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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Pomegranate vs Cranberries – Which is Healthier?
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Our Verdict
When comparing pomegranate to cranberries, we picked the pomegranate.
Why?
Starting with the macros: pomegranate has nearly 4x the protein (actually quite a lot for a fruit, but this is not too surprising—it’s because we are eating the seeds!), and slightly more carbs and fiber. Their glycemic indices are comparable, both being low GI foods. While both of these fruits have excellent macro profiles, we say the pomegranate is slightly better, because of the protein, and when it comes to the carbs and fiber, since they balance each other out, we’ll go with the option that’s more nutritionally dense. We like foods that add more nutrients!
In the category of vitamins, pomegranate is higher in vitamins B1, B2, B3, B5, B6, B9, K, and choline, while cranberry is higher in vitamins A, C, and E. Both are very respectable profiles, but pomegranate wins on strength of numbers (and also some higher margins of difference).
When it comes to minerals, it is not close; pomegranate is higher in calcium, copper, iron, magnesium, phosphorus, potassium, selenium, and zinc, while cranberry is higher in manganese. An easy win for pomegranate here.
Both of these fruits have additional “special” properties, though it’s worth noting that:
- pomegranate’s bonus properties, which are too many to list here, but we link to an article below, are mostly in its peel (so dry it, and grind it into a powder supplement, that can be worked into foods, or used like an instant fruit tea, just without the sugar)
- cranberries’ bonus properties (including: famously very good at reducing UTI risk) come with some warnings, including that they may increase the risk of kidney stones if you are prone to such, and also that cranberries have anti-clotting effects, which are great for heart health but can be a risk of you’re on blood thinners or have a bleeding disorder.
You can read about both of these fruits’ special properties in more detail below:
Want to learn more?
You might like to read:
- Health Benefits Of Cranberries (But: You’d Better Watch Out)
- Pomegranate’s Health Gifts Are Mostly In Its Peel
Take care!
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Asbestos in mulch? Here’s the risk if you’ve been exposed
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Mulch containing asbestos has now been found at 41 locations in New South Wales, including Sydney parks, schools, hospitals, a supermarket and at least one regional site. Tests are under way at other sites.
As a precautionary measure, some parks have been cordoned off and some schools have closed temporarily. Fair Day – a large public event that traditionally marks the start of Mardi Gras – was cancelled after contaminated mulch was found at the site.
The New South Wales government has announced a new taskforce to help investigate how the asbestos ended up in the mulch.
Here’s what we know about the risk to public health of mulch contaminated with asbestos, including “friable” asbestos, which has been found in one site (Harmony Park in Surry Hills).
What are the health risks of asbestos?
Asbestos is a naturally occurring, heat-resistant fibre that was widely used in building materials from the 1940s to the 1980s. It can be found in either a bonded or friable form.
Bonded asbestos means the fibres are bound in a cement matrix. Asbestos sheeting that was used for walls, fences, roofs and eaves are examples of bonded asbestos. The fibres don’t escape this matrix unless the product is severely damaged or worn.
A lot of asbestos fragments from broken asbestos products are still considered bonded as the fibres are not released as they lay on the ground.
Asbestos sheeting was used for walls and roofs.
Tomas Regina/ShutterstockFriable asbestos, in contrast, can be easily crumbled by touch. It will include raw asbestos fibres and previously bonded products that have worn to the point that they crumble easily.
The risk of disease from asbestos exposure is due to the inhalation of fibres. It doesn’t matter if those fibres are from friable or bonded sources.
However, fibres can more easily become airborne, and therefore inhalable, if the asbestos is friable. This means there is more of a risk of exposure if you are disturbing friable asbestos than if you disturb fragments of bonded asbestos.
Who is most at risk from asbestos exposure?
The most important factor for disease risk is exposure – you actually have to inhale fibres to be at risk of disease.
Just being in the vicinity of asbestos, or material containing asbestos, does not put you at risk of asbestos-related disease.
For those who accessed the contaminated areas, the level of exposure will depend on disturbing the asbestos and how many fibres become airborne due to that disturbance.
However, if you have been exposed to, and inhaled, asbestos fibres it does not mean you will get an asbestos-related disease. Exposure levels from the sites across Sydney will be low and the chance of disease is highly unlikely.
The evidence for disease risk from ingestion remains highly uncertain, although you are not likely to ingest sufficient fibres from the air, or even the hand to mouth activities that may occur with playing in contaminated mulch, for this to be a concern.
The risk of disease from exposure depends on the intensity, frequency and duration of that exposure. That is, the more you are exposed to asbestos, the greater the risk of disease.
Most asbestos-related disease has occurred in people who work with raw asbestos (for example, asbestos miners) or asbestos-containing products (such as building tradespeople). This has been a tragedy and fortunately asbestos is now banned.
There have been cases of asbestos-related disease, most notably mesothelioma – a cancer of the lining of the lung (mostly) or peritoneum – from non-occupational exposures. This has included people who have undertaken DIY home renovations and may have only had short-term exposures. The level of exposure in these cases is not known and it is also impossible to determine if those activities have been the only exposure.
There is no known safe level of exposure – but this does not mean that one fibre will kill. Asbestos needs to be treated with caution.
As far as we are aware, there have been no cases of mesothelioma, or other asbestos-related disease, that have been caused by exposure from contaminated soils or mulch.
Has asbestos been found in mulch before?
Asbestos contamination of mulch is, unfortunately, not new. Environmental and health agencies have dealt with these situations in the past. All jurisdictions have strict regulations about removing asbestos products from the green waste stream but, as is happening in Sydney now, this does not always happen.
Mulch contamination is not new.
gibleho/ShutterstockWhat if I’ve been near contaminated mulch?
Exposure from mulch contamination is generally much lower than from current renovation or construction activities and will be many orders of magnitude lower than past occupational exposures.
Unlike activities such as demolition, construction and mining, the generation of airborne fibres from asbestos fragments in mulch will be very low. The asbestos contamination will be sparsely spread throughout the mulch and it is unlikely there will be sufficient disturbance to generate large quantities of airborne fibres.
Despite the low chance of exposure, if you’re near contaminated mulch, do not disturb it.
If, by chance, you have had an exposure, or think you have had an exposure, it’s highly unlikely you will develop an asbestos-related disease in the future. If you’re worried, the Asbestos Safety and Eradication Agency is a good source of information.
Peter Franklin, Associate Professor and Director, Occupational Respiratory Epidemiology, The University of Western Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Grain Brain – by Dr. David Perlmutter
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If you’re a regular 10almonds reader, you probably know that refined flour, and processed food in general, is not great for the health. So, what does this book offer more?
Dr. Perlmutter sets out the case against (as the subtitle suggests) wheat, carbs, and sugar. Yes, including wholegrain wheat, and including starchy vegetables such as potatoes and parsnips. Fruit does also come under scrutiny, a clear distinction is made between whole fruits and juices. In the latter case, the lack of fiber (along with the more readily absorbable liquid state) allows for those sugars to zip straight into our blood.
The book includes lots of stats and facts, and many study citations, along with infographics and clear explanations.
If the book has a weakness, it’s when it forgets to clarify something that was obvious to the author. For example, when he talks about our ancestors’ diets being 75% fat and 5% carbs, he neglects to mention that this is 75% by calorie count, not by mass or volume. This makes a huge difference! It’s the difference between a fat-guzzling engine, and someone who eats mostly fruit and oily nuts but also some very high-fat meat/organs.
The book’s strengths, on the other hand, are found in its explanation, backed by good science, of what wheat, along with excessive carbohydrates (especially sugar) can do to our body, including (and most focusedly, hence the title) our brain, leading the way to not just obvious metabolic disorders like diabetes, but also inflammatory diseases like Alzheimer’s.
Bottom line: you don’t have to completely revamp your diet if it’s working for you, but data is data, and this book has lots, making it well-worth a read.
Click here to check out Grain Brain, and learn about how to avoid inflaming yours!
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Celery vs Radish – Which is Healthier?
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Our Verdict
When comparing celery to radish, we picked the celery.
Why?
It was very close! And yes, surprising, we know. Generally speaking, the more colorful/pigmented an edible plant is, the healthier it is. Celery is just one of those weird exceptions (as is cauliflower, by the way).
Macros-wise, these two are pretty much the same—95% water, with just enough other stuff to hold them together. The proportions of “other stuff” are also pretty much equal.
In the category of vitamins, celery has more vitamin K while radish has more vitamin C; the other vitamins are pretty close to equal. We’ll call this one a minor win for celery, as vitamin K is found in fewer foods than vitamin C.
When it comes to minerals, celery has more calcium, manganese, phosphorus, and potassium, while radish has more copper, iron, selenium, and zinc. We’ll call this a minor win for radish, as the margins are a little wider for its minerals.
So, that makes the score 1–1 so far.
Both plants have an assortment of polyphenols, of which, when we add up the averages, celery comes out on top by some way. Celery also comes out on top when we do a head-to-head of the top flavonoid of each; celery has 5.15mg/100g of apigenin to radish’s 0.63mg/100g kaempferol.
Which means, both are great healthy foods, but celery wins the day.
Want to learn more?
You might like to read:
Celery vs Cucumber – Which is Healthier?
Take care!
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What the Most Successful People Do Before Breakfast – by Laura Vanderkram
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First, what this is not:this is not a rehash of “The 5AM Club”, and nor is it a rehash of “The Seven Habits of Highly Effective People”.
What it is: packed with tips about time management for real people operating here in the real world. The kind of people who have non-negotiable time-specific responsibilities, and frequent unavoidable interruptions. The kind of people who have partners, families, and personal goals and aspirations too.
The “two other short guides” mentioned in the subtitle are her other books, whose titles start the same but instead of “…before Breakfast”, substitute:
- …on the Weekend
- …at Work
However, if you’re retired (we know many of our subscribers are), this still applies to you:
- The “weekend” book is about getting the most out of one’s leisure time, and we hope you have that too!
- The “work” book is about not getting lost in the nitty-gritty of the daily grind, and instead making sure to keep track of the big picture. You probably have this in your personal projects, too!
Bottom line: if, in the mornings, it sometimes seems like your get-up-and-go has got up and gone without you, then you will surely benefit from this book that outstrips its competitors in usefulness and applicability.
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What Teas To Drink Before Bed (By Science!)
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Which Sleepy Tea?
Herbal “tea” preparations (henceforth we will write it without the quotation marks, although these are not true teas) are popular for winding down at the end of a long day ready for a relaxing sleep.
Today we’ll look at the science for them! We’ll be brief for each, because we’ve selected five and have only so much room, but here goes:
Camomile
Simply put, it works and has plenty of good science for it. Here’s just one example:
❝Noteworthy, our meta-analysis showed a significant improvement in sleep quality after chamomile administration❞
Also this writer’s favourite relaxation drink!
(example on Amazon if you want some)
Lavender
We didn’t find robust science for its popularly-claimed sedative properties, but it does appear to be anxiolytic, and anxiety gets in the way of sleep, so while lavender may not be a sedative, it may calm a racing mind all the same, thus facilitating better sleep:
(example on Amazon if you want some)
Magnolia
Animal study for the mechanism:
Human study for “it is observed to help humans sleep better”:
As you can see from the title, its sedative properties weren’t the point of the study, but if you click through to read it, you can see that they found (and recorded) this benefit anyway
(example on Amazon if you want some)
Passionflower
There’s not a lot of evidence for this one, but there is some. Here’s a small study (n=41) that found:
❝Of six sleep-diary measures analysed, sleep quality showed a significantly better rating for passionflower compared with placebo (t(40) = 2.70, p < 0.01). These initial findings suggest that the consumption of a low dose of Passiflora incarnata, in the form of tea, yields short-term subjective sleep benefits for healthy adults with mild fluctuations in sleep quality.❞
So, that’s not exactly a huge body of evidence, but it is promising.
(example on Amazon if you want some)
Valerian
We’ll be honest, the science for this one is sloppy. It’s very rare to find Valerian tested by itself (or sold by itself; we had to dig a bit to find one for the Amazon link below), and that skews the results of science and renders any conclusions questionable.
And the studies that were done? Dubious methods, and inconclusive results:
Nevertheless, if you want to try it for yourself, you can do a case study (i.e., n=1 sample) if not a randomized controlled trial, and let us know how it goes 🙂
(example on Amazon if you want some)
Summary
- Valerian we really don’t have the science to say anything about it
- Passionflower has some nascent science for it, but not much
- Lavender is probably not soporific, but it is anxiolytic
- Magnolia almost certainly helps, but isn’t nearly so well-backed as…
- Camomile comes out on top, easily—by both sheer weight of evidence, and by clear conclusive uncontroversial results.
Enjoy!
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