Mediterranean Diet… In A Pill?

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Does It Come In A Pill?

For any as yet unfamiliar with the Mediterranean diet, you may be wondering what it involves, beyond a general expectation that it’s a diet popularly enjoyed in the Mediterranean. What image comes to mind?

We’re willing to bet that tomatoes feature (great source of lycopene, by the way, and if you’re not getting lycopene, you’re missing out), but what else?

  • Salads, perhaps? Vegetables, olives? Olive oil, yea or nay?
  • Bread? Pasta? Prosciutto, salami? Cheese?
  • Pizza but only if it’s Romana style, not Chicago?
  • Pan-seared liver, with some fava beans and a nice Chianti?

In fact, the Mediterranean diet is quite clear on all these questions, so to read about these and more (including a “this yes, that no” list), see:

What Is The Mediterranean Diet, And What Is It Good For?

So, how do we get that in a pill?

A plucky band of researchers, Dr. Chiara de Lucia et al. (quite a lot of “et al.”; nine listed authors on the study), wondered to what extent the benefits of the Mediterranean diet come from the fact that the Mediterranean diet is very rich in polyphenols, and set about testing that, by putting the same polyphenols in capsule form, and running a randomized, double-blind, placebo-controlled, crossover clinical intervention trial.

Now, polyphenols are not the only reason the Mediterranean diet is great; there are also other considerations, such as:

  • a great macronutrient balance with lots of fiber, healthy fats, moderate carbs, and protein from select sources
  • the absence or at least very low presence of a lot of harmful substances such as refined seed oils, added sugars, refined carbohydrates, and the like (“but pasta” yes pasta; in moderation and wholegrain and served with extra sources of fiber and healthy fats, all of which slow down the absorption of the carbs)

…but polyphenols are admittedly very important too; we wrote about some common aspects of them here:

Tasty Polyphenols: Enjoy Bitter Foods For Your Heart & Brain

As for what Dr. de Lucia et al. put into the capsule, behold…

The ingredients:

  1. Apple Extract 10.0%
  2. Pomegranate Extract 10.0%
  3. Tomato Powder 2.5%
  4. Beet, Spray Dried 2.5%
  5. Olive Extract 7.5%
  6. Rosemary Extract 7.5%
  7. Green Coffee Bean Extract (CA) 7.5%
  8. Kale, Freeze Dried 2.5%
  9. Onion Extract 10.0%
  10. Ginger Extract 10.0%
  11. Grapefruit Extract 2.5%
  12. Carrot, Air Dried 2.5%
  13. Grape Skin Extract 17.5%
  14. Blueberry Extract 2.5%
  15. Currant, Freeze Dried 2.5%
  16. Elderberry, Freeze Dried 2.5%

And the relevant phytochemicals they contain:

  • Quercetin
  • Luteolin
  • Catechins
  • Punicalagins
  • Phloretin
  • Ellagic Acid
  • Naringin
  • Apigenin
  • Isorhamnetin
  • Chlorogenic Acids
  • Rosmarinic Acid
  • Anthocyanins
  • Kaempferol
  • Proanthocyanidins
  • Myricetin
  • Betanin

And what, you may wonder, did they find? Well, first let’s briefly summarise the setup of the study:

They took volunteers (n=30), average age 67, BMI >25, without serious health complaints, not taking other supplements, not vegetarian or vegan, not consuming >5 cups of coffee per day, and various other stipulations like that, to create a fairly homogenous study group who were expected to respond well to the intervention. In contrast, someone who takes antioxidant supplements, already eats many different color plants per day, and drinks 10 cups of coffee, probably already has a lot of antioxidant activity going on, and someone with a lower BMI will generally have lower resting levels of inflammatory markers, so it’s harder to see a change, proportionally.

About those inflammatory markers: that’s what they were testing, to see whether the intervention “worked”; essentially, did the levels of inflammatory markers go up or down (up is bad; down is good).

For more on inflammation, by the way, see:

How to Prevent (or Reduce) Inflammation

…which also explains what it actually is, and some important nuances about it.

Back to the study…

They gave half the participants the supplement for a week and the other half placebo; had a week’s gap as a “washout”, then repeated it, switching the groups, taking blood samples before and after each stage.

What they found:

The group taking the supplement had lower inflammatory markers after a week of taking it, while the group taking the placebo had relatively higher inflammatory markers after a week of taking it; this trend was preserved across both groups (i.e., when they switched roles for the second half).

The results were very significant (p=0.01 or thereabouts), and yet at the same time, quite modest (i.e. the supplement made a very reliable, very small difference), probably because of the small dose (150mg) and small intervention period (1 week).

What the researchers concluded from this

The researchers concluded that this was a success; the study had been primarily to provide proof of principle, not to rock the world. Now they want the experiment to be repeated with larger sample sizes, greater heterogeneity, larger doses, and longer intervention periods.

This is all very reasonable and good science.

Read in full: A Randomised, Double-Blind, Placebo-Controlled, Cross-Over Clinical Trial to Evaluate the Biological Effects and Safety of a Polyphenol Supplement on Healthy Ageing

What we conclude from this

That ingredients list makes for a good shopping list!

Well, not the extracts they listed, necessarily, but rather those actual fruits, vegetables, etc.

If nine top scientists (anti-aging specialists, neurobiologists, pharmacologists, and at least one professor of applied statistics) came to the conclusion that to get the absolute most bang-for-buck possible, those are the plants to get the phytochemicals from, then we’re not going to ignore that.

So, take another list above and ask yourself: how many of those 16 foods do you eat regularly, and could you work the others in?

Want to make your Mediterranean diet even better?

While the Mediterranean diet is a top-tier catch-all, it can be tweaked for specific areas of health, for example giving it an extra focus on heart health, or brain health, or being anti-inflammatory, or being especially gut healthy:

Four Ways To Upgrade The Mediterranean

Enjoy!

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  • Getting to Neutral – by Trevor Moawad

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    We all know that a pessimistic outlook is self-defeating… And yet, toxic positivity can also be a set-up for failure! At some point, reckless faith in the kindly nature of the universe will get crushed, badly. Sometimes that point is a low point in life… sometimes it’s six times a day. But one thing’s for sure: we can’t “just decide everything will go great!” because the world just doesn’t work that way.

    That’s where Trevor Moawad comes in. “Getting to neutral” is not a popular selling point. Everyone wants joy, abundance, and high after high. And neutrality itself is often associated with boredom and soullessness. But, Moawad argues, it doesn’t have to be that way.

    This book’s goal—which it accomplishes well—is to provide a framework for being a genuine realist. What does that mean?

    “I’m not a pessimist; I’m a realist” – every pessimist ever.

    ^Not that. That’s not what it means. What it means instead is:

    1. Hope for the best
    2. Prepare for the worst
    3. Adapt as you go

    …taking care to use past experiences to inform future decisions, but without falling into the trap of thinking that because something happened a certain way before, it always will in the future.

    To be rational, in short. Consciously and actively rational.

    Feel the highs! Feel the lows! But keep your baseline when actually making decisions.

    Bottom line: this book is as much an antidote to pessimism and self-defeat, as it is to reckless optimism and resultant fragility. Highly recommendable.

    Click here to check out “Getting to Neutral” and start creating your best, most reason-based life!

    PS: in this book, Moawad draws heavily from his own experiences of battling adversity in the form of cancer—of which he died, before this book’s publication. A poignant reminder that he was right: we won’t always get the most positive outcome of any given situation, so what matters the most is making the best use of the time we have.

    Share This Post

  • Building Psychological Resilience (Without Undue Hardship)

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    What’s The Worst That Could Happen?

    When we talk about the five lifestyle factors that make the biggest difference to health, stress management would be a worthy addition as number six. We haven’t focused explicitly on that for a while, so let’s get ready to start the New Year on a good footing…

    You’re not going to have a stress-free 2024

    What a tender world that would be! Hopefully your stressors will be small and manageable, but rest assured, things will stress you.

    And that’s key: “rest assured”. Know it now, prepare for it, and build resilience.

    Sounds grim, doesn’t it? It doesn’t have to be, though.

    When the forecast weather is cold and wet, you’re not afraid of it when you have a warm dry house. When the heating bill comes for that warm dry house, you’re not afraid of it when you have money to pay it. If you didn’t have the money and the warm dry house, the cold wet weather could be devastating to you.

    The lesson here is: we can generally handle what we’re prepared for.

    Negative visualization and the PNS

    This is the opposite of what a lot of “think and grow rich”-style gurus would advise. And indeed, it’s not helpful to slide into anxious worrying.

    If you do find yourself spiralling, here’s a tool for getting out of that spiral:

    RAIN: an intervention for dealing with difficult emotions

    For now, however, we’re going to practice Radical Acceptance.

    First, some biology: you may be aware that your Central Nervous System (CNS) branches into the Sympathetic Nervous System (SNS) and the Parasympathetic Nervous System (PNS).

    The PNS is the part that cues our body to relax, and suppresses our fight/flight response. We’re going to activate it.

    Activating the PNS is easy for most people in comfortable circumstances (e.g., you are not currently exposed to stressful stimuli). It may well be activated already, and if it’s not, a few deep breaths is usually all it takes.

    If you’d like a quick and easy Mindfulness-Based Stress Reduction (MBSR) technique, here you go:

    No-Frills, Evidence-Based Mindfulness

    Activating the PNS is hard for most people in difficult circumstances (e.g., you either are currently exposed to stressful stimuli, or you are in one of the emotional spirals we discussed earlier).

    However, we can trick our bodies and brains by—when we are safe and unstressed—practicing imagining those stressful stimuli. Taking a moment to not just imagine it experientially, but immersively. This, in CBT and DBT, is the modern equivalent to the old samurai who simply accepted, before battle, that they were already dead—and thus went into battle with zero fear of death.

    A less drastic example is the zen master who had a favorite teacup, and feared it would get broken. So he would tell himself “the cup is already broken”. One day, it actually broke, and he simply smiled ruefully and said “Of course”.

    How this ties together: practice the mindfulness-based stress reduction we linked above, while imagining the things that do/would stress you the most.

    Since it’s just imagination, this is a little easier than when the thing is actually happening. Practicing this way means that when and if the thing actually happens (an unfortunate diagnosis, a financial reversal, whatever it may be), our CNS is already well-trained to respond to stress with a dose of PNS-induced calm.

    You can also leverage hormesis, a beneficial aspect of (in this case, optional and chosen by you) acute stress:

    Dr. Elissa Epel | The Stress Prescription

    Psychological resilience training

    This (learned!) ability to respond to stress in an adaptive fashion (without maladaptive coping strategies such as unhelpful behavioral reactivity and/or substance use) is a key part of what in psychology is called resilience:

    Psychological resilience: an update on definitions, a critical appraisal, and research recommendations

    And yes, the CBT/DBT/MBSR methods we’ve been giving you are the evidence-based gold standard.

    Only the best for 10almonds subscribers! 😎

    Road to resilience: a systematic review and meta-analysis of resilience training programmes and interventions

    ❝That was helpful, but not cheery; can we finish the year on a cheerier note?❞

    We can indeed:

    How To Get Your Brain On A More Positive Track (Without Toxic Positivity)

    Take care!

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  • The Problem With Active Listening

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    The problem with active listening

    Listening is an important skill to keep well-trained at any age. It’s important in romantic relationships, parent-child relationships, friendships, and more.

    First, for any unfamiliar or hazy-of-memory: active listening is the practice of listening, actively. The “active” side of this comes in several parts:

    1. Asking helpful questions
    2. Giving feedback to indicate that the answer has been understood
    3. Prompting further information-giving

    This can look like:

    • A: How did you feel when that happened?
    • B: My heart was racing and I felt panicked, it really shocked me
    • A: It really shocked you?
    • B: Yes, because it was so unexpected; I’d never imagined something like this happening
    • A: You’d never expect something like that
    • B: No, I mean, I had no reason to

    And… As a superficial listening technique, it’s not terrible, and it has its place

    But unfortunately, if it’s one’s only listening technique, one will very quickly start sounding like a Furby—that children’s toy from the 90s that allegedly randomly parroted fragments of things that had been said to it. In fact this was a trick of programming, but that’s beyond the scope of this article.

    The point is: the above technique, if used indiscriminately and/or too often, starts to feel like talking to a very basic simulacrum.

    Which is the opposite of feeling like being listened to!

    A better way to listen

    Start off similarly, but better.

    Ask open questions, or otherwise invite sharing of information.

    People can be resistant to stock phrases like “How did that make you feel?”, but this can be got around by simply changing it up, e.g.:

    • “What was your reaction?” ← oblique but often elicits the same information
    • “I’m not sure how I’d feel about that, in your shoes” ← not even a question, but shows active attention much better than the “mmhmm” noises of traditional active listening, and again prompts the same information

    Express understanding… But better

    People have been told “I understand” a lot, and often it’s code for “Stop talking”. So, avoid “I understand”. Instead, try:

    • “I can understand that”
    • “Understandable”
    • “That makes sense”

    Ask clarifying questions… Better

    Sometimes, a clarifying question doesn’t have to have its own point, beyond prompting more sharing, and sometimes, an “open question” can be truly wide open, meaning that vaguer is better, such as:

    • “Oh?”
    • “How so?” ← this is the heavy artillery that can open up a lot

    Know when to STFU

    Something that good therapists (and also military interrogators) know: when to STFU

    If someone is talking, don’t interrupt them. If you do, they might not start again, or might skip what they were going to say.

    Interruption says “I think you’ve said all that needs to be said there”, or else, if the interruption was to ask one of the above questions, it says “you’re not doing a good enough job of talking”, and neither of those sentiments encourage people to share, nor do they make someone feel listened-to!

    Instead, just listen. Passive listening has its place too! When there’s a break, then you can go to one of the above questions/prompts/expressions of understanding, as appropriate.

    Judge not, lest they feel judged

    Reserve judgement until the conversation is over, at the earliest. If asked for your judgement of some aspect, be as reassuring as you can. People feel listened-to when they don’t feel judged.

    If they feel judged, conversely, they can often feel you didn’t listen properly, or else you’d be in agreement with them. So instead, just sit on it for as long as you can.

    Note: that goes for positive judgements too! Sit on it. Expressing a positive judgement too soon can seem that you were simply eager to please, and can suggest insincerity.

    If this seems simple, that’s because it is. But, try it, and see the difference.

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  • Metabolic Health Roadmap – by Brenda Wollenberg

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The term “roadmap” is often used in informative books, but in this case, Wollenberg (a nutritionist with decades of experience) really does deliver what can very reasonably be described as a roadmap:

    She provides chapters in the form of legs of a journey [to better metabolic health], and those legs are broadly divided into an “information center” to deliver new information, a “rest stop” for reflection, “roadwork” to guide the reader through implementing the information we just learned, in a practical fashion, and finally “traveller assistance” to give additional support / resources, as well as any potential troubleshooting, etc.

    The information and guidance within are all based on very good science; a lot is what you will have read already about blood sugar management (generally the lynchpin of metabolic health in general), but there’s also a lot about leveraging epigenetics for our benefit, rather than being sabotaged by such.

    There’s a little guidance that falls outside of nutrition (sleep, exercise, etc), but for the most part, Wollenberg stays within her own field of expertise, nutrition.

    The style is idiosyncratic; it’s very clear that her goal is providing the promised roadmap, and not living up to any editor’s wish or publisher’s hope of living up to industry standard norms of book formatting. However, this pays off, because her delivery is clear and helpful while remaining personable and yet still bringing just as much actual science, and this makes for a very pleasant and informative read.

    Bottom line: if you’d like to improve your metabolic health, as well as get held-by-the-hand through your health-improvement journey by a charming guide, this is very much the book for you!

    Click here to check out the Metabolic Health Roadmap, and start taking steps!

    Don’t Forget…

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  • Collard Greens vs Kale – Which is Healthier?

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    Our Verdict

    When comparing collard greens to kale, we picked the collard greens.

    Why?

    Once again we have Brassica oleracea vs Brassica oleracea, (the same species that is also broccoli, cauliflower, Brussels sprouts, various kinds of cabbage, and more) and once again there are nutritional differences between the two cultivars:

    In terms of macros, collard greens have more protein, equal carbs, and 2x the fiber. So that’s a win for collard greens.

    In the category of vitamins, collard greens have more of vitamins B2, B3, B5, B9, E, and choline, while kale has more of vitamins A, B1, B6, C, and K. Nominally a 6:5 win for collard greens, though it’s worth noting that while most of the margins of difference are about the same, collard greens have more than 10x the choline, too.

    When it comes to minerals, collard greens have more calcium, iron, magnesium, manganese, and phosphorus, while kale has more copper, potassium, selenium, and zinc. A genuinely marginal 5:4 win for collard greens this time.

    All in all, a clear win for collard greens over the (otherwise rightly) established superfood kale. Collard greens just don’t get enough appreciation in comparison!

    Want to learn more?

    You might like to read:

    What’s Your Plant Diversity Score? ← another reason it’s good to mix things up rather than just using the same ingredients out of habit!

    Take care!

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  • Thai Green Curry With Crispy Tofu Balls

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    Diversity is key here, with a wide range of mostly plants, offering an even wider range of phytochemical benefits:

    You will need

    • 7 oz firm tofu
    • 1 oz cashew nuts (don’t soak them)
    • 1 tbsp nutritional yeast
    • 1 tsp turmeric
    • 4 scallions, sliced
    • 7 oz mangetout
    • 7 oz fermented red cabbage (i.e., from a jar)
    • 1 cup coconut milk
    • Juice of ½ lime
    • 2 tsp light soy sauce
    • 1 handful fresh cilantro, or if you have the “cilantro tastes like soap” gene, then parsley
    • 1 handful fresh basil
    • 1 green chili, chopped (multiply per heat preference)
    • 1″ piece fresh ginger, roughly chopped
    • ¼ bulb garlic, crushed
    • 1 tsp red chili flakes
    • 1 tsp black pepper, coarse ground
    • ½ tsp MSG or 1 tsp low-sodium salt
    • Avocado oil for frying
    • Recommended, to serve: lime wedges
    • Recommended, to serve: your carbohydrate of choice, such as soba noodles or perhaps our Tasty Versatile Rice.

    Method

    (we suggest you read everything at least once before doing anything)

    1) Heat the oven to 350℉ / 180℃, and bake the cashews on a baking tray for about 8 minutes until lightly toasted. Remove from the oven and allow to cool a little.

    2) Combine the nuts, tofu, nutritional yeast, turmeric, and scallions in a food processor, and process until the ingredients begin to clump together. Shape into about 20 small balls.

    3) Heat some oil in a skillet and fry the tofu balls, jiggling frequently to get all sides; it should take about 5 minutes to see them lightly browned. Set aside.

    4) Combine the coconut milk, lime juice, soy sauce, cilantro/parsley, basil, scallions, green chili, ginger, garlic, and MSG/salt in a high-speed blender, and blend until a smooth liquid.

    5) Transfer the liquid to a saucepan, and bring to the boil. Reduce the heat, add the mangetout, and simmer for about 5 minutes to reduce slightly. Stir in the red chili flakes and black pepper.

    6) Serve with your preferred carbohydrate, adding the fermented red cabbage and the crispy tofu balls you set aside, along with any garnish you might like to add.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    *but not MSG or salt, as while they may in culinary terms get lumped in with spices, they are of course not plants. Nor is nutritional yeast (nor any other yeast, for that matter). However, mushrooms (not seen in this recipe, though to be honest they would be a respectable addition) would get included for a whole point per mushroom type, since while they are not technically plants but fungi, the nutritional profile is plantlike.

    Take care!

    Don’t Forget…

    Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!

    Learn to Age Gracefully

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