Kava vs Anxiety

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Kava, sometimes also called “kava kava” but we’re just going to call it kava once for the sake of brevity, is a heart-shaped herb that bestows the powers of the Black Panther is popularly enjoyed for its anxiolytic (anxiety-reducing) effects. Despite the similarity of the name in many languages, it is unrelated to coffee (except insofar as they are both plants), and its botanical name is Piper methysticum.

Does it work?

Yes! At least in the short-term; more on that later.

Firstly, you may be wondering how it works; it works by its potentiation of GABA receptors in the brain. GABA (or gamma-aminobutyric acid, to give it its full name), as you may recall, is a neurotransmitter that is associated with feelings of calm; we wrote about it here:

GABA Against Stress/Anxiety

So, what does “potentiation of GABA receptors” mean? It means… Scientists don’t for 100% sure know how it works yet, but it does make GABA receptors fire more. It’s possible that to some degree GABA fits the “molecular lock” of the receptors and causes them to say “GABA is here”; it’s also possible that they just make them more sensitive to the real GABA that is there, or there could be another explanation as yet undiscovered. Either way, it means that taking kava has a similar effect to having increased GABA levels in the brain:

Kavain, the Major Constituent of the Anxiolytic Kava Extract, Potentiates GABAA Receptors: Functional Characteristics and Molecular Mechanism

As for how much to use, 20–300mg appears to be an effective dose, and most sources recommend 80–250mg:

Kava as a Clinical Nutrient: Promises and Challenges

This review of clinical trials found that it was more effective than placebo in only 3 of 7 trials; specifically, it was beneficial in the short-term and not in the long-term. For these reasons, the researchers concluded:

❝Kava Kava appears to be a short-term treatment for anxiety, but not a replacement for prolonged anti-anxiety use. Although not witnessed in this review, liver toxicity is especially possible if taken longer than 8 weeks.❞

Source: The effectiveness and safety of Kava Kava for treating anxiety symptoms: A systematic review and analysis of randomized clinical trials

Another review of clinical trials found better results over the course of 11 clinical trials, though again, short-term treatment only was considered to be where the “safe and effective” claim can be placed:

❝Compared with placebo, kava extract appears to be an effective symptomatic treatment option for anxiety. The data available from the reviewed studies suggest that kava is relatively safe for short-term treatment (1 to 24 weeks), although more information is required. Further rigorous investigations, particularly into the long-term safety profile of kava are warrant❞

Source: Kava extract for treating anxiety

Is it safe?

Nope! It has been associated with liver damage:

FDA | Consumer Advisory: Kava-Containing Dietary Supplements May be Associated With Severe Liver Injury

The likely main mechanism of toxicity is that it simply monopolizes the liver’s metabolic abilities, meaning that while it’s metabolizing the kava, it’s not metabolizing other things (such as alcohol or other medications), which will then build up, and potentially overwhelm the liver:

Constituents in kava extracts potentially involved in hepatotoxicity: a review

However, traditionally-prepared kava has not had the same effect as modern extracts; at first it seemed the difference was the traditional aqueous extracts vs modern acetonic/ethanolic extracts, but eventually that was found not to be the case, as toxicity occurred with industrial aqueous extracts too. The conclusion so far is that it is about the quality of the source ingredients, and the problems inherent to mass-production:

Kava hepatotoxicity in traditional and modern use: the presumed Pacific kava paradox hypothesis revisited

Meanwhile, short-term use doesn’t seem to have this problem, if you’re not drinking alcohol or taking medications that affect the liver:

Mechanisms/risk factors – kava-associated hepatotoxicity ← you’ll need to scroll down to 4.2.4 to read about this

Want to try it?

If the potential for hepatotoxicity doesn’t put you off, here’s an example product on Amazon ← we do not recommend it, but we are not the boss of you, and maybe you’re confident about your liver and want to use it only very short-term?

Take care!

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  • What are heart rate zones, and how can you incorporate them into your exercise routine?

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    If you spend a lot of time exploring fitness content online, you might have come across the concept of heart rate zones. Heart rate zone training has become more popular in recent years partly because of the boom in wearable technology which, among other functions, allows people to easily track their heart rates.

    Heart rate zones reflect different levels of intensity during aerobic exercise. They’re most often based on a percentage of your maximum heart rate, which is the highest number of beats your heart can achieve per minute.

    But what are the different heart rate zones, and how can you use these zones to optimise your workout?

    The three-zone model

    While there are several models used to describe heart rate zones, the most common model in the scientific literature is the three-zone model, where the zones may be categorised as follows:

    • zone 1: 55%–82% of maximum heart rate
    • zone 2: 82%–87% of maximum heart rate
    • zone 3: 87%–97% of maximum heart rate.

    If you’re not sure what your maximum heart rate is, it can be calculated using this equation: 208 – (0.7 × age in years). For example, I’m 32 years old. 208 – (0.7 x 32) = 185.6, so my predicted maximum heart rate is around 186 beats per minute.

    There are also other models used to describe heart rate zones, such as the five-zone model (as its name implies, this one has five distinct zones). These models largely describe the same thing and can mostly be used interchangeably.

    What do the different zones involve?

    The three zones are based around a person’s lactate threshold, which describes the point at which exercise intensity moves from being predominantly aerobic, to predominantly anaerobic.

    Aerobic exercise uses oxygen to help our muscles keep going, ensuring we can continue for a long time without fatiguing. Anaerobic exercise, however, uses stored energy to fuel exercise. Anaerobic exercise also accrues metabolic byproducts (such as lactate) that increase fatigue, meaning we can only produce energy anaerobically for a short time.

    On average your lactate threshold tends to sit around 85% of your maximum heart rate, although this varies from person to person, and can be higher in athletes.

    A woman with an activity tracker on her wrist looking at a smartphone.
    Wearable technology has taken off in recent years. Ketut Subiyanto/Pexels

    In the three-zone model, each zone loosely describes one of three types of training.

    Zone 1 represents high-volume, low-intensity exercise, usually performed for long periods and at an easy pace, well below lactate threshold. Examples include jogging or cycling at a gentle pace.

    Zone 2 is threshold training, also known as tempo training, a moderate intensity training method performed for moderate durations, at (or around) lactate threshold. This could be running, rowing or cycling at a speed where it’s difficult to speak full sentences.

    Zone 3 mostly describes methods of high-intensity interval training, which are performed for shorter durations and at intensities above lactate threshold. For example, any circuit style workout that has you exercising hard for 30 seconds then resting for 30 seconds would be zone 3.

    Striking a balance

    To maximise endurance performance, you need to strike a balance between doing enough training to elicit positive changes, while avoiding over-training, injury and burnout.

    While zone 3 is thought to produce the largest improvements in maximal oxygen uptake – one of the best predictors of endurance performance and overall health – it’s also the most tiring. This means you can only perform so much of it before it becomes too much.

    Training in different heart rate zones improves slightly different physiological qualities, and so by spending time in each zone, you ensure a variety of benefits for performance and health.

    So how much time should you spend in each zone?

    Most elite endurance athletes, including runners, rowers, and even cross-country skiers, tend to spend most of their training (around 80%) in zone 1, with the rest split between zones 2 and 3.

    Because elite endurance athletes train a lot, most of it needs to be in zone 1, otherwise they risk injury and burnout. For example, some runners accumulate more than 250 kilometres per week, which would be impossible to recover from if it was all performed in zone 2 or 3.

    Of course, most people are not professional athletes. The World Health Organization recommends adults aim for 150–300 minutes of moderate intensity exercise per week, or 75–150 minutes of vigorous exercise per week.

    If you look at this in the context of heart rate zones, you could consider zone 1 training as moderate intensity, and zones 2 and 3 as vigorous. Then, you can use heart rate zones to make sure you’re exercising to meet these guidelines.

    What if I don’t have a heart rate monitor?

    If you don’t have access to a heart rate tracker, that doesn’t mean you can’t use heart rate zones to guide your training.

    The three heart rate zones discussed in this article can also be prescribed based on feel using a simple 10-point scale, where 0 indicates no effort, and 10 indicates the maximum amount of effort you can produce.

    With this system, zone 1 aligns with a 4 or less out of 10, zone 2 with 4.5 to 6.5 out of 10, and zone 3 as a 7 or higher out of 10.

    Heart rate zones are not a perfect measure of exercise intensity, but can be a useful tool. And if you don’t want to worry about heart rate zones at all, that’s also fine. The most important thing is to simply get moving.

    Hunter Bennett, Lecturer in Exercise Science, University of South Australia

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

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  • Lobster vs Crab – Which is Healthier?

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    Our Verdict

    When comparing lobster to crab, we picked the crab.

    Why?

    Generally speaking, most seafood is healthy in moderation (assuming it’s well-prepared, not poisonous, and you don’t have an allergy), and for most people, these two sea creatures are indeed considered a reasonable part of a healthy balanced diet.

    In terms of macros, they’re comparable in protein, and technically crab has about 2x the fat, but in both cases it’s next to nothing, so 2x almost nothing is still almost nothing. And, if we break down the lipids profiles, crab has a sufficiently smaller percentage of saturated fat (compared to monounsaturated and polyunsaturated), that crab actually has less saturated fat than lobster. In balance, the category of macros is either a tie or a slight win for crab, depending on your personal priorities.

    When it comes to vitamins, crab wins easily with more of vitamins A, B1, B2, B6, B9, B12, and C, in most cases by considerable margins (we’re talking multiples of what lobster has). Lobster, meanwhile, has more of vitamin B3 (tiny margin) and vitamin B5 (pantothenic acid, as in, the vitamin that’s in basically everything edible, and thus almost impossible to be deficient in unless literally starving).

    The minerals scene is more balanced; lobster has more calcium, copper, manganese, and selenium, while crab has more iron, magnesium, phosphorus, potassium, and zinc. The margins are comparable from one creature to another, so all in all the 4:5 score means a modest win for crab.

    Both of these creatures are good sources of omega-3 fatty acids, but crab is better.

    Lobster and crab are both somewhat high in cholesterol, but crab is the relatively lower of the two.

    In short: for most people most of the time, both are fine to enjoy in moderation, but if picking one, crab is the healthier by most metrics.

    Want to learn more?

    You might like to read:

    Shrimp vs Caviar – Which is Healthier?

    Take care!

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  • Toothpastes & Mouthwashes: Which Help And Which Harm?

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

    You almost certainly brush your teeth. You might use mouthwash. A lot of people floss for three weeks at a time, often in January.

    There are a lot of options for oral hygiene; variations of the above, and many alternatives too. This is a big topic, so rather than try to squeeze it all in one, this will be a several-part series.

    For today, let’s look at toothpastes and mouthwashes, to start!

    Toothpaste options

    Toothpastes may contain one, some, or all of the following, so here are some notes on those:

    Fluoride

    Most toothpastes contain fluoride; this is generally recognized as safe though is not without its controversies. The fluoride content is the reason it’s recommended not to swallow toothpaste, though.

    The fluoride in toothpaste can cause some small problems if overused; if you see unusually white patches on your teeth (your teeth are supposed to be ivory-colored, not truly white), that is probably a case of localized overcalcification because of the fluoride, and yes, you can have too much of a good thing.

    Overall, the benefits are considered to far outweigh the risks, though.

    Baking soda

    Whether by itself or as part of a toothpaste, baking soda is a safe and effective choice, not just for cosmetic purposes, but for boosting genuine oral hygiene too:

    Activated charcoal

    Activated charcoal is great at removing many chemicals from things it touches. That includes the kind you might see on your teeth in the form of stains.

    A topical aside on safety: activated charcoal is a common ingredient in a lot of black-colored Halloween-themed foods and drinks around this time of year. Beware, if you ingest these, there’s a good chance of it also cleaning out any meds you are taking. Ask your pharmacist about your own personal meds, but meds that (ingested) activated charcoal will usually remove include:

    • Oral HRT / contraceptives
    • Antidepressants (many kinds)
    • Heart medications (at least several major kinds)

    Toothpaste, assuming you are spitting-not-swallowing, won’t remove your medications though. Nor, in case you were worrying, will it strip tooth enamel, even if you have extant tooth enamel erosion:

    Source: Activated charcoal toothpastes do not increase erosive tooth wear

    However, it’s of no special extra help when it comes to oral hygiene itself, just removing stains.

    So, if you’d like to use it for cosmetic reasons, go right ahead. If not, no need.

    Hydrogen peroxide

    This is generally not a good idea, speaking for the health. For whitening, yes, it works. But for health, not so much:

    Hydrogen peroxide-based products alter inflammatory and tissue damage-related proteins in the gingival crevicular fluid of healthy volunteers: a randomized trial

    To be clear, when they say “alter”, they mean “in a bad way”. It increases inflammation and tissue damage.

    If buying commercially-available whitening toothpaste made with hydrogen peroxide, the academic answer is that it’s a lottery, because brands’ proprietorial compounding processes vary widely and constantly with little oversight and even less transparency:

    Is whitening toothpaste safe for dental health?: RDA-PE method

    Mouthwash options

    In the case of fluoride and hydrogen peroxide, the same advice (for and against) goes as per toothpaste.

    Alcohol

    There has been some concern about the potential carcinogenic effect of alcohol-based mouthwashes. According to the best current science, this one’s not an easy yes-or-no, but rather:

    • If there are no other cancer risk factors, it does not seem to increase cancer risk
    • If there are other cancer risk factors, it does make the risk worse

    Read more:

    Non-Alcohol

    Non-alcoholic mouthwashes are not without their concerns either. In this case, the potential problem is changing the oral microbiome (we are supposed to have one!), and specifically, that the spread of what it kills and what it doesn’t may result in an imbalance that causes a lowering of the pH of the mouth.

    Put differently: it makes your saliva more acidic.

    Needless to say, that can cause its own problems for teeth. The research on this is still emerging, with regard to whether the benefits outweigh the problems, but the fact that it has this effect seems to be a consensus. Here’s an example paper; there are others:

    Effects of Chlorhexidine mouthwash on the oral microbiome

    Flossing, scraping, and alternatives

    These are important (and varied, and interesting) enough to merit their own main feature, rather than squeezing them in at the end.

    So, watch this space for a main feature on these soon!

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  • The Vitamin Solution – by Dr. Romy Block & Dr. Arielle Levitan

    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.

    A quick note: it would be remiss of us not to mention that the authors of this book are also the founders of a vitamin company, thus presenting a potential conflict of interest.

    That said… In this reviewer’s opinion, the book does seem balanced and objective, regardless.

    We talk a lot about supplements here at 10almonds, especially in our Monday Research Review editions. And yesterday, we featured a book by a doctor who hates supplements. Today, we feature a book by two doctors who have made them their business.

    The authors cover all the most common vitamins and minerals popularly enjoyed as supplements, and examine:

    • why people take them
    • factors affecting whether they help
    • problems that can arise
    • complicating factors

    The “complicating factors” include, for example, the way many vitamins and/or minerals interplay with each other, either by requiring the presence of another, or else competing for resources for absorption, or needing to be delicately balanced on pain of diverse woes.

    This is the greatest value of the book, perhaps; it’s where most people go wrong with supplementation, if they go wrong.

    While both authors are medical doctors, Dr. Romy Block is an endocrinologist specifically, and she clearly brought a lot of extra attention to relevant metabolic/thyroid issues, and how vitamins and minerals (such as thiamin and iron) can improve or sabotage such, depending on various factors that she explains. Informative, and so far as this reviewer could see, objective and well-balanced.

    Bottom line: supplementation is a vast and complex topic, but this book does a fine job of demystifying and simplifying it in a clear and objective fashion, without resorting to either scaremongering or hype.

    Click here to check out The Vitamin Solution, and upgrade your knowledge!

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  • What Size Breakfast Is Best, By Science?

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    “Breakfast is the most important meal of the day”, the popular wisdom goes. But, what should it consist of, and how much should we be eating for breakfast?

    It has been previously established that it is good if breakfast is the largest meal of the day:

    Mythbusting Breaktime

    …with meals getting progressively smaller thereafter.

    Of course, very many people do the inverse: small (or skipped) breakfast, moderate lunch, larger dinner. This, however, is probably more a result of when eating fits around the modern industrialized workday (and thus gets normalized), rather than actual health considerations.

    So, what’s the latest science?

    A plucky band of researchers led by Dr. Karla-Alejandra Pérez-Vega investigated the importance of breakfast in the context of heart health. This research was done as part of a larger study into the effects of the Mediterranean Diet on cardiovascular health, so if anyone wants a quick recap before we carry on, then:

    The Mediterranean Diet: What Is It Good For? ← the answer, by the way, is “pretty much everything”

    …and there are also different versions that each use the Mediterranean Diet as the core, while focussing extra on a different area of health, including one to make it extra heart-healthy:

    Four Ways To Upgrade The Mediterranean ← most anti-inflammatory / gut-healthiest / heart-healthiest / brain-healthiest

    What they found

    In their sample population (n=383) of Spanish adults aged 55–75 with pre-diagnosed metabolic syndrome who, as part of the intervention of this 36-month interventional study, had now for the past 36 months been on a Mediterranean diet but without specific guidance on portion sizes:

    • Participants with insufficient breakfast energy intake had the highest adiposity (which is a measure of body fat expressed as a percentage of total mass)
    • Participants with low or high (but not moderate) breakfast energy intake had the larger BMI and waist circumference over time
    • Participants with low or high (but not moderate) breakfast energy intake had higher triglyceride and lower HDL (good) cholesterol levels
    • Participants who consumed 20–30% of their daily calories at breakfast enjoyed the greatest improvements in lipid profiles, with lower triglycerides and higher HDL (good) cholesterol levels
    • Participants with lower breakfast quality (lower adherence to Mediterranean Diet) had higher blood pressure levels
    • Participants with lower breakfast quality (lower adherence to Mediterranean Diet) had higher blood sugar levels
    • Participants with lower breakfast quality (lower adherence to Mediterranean Diet) had lower estimated glomerular filtration rate (which is an indicator of kidney function)
    • Participants with higher breakfast quality (higher adherence to Mediterranean Diet) had lower waist circumference, higher HDL cholesterol, and better kidney function

    You can see the paper itself here in the Journal of Nutrition, Health, and Aging:

    Breakfast energy intake and dietary quality and trajectories of cardiometabolic risk factors in older adults

    What this means

    According to this research, the heart-healthiest breakfast is:

    • not skipped
    • Mediterranean Diet adherent
    • within the range of of 20–30% of the total calories for the day

    Want to make it even better?

    Consider:

    Before You Eat Breakfast: 3 Surprising Facts About Intermittent Fasting

    Enjoy!

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  • It’s Not A Bloody Trend – by Kat Brown

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    This one’s not a clinical book, and the author is not a clinician. However, it’s not just a personal account, either. Kat Brown is an award-winning journalist (with ADHD) and has approached this journalistically.

    Not just in terms of investigative journalism, either. Rather, also with her knowledge and understanding of the industry, doing for us some meta-journalism and explaining why the press have gone for many misleading headlines.

    Which in this case means for example it’s not newsworthy to say that people have gone undiagnosed and untreated for years and that many continue to go unseen; we know this also about such things as endometriosis, adenomyosis, and PCOS. But some more reactionary headlines will always get attention, e.g. “look at these malingering attention-seekers”.

    She also digs into the common comorbidities of various conditions, the differences it makes to friendships, families, relationships, work, self-esteem, parenting, and more.

    This isn’t a “how to” book, but there’s a lot of value here if a) you have ADHD, and/or b) you spend any amount of time with someone who does.

    Bottom line: if you’d like to understand “what all the fuss is about” in one book, this is the one for ADHD.

    Click here to check out It’s Not A Bloody Trend, and discover a whole world of things that might have passed you by!

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