Migraine Mythbusting
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Migraine: When Headaches Are The Tip Of The Neurological Iceberg
Yesterday, we asked you “What is a migraine?” and got the above-depicted, below-described spread of responses:
- Just under 46% said “a headache, but above a certain level of severity”
- Just under 23% said “a headache, but caused by a neurological disorder”
- Just over 21% said “a neurological disorder that can cause headaches”
- Just under 10% said “a headache, but with an attention-grabbing name”
So… What does the science say?
A migraine is a headache, but above a certain level of severity: True or False?
While that’s usually a very noticeable part of it… That’s only one part of it, and not a required diagnostic criterion. So, in terms of defining what a migraine is, False.
Indeed, migraine may occur without any headache, let alone a severe one, for example: Abdominal Migraine—though this is much less well-researched than the more common with-headache varieties.
Here are the defining characteristics of a migraine, with the handy mnemonic 5-4-3-2-1:
- 5 or more attacks
- 4 hours to 3 days in duration
- 2 or more of the following:
- Unilateral (affects only one side of the head)
- Pulsating
- Moderate or severe pain intensity
- Worsened by or causing avoidance of routine physical activity
- 1 or more of the following:
- Nausea and/or vomiting
- Sensitivity to both light and sound
Source: Cephalalgia | ICHD-II Classification: Parts 1–3: Primary, Secondary and Other
As one of our subscribers wrote:
❝I have chronic migraine, and it is NOT fun. It takes away from my enjoyment of family activities, time with friends, and even enjoying alone time. Anyone who says a migraine is just a bad headache has not had to deal with vertigo, nausea, loss of balance, photophobia, light sensitivity, or a host of other symptoms.❞
Migraine is a neurological disorder: True or False?
True! While the underlying causes aren’t known, what is known is that there are genetic and neurological factors at play.
❝Migraine is a recurrent, disabling neurological disorder. The World Health Organization ranks migraine as the most prevalent, disabling, long-term neurological condition when taking into account years lost due to disability.
Considerable progress has been made in elucidating the pathophysiological mechanisms of migraine, associated genetic factors that may influence susceptibility to the disease❞
Source: JHP | Mechanisms of migraine as a chronic evolutive condition
Migraine is just a headache with a more attention-grabbing name: True or False?
Clearly, False.
As we’ve already covered why above, we’ll just close today with a nod to an old joke amongst people with chronic illnesses in general:
“Are you just saying that because you want attention?”
“Yes… Medical attention!”
Want to learn more?
You can find a lot of resources at…
NIH | National Institute of Neurological Disorders & Stroke | Migraine
and…
The Migraine Trust ← helpfully, this one has a “Calm mode” to tone down the colorscheme of the website!
Particularly useful from the above site are its pages:
Take care!
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Tasty Versatile Rice
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In the nearish future, we’re going to do some incredible rice dishes, but first we need to make sure we’re all on the same page about cooking rice, so here’s a simple recipe first, to get technique down and work in some essentials. We’ll be using wholegrain basmati rice, because it has a low glycemic index, lowest likelihood of heavy metal contamination (a problem for some kinds of rice), and it’s one of the easiest rices to cook well.
You will need
- 1 cup wholegrain basmati rice (it may also be called “brown basmati rice“; this is the same)
- 1 1/2 cups vegetable stock (ideally you have made this yourself from vegetable offcuts that you saved in the freezer, then it will be healthiest and lowest in sodium; failing that, low-sodium vegetable stock cubes can be purchased at most large supermarkets. and then made up at home with hot water)
- 1 tbsp extra virgin olive oil
- 1 tbsp chia seeds
- 1 tbsp black pepper, coarse ground
- 1 tsp turmeric powder (this small quantity will not change the flavor, but it has important health benefits, and also makes the rice a pleasant golden color)
- 1 tsp garlic powder
- 1 tsp yeast extract (this gently improves the savory flavor and also adds vitamin B12)
- Optional small quantity of green herbs for garnish. Cilantro is good (unless you have the soap gene); parsley never fails.
This is the ingredients list for a super-basic rice that will go with anything rice will go with; another day we can talk more extensive mixes of herbs and spice blends for different kinds of dishes (and different health benefits!), but for now, let’s get going!
Method
(we suggest you read everything at least once before doing anything)
1) Wash the rice thoroughly. We recommend using a made-for-purpose rice-washing bowl (like this one, for example), but failing that, simply rinse it thoroughly with cold water using a bowl and a sieve. You will probably need to rinse it 4–5 times, but with practice, it will only take a few seconds per rinse, and the water will be coming up clear.
2) Warm the pan. It doesn’t matter for the moment whether you’re using an electronic rice cooker, a stovetop pressure cooker, electronic pressure cooker, or just a sturdy pan with a heavy lid available, aside from that if it’s something non-stovetop, you now want it to be on low to warm up already.
3) Separately in a saucepan, bring your stock to a simmer
4) Put the tbsp of olive oil into the pan (even if you’re confident the rice won’t stick; this isn’t entirely about that) and turn up the heat (if it’s a very simple rice cooker, most at least have a warm/cook differentiation; if so, turn it to “cook”). You don’t want the oil to get to the point of smoking, so, to test the temperature as it heats, flick a single drop of water from your fingertip (you did wash your hands first, right? We haven’t been including that step, but please do wash your hands before doing kitchen things) into the pan. If it sizzles, the pan is hot enough now for the next step.
5) Put the rice into the pan. That’s right, with no extra liquid yet; we’re going to toast it for a moment. Stir it a little, for no more than a minute; keep it moving; don’t let it burn! If you try this several times and fail, it could be that you need a better pan. Treat yourself to one when you get the opportunity; until then, skip the toasting part if necessary.
6) Add the chia seeds and spices, followed by the stock, followed by the yeast extract. Why did we do the stock before the yeast extract? It’s because hot liquid will get all the yeast extract off the teaspoon 🙂
7) Put the lid on/down (per what kind of pan or rice cooker you are using), and turn up the heat (if it is a variable heat source) until a tiny bit of steam starts making its way out. When it does, turn it down to a simmer, and let the rice cook. Don’t stir it, don’t jiggle it; trust the process. If you stir or jiggle it, the rice will cook unevenly and, paradoxically, probably stick.
8) Do keep an eye on it, because when steam stops coming out, it is done, and needs taking off the heat immediately. If using an automatic rice cooker, you can be less attentive if you like, because it will monitor this for you.
Note: if you are using a simple pan with a non-fastening lid (any other kind of rice cooking setup is better), more steam will escape than the other methods, and it’s possible that it might run out of steam (literally) before the rice is finished. If the steam stops and you find the rice isn’t done, add a splash of water as necessary (the rice doesn’t need to be submerged, it just needs to have liquid; the steam is part of the cooking process), and make a note of how much you had to add (so that next time you can just add it at the start), and put it back on the heat until it is done.
9) Having taken it off the heat, let it sit for 5 minutes (with the lid still on) before doing any fluffing-up. Then you can fluff-up and serve, adding the garnish if you want one.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Should You Go Light Or Heavy On Carbs?
- Chia: The Tiniest Seeds With The Most Value
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- Why Curcumin (Turmeric) Is Worth Its Weight In Gold
- The Many Health Benefits Of Garlic
Take care!
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California Is Investing $500M in Therapy Apps for Youth. Advocates Fear It Won’t Pay Off.
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With little pomp, California launched two apps at the start of the year offering free behavioral health services to youths to help them cope with everything from living with anxiety to body acceptance.
Through their phones, young people and some caregivers can meet BrightLife Kids and Soluna coaches, some who specialize in peer support or substance use disorders, for roughly 30-minute virtual counseling sessions that are best suited to those with more mild needs, typically those without a clinical diagnosis. The apps also feature self-directed activities, such as white noise sessions, guided breathing, and videos of ocean waves to help users relax.
“We believe they’re going to have not just great impact, but wide impact across California, especially in places where maybe it’s not so easy to find an in-person behavioral health visit or the kind of coaching and supports that parents and young people need,” said Gov. Gavin Newsom’s health secretary, Mark Ghaly, during the Jan. 16 announcement.
The apps represent one of the Democratic governor’s major forays into health technology and come with four-year contracts valued at $498 million. California is believed to be the first state to offer a mental health app with free coaching to all young residents, according to the Department of Health Care Services, which operates the program.
However, the rollout has been slow. Only about 15,000 of the state’s 12.6 million children and young adults have signed up for the apps, school counselors say they’ve never heard of them, and one of the companies isn’t making its app available on Android phones until summer.
Advocates for youth question the wisdom of investing taxpayer dollars in two private companies. Social workers are concerned the companies’ coaches won’t properly identify youths who need referrals for clinical care. And the spending is drawing lawmaker scrutiny amid a state deficit pegged at as much as $73 billion.
An App for That
Newsom’s administration says the apps fill a need for young Californians and their families to access professional telehealth for free, in multiple languages, and outside of standard 9-to-5 hours. It’s part of Newsom’s sweeping $4.7 billion master plan for kids’ mental health, which was introduced in 2022 to increase access to mental health and substance use support services. In addition to launching virtual tools such as the teletherapy apps, the initiative is working to expand workforce capacity, especially in underserved areas.
“The reality is that we are rarely 6 feet away from our devices,” said Sohil Sud, director of Newsom’s Children and Youth Behavioral Health Initiative. “The question is how we can leverage technology as a resource for all California youth and families, not in place of, but in addition to, other behavioral health services that are being developed and expanded.”
The virtual platforms come amid rising depression and suicide rates among youth and a shortage of mental health providers. Nearly half of California youths from the ages of 12 to 17 report having recently struggled with mental health issues, with nearly a third experiencing serious psychological distress, according to a 2021 study by the UCLA Center for Health Policy Research. These rates are even higher for multiracial youths and those from low-income families.
But those supporting youth mental health at the local level question whether the apps will move the needle on climbing depression and suicide rates.
“It’s fair to applaud the state of California for aggressively seeking new tools,” said Alex Briscoe of California Children’s Trust, a statewide initiative that, along with more than 100 local partners, works to improve the social and emotional health of children. “We just don’t see it as fundamental. And we don’t believe the youth mental health crisis will be solved by technology projects built by a professional class who don’t share the lived experience of marginalized communities.”
The apps, BrightLife Kids and Soluna, are operated by two companies: Brightline, a 5-year-old venture capital-backed startup; and Kooth, a London-based publicly traded company that has experience in the U.K. and has also signed on some schools in Kentucky and Pennsylvania and a health plan in Illinois. In the first five months of Kooth’s Pennsylvania pilot, 6% of students who had access to the app signed up.
Brightline and Kooth represent a growing number of health tech firms seeking to profit in this space. They beat out dozens of other bidders including international consulting companies and other youth telehealth platforms that had already snapped up contracts in California.
Although the service is intended to be free with no insurance requirement, Brightline’s app, BrightLife Kids, is folded into and only accessible through the company’s main app, which asks for insurance information and directs users to paid licensed counseling options alongside the free coaching. After KFF Health News questioned why the free coaching was advertised below paid options, Brightline reordered the page so that, even if a child has high-acuity needs, free coaching shows up first.
The apps take an expansive view of behavioral health, making the tools available to all California youth under age 26 as well as caregivers of babies, toddlers, and children 12 and under. When KFF Health News asked to speak with an app user, Brightline connected a reporter with a mother whose 3-year-old daughter was learning to sleep on her own.
‘It’s Like Crickets’
Despite being months into the launch and having millions in marketing funds, the companies don’t have a definitive rollout timeline. Brightline said it hopes to have deployed teams across the state to present the tools in person by midyear. Kooth said developing a strategy to hit every school would be “the main focus for this calendar year.”
“It’s a big state — 58 counties,” Bob McCullough of Kooth said. “It’ll take us a while to get to all of them.”
So far BrightLife Kids is available only on Apple phones. Brightline said it’s aiming to launch the Android version over the summer.
“Nobody’s really done anything like this at this magnitude, I think, in the U.S. before,” said Naomi Allen, a co-founder and the CEO of Brightline. “We’re very much in the early innings. We’re already learning a lot.”
The contracts, obtained by KFF Health News through a records request, show the companies operating the two apps could earn as much as $498 million through the contract term, which ends in June 2027, months after Newsom is set to leave office. And the state is spending hundreds of millions more on Newsom’s virtual behavioral health strategy. The state said it aims to make the apps available long-term, depending on usage.
The state said 15,000 people signed up in the first three months. When KFF Health News asked how many of those users actively engaged with the app, it declined to say, noting that data would be released this summer.
KFF Health News reached out to nearly a dozen California mental health professionals and youths. None of them were aware of the apps.
“I’m not hearing anything,” said Loretta Whitson, executive director of the California Association of School Counselors. “It’s like crickets.”
Whitson said she doesn’t think the apps are on “anyone’s” radar in schools, and she doesn’t know of any schools that are actively advertising them. Brightline will be presenting its tool to the counselor association in May, but Whitson said the company didn’t reach out to plan the meeting; she did.
Concern Over Referrals
Whitson isn’t comfortable promoting the apps just yet. Although both companies said they have a clinical team on staff to assist, Whitson said she’s concerned that the coaches, who aren’t all licensed therapists, won’t have the training to detect when users need more help and refer them to clinical care.
This sentiment was echoed by other school-based social workers, who also noted the apps’ duplicative nature — in some counties, like Los Angeles, youths can access free virtual counseling sessions through Hazel Health, a for-profit company. Nonprofits, too, have entered this space. For example, Teen Line, a peer-to-peer hotline operated by Southern California-based Didi Hirsch Mental Health Services, is free nationwide.
While the state is also funneling money to the schools as part of Newsom’s master plan, students and school-based mental health professionals voiced confusion at the large app investment when, in many school districts, few in-person counseling roles exist, and in some cases are dwindling.
Kelly Merchant, a student at College of the Desert in Palm Desert, noted that it can be hard to access in-person therapy at her school. She believes the community college, which has about 15,000 students, has only one full-time counselor and one part-time bilingual counselor. She and several students interviewed by KFF Health News said they appreciated having engaging content on their phone and the ability to speak to a coach, but all said they’d prefer in-person therapy.
“There are a lot of people who are seeking therapy, and people close to me that I know. But their insurances are taking forever, and they’re on the waitlist,” Merchant said. “And, like, you’re seeing all these people struggle.”
Fiscal conservatives question whether the money could be spent more effectively, like to bolster county efforts and existing youth behavioral health programs.
Republican state Sen. Roger Niello, vice chair of the Senate Budget and Fiscal Review Committee, noted that California is forecasted to face deficits for the next three years, and taxpayer watchdogs worry the apps might cost even more in the long run.
“What starts as a small financial commitment can become uncontrollable expenses down the road,” said Susan Shelley of the Howard Jarvis Taxpayers Association.
This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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Ghanaian Red Bean & Sweet Potato Groundnut Stew
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This is a dish popular in principle throughout West Africa. We say “in principle” because that’s a big place, and there is a lot of regional variation. The archetypal peanut stew is from Senegal (as maafe) or Mali (as tigadèguèna), but for its more balanced nutritional profile we’ve chosen one from Ghana—and since there are regional variations within Ghana too, we should specify that this one is from the south.
If you are allergic to nuts, you can substitute a seed butter (or tahini) for the nut butter, and omit the nuts—this will work in culinary terms and be fine healthwise, but we can’t claim it would be the same dish, having lost its defining ingredient. If your allergy is solely to peanuts, then substituting with any oily nut would work. So, not almonds for example, but cashews or even walnuts would be fine.
You will need
- 1½ lbs sweet potatoes, peeled and cut into ½” cubes
- 2 cups low-sodium vegetable stock
- 2 cans kidney beans, drained, cooked, and rinsed (or 2 cups same; cooked, drained, and rinsed)
- 1 can chopped tomatoes
- ½ cup unsalted dry-roasted peanuts
- 1 onion, chopped
- 1 red bell pepper, deseeded and chopped
- ¼ bulb garlic, finely chopped
- 2 heaped tbsp unsalted peanut butter, minimal (ideally: no) additives
- 2 tsp white miso paste
- 2 tsp grated fresh ginger
- 1 tsp ground cumin
- 1 tsp cayenne pepper
- 1 tsp black pepper
- ½ tsp MSG or 1 tsp low-sodium salt
- ½ tsp coarsely ground nigella seeds
- Extra virgin olive oil
Method
(we suggest you read everything at least once before doing anything)
1) Heat some oil in a sauté pan, or other pan suitable for both frying and fitting the entire stew in. Fry the onions until softened, turn the heat down low, and add the garlic, ginger, red bell pepper, cumin, cayenne, black pepper, and MSG/salt.
2) Add ¼ cup of the vegetable stock, and the sweet potato, and turn the heat back up, on high for about 30 seconds to get it to temperature, and then take it down to a simmer.
3) Stir in the miso paste and chopped tomatoes.
4) Add most of the rest of the vegetable stock, keeping ¼ cup aside. Simmer for about 20 minutes.
5) Stir in the kidney beans, and simmer for about 30 minutes more—the sweet potato should be soft now; if it isn’t, let it simmer a while longer until it is.
6) Combine the peanut butter with the remaining ¼ cup vegetable stock, and blend until smooth. Stir it into the stew.
7) If the stew is looking more like a soup than a stew, take out 1 cup and blend this 1 cup to a purée, adding it back in.
8) Add half the peanuts unto the stew. Taste, and adjust the seasonings if necessary.
9) Crush the remaining peanuts using a pestle and mortar; not too much though; you want them broken into bits, not pulverised.
10) Garnish with the crushed nuts and nigella seeds, and serve.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Eat More (Of This) For Lower Blood Pressure
- Lycopene’s Benefits For The Gut, Heart, Brain, & More
- Our Top 5 Spices: How Much Is Enough For Benefits? ← we used 4/5 today!
Take care!
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Apples vs Carrots – Which is Healthier?
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Our Verdict
When comparing apples to carrots, we picked the carrots.
Why?
Both are sweet crunchy snacks, both rightly considered very healthy options, but one comes out clearly on top…
Both contain lots of antioxidants, albeit mostly different ones. They’re both good for this.
Looking at their macros, however, apples have more carbs while carrots have more fiber. The carb:fiber ratio in apples is already sufficient to make them very healthy, but carrots do win.
In the category of vitamins, carrots have many times more of vitamins A, B1, B2, B3, B5, B6, B9, C, E, K, and choline. Apples are not higher in any vitamins.
In terms of minerals, carrots have a lot more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc. Apples are not higher in any minerals.
If “an apple a day keeps the doctor away”, what might a carrot a day do?
Want to learn more?
You might like to read:
Sugar: From Apples to Bees, and High-Fructose C’s
Take care!
Don’t Forget…
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It’s Not Fantastic To Be Plastic
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We Are Such Stuff As Bottles Are Made Of
We’ve written before about PFAS, often found in non-stick coatings and the like:
PFAS Exposure & Cancer: The Numbers Are High
Today we’re going to be talking about microplastics & nanoplastics!
What are microplastics and nanoplastics?
Firstly, they’renot just the now-banned plastic microbeads that have seen some use is toiletries (although those are classified as microplastics too).
Many are much smaller than that, and if they get smaller than a thousandth of a millimeter, then they get the additional classification of “nanoplastic”.
In other words: not something that can be filtered even if you were to use a single-micron filter. The microplastics would still get through, for example:
Scientists find about a quarter million invisible nanoplastic particles in a liter of bottled water
And unfortunately, that’s bad:
❝What’s disturbing is that small particles can appear in different organs and may cross membranes that they aren’t meant to cross, such as the blood-brain barrier❞
Note: they’re crossing the same blood-brain barrier that many of our nutrients and neurochemicals are too big to cross.
These microplastics are also being found in arterial plaque
What makes arterial plaque bad for the health is precisely its plasticity (the arterial walls themselves are elastic), so you most certainly do not want actual plastic being used as part of the cement that shouldn’t even be lining your arteries in the first place:
Microplastics found in artery plaque linked with higher risk of heart attack, stroke and death
❝In this study, patients with carotid artery plaque in which MNPs were detected had a higher risk of a composite of myocardial infarction, stroke, or death from any cause at 34 months of follow-up than those in whom MNPs were not detected❞
~ Dr. Raffaele Marfella et al.
(MNP = Micro/Nanoplastics)
Source: Microplastics and Nanoplastics in Atheromas and Cardiovascular Events
We don’t know how bad this is yet
There are various ways this might not be as bad as it looks (the results may not be repeated, the samples could have been compromised, etc), but also, perhaps cynically but nevertheless honestly, it could also be worse than we know yet—only more experiments being done will tell us which.
In the meantime, here’s a rundown of what we do and don’t know:
Study links microplastics with human health problems—but there’s still a lot we don’t know
Take care!
Don’t Forget…
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Learn to Age Gracefully
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An Addiction Expert’s Insights On Festive Drinking
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This is Dr. Christopher Kahler. He’s Professor of Behavioral and Social Sciences, Director of Alcohol and Addiction Studies, Professor of Psychiatry and Human Behavior, all at Brown University.
What does he want us to know?
It’s the trickiest time of the year
Per stats, alcohol sales peak in December, with the heaviest drinking being from mid-December (getting an early start on the Christmas cheer) to New Year’s Eve. As for why, there’s a collection of reasons, as he notes:
❝The main challenge is there’s an extra layer of stress, with a lot of obligations and expectations from friends and family. We’re around people who maybe we’re not usually around, and in larger groups. It’s also a time of heightened emotion and, for some people, loneliness.
On top of that, alcohol use is built into a lot of our winter holiday traditions. It’s often marketed as part of the “good life.” We’re expected to have alcohol when we celebrate.❞
As for how much alcohol is safe to drink… According to the World Health Organization, the only safe amount of alcohol is zero:
Dr. Kahler acknowledges, however, that many people will wish to imbibe anyway, and indeed, he himself does drink a little, but endeavours to do so mindfully, and as such, he recommends that we…
HALT!
Dr. Kahler counsels us against making decisions (including the decision to drink alcohol), on occasions when we are one or more of the following:
- Hungry
- Angry
- Lonely
- Tired
He also notes that around this time of year, often our normal schedules and habits are disrupted, which introduces more microdecisions to our daily lives, which in turn means more “decision fatigue”, and the greater chance of making bad decisions.
We share some practical tips on how to reduce the chances of thusly erring, here:
Set your intentions now
He bids us figure out what our goal is, and really think it through, including not just “how many drinks to have” if we’re drinking, but also such things as “what feelings are likely to come up”. Because, if we’ve historically used alcohol as a maladaptive coping mechanism, we’re going to need a different, better, healthier coping mechanism (we talked more about that in our above-linked article about reducing or quitting alcohol, too, with some examples).
He also suggests that we memorize our social responses—exactly what we’re going to say if offered a drink, for example:
❝It’s important to know what you’re going to say about your alcohol use. If someone asks if they can get you a drink, good responses could be: “A glass of water would be great” or “Do you have any non-alcoholic cider?” You don’t have to explain yourself. Just ask for what you want, because saying no to someone can be difficult.❞
See also:
December’s Traps To Plan Around
Mix it up and slow it down
No, that doesn’t mean mix yourself a sloe gin cocktail. But rather, it’s about alternating alcoholic and non-alcoholic drinks, to give your body half a chance to process the alcohol, and also to rehydrate a little along the way.
We talk about this and other damage-limitation methods, here:
How To Reduce The Harm Of Festive Drinking (Without Abstaining)
Take care!
Don’t Forget…
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Learn to Age Gracefully
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