Lies I Taught in Medical School – by Dr. Robert Lufkin
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There seems to be a pattern of doctors who practice medicine one way, get a serious disease personally, and then completely change their practice of medicine afterwards. This is one of those cases.
Dr. Lufkin here presents, on a chapter-by-chapter basis, the titularly promised “lies” or, in more legally compliant speak (as he acknowledges in his preface), flawed hypotheses that are generally taught as truths. In many cases, the “lie” is some manner of “xyz is normal and nothing to worry about”, and/or “there is nothing to be done about xyz; suck it up”.
The end result of the information is not complicated—enjoy a plants-forward whole foods low-carb diet to avoid metabolic diseases and all the other things to branch off from same (Dr. Lufkin makes a fair case for metabolic disease leading to a lot of secondary diseases that aren’t considered metabolic diseases per se). But, the journey there is actually important, as it answers a lot of questions that are much less commonly understood, and often not even especially talked-about, despite their great import and how they may affect health decisions beyond the dietary. Things like understanding the downsides of statins, or the statistical models that can be used to skew studies, per relative risk reduction and so forth.
Bottom line: this book gives the ins and outs of what can go right or wrong with metabolic health and why, and how to make sure you don’t sabotage your health through missing information.
Click here to check out Lies I Taught In Medical School, and arm yourself with knowledge!
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Lost for words? Research shows art therapy brings benefits for mental health
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Creating art for healing purposes dates back tens of thousands of years, to the practices of First Nations people around the world. Art therapy uses creative processes, primarily visual art such as painting, drawing or sculpture, with a view to improving physical health and emotional wellbeing.
When people face significant physical or mental ill-health, it can be challenging to put their experiences into words. Art therapists support people to explore and process overwhelming thoughts, feelings and experiences through a reflective art-making process. This is distinct from art classes, which often focus on technical aspects of the artwork, or the aesthetics of the final product.
Art therapy can be used to support treatment for a wide range of physical and mental health conditions. It has been linked to benefits including improved self-awareness, social connection and emotional regulation, while lowering levels of distress, anxiety and even pain scores.
In a study published this week in the Journal of Mental Health, we found art therapy was associated with positive outcomes for children and adolescents in a hospital-based mental health unit.
An option for those who can’t find the words
While a person’s engagement in talk therapies may sometimes be affected by the nature of their illness, verbal reflection is optional in art therapy.
Where possible, after finishing an artwork, a person can explore the meaning of their work with the art therapist, translating unspoken symbolic material into verbal reflection.
However, as the talking component is less central to the therapeutic process, art therapy is an accessible option for people who may not be able to find the words to describe their experiences.
Art therapy has supported improved mental health outcomes for people who have experienced trauma, people with eating disorders, schizophrenia and dementia, as well as children with autism.
Art therapy has also been linked to improved outcomes for people with a range of physical health conditions. These include lower levels of anxiety, depression and fatigue among people with cancer, enhanced psychological stability for patients with heart disease, and improved social connection among people who have experienced a traumatic brain injury.
Art therapy has been associated with improved mood and anxiety levels for patients in hospital, and lower pain, tiredness and depression among palliative care patients.
Studies suggest art therapy could support people with a range of health conditions. mojo cp/Shutterstock Our research
Mental ill-health, including among children and young people, presents a major challenge for our society. While most care takes place in the community, a small proportion of young people require care in hospital to ensure their safety.
In this environment, practices that place even greater restriction, such as seclusion or physical restraint, may be used briefly as a last resort to ensure immediate physical safety. However, these “restrictive practices” are associated with negative effects such as post-traumatic stress for patients and health professionals.
Worryingly, staff report a lack of alternatives to keep patients safe. However, the elimination of restrictive practices is a major aim of mental health services in Australia and internationally.
Our research looked at more than six years of data from a child and adolescent mental health hospital ward in Australia. We sought to determine whether there was a reduction in restrictive practices during the periods when art therapy was offered on the unit, compared to times when it was absent.
We found a clear association between the provision of art therapy and reduced frequency of seclusion, physical restraint and injection of sedatives on the unit.
We don’t know the precise reason for this. However, art therapy may have lessened levels of severe distress among patients, thereby reducing the risk they would harm themselves or others, and the likelihood of staff using restrictive practices to prevent this.
This artwork was described by the young person who made it as a dead tree with new growth, representing a sense of hope emerging as they started to move towards their recovery. Author provided That said, hospital admission involves multiple therapeutic interventions including talk-based therapies and medications. Confirming the effect of a therapeutic intervention requires controlled clinical trials where people are randomly assigned one treatment or another.
Although ours was an observational study, randomised controlled trials support the benefits of art therapy in youth mental health services. For instance, a 2011 hospital-based study showed reduced symptoms of post-traumatic stress disorder among adolescents randomised to trauma-focussed art therapy compared to a “control” arts and crafts group.
Artwork made by a young person during an art therapy session in an in-patient mental health unit. Author provided What do young people think?
In previous research we found art therapy was considered by adolescents in hospital-based mental health care to be the most helpful group therapy intervention compared to other talk-based therapy groups and creative activities.
In research not yet published, we’re speaking with young people to better understand their experiences of art therapy, and why it might reduce distress. One young person accessing art therapy in an acute mental health service shared:
[Art therapy] is a way of sort of letting out your emotions in a way that doesn’t involve being judged […] It let me release a lot of stuff that was bottling up and stuff that I couldn’t explain through words.
A promising area
The burgeoning research showing the benefits of art therapy for both physical and especially mental health highlights the value of creative and innovative approaches to treatment in health care.
There are opportunities to expand art therapy services in a range of health-care settings. Doing so would enable greater access to art therapy for people with a variety of physical and mental health conditions.
Sarah Versitano, Academic, Master of Art Therapy Program, Western Sydney University and Iain Perkes, Senior Lecturer, Child and Adolescent Psychiatry, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Want to sleep longer? Adding mini-bursts of exercise to your evening routine can help – new study
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Exercising before bed has long been discouraged as the body doesn’t have time to wind down before the lights go out.
But new research has found breaking up a quiet, sedentary evening of watching television with short bursts of resistance exercise can lead to longer periods of sleep.
Adults spend almost one third of the 24-hour day sleeping. But the quality and length of sleep can affect long-term health. Sleeping too little or waking often in the night is associated with an increased risk of heart disease and diabetes.
Physical activity during the day can help improve sleep. However, current recommendations discourage intense exercise before going to bed as it can increase a person’s heart rate and core temperature, which can ultimately disrupt sleep.
Nighttime habits
For many, the longest period of uninterrupted sitting happens at home in the evening. People also usually consume their largest meal during this time (or snack throughout the evening).
Insulin (the hormone that helps to remove sugar from the blood stream) tends to be at a lower level in the evening than in the morning.
Together these factors promote elevated blood sugar levels, which over the long term can be bad for a person’s health.
Our previous research found interrupting evening sitting every 30 minutes with three minutes of resistance exercise reduces the amount of sugar in the bloodstream after eating a meal.
But because sleep guidelines currently discourage exercising in the hours before going to sleep, we wanted to know if frequently performing these short bursts of light activity in the evening would affect sleep.
Activity breaks for better sleep
In our latest research, we asked 30 adults to complete two sessions based in a laboratory.
During one session the adults sat continuously for a four-hour period while watching streaming services. During the other session, they interrupted sitting by performing three minutes of body-weight resistance exercises (squats, calf raises and hip extensions) every 30 minutes.
After these sessions, participants went home to their normal life routines. Their sleep that evening was measured using a wrist monitor.
Our research found the quality of sleep (measured by how many times they woke in the night and the length of these awakenings) was the same after the two sessions. But the night after the participants did the exercise “activity breaks” they slept for almost 30 minutes longer.
Identifying the biological reasons for the extended sleep in our study requires further research.
But regardless of the reason, if activity breaks can extend sleep duration, then getting up and moving at regular intervals in the evening is likely to have clear health benefits.
Time to revisit guidelines
These results add to earlier work suggesting current sleep guidelines, which discourage evening exercise before bed, may need to be reviewed.
As the activity breaks were performed in a highly controlled laboratory environment, future research should explore how activity breaks performed in real life affect peoples sleep.
We selected simple, body-weight exercises to use in this study as they don’t require people to interrupt the show they may be watching, and don’t require a large space or equipment.
If people wanted to incorporate activity breaks in their own evening routines, they could probably get the same benefit from other types of exercise. For example, marching on the spot, walking up and down stairs, or even dancing in the living room.
The key is to frequently interrupt evening sitting time, with a little bit of whole-body movement at regular intervals.
In the long run, performing activity breaks may improve health by improving sleep and post-meal blood sugar levels. The most important thing is to get up frequently and move the body, in a way the works best for a person’s individual household.
Jennifer Gale, PhD candidate, Department of Human Nutrition, University of Otago and Meredith Peddie, Senior Lecturer, Department of Human Nutrition, University of Otago
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Pineapple vs Passion Fruit – Which is Healthier?
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Our Verdict
When comparing pineapple to passion fruit, we picked the passion fruit.
Why?
Both are certainly great, and both have won their respective previous comparisons! And this one’s close:
In terms of macros, passion fruit has about 4x the protein, nearly 2x the carbs, and more than 7x the fiber. So, this one’s a clear and overwhelming win for passion fruit.
Vitamins are quite close; pineapple has more of vitamins B1, B5, B6, B9, and C, while passion fruit has more of vitamins A, B2, B3, and choline. So, a 5:4 marginal win for pineapple.
When it comes to minerals, pineapple has more calcium, copper, manganese, and zinc, while passion fruit has more iron, manganese, phosphorus, potassium, and selenium. Superficially, this would be a 5:5 tie, but looking at the numbers, passion fruit’s margins of difference are much greater, which means it gives the better overall mineral coverage, and thus wins the category.
Looking at polyphenols, pineapple wins this category with its variety of lignans, while passion fruit has just secoisolariciresinol, of which pineapple has more anyway. Plus, not a polyphenol but doing much of the same job of same, pineapple has bromelain, which is unique to it. So pineapple wins on the phytochemicals reckoning.
Adding up the sections and weighting them for importance (e.g. what a difference it makes to health) and statistical relevance (e.g. greater or smaller margins of difference) makes for a nominal passion fruit win, but like we say, both of these fruits are great, so enjoy both!
Want to learn more?
You might like to read:
Bromelain vs Inflammation & Much More
Take care!
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Apricots vs Peaches – Which is Healthier?
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Our Verdict
When comparing apricots to peaches, we picked the apricots.
Why?
Both are great! But there’s a clear winner:
In terms of macros, apricots have more fiber and, which is less important because the numbers are small, more protein. Apricots do also have more carbs, and/but carbs from whole fruit are not a problem for most people (especially because of the fiber), unless undertaking a very carb-controlled diet.
When it comes to vitamins, apricots sweep with more of vitamins A, B1, B2, B5, B6, B9, C, E, & K. Peaches meanwhile boast more vitamin B3, and that only marginally, as well as more choline.
In the category of minerals, apricots sweep again with more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc. Peaches are not higher in any minerals.
Finally, if we consider polyphenols, apricots sweep yet again. The flavonols that peaches have, apricots have more of, and apricots have a long list of flavonols that peaches don’t.
Outside of flavonols, there is one (1) phenolic acid that peaches have more of (it’s 3-Caffeoylquinic acid), and it’s only slightly more, and it’s mostly in the skin which isn’t included if you buy your fruit ready-chopped. So in those cases, apricots would have the higher 3-Caffeoylquinic acid content anyway.
All in all, with their higher content of fiber, vitamins, minerals, and polyphenols, apricots easily win the day.
Enjoy both, though! Diversity is healthy!
Want to learn more?
You might like to read:
- Dried Apricots vs Dried Prunes – Which is Healthier?
- Which Sugars Are Healthier, And Which Are Just The Same? ← we know we link this one a lot, but we think it’s important for everyone to know how fruit is good and juice isn’t (and why, less that seem bizarrely arbitrary)
Take care!
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Should We Skip Shampoo?
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? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝What’s the science on “no poo”? Is it really better for hair? There are so many mixed reports out there.❞
First, for any unfamiliar: this is not about constipation; rather, it is about skipping shampoo, and either:
- Using an alternative cleaning agent, such as vinegar and/or sodium bicarbonate
- Using nothing at all, just conditioner when wet and brushing when dry
Let’s examine why the trend became a thing: the thinking went “shampoo does not exist in nature, and most of our body is more or less self-cleaning; shampoos remove oils from hair, and the body has to produce more sebum to compensate, resulting in a rapid cycle of dry and greasy hair”.
Now let’s fact-check each of those:
- shampoo does not exist in nature: true (except in the sense that everything that exists can be argued to exist in nature, since nature encompasses everything—but the point is that shampoo is a purely artificial human invention)
- most of our body is more or less self-cleaning: true, but our hair is not, for the same reason our nails are not: they’re not really a living part of the overall organism that is our body, so much as a keratinous protrusion of neatly stacked and hardened dead cells from our body. Dead things are not self-cleaning.
- shampoos remove oils from hair: true; that is what they were invented for and they do it well
- the body has to produce more sebum to compensate, resulting in a rapid cycle of dry and greasy hair: false; or at least, there is no evidence for this.
Our hair’s natural oils are great at protecting it, and also great at getting dirt stuck in it. For the former reason we want the oil there; for the latter reason, we don’t.
So the trick becomes: how to remove the oil (and thus the dirt stuck in it) and then put clean oil back (but not too much, because we don’t want it greasy, just, shiny and not dry)?
The popular answer is: shampoo to clean the hair, conditioner to put an appropriate amount of oil* back.
*these days, mostly not actually oil, but rather silicon-based substitutes, that do the same job of protecting hair and keeping it shiny and not brittle, without attracting so much dirt. Remember also that silicon is inert and very body safe; its molecules are simply too large to be absorbed, which is why it gets used in hair products, some skin products, and lube.
See also: Water-based Lubricant vs Silicon-based Lubricant – Which is Healthier?
If you go “no poo”, then what will happen is either you dry your hair out much worse by using vinegar or (even worse) bicarbonate of soda, or you just have oil (and any dirt stuck in it) in your hair for the life of the hair. As in, each individual strand of hair has a lifespan, and when it falls out, the dirt will go with it. But until that day, it’s staying with you, oil and dirt and all.
If you use a conditioner after using those “more natural” harsh cleaners* that aren’t shampoo, then you’ll undo a lot of the damage done, and you’ll probably be fine.
*in fact, if you’re going to skip shampoo, then instead of vinegar or bicarbonate of soda, dish soap from your kitchen may actually do less damage, because at least it’s pH-balanced. However, please don’t use that either.
If you’re going to err one way or the other with regard to pH though, erring on the side of slightly acidic is much better than slightly alkaline.
More on pH: Journal of Trichology | The Shampoo pH can Affect the Hair: Myth or Reality?
If you use nothing, then brushing a lot will mitigate some of the accumulation of dirt, but honestly, it’s never going to be clean until you clean it.
Our recommendation
When your hair seems dirty, and not before, wash it with a simple shampoo (most have far too many unnecessary ingredients; it just needs a simple detergent, and the rest is basically for marketing; to make it foam completely unnecessarily but people like foam, to make it thicker so it feels more substantial, to make it smell nice, to make it a color that gives us confidence it has ingredients in it, etc).
Then, after rinsing, enjoy a nice conditioner. Again there are usually a lot of unnecessary ingredients, but an argument can be made this time for some being more relevant as unlike with the shampoo, many ingredients are going to remain on your hair after rinsing.
Between washes, if you have long hair, consider putting some hair-friendly oil (such as argan oil or coconut oil) on the tips daily, to avoid split ends.
And if you have tight curly hair, then this advice goes double for you, because it takes a lot longer for natural oils to get from your scalp to the ends of your hair. For those of us with straight hair, it pretty much zips straight on down there within a day or two; not so if you have beautiful 4C curls to take care of!
For more on taking care of hair gently, check out:
Gentler Hair Care Options, According To Science
Take care!
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The Best Form Of Sugar During Exercise
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? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝What is the best form of sugar for an energy kick during exercise? Both type of sugar eg glicoae fructose dextrose etc and medium, ie drink, gel, solids etc❞
Great question! Let’s be clear first that we’re going to answer this specifically for the context of during exercise.
Because, if you’re not actively exercising strenuously right at the time when you’re taking the various things we’re going to be talking about, the results will not be the same.
For scenarios that are anything less than “I am exercising right now and my muscles (not joints, or anything else) are feeling the burn”, then instead please see this:
Snacks & Hacks: Eating For Energy (In Ways That Actually Work)
Because, to answer your question, we’re going to be going 100% against the first piece of advice in that article, which was “Skip the quasi-injectables”, i.e., anything marketed as very quick release. Those things are useful for diabetics to have handy just in case of needing to urgently correct a hypo, but for most people most of the time, they’re not. See also:
Which Sugars Are Healthier, And Which Are Just The Same?
However…
When strenuously exercising in a way that is taxing our muscles, we do not have to worry about the usual problem of messing up our glucose metabolism by overloading our body with sugars faster than it can use it (thus: it has to hurriedly convert glucose and shove it anywhere it’ll fit to put it away, which is very bad for us), because right now, in the exercise scenario we’re describing, the body is already running its fastest metabolism and is grabbing glucose anywhere it can find it.
Which brings us to our first key: the best type of sugar for this purpose is glucose. Because:
- glucose: the body can use immediately and easily convert whatever’s spare to glycogen (a polysaccharide of glucose) for storage
- fructose: the body cannot use immediately and any conversion of fructose to glycogen has to happen in the liver, so if you take too much fructose (without anything to slow it down, such as the fiber in whole fruit), you’re not only not going to get usable energy (the sugar is just going to be there in your bloodstream, circulating, not getting used, because it doesn’t trigger insulin release and insulin is the gatekeeper that allows sugar to be used), but also, it’s going to tax the liver, which if done to excess, is how we get non-alcoholic fatty liver disease.
- sucrose: is just a disaccharide of glucose and fructose, so it first gets broken down into those, and then its constituent parts get processed as above. Other disaccharides you’ll see mentioned sometimes are maltose and lactose, but again, they’re just an extra step removed from useful metabolism, so to save space, we’ll leave it at that for those today.
- dextrose: is just glucose, but when the labeller is feeling fancy. It’s technically informational because it specifies what isomer of glucose it is, but basically all glucose found in food is d-glucose, i.e. dextrose. Other isomers of glucose can be synthesized (very expensively) in laboratories or potentially found in obscure places (the universe is vast and weird), but in short: unless someone’s going to extreme lengths to get something else, all glucose we encounter is dextrose, and all (absolutely all) dextrose is glucose.
We’d like to show scientific papers contesting these head-to-head for empirical proof, but since the above is basic chemistry and physiology, all we could find is papers taking this for granted and stating in their initial premise that sports drinks, gels, bars usually contain glucose as their main sugar, potentially with some fructose and sucrose. Like this one:
A Comprehensive Study on Sports and Energy Drinks
As for how to take it, again this is the complete opposite of our usual health advice of “don’t drink your calories”, because in this case, for once…
(and again, we must emphasize: only while actively doing strenuous exercise that is making specifically your muscles burn, not your joints or anything else; if your joints are burning you need to rest and definitely don’t spike your blood sugars because that will worsen inflammation)
…just this once, we do want those sugars to be zipping straight into the blood. Which means: liquid is best for this purpose.
And when we say liquid: gel is the same as a drink, so far as the body is concerned, provided the body in question is adequately hydrated (i.e., you are also drinking water).
Here are a pair of studies (by the same team, with the same general methodology), testing things head-to-head, with endurance cyclists on 6-hour stationary cycle rides:
CHO Oxidation from a CHO Gel Compared with a Drink during Exercise
Meanwhile, liquid beat solid, but only significantly so from the 90-minute mark onwards, and even that significant difference was modest (i.e. it’s clinically significant, it’s a statistically reliable result and improbable as random happenstance, but the actual size of the difference was not huge):
Oxidation of Solid versus Liquid CHO Sources during Exercise
We would hypothesize that the reason that liquids only barely outperformed solids for this task is precisely because the solids in question were also designed for the task. When a company makes a fast-release energy bar, they don’t load it with fiber to slow it down. Which differentiates this greatly from, say, getting one’s sugars from whole fruit.
If the study had compared apples to apple juice, we hypothesize the results would have been very different. But alas, if that study has been done, we couldn’t find it.
Today has been all about what’s best during exercise, so let’s quickly finish with a note on what’s best before and after:
Before: What To Eat, Take, And Do Before A Workout
After: Overdone It? How To Speed Up Recovery After Exercise
Take care!
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