked about much at all elsewhere, such as the processes of grounding and unburdening, as he describes them.
The style is mostly narrative with many anecdotes to illustrate points, but with practical advice woven throughout also, all very readable. There’s a respectable bibliography at the back.
Bottom line: if you’d like your brain health to get gradually better instead of gradually worse, this book can help set you on the right track.
Click here to check out Healing The Modern Brain, and heal your modern brain!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
The Anti-Stress Herb That Also Fights Cancer
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.
What does Rhodiola rosea actually do, anyway?
Rhodiola rosea (henceforth, “rhodiola”) is a flowering herb whose roots have adaptogenic properties.
In the cold, mountainous regions of Europe and Asia where it grows, it has been used in herbal medicine for centuries to alleviate anxiety, fatigue, and depression.
What does the science say?
Well, let’s just say the science is more advanced than the traditional use:
❝In addition to its multiplex stress-protective activity, Rhodiola rosea extracts have recently demonstrated its anti-aging, anti-inflammation, immunostimulating, DNA repair and anti-cancer effects in different model systems❞
Nor is how it works a mystery, as the same paper explains:
❝Molecular mechanisms of Rhodiola rosea extracts’s action have been studied mainly along with one of its bioactive compounds, salidroside. Both Rhodiola rosea extracts and salidroside have contrasting molecular mechanisms on cancer and normal physiological functions.
For cancer, Rhodiola rosea extracts and salidroside inhibit the mTOR pathway and reduce angiogenesis through down-regulation of the expression of HIF-1α/HIF-2α.
For normal physiological functions, Rhodiola rosea extracts and salidroside activate the mTOR pathway, stimulate paracrine function and promote neovascularization by inhibiting PHD3 and stabilizing HIF-1α proteins in skeletal muscles❞
~ Ibid.
And, as for the question of “do the supplements work?”,
❝In contrast to many natural compounds, salidroside is water-soluble and highly bioavailable via oral administration❞
~ Ibid.
And as to how good it is:
❝Rhodiola rosea extracts and salidroside can impose cellular and systemic benefits similar to the effect of positive lifestyle interventions to normal physiological functions and for anti-cancer❞
~ Ibid.
Source: Rhodiola rosea: anti-stress, anti-aging, and immunostimulating properties for cancer chemoprevention
But that’s not all…
We can’t claim this as a research review if we only cite one paper (even if that paper has 144 citations of its own), and besides, it didn’t cover all the benefits yet!
Let’s first look at the science for the “traditional use” trio of benefits:
When you read those, what are your first thoughts?
Please don’t just take our word for things! Reading even just the abstracts (summaries) at the top of papers is a very good habit to get into, if you don’t have time (or easy access) to read the full text.
Reading the abstracts is also a very good way to know whether to take the time to read the whole paper, or whether it’s better to skip onto a different one.
- Perhaps you noticed that the paper we cited for anxiety was quite a small study.
- The fact is, while we found mountains of evidence for rhodiola’s anxiolytic (antianxiety) effects, they were all small and/or animal studies. So we picked a human study and went with it as illustrative.
- Perhaps you noticed that the paper we cited for fatigue pertained mostly to stress-related fatigue.
- This, we think, is a feature not a bug. After all, most of us experience fatigue because of the general everything of life, not because we just ran a literal marathon.
- Perhaps you noticed that the paper we cited for depression said it didn’t work as well as sertraline (a very common pharmaceutical SSRI antidepressant).
- But, it worked almost as well and it had far fewer adverse effects reported. Bear in mind, the side effects of antidepressants are the reason many people avoid them, or desist in taking them. So rhodiola working almost as well as sertraline for far fewer adverse effects, is quite a big deal!
Bonus features
Rhodiola also putatively offers protection against Alzheimer’s disease, Parkinson’s disease, and cerebrovascular disease in general:
Rosenroot (Rhodiola): Potential Applications in Aging-related Diseases
It may also be useful in the management of diabetes (types 1 and 2), but studies so far have only been animal studies, and/or in vitro studies. Here are two examples:
- Antihyperglycemic action of rhodiola-aqeous extract in type 1 diabetic rats
- Evaluation of Rhodiola crenulata and Rhodiola rosea for management of type 2 diabetes and hypertension
How much to take?
Dosages have varied a lot in studies. However, 120mg/day seems to cover most bases. It also depends on which of rhodiola’s 140 active compounds a particular benefit depends on, though salidroside and rosavin are the top performers.
Where to get it?
As ever, we don’t sell it (or anything else) but here’s an example product on Amazon.
Enjoy!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
- Perhaps you noticed that the paper we cited for anxiety was quite a small study.
-
Which B Vitamins? It Makes A Difference
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.
Everyone knows “B vitamins are for energy!” and that is definitely a theme, but there’s a lot more to it than that, and in some cases, there are big mistakes that people make when it comes to supplementing their diet.
First, let’s do a quick overview of what each of the B vitamins do, by number, and putting names to them:
B1 (Thiamine)
- Function: helps convert carbohydrates into energy, supports nerve function
- Forms: thiamine hydrochloride, thiamine mononitrate, benfotiamine (fat-soluble form)
- Example foods: lentils, sunflower seeds
B2 (Riboflavin)
- Function: supports energy production, skin health, and eye function, turns your pee fluorescent yellow (the latter is really only if you consume exciting amounts of it; this will usually occur from supplementation, not from normal diet)
- Forms: riboflavin, riboflavin-5’-phosphate
- Example foods: almonds, mushrooms
B3 (Niacin)
- Function: aids metabolism, supports skin, nerves, and cholesterol levels
- Forms: niacin (nicotinic acid), niacinamide (nicotinamide), inositol hexanicotinate (flush-free niacin)
- Example foods: whole grains, peanuts (literally the best nut for this)
B5 (Pantothenic Acid)
- Function: essential for fatty acid metabolism and hormone production
- Forms: pantothenic acid, calcium pantothenate, panthenol (alcohol form!)
- Example foods: it’s in pretty much everything (hence the name); it’s almost impossible to be deficient in this vitamin unless you are literally starving
B6 (Pyridoxine)
- Function: needed for red blood cell production, supports brain function, as well as specifically being a part of neurotransmitter production (including dopamine and serotonin, despite them being made in different places—the brain and the gut, respectively),
- Forms: pyridoxine hydrochloride, pyridoxal-5’-phosphate (active form)
- Example foods: bananas, potatoes
B7 (Biotin)
- Function: helps with fatty acid synthesis, skin, hair, and nail health
- Forms: d-biotin, biotinylated compounds of various kinds
- Example foods: fava beans, walnuts
B9 (Folate/Folic Acid)
- Function: crucial for DNA synthesis, cell division, and fetal development
- Forms: folic acid, folinic acid, 5-methyltetrahydrofolate (5-MTHF, active form)
- Example foods: chickpeas, spinach ← we only mentioned one leafy green here for fairness, but leafy greens in general are great sources of vitamin B9, hence the name, from the Latin “folium”, meaning leaf.
B12 (Cobalamin)
- Function: supports red blood cell formation, nerve function, and DNA synthesis
- Forms: cyanocobalamin, methylcobalamin (active), hydroxocobalamin (active), adenosylcobalamin (active)
- Example foods: nutritional yeast, nori
You may be wondering: what about vitamins B4, B8, B10, and B11? Those are now vacant spots, that once contained things that are no longer considered vitamins.
Three Critical Vitamin B Mistakes That May Be Sabotaging Your Health
Some mistakes that people make include:
Not supplementing when necessary
This occurs most often after midlife, especially in women, and the most common deficiencies are B1, B9, and B12.
See also: These Signs Often Mean These Nutrient Deficiencies (Do You Have Any?)
While it’s tempting to think “if I have a good balanced diet, I won’t need…” but the fact is sometimes our diet isn’t as nutrient dense as we hope—often through no fault of our own! But many modern farming methods prioritize yield over nutritional value, and that can result in plants and animals that do not have the nutritional qualities they “should”.
We wrote about this a while back, weighing up the “supplementation vs diet alone” dilemma:
Does Our Diet Need A Little Help? ← this also has a very useful chart of which vitamins people usually get too little or too much of. Note however that the statement of marginally excessive folate is slightly misleading, as the data pool contains men and women aged 18–65, while B9 is mostly needed more by women, and especially around childbirth or menopause, so B9 is actually a very common deficiency, but here it’s being balanced out lots of men getting too much (because every multivitamin has it).
Supplementing to excess
Most B vitamins have a very high maximum tolerable dose, because (with the exception of where we marked otherwise) they are water-soluble, which means that if you take more than you need, you’ll just pee it out later. Hence the famous fluorescence, for example.
However, the fat soluble form of vitamin B1 is harder to get in and harder to get out.
As for the others, problems usually only occur if you take enough to cause toxicity, faster than you pee it out. In other words, go easy on those Berocca drinks!
Nevertheless, there are other problems that can arise:
Vitamin B6 is essential—but too much can be toxic. Here’s what to know to stay safe ← tl;dr: there are issues with it causing peripheral neuropathy at doses over 10mg (the safe dose is disputed, so we’re mentioning the lowest safe dose here, but you can read about the others in the article)
Getting forms that don’t work so well
Those different forms we listed? They are not all created equal! For example:
- Folic acid is cheap; unfortunately, it’s not absorbed or used well
- Cyanocobalamin is cheap; unfortunately, it’s not absorbed or used well
Let us quote a recent book review of ours:
❝Rather, the most common forms of vitamins B9 and B12 provided in supplements are folic acid and cyanocobalamin, respectively, which as he demonstrates with extensive research to back up his claims, cannot be easily absorbed or used especially well.
About those vitamers: a vitamer is simply a form of a vitamin—most vitamins we need can arrive in a variety of forms. In the case of vitamins B9 and B12, he advocates for ditching vitamers folic acid and cyanocobalamin, cheap as they are, and springing for bioactive vitamers L-methylfolate, methylcobalamin, and adenosylcobalamin.
He also discusses (again, just as well-evidenced as the above things) why we might struggle to get enough from our diet after a certain age. For example, if trying to get these vitamins from meat, 50% of people over 50 cannot manufacture enough stomach acid to break down that protein to release the vitamins.
And as for methyl-B12 vitamers, you might expect you can get those from meat, and technically you can, but they don’t occur in all animals, just in one kind of animal. Specifically, the kind that has the largest brain-to-body ratio. However, eating the meat of this animal can result in protein folding errors in general and Creutzfeldt–Jakob disease in particular, so the author does not recommend eating humans, however nutritionally convenient that would be.
All this means that supplementation after a certain age really can be a sensible way to do it—but do it wisely, and pick the right vitamers.❞
You can read that review in full here: Your Vitamins are Obsolete: The Vitamer Revolution – by Dr. Sheldon Zablow
Want to try those latter two?
We don’t sell them, but here for your convenience are example products on Amazon:
L-methylfolate (active form of vitamin B9)
Methylcobalamin, adenosylcobalamin, & hydroxocobalamin (active forms of vitamin B12)
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: