Caesar Salad, Anyone? (Ides of March Edition!)
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The Mediterranean Diet: What Is It Good For?
More to the point: what isnât it good for?
- Itâs been found to reduce all-cause mortality, which is about the best thing one can say of any diet.
- Itâs especially good for heart health and against cancer.
- Itâs particularly recommended for the prevention or management of diabetes.
- Itâs also been found, societally, to reduce general healthcare costsâbasically, people get sick less and so have fewer healthcare costs.
What brought it to the attention of the worldâs scientific community?
Back in the 1950s, physiologist Ancel Keys wondered why poor people in Italian villages were healthier than wealthy New Yorkers. Upon undertaking studies, he narrowed it down to the Mediterranean dietâsomething he’d then take on as a public health cause for the rest of his career.
Keys himself lived to the ripe old age of 100, by the way.
When we say “Mediterranean Diet”, what image comes to mind?
We’re willing to bet that tomatoes feature (great source of lycopene, by the way), 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 reality, the diet is based on what was historically eaten specifically by Italian peasants. If the word “peasants” conjures an image of medieval paupers in smocks and cowls, and that’s not necessarily wrong, further back historically… but the relevant part here is that they were people who lived and worked in the countryside.
They didn’t have money for meat, which was expensive, nor the industrial setting for refined grain products to be affordable. They didn’t have big monocrops either, which meant no canola oil, for example… Olives produce much more easily extractable oil per plant, so olive oil was easier to get. Nor, of course, did they have the money (or infrastructure) for much in the way of imports.
So what foods are part of “the” Mediterranean Diet?
- Fruits. These would be fruits grown locally, but no need to sweat that, dietwise. It’s hard to go wrong with fruit.
- Tomatoes yes. So many tomatoes. (Knowledge is knowing tomato is a fruit. Wisdom is not putting it in a fruit salad)
- Non-starchy vegetables (e.g. eggplant yes, potatoes no)
- Greens (spinach, kale, lettuce, all those sorts of things)
- Beans and other legumes (whatever was grown nearby)
- Whole grain products in moderation (wholegrain bread, wholewheat pasta)
- Olives and olive oil. Special category, single largest source of fat in the Mediterranean diet, but don’t overdo it.
- Dairy products in moderation (usually hard cheeses, as these keep well)
- Fish, in moderation. Typically grilled, baked, steamed even. Not fried.
- Other meats as a rarer luxury in considerable moderation. There’s more than one reason prosciutto is so thinly sliced!
Want to super-power this already super diet?
Try: A Pesco-Mediterranean Diet With Intermittent Fasting: JACC Review Topic of the Week
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Can Ginkgo Tea Be Made Safe? (And Other Questions)
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Itâs Q&A Day at 10almonds!
Have a question or a request? You can always hit âreplyâ to any of our emails, or use the feedback widget at the bottom!
In cases where weâve 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 tooâthereâs always more to say!
As ever: if the question/request can be answered briefly, weâll do it here in our Q&A Thursday edition. If not, weâll make a main feature of it shortly afterwards!
So, no question/request too big or small
âI’d be interested in OTC prostrate medication safety and effectiveness.â
Great idea! Sounds like a topic for a main feature one day soon, but while youâre waiting, you might like this previous main feature we did, about a supplement that performs equally to some prescription BPH meds:
âWas very interested in the article on ginko bilboa as i moved into a home that has the tree growing in the backyard. Is there any way i can process the leaves to make a tea out of it.â
Glad you enjoyed! First, for any who missed it, here was the article on Ginkgo biloba:
Ginkgo Biloba, For Memory And, Uh, What Else Again?
Now, as that article noted, Ginkgo biloba seeds and leaves are poisonous. However, there are differences:
The seeds, raw or roasted, contain dangerous levels of a variety of toxins, though roasting takes away some toxins and other methods of processing (boiling etc) take away more. However, the general consensus on the seeds is âdo not consume; it will poison your liver, poison your kidneys, and possibly give you cancerâ:
Ginkgo biloba L. seed; A comprehensive review of bioactives, toxicants, and processing effects
The leaves, meanwhile, are much less poisonous with their ginkgolic acids, and their other relevant poison is very closely related to that of poison ivy, involving long-chain alkylphenols that can be broken down by thermolysis, in other words, heat:
However, this very thorough examination of the potential health benefits and risks of ginkgo tea, comes to the general conclusion âthis is not a good idea, and is especially worrying in elders, and/or if taking various medicationsâ:
In summary:
- Be careful
- Avoid completely if you have a stronger-than-usual reaction to poison ivy
- If you do make tea from it, green leaves appear to be safer than yellow ones
- If you do make tea from it, boil and stew to excess to minimize toxins
- If you do make tea from it, doing a poison test is sensible (i.e. start with checking for a skin reaction to a topical application on the inside of the wrist, then repeat at least 6 hours later on the lips, then at least 6 hours later do a mouth swill, then at least 12 hours later drink a small amount, etc, and gradually build up to âthis is safe to consumeâ)
For safety (and legal) purposes, let us be absolutely clear that we are not advising you that it is safe to consume a known poisonous plant, and nor are we advising you to do so.
But the hopefully only-ever theoretical knowledge of how to do a poison test is a good life skill, just in case
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Whatâs behind rising heart attack rates in younger adults
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Deaths from heart attacks have been in decline for decades, thanks to improved diagnosis and treatments. But, among younger adults under 50 and those from communities that have been marginalized, the trend has reversed.
More young people have suffered heart attacks each year since the 2000sâand the reasons why arenât always clear.
Hereâs what you need to know about heart attack trends in younger adults.
Heart attack deaths began declining in the 1980s
Heart disease has been a leading cause of death in the United States for more than a century, but rates have declined for decades as diagnosis and treatments improved. In the 1950s, half of all Americans who had heart attacks died, compared to one in eight today.
A 2023 study found that heart attack deaths declined 4 percent a year between 1999 and 2020.
The downward trend plateaued in the 2000s as heart attacks in young adults rose
In 2012, the decline in heart disease deaths in the U.S. began to slow. A 2018 study revealed that a growing number of younger adults were suffering heart attacks, with women more affected than men. Additionally, younger adults made up one-third of heart attack hospitalizations, with one in five heart attack patients being under 40.
The following year, data showed that heart attack rates among adults under 40 had increased steadily since 2006. Even more troubling, young patients were just as likely to die from heart attacks as patients more than a decade older.
Why are more younger adults having heart attacks?
Heart attacks have historically been viewed as a condition that primarily affects older adults. So, what has changed in recent decades that puts younger adults at higher risk?
Higher rates of obesity, diabetes, and high blood pressure
Several leading risk factors for heart attacks are rising among younger adults.
Between 2009 and 2020, diabetes and obesity rates increased in Americans ages 20 to 44.During the same period, hypertension, or high blood pressure, rates did not improve in younger adults overall and worsened in young Hispanic people. Notably, young Black adults had hypertension rates nearly twice as high as the general population.
Hypertension significantly increases the risk of heart attack and cardiovascular death in young adults.
Increased substance use
Substance use of all kinds increases the risk of cardiovascular issues, including heart attacks. A recent study found that cardiovascular deaths associated with substance use increased by 4 percent annually between 1999 and 2019.
The rise in substance use-related deaths has accelerated since 2012 and was particularly pronounced among women, younger adults (25-39), American Indians and Alaska Natives, and those in rural areas.
Alcohol was linked to 65 percent of the deaths, but stimulants (like methamphetamine) and cannabis were the substances associated with the greatest increase in cardiovascular deaths during the study period.
Poor mental health
Depression and poor mental health have been linked to cardiovascular issues in young adults. A 2023 study of nearly 600,000 adults under 50 found that depression and self-reported poor mental health are a risk factor for heart disease, regardless of socioeconomic or other cardiovascular risk factors.
Adults under 50 years consistently report mental health conditions at around twice the rate of older adults. Additionally, U.S. depression rates have trended up and reached an all-time high in 2023, when 17.8 percent of adults reported having depression.
Depression rates are rising fastest among women, adults under 44, and Black and Hispanic populations.
COVID-19
COVID-19 can cause real, lasting damage to the heart, increasing the risk of certain cardiovascular diseases for up to a year after infection. Vaccination reduces the risk of heart attack and other cardiovascular events caused by COVID-19 infection.
The first year of the pandemic marked the largest single-year spike in heart-related deaths in five years, including a 14 percent increase in heart attacks. In the second year of the pandemic, heart attacks in young adults increased by 30 percent.
Heart attack prevention
Not every heart attack is preventable, but everyone can take steps to reduce their risks. The American Heart Association recommends managing health conditions that increase heart disease risk, including diabetes, obesity, and high blood pressure.
Lifestyle changes like improving diet, reducing substance use, and increasing physical activity can also help reduce heart attack risk.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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The Art and Science of Connection â by Kasley Killam, MPH
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We can eat well, exercise well, and even sleep well, and weâll still have a +53% increased all-cause mortality if we lack social connectionâeven if we technically have support and access to social resources, just not the real human connection itself. And as we get older, it gets increasingly easy to find ourselves isolated.
The author is a social scientist by profession, and it shows. None of what she shares in the book is wishy-washy; it has abundant scientific references coming thick and fast, and a great deal of clarity with regard to terms, something often not found in books of this genre that lean more towards the art than the science.
On which note, for the reader who may be thinking âI am indeed quite aloneâ, she also offers proven techniques for remedying that; not in the way that many books use the word âprovenâ to mean âwe got some testimonialsâ, but rather, proven in the sense of âwe did science to it and based on these 17 large population-based retrospective cohort studies, we can say with 99% confidence that this is an effective tool to mediate improved social bonds and social health outcomesâ.
To this end, itâs a very practical book also, and should bestow upon any isolated reader a sense of confidence that in fact, things can be better. A particular strength is that it also looks at many different scenarios, so for the âwhat if IâŠâ people with clear reasons why social connection is not abundantly available, yes, she has such cases covered too.
Bottom line: if youâd like to live more healthily for longer, social health is an underrated and oft-forgotten way of greatly increasing those things, by science.
Click here to check out The Art And Science Of Social Connection, and get connected!
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Why do I poo in the morning? A gut expert explains
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No, youâre not imagining it. People really are more likely to poo in the morning, shortly after breakfast. Researchers have actually studied this.
But why mornings? What if you tend to poo later in the day? And is it worth training yourself to be a morning pooper?
To understand what makes us poo when we do, we need to consider a range of factors including our body clock, gut muscles and what we have for breakfast.
Hereâs what the science says.
H_Ko/Shutterstock So morning poos are real?
In a UK study from the early 1990s, researchers asked nearly 2,000 men and women in Bristol about their bowel habits.
The most common time to poo was in the early morning. The peak time was 7-8am for men and about an hour later for women. The researchers speculated that the earlier time for men was because they woke up earlier for work.
About a decade later, a Chinese study found a similar pattern. Some 77% of the almost 2,500 participants said they did a poo in the morning.
But why the morning?
There are a few reasons. The first involves our circadian rhythm â our 24-hour internal clock that helps regulate bodily processes, such as digestion.
For healthy people, our internal clock means the muscular contractions in our colon follow a distinct rhythm.
Thereâs minimal activity in the night. The deeper and more restful our sleep, the fewer of these muscle contractions we have. Itâs one reason why we donât tend to poo in our sleep.
Your lower gut is a muscular tube that contracts more strongly at certain times of day. Vectomart/Shutterstock But thereâs increasing activity during the day. Contractions in our colon are most active in the morning after waking up and after any meal.
One particular type of colon contraction partly controlled by our internal clock are known as âmass movementsâ. These are powerful contractions that push poo down to the rectum to prepare for the poo to be expelled from the body, but donât always result in a bowel movement. In healthy people, these contractions occur a few times a day. They are more frequent in the morning than in the evening, and after meals.
Breakfast is also a trigger for us to poo. When we eat and drink our stomach stretches, which triggers the âgastrocolic reflexâ. This reflex stimulates the colon to forcefully contract and can lead you to push existing poo in the colon out of the body. We know the gastrocolic reflex is strongest in the morning. So that explains why breakfast can be such a powerful trigger for a bowel motion.
Then thereâs our morning coffee. This is a very powerful stimulant of contractions in the sigmoid colon (the last part of the colon before the rectum) and of the rectum itself. This leads to a bowel motion.
How important are morning poos?
Large international surveys show the vast majority of people will poo between three times a day and three times a week.
This still leaves a lot of people who donât have regular bowel habits, are regular but poo at different frequencies, or who donât always poo in the morning.
So if youâre healthy, itâs much more important that your bowel habits are comfortable and regular for you. Bowel motions do not have to occur once a day in the morning.
Morning poos are also not a good thing for everyone. Some people with irritable bowel syndrome feel the urgent need to poo in the morning â often several times after getting up, during and after breakfast. This can be quite distressing. It appears this early-morning rush to poo is due to overstimulation of colon contractions in the morning.
Can you train yourself to be regular?
Yes, for example, to help treat constipation using the gastrocolic reflex. Children and elderly people with constipation can use the toilet immediately after eating breakfast to relieve symptoms. And for adults with constipation, drinking coffee regularly can help stimulate the gut, particularly in the morning.
A disturbed circadian rhythm can also lead to irregular bowel motions and people more likely to poo in the evenings. So better sleep habits can not only help people get a better nightâs sleep, it can help them get into a more regular bowel routine.
A regular morning coffee can help relieve constipation. Caterina Trimarchi/Shutterstock Regular physical activity and avoiding sitting down a lot are also important in stimulating bowel movements, particularly in people with constipation.
We know stress can contribute to irregular bowel habits. So minimising stress and focusing on relaxation can help bowel habits become more regular.
Fibre from fruits and vegetables also helps make bowel motions more regular.
Finally, ensuring adequate hydration helps minimise the chance of developing constipation, and helps make bowel motions more regular.
Monitoring your bowel habits
Most of us consider pooing in the morning to be regular. But thereâs a wide variation in normal so donât be concerned if your poos donât follow this pattern. Itâs more important your poos are comfortable and regular for you.
If thereâs a major change in the regularity of your bowel habits thatâs concerning you, see your GP. The reason might be as simple as a change in diet or starting a new medication.
But sometimes this can signify an important change in the health of your gut. So your GP may need to arrange further investigations, which could include blood tests or imaging.
Vincent Ho, Associate Professor and clinical academic gastroenterologist, Western Sydney University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Sunflower Seeds vs Sesame Seeds â Which is Healthier?
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Our Verdict
When comparing sunflower seeds to sesame seeds, we picked the sunflower.
Why?
In moderation, both are very healthy. We say “in moderation” because they’re both about 50% fat and such fats, while vital for life, are generally best enjoyed in small portions. Of that fat, sunflower has the slightly better fat profile; they’re both mostly poly- and monounsaturated fats, but sunflower has 10% saturated fat while sesame has 15%. Aside from fats, sunflower has slightly more protein and sesame has slightly more carbs. While sesame has slightly more fiber, because of the carb profile sunflower still has the lower glycemic index. All in all, a moderate win for sunflower in the macros category.
You may be wondering, with all that discussion of fats, what they’re like for omega-3, and sesame seeds have more omega-3, though sunflower seeds contain it too. Still, a point in sesame’s favor here.
When it comes to vitamins, sunflower has more of vitamins A, B1, B2, B3, B5, B6, B9, C, E, and choline, while sesame is not higher in any vitamins.
In the category of minerals, sunflower has more phosphorus, potassium, and selenium, while sesame has more calcium, copper, iron, and zinc. This is nominally a marginal win for sesame, but it should be noted that sunflower is still very rich in copper, iron, and zinc too (but not calcium).
Adding up the categories makes for a moderate win for sunflower seeds, but as ever, enjoy both; diversity is best!
Want to learn more?
You might like to read:
Sunflower Seeds vs Pumpkin Seeds â Which is Healthier?
Take care!
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Breast Milk’s Benefits That Are (So Far) Not Replicable
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Simply The Breast đ¶
In Wednesdayâs newsletter, we asked you for your opinion on breast vs formula milk (for babies!), and got the above-depicted, below-described, set of responses:
- 80% said âBreast is best, as the slogan goes, and should be first choiceâ
- 20% said âThey both have their strengths and weaknesses; use whateverâ
- 0% said âFormula is formulated to be best, and should be first choiceâ
Thatâs the first time weâve ever had a possible poll option come back with zero votes whatsoever! It seems this topic is relatively uncontentious amongst our readership, so weâll keep things brief today, but there is still a little mythbusting to be done.
So, what does the science say?
[Breast milk should be the first choice] at least for the few few weeks and months for the benefit of baby’s health as breast milk has protective factors formula does not: True or False?
True! The wording here was taken from one of our readersâ responses, by the way (thank you, Robin). There are a good number of those protective factors, the most well-known of which is passing on immune cells and cell-like things; in other words, immune-related information being passed from parent* to child.
*usually the mother, though in principle it could be someone else and in practice sometimes it is; the only real requirements are that the other person be healthy, lactating, and willing.
As for immune benefits, see for example:
Perspectives on Immunoglobulins in Colostrum and Milk
And for that matter, also:
(Colostrum is simply the milk that is produced for a short period after giving birth; the composition of milk will tend to change later)
In any case, immunoglobulin A is a very important component in breast milk (colostrum and later), as well as lactoferrin (has an important antimicrobial effect and is good for the newbornâs gut), and a plethora of cytokines:
As for that about the gut, lactoferrin isnât the only breast milk component that benefits this, by far, and thereâs a lot that canât be replicated yet:
Human Breast Milk and the Gastrointestinal Innate Immune System
As long as your infant/child is nutritiously fed, it shouldn’t matter if it comes from breast or formula: True or False?
False! Formula milk will not convey those immune benefits.
This doesnât mean that formula-feeding is neglectful; as several people who commented mentioned*, there are many reasons a person may not be able to breastfeed, and they certainly should not be shamed for that.
*(including the reader whose words we borrowed for this True/False item; the words we quoted above were prefaced with: âNot everyone is able to breastfeed for many different reasonsâ)
But, while formula milk is a very good second choice, and absolutely a respectable choice if breast milk isnât an option (or an acceptable option) for whatever reason, it still does not convey all the health benefits of breast milkâyet! The day may come when theyâll find a way to replicate the immune benefits, but today is not that day.
They both have their strengths and weaknesses: True or False?
True! But formulaâs strengths are only in the category of convenience and sometimes necessityâformula conveys no health benefits that breast milk could not do better, if available.
For many babies, formula means they get to eat, when without it they would starve due to non-availability of breast milk. Thatâs a pretty important role!
Note also: this is a health science publication, not a philosophical publication, but weâd be remiss not to mention one thing; letâs bring it in under the umbrella of sociology:
The right to bodily autonomy continues to be the right to bodily autonomy even if somebody else wants/needs something from your body.
Therefore, while there are indeed many good reasons for not being able to breastfeed, or even just not being safely* able to breastfeed, it is at the very least this writerâs opinion that nobody should be pressed to give their reason for not breastfeeding; ânoâ is already a sufficient answer.
*Writerâs example re safety: when I was born, my mother was on such drugs that it would have been a very bad idea for her to breastfeed me. There are plenty of other possible reasons why it might be unsafe for someone one way or another, but âon drugs that have a clear âdo not take while pregnant or nursingâ warningâ is a relatively common one.
All that said, for those who are willing and safely able, the science is clear: breast is best.
Want to read more?
The World Health Organization has a wealth of information (including explanations of its recommendations of, where possible, exclusive breastfeeding for the first 6 months, ideally continuing some breastfeeding for the first 2 years), here:
World Health Organization | Breastfeeding
Take care!
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