Meditations for Mortals – by Oliver Burkeman
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We previously reviewed this author’s “Four Thousand Weeks”, but for those who might have used a lot of those four thousand weeks already, and would like to consider things within a smaller timeframe for now, this work is a 28-day daily reader.
Now, daily readers are usually 366 days, but the chapters here are not the single page chapters that 366-page daily readers usually have. So, expect to invest a little more time per day (say, about 6 pages for each daily chapter).
Burkeman does not start the way we might expect, by telling us to take the time to smell the roses. Instead, he starts by examining the mistakes that most of us make most of the time, often due to unexamined assumptions about the world and how it works. Simply put, we’ve often received bad lessons in life (usually not explicitly, but rather, from our environments), and it takes some unpacking first to deal with that.
Nor is the book systems-based, as many books that get filed under “time management” may be, but rather, is simply principles-based. This is a strength, because principles are a lot easier to keep to than systems.
The writing style is direct and conversational, and neither overly familiar nor overly academic. It strikes a very comfortably readable balance.
Bottom line: if you’d like to get the most out of your days, this book can definitely help improve things a lot.
Click here to check out Meditations For Mortals, and live fulfilling days!
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What To Leave Off Your Table (To Stay Off This Surgeon’s)
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Why we eat too much (and how we can fix that)
This is Dr. Andrew Jenkinson. He’s a Consultant Surgeon specializing in the treatment of obesity, gallstones, hernias, heartburn and abdominal pain. He runs regular clinics in both London and Dubai. What he has to offer us today, though, is insight as to what’s on our table that puts us on his table, and how we can quite easily change that up.
So, why do we eat too much?
First things first: some metabolic calculations. No, we’re not going to require you to grab a calculator here… Your body does it for you!
Our body’s amazing homeostatic system (the system that does its best to keep us in the “Goldilocks Zone” of all our bodily systems; not too hot or too cold, not dehydrated or overhydrated, not hyperglycemic or hypoglycemic, blood pressure not too high or too low, etc, etc) keeps track of our metabolic input and output.
What this means: if we increase or decrease our caloric consumption, our body will do its best to increase or decrease our metabolism accordingly:
- If we don’t give it enough energy, it will try to conserve energy (first by slowing our activities; eventually by shutting down organs in a last-ditch attempt to save the rest of us)
- If we give it too much energy, it will try to burn it off, and what it can’t burn, it will store
In short: if we eat 10% or 20% more or less than usual, our body will try to use 10% to 20% more or less than usual, accordingly.
So… How does this get out of balance?
The problem is in how our system does that, and how we inadvertently trick it, to our detriment.
For a system to function, it needs at its most base level two things—a sensor and a switch:
- A sensor: to know what’s going on
- A switch: to change what it’s doing accordingly
Now, if we eat the way we’re evolved to—as hunter-gatherers, eating mostly fruit and vegetables, supplemented by animal products when we can get them—then our body knows exactly what it’s eating, and how to respond accordingly.
Furthermore, that kind of food takes some eating! Most fruit these days is mostly water and fiber; in those days it often had denser fiber (before agricultural science made things easier to eat), but either way, our body knows when we are eating fruit and how to handle that. Vegetables, similarly. Unprocessed animal products, again, the gut goes “we know what this is” and responds accordingly.
But modern ultra-processed foods with trans-fatty acids, processed sugar and flour?
These foods zip calories straight into our bloodstream like greased lightning. We get them so quickly so easily and in such great caloric density, that our body doesn’t have the chance to count them on the way in!
What this means is: the body has no idea what it’s just consumed or how much or what to do with it, and doesn’t adjust our metabolism accordingly.
Bottom line:
Evolutionarily speaking, your body has no idea what ultra-processed food is. If you skip it and go for whole foods, you can, within the bounds of reason, eat what you like and your body will handle it by adjusting your metabolism accordingly.
Now, advising you “avoid ultra-processed foods and eat whole foods” was probably not a revelation in and of itself.
But: sometimes knowing a little more about the “why” makes the difference when it comes to motivation.
Want to know more about Dr. Jenkinson’s expert insights on this topic?
If you like, you can check out his website here—he has a book too
Why We Eat (Too Much) – Dr. Andrew Jenkinson on the Science of Appetite
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Stretching to Stay Young – by Jessica Matthews
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A lot of stretching gurus (especially the Instagrammable kind) offer advices like “if you can’t do the splits balanced between two chairs to start with, that’s fine… just practise by doing the splits against a wall first!”
Jessica Matthews, meanwhile, takes a more grounded approach. A lot of this is less like yoga and more like physiotherapy—it’s uncomplicated and functional. There’s nothing flashy here… just the promise of being able to thrive in your body; supple and comfortable, doing the activities that matter to you.
On which note: the book gives advices about stretches for before and after common activities, for example:
- a bedtime routine set
- a pre-gardening set
- a post-phonecall set
- a level-up-your golf set
- a get ready for dancing set
…and many more. Whether “your thing” is cross-country skiing or knitting, she’s got you covered.
The book covers the whole body from head to toe. Whether you want to be sure to stretch everything, or just work on a particular part of your body that needs special attention, it’s there… with beautifully clear illustrations (the front cover illustration is indicative of the style—note how the muscle being stretched is highlighted in orange, too) and simple, easy-to-understand instructions.
All in all, we’re none of us getting any younger, but we sure can take some of our youth into whatever years come next. This is the stuff that life is made of!
Get your copy of “Stretching To Stay Young” from Amazon today!
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When Doctors Make House Calls, Modern-Style!
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In Tuesday’s newsletter, we asked you foryour opinion of telehealth for primary care consultations*, and got the above-depicted, below-described, set of responses:
- About 46% said “It is no substitute for an in-person meeting with a doctor; let’s keep the human touch”
- About 29% said “It means less waiting and more accessibility, while avoiding transmission of diseases”
- And 25 % said “I find that the pros and cons of telehealth vs in-person balance out, so: no preference”
*We specified that by “primary care” we mean the initial consultation with a non-specialist doctor, before receiving treatment or being referred to a specialist. By “telehealth” we mean by videocall or phonecall.
So, what does the science say?
A quick note first
Because telehealth was barely a thing (statistically speaking) before the first stages of the COVID pandemic, compared to how it is now, most of the science for this is young, and a lot of the science simply hasn’t been done yet, and/or has not been published yet, because the process can take years.
Because of this, some studies we do have aren’t specifically about primary care, and are sometimes about specialists. We think this should not affect the results much, but it bears highlighting.
Nevertheless, we’ll do what we can with the science we have!
Telehealth is more accessible than in-person consultations: True or False?
True, for most people. For example…
❝Data was found from a variety of emergency and non-emergency departments of primary, secondary, and specialised healthcare.
Satisfaction was high among recipients of healthcare, scoring 9-10 on a scale of 0-10 or ranging from 73.3% to 100%.
Convenience was rated high in every specialty examined. Satisfaction of clinicians was high throughout the specialities despite connection failure and concerns about confidentiality of information.❞
whereas…
❝Nonetheless, studies reported perception of increased barriers to accessing care and inequalities for vulnerable patients especially in older people❞
~ Ibid.
Source: Satisfaction with telemedicine use during COVID-19 pandemic in the UK: a systematic review
Now, perception of those things does necessarily equate to an actual increased barrier, but it is reasonable that someone who thinks something is inaccessible will be less inclined to try to access it.
The quality of care provided via telehealth is as good as in-person: True or False?
True, ostensibly, with caveats. The caveats are:
- We’re going offreported patient satisfaction, not objective patient health outcomes (we found little* science as yet for the relative incidence of misdiagnosis, for example—which kind of thing will take time to be revealed).
- We’re also therefore speaking (as statistics do) for the significant majority of people. However, if we happen to be (statistically speaking) an insignificant minority, well, that just sucks for us personally.
*we did find some, but it wasn’t very helpful yet. For example:
An electronic trigger to detect telemedicine-related diagnostic errors
this one does look at the incidence of diagnostic errors, but provides no control group (i.e. otherwise-comparable in-person consultations) for comparison.
While most oft-considered demographic groups reported comparable patient satisfaction (per race, gender, and socioeconomic status, for example), there was one outlier variable, which was age (as we quoted from that first study above).
However!
Looking under the hood of these stats, it seems that age is not the real culprit, so much as technological illiteracy, which is heavily correlated with age:
❝Lower eHealth literacy is associated with more negative attitudes towards I/C technology in healthcare. This trend is consistent across diverse demographics and regions. ❞
Source: Meta-analysis: eHealth literacy and attitudes towards internet/computer technology
There are things that can be done at an in-person consultation that can’t be done by telehealth: True or False?
True, of course. It is incredibly rare that we will cite “common sense”, (as sometimes “common sense” is actually “common mistakes” and is simply and verifiably wrong), but in this case, as one 10almonds subscriber put it:
❝The doctor uses his five senses to assess. This cannot be attained over the phone❞
~ 10almonds subscriber
A quick note first: if your doctor is using their sense of taste to diagnose you, please get a different doctor, because they should definitely not be doing that!
Not in this century, anyway… Once upon a time, diabetes was diagnosed by urine-tasting (and yes, that was a fairly reliable method).
However, nowadays indeed a doctor will use sight, sound, touch, and sometimes even smell.
In a videocall we’re down to two of those senses (sight and sound), and in a phonecall, down to one (sound) and even that is hampered. Your doctor cannot, for example, use a stethoscope over the phone.
With this in mind, it really comes down to what you need from your doctor in that consultation.
- If you’re 99% sure that what you need is to be prescribed an antidepressant, that probably doesn’t need a full physical.
- If you’re 99% sure that what you need is a referral, chances are that’ll be fine by telehealth too.
- If your doctor is 99% sure that what you need is a verbal check-up (e.g. “How’s it been going for you, with the medication that I prescribed for you a month ago?”, then again, a call is probably fine.
If you have a worrying lump, or an unhappy bodily discharge, or an unexplained mysterious pain? These things, more likely an in-person check-up is in order.
Take care!
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Chetna’s Healthy Indian – by Chetna Makan
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.
Indian food is wonderful—a subjective opinion perhaps, but a popular view, and one this reviewer certainly shares. And of course, cooking with plenty of vegetables and spices is a great way to get a lot of health benefits.
There are usually downsides though, such as that in a lot of Indian cookbooks, every second thing is deep-fried, and what’s not deep-fried contains an entire day or more’s saturated fat content in ghee, and a lot of sides have more than their fair share of sugar.
This book fixes all that, by offering 80 recipes that prioritize health without sacrificing flavor.
The recipes are, as the title suggests, vegetarian, though many are not vegan (yogurt and cheese featuring in many recipes). That said, even if you are vegan, it’s pretty easy to veganize those with the obvious plant-based substitutions. If you have soy yogurt and can whip up vegan paneer yourself (here’s our own recipe for that), you’re pretty much sorted.
The cookbook strikes a good balance of being neither complicated nor “did we really need a recipe for this?” basic, and delivers value in all of its recipes. The ingredients, often a worry for many Westerners, should be easily found if you have a well-stocked supermarket near you; there’s nothing obscure here.
Bottom line: if you’d like to cook more Indian food and want your food to be exciting without also making your blood pressure exciting, then this is an excellent book for keeping you well-nourished, body and soul.
Click here to check out Chetna’s Healthy Indian, and spice up your culinary repertoire!
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The Circadian Rhythm: Far More Than Most People Know
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The Circadian Rhythm: Far More Than Most People Know
This is Dr. Satchidananda (Satchin) Panda, the scientist behind the discovery of the blue-light sensing cell type in the retina, and the many things it affects. But, he’s discovered more…
First, what you probably know (with a little more science)
Dr. Panda discovered that melanopsin, a photopigment, is “the primary candidate for photoreceptor-mediated entrainment”.
To put that in lay terms, it’s the brain’s go-to for knowing approximately what time of day or night it is, according to how much light there is (or isn’t), and how long it has (or hasn’t) been there.
But… the brain’s “go-to” isn’t the only method. By creating mice without melanopsin, he was able to find that they still keep a circadian rhythm, even in complete darkness:
Melanopsin (Opn4) Requirement for Normal Light-Induced Circadian Phase Shifting
In other words, it was a helpful, but not completely necessary, means of keeping a circadian rhythm.
So… What else is going on?
Dr. Panda and his team did a lot of science that is well beyond the scope of this main feature, but to give you an idea:
- With jargon: it explored the mechanisms and transcription translation negative feedback loops that regulate chronobiological processes, such as a histone lysine demathlyase 1a (JARID1a) that enhances Clock-Bmal1 transcription, and then used assorted genomic techniques to develop a model for how JARID1a works to moderate the level of Per transcription by regulating the transition between its repression and activation, and discovered that this heavily centered on hepatic gluconeogenesis and glucose homeostasis, facilitated by the protein cryptochrome regulating the fasting signal that occurs when glucagon binds to a G-protein coupled receptor, triggering CREB activation.
- Without jargon: a special protein tells our body how to respond to eating/fasting at different times of day—and conversely, certain physiological responses triggered by eating/fasting help us know what time of day it is.
- Simplest: our body keeps on its best cycle if we eat at the same time every day
This is important, because our circadian rhythm matters for a lot more than sleeping/waking! Take hormones, for example:
- Obvious hormones: testosterone and estrogen peak in the mornings around 9am, progesterone peaks between 10pm and 2am
- Forgotten hormones: cortisol peaks in the morning around 8:30am, melatonin peaks between 10pm and 2am
- More hormones: ghrelin (hunger hormone) peaks around 10am, leptin (satiety hormone) peaks 20 minutes after eating a certain amount of satiety-triggering food (protein does this most quickly), insulin is heavily tied to carbohydrate intake, but will still peak and trough according to when the body expects food.
What does this mean for us in practical terms?
For a start, it means that intermittent fasting can help guard against metabolic and related diseases (including inflammation, and thus also cancer, diabetes, arthritis, and more) a lot more if we practice it with our circadian rhythm in mind.
So that “8-hour window” for eating, that many intermittent fasting practitioners adhere to, is going to do much, much better if it’s 10am to 6pm, rather than, say, 4pm to midnight.
Additionally, Dr. Panda and his team found that a 12-hour eating window wasn’t sufficient to help significantly.
Some other take-aways:
- For reasons beyond the scope of this article, it’s good to exercise a) early b) before eating, so getting in some exercise between 8.30am and 10am is ideal
- It also means it’s beneficial to “front-load” eating, so a large breakfast at 10am, and smaller meals/snacks afterwards, is best.
- It also means that getting sunlight (even if cloud-covered) around 8.30am helps guard against metabolic disorders a lot, since the light remains the body’s go-to way of knowing the time.
- We realize that sunlight is not available at 8.30am at all latitudes at all times of year. Artificial is next-best.
- It also means sexual desire will typically peak in men in the mornings (per testosterone) and women in the evenings (per progesterone), but this is just an interesting bit of trivia, and not so relevant to metabolic health
What to do next…
Want to stabilize your own circadian rhythm in the best way, and also help Dr. Panda with his research?
His team’s (free!) app, “My Circadian Clock”, can help you track and organize all of the body’s measurable-by-you circadian events, and, if you give permission, will contribute to what will be the largest-yet human study into the topics covered today, to refine the conclusions and learn more about what works best.
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Codependent No More – by Melody Beattie
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This is a book review, not a book summary, but first let’s quickly cover a common misconception, because the word “codependent” gets misused a lot in popular parlance:
- What codependence isn’t: “we depend on each other and must do everything together”
- What codependence is:“person 1 has a dependency on a substance (or perhaps a behavior, such as gambling); person 2 is trying to look after person 1, and so has developed a secondary relationship with the substance/behavior. Person 2 is now said to be codependent, because it becomes all-consuming for them too, even if they’re not using the substance/behavior directly”
Funny how often it happens that the reality is more complex than the perception, isn’t it?
Melody Beattie unravels all this for us. We get a compassionate and insightful look at how we can look after ourselves, while looking after another. Perhaps most importantly: how and where to draw a line of what we can and cannot do/change for them.
Because when we love someone, of course we want to fight their battles with them, if not for them. But if we want to be their rock of strength, we can’t get lost in it too, and of course that hurts.
Beatty takes us through these ideas and more, for example:
- How to examine our own feelings even when it’s scary
- How to practice self-love and regain self-worth, while still caring for them
- How to stop being reactionary, step back, and act with purpose
If the book has any weak point, it’s that it repeatedly recommends 12-step programs, when in reality that’s just one option. But for those who wish to take another approach, this book does not require involvement in a 12-step program, so it’s not a barrier to usefulness.
Click here to check out Codependent No More and take care of yourself, too
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