The Bitter Truth About Coffee (or is it?)

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The Bitter Truth About Coffee (or is it?)

Yesterday, we asked you for your (health-related) views on coffee. The results were clear: if we assume the responses to be representative, we’re a large group of coffee-enthusiasts!

One subscriber who voted for “Coffee is a healthy stimulant, hydrating, and full of antioxidants” wrote:

❝Not so sure about how hydrating it is! Like most food and drink, moderation is key. More than 2 or 3 cups make me buzz! Just too much.❞

And that fine point brings us to our first potential myth:

Coffee is dehydrating: True or False?

False. With caveats…

Coffee, in whatever form we drink it, is wet. This may not come as a startling revelation, but it’s an important starting point. It’s mostly water. Water itself is not dehydrating.

Caffeine, however, is a diuretic—meaning you will tend to pee more. It achieves its diuretic effect by increasing blood flow to your kidneys, which prompts them to release more water through urination.

See: Effect of caffeine on bladder function in patients with overactive bladder symptoms

How much caffeine is required to have a diuretic effect? About 4.5 mg/kg.

What this means in practical terms: if you weigh 70kg (a little over 150lbs), 4.5×70 gives us 315.

315mg is about how much caffeine might be in six shots of espresso. We say “might” because while dosage calculations are an exact science, the actual amount in your shot of espresso can vary depending on many factors, including:

  • The kind of coffee bean
  • How and when it was roasted
  • How and when it was ground
  • The water used to make the espresso
  • The pressure and temperature of the water

…and that’s all without looking at the most obvious factor: “is the coffee decaffeinated?”

If it doesn’t contain caffeine, it’s not diuretic. Decaffeinated coffee does usually contain tiny amounts of caffeine still, but with nearer 3mg than 300mg, it’s orders of magnitude away from having a diuretic effect.

If it does contain caffeine, then the next question becomes: “and how much water?”

For example, an Americano (espresso, with hot water added to make it a long drink) will be more hydrating than a ristretto (espresso, stopped halfway through pushing, meaning it is shorter and stronger than a normal espresso).

A subscriber who voted for “Coffee messes with sleep, creates dependency, is bad for the heart and gut, and is dehydrating too” wrote:

❝Coffee causes tachycardia for me so staying away is best. People with colon cancer are urged to stay away from coffee completely.❞

These are great points! It brings us to our next potential myth:

Coffee is bad for the heart: True or False?

False… For most people.

Some people, like our subscriber above, have an adverse reaction to caffeine, such as tachycardia. An important reason (beyond basic decency) for anyone providing coffee to honor requests for decaff.

For most people, caffeine is “heart neutral”. It doesn’t provide direct benefits or cause direct harm, provided it is enjoyed in moderation.

See also: Can you overdose on caffeine?

Some quick extra notes…

That’s all we have time for in myth-busting, but it’s worth noting before we close that coffee has a lot of health benefits; we didn’t cover them today because they’re not contentious, but they are interesting nevertheless:

Enjoy!

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  • Pear vs Peach – Which is Healthier?

    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.

    Our Verdict

    When comparing pears to peaches, we picked the peaches.

    Why?

    Both are great! But peaches are exceptional in some ways that pears just can’t match up to:

    In terms of macros, pears have more carbs and fiber, the ratio of which results in an approximately equal glycemic index. Thus, we’ll say that pears win this round by virtue of being the nutritionally denser option.

    Looking at the vitamins, pears have (slightly) more of vitamins B6, B9, and K, while peaches have (much) more of vitamins A, B1, B2, B3, B5, B7, C, E, and choline—thus sweeping this category easily for peaches.

    In the category of minerals, pears have more calcium and copper, while peaches have more iron, magnesium, manganese, phosphorus, potassium, and zinc. This time, the margins of difference for each mineral are comparably low (i.e. pears are close behind peaches on all those minerals), but still, by strength of numbers, it’s a clear win for peaches.

    When it comes to polyphenols, not only do peaches have more, but also, they have anticancer properties that pears don’t—see our link below for more about that!

    Meanwhile, adding up the sections makes for an overall win for peaches, but as ever when it comes to fruits, by all means enjoy either or both; diversity is good!

    Want to learn more?

    You might like to read:

    Top 8 Fruits That Prevent & Kill Cancer ← peaches in the #2 spot! They induce cell death in cancer cells while sparing healthy ones

    Enjoy!

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  • Weight Vests Against Osteoporosis: Do They Really Build Bone?

    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.

    Dr. Doug Lucas is a dual board-certified physician specializing in optimizing healthspan and bone health for women experiencing osteoporosis, perimenopause, and menopause. Here, he talks weight vests:

    Worth the weight?

    Dr. Lucas cites “Wolf’s Law”—bones respond to stress. A weighted vest adds stress, to help build bone density. That said, they may not be suitable for everyone (for example, in cases of severe osteoporosis or a recent vertebral fracture).

    He also cites some studies:

    • Erlanger Fitness Study (2004): participants with a weighted vest maintained or improved bone density compared to a control group, but there was no group with exercise alone, making it unclear if the vest itself had the biggest impact.
    • Newer studies (2016, 2017): showed improved outcomes for groups wearing a weighted vest, but again lacked an exercise-only group for comparison.
    • 2012 study: included three groups (control, weighted vest, exercise only). Results showed no significant bone density difference between vest and exercise-only groups, though the vest group showed better balance and motor control.

    Dr. Lucas concludes that weighted vests are a useful tool while nevertheless not being a magic bullet for bone health. In other words, they can complement exercise but you will also be fine without. If you do choose to level-up your exercise by using a weight vest, then starting with 5–10% of body weight in a vest is often recommended, but it depends on individual circumstances. If in doubt, start low and build up. Wearing the vest for daily activities can be effective, but improper use (awkward positions or improper impact training) can increase injury risk, so do be careful with that.

    For more on all of this, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

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  • Which Sugars Are Healthier, And Which Are Just The Same?

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    From Apples to Bees, and High-Fructose Cs

    We asked you for your (health-related) policy on sugar. The trends were as follows:

    • About half of all respondents voted for “I try to limit sugar intake, but struggle because it’s in everything”
    • About a quarter of all respondents voted for “Refined sugar is terrible; natural sugars (e.g. honey, agave) are fine”
    • About a quarter of all respondents voted for “Sugar is sugar and sugar is bad; I avoid it entirely”
    • One (1) respondent voted for “Sugar is an important source of energy, so I consume plenty”

    Writer’s note: I always forget to vote in these, but I’d have voted for “I try to limit sugar intake, but struggle because it’s in everything”.

    Sometimes I would like to make my own [whatever] to not have the sugar, but it takes so much more time, and often money too.

    So while I make most things from scratch (and typically spend about an hour cooking each day), sometimes store-bought is the regretfully practical timesaver/moneysaver (especially when it comes to condiments).

    So, where does the science stand?

    There has, of course, been a lot of research into the health impact of sugar.

    Unfortunately, a lot of it has been funded by sugar companies, which has not helped. Conversely, there are also studies funded by other institutions with other agendas to push, and some of them will seek to make sugar out to be worse than it is.

    So for today’s mythbusting overview, we’ve done our best to quality-control studies for not having financial conflicts of interest. And of course, the usual considerations of favoring high quality studies where possible Large sample sizes, good method, human subjects, that sort of thing.

    Sugar is sugar and sugar is bad: True or False?

    False and True, respectively.

    • Sucrose is sucrose, and is generally bad.
    • Fructose is fructose, and is worse.

    Both ultimately get converted into glycogen (if not used immediately for energy), but for fructose, this happens mostly* in the liver, which a) taxes it b) goes very unregulated by the pancreas, causing potentially dangerous blood sugar spikes.

    This has several interesting effects:

    • Because fructose doesn’t directly affect insulin levels, it doesn’t cause insulin insensitivity (yay)
    • Because fructose doesn’t directly affect insulin levels, this leaves hyperglycemia untreated (oh dear)
    • Because fructose is metabolized by the liver and converted to glycogen which is stored there, it’s one of the main contributors to non-alcoholic fatty liver disease (at this point, we’re retracting our “yay”)

    Read more: Fructose and sugar: a major mediator of non-alcoholic fatty liver disease

    *”Mostly” in the liver being about 80% in the liver. The remaining 20%ish is processed by the kidneys, where it contributes to kidney stones instead. So, still not fabulous.

    Fructose is very bad, so we shouldn’t eat too much fruit: True or False?

    False! Fruit is really not the bad guy here. Fruit is good for you!

    Fruit does contain fructose yes, but not actually that much in the grand scheme of things, and moreover, fruit contains (unless you have done something unnatural to it) plenty of fiber, which mitigates the impact of the fructose.

    • A medium-sized apple (one of the most sugary fruits there is) might contain around 11g of fructose
    • A tablespoon of high-fructose corn syrup can have about 27g of fructose (plus about 3g glucose)

    Read more about it: Effects of high-fructose (90%) corn syrup on plasma glucose, insulin, and C-peptide in non-insulin-dependent diabetes mellitus and normal subjects

    However! The fiber content (in fruit) mitigates the impact of the fructose almost entirely anyway.

    And if you take fruits that are high in sugar and/but high in polyphenols, like berries, they now have a considerable net positive impact on glycemic health:

    You may be wondering: what was that about “unless you have done something unnatural to it”?

    That’s mostly about juicing. Juicing removes much (or all) of the fiber, and if you do that, you’re basically back to shooting fructose into your veins:

    Natural sugars like honey, agave, and maple syrup, are healthier than refined sugars: True or False?

    TrueSometimes, and sometimes marginally.

    This is partly because of the glycemic index and glycemic load. The glycemic index scores tail off thus:

    • table sugar = 65
    • maple syrup = 54
    • honey = 46
    • agave syrup = 15

    So, that’s a big difference there between agave syrup and maple syrup, for example… But it might not matter if you’re using a very small amount, which means it may have a high glycemic index but a low glycemic load.

    Note, incidentally, that table sugar, sucrose, is a disaccharide, and is 50% glucose and 50% fructose.

    The other more marginal health benefits come from that fact that natural sugars are usually found in foods high in other nutrients. Maple syrup is very high in manganese, for example, and also a fair source of other minerals.

    But… Because of its GI, you really don’t want to be relying on it for your nutrients.

    Wait, why is sugar bad again?

    We’ve been covering mostly the more “mythbusting” aspects of different forms of sugar, rather than the less controversial harms it does, but let’s give at least a cursory nod to the health risks of sugar overall:

    That last one, by the way, was a huge systematic review of 37 large longitudinal cohort studies. Results varied depending on what, specifically, was being examined (e.g. total sugar, fructose content, sugary beverages, etc), and gave up to 200% increased cancer risk in some studies on sugary beverages, but 95% increased risk is a respectable example figure to cite here, pertaining to added sugars in foods.

    And finally…

    The 56 Most Common Names for Sugar (Some Are Tricky)

    How many did you know?

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  • Pain Doesn’t Belong on a Scale of Zero to 10

    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.

    Over the past two years, a simple but baffling request has preceded most of my encounters with medical professionals: “Rate your pain on a scale of zero to 10.”

    I trained as a physician and have asked patients the very same question thousands of times, so I think hard about how to quantify the sum of the sore hips, the prickly thighs, and the numbing, itchy pain near my left shoulder blade. I pause and then, mostly arbitrarily, choose a number. “Three or four?” I venture, knowing the real answer is long, complicated, and not measurable in this one-dimensional way.

    Pain is a squirrely thing. It’s sometimes burning, sometimes drilling, sometimes a deep-in-the-muscles clenching ache. Mine can depend on my mood or how much attention I afford it and can recede nearly entirely if I’m engrossed in a film or a task. Pain can also be disabling enough to cancel vacations, or so overwhelming that it leads people to opioid addiction. Even 10+ pain can be bearable when it’s endured for good reason, like giving birth to a child. But what’s the purpose of the pains I have now, the lingering effects of a head injury?

    The concept of reducing these shades of pain to a single number dates to the 1970s. But the zero-to-10 scale is ubiquitous today because of what was called a “pain revolution” in the ’90s, when intense new attention to addressing pain — primarily with opioids — was framed as progress. Doctors today have a fuller understanding of treating pain, as well as the terrible consequences of prescribing opioids so readily. What they are learning only now is how to better measure pain and treat its many forms.

    About 30 years ago, physicians who championed the use of opioids gave robust new life to what had been a niche specialty: pain management. They started pushing the idea that pain should be measured at every appointment as a “fifth vital sign.” The American Pain Society went as far as copyrighting the phrase. But unlike the other vital signs — blood pressure, temperature, heart rate, and breathing rate — pain had no objective scale. How to measure the unmeasurable? The society encouraged doctors and nurses to use the zero-to-10 rating system. Around that time, the FDA approved OxyContin, a slow-release opioid painkiller made by Purdue Pharma. The drugmaker itself encouraged doctors to routinely record and treat pain, and aggressively marketed opioids as an obvious solution.

    To be fair, in an era when pain was too often ignored or undertreated, the zero-to-10 rating system could be regarded as an advance. Morphine pumps were not available for those cancer patients I saw in the ’80s, even those in agonizing pain from cancer in their bones; doctors regarded pain as an inevitable part of disease. In the emergency room where I practiced in the early ’90s, prescribing even a few opioid pills was a hassle: It required asking the head nurse to unlock a special prescription pad and making a copy for the state agency that tracked prescribing patterns. Regulators (rightly) worried that handing out narcotics would lead to addiction. As a result, some patients in need of relief likely went without.

    After pain doctors and opioid manufacturers campaigned for broader use of opioids — claiming that newer forms were not addictive, or much less so than previous incarnations — prescribing the drugs became far easier and were promoted for all kinds of pain, whether from knee arthritis or back problems. As a young doctor joining the “pain revolution,” I probably asked patients thousands of times to rate their pain on a scale of zero to 10 and wrote many scripts each week for pain medication, as monitoring “the fifth vital sign” quickly became routine in the medical system. In time, a zero-to-10 pain measurement became a necessary box to fill in electronic medical records. The Joint Commission on the Accreditation of Healthcare Organizations made regularly assessing pain a prerequisite for medical centers receiving federal health care dollars. Medical groups added treatment of pain to their list of patient rights, and satisfaction with pain treatment became a component of post-visit patient surveys. (A poor showing could mean lower reimbursement from some insurers.)

    But this approach to pain management had clear drawbacks. Studies accumulated showing that measuring patients’ pain didn’t result in better pain control. Doctors showed little interest in or didn’t know how to respond to the recorded answer. And patients’ satisfaction with their doctors’ discussion of pain didn’t necessarily mean they got adequate treatment. At the same time, the drugs were fueling the growing opioid epidemic. Research showed that an estimated 3% to 19% of people who received a prescription for pain medication from a doctor developed an addiction.

    Doctors who wanted to treat pain had few other options, though. “We had a good sense that these drugs weren’t the only way to manage pain,” Linda Porter, director of the National Institutes of Health’s Office of Pain Policy and Planning, told me. “But we didn’t have a good understanding of the complexity or alternatives.” The enthusiasm for narcotics left many varietals of pain underexplored and undertreated for years. Only in 2018, a year when nearly 50,000 Americans died of an overdose, did Congress start funding a program — the Early Phase Pain Investigation Clinical Network, or EPPIC-Net — designed to explore types of pain and find better solutions. The network connects specialists at 12 academic specialized clinical centers and is meant to jump-start new research in the field and find bespoke solutions for different kinds of pain.

    A zero-to-10 scale may make sense in certain situations, such as when a nurse uses it to adjust a medication dose for a patient hospitalized after surgery or an accident. And researchers and pain specialists have tried to create better rating tools — dozens, in fact, none of which was adequate to capture pain’s complexity, a European panel of experts concluded. The Veterans Health Administration, for instance, created one that had supplemental questions and visual prompts: A rating of 5 correlated with a frown and a pain level that “interrupts some activities.” The survey took much longer to administer and produced results that were no better than the zero-to-10 system. By the 2010s, many medical organizations, including the American Medical Association and the American Academy of Family Physicians, were rejecting not just the zero-to-10 scale but the entire notion that pain could be meaningfully self-reported numerically by a patient.

    In the years that opioids had dominated pain remedies, a few drugs — such as gabapentin and pregabalin for neuropathy, and lidocaine patches and creams for musculoskeletal aches — had become available. “There was a growing awareness of the incredible complexity of pain — that you would have to find the right drugs for the right patients,” Rebecca Hommer, EPPIC-Net’s interim director, told me. Researchers are now looking for biomarkers associated with different kinds of pain so that drug studies can use more objective measures to assess the medications’ effect. A better understanding of the neural pathways and neurotransmitters that create different types of pain could also help researchers design drugs to interrupt and tame them.

    Any treatments that come out of this research are unlikely to be blockbusters like opioids; by design, they will be useful to fewer people. That also makes them less appealing prospects to drug companies. So EPPIC-Net is helping small drug companies, academics, and even individual doctors design and conduct early-stage trials to test the safety and efficacy of promising pain-taming molecules. That information will be handed over to drug manufacturers for late-stage trials, all with the aim of getting new drugs approved by the FDA more quickly.

    The first EPPIC-Net trials are just getting underway. Finding better treatments will be no easy task, because the nervous system is a largely unexplored universe of molecules, cells, and electronic connections that interact in countless ways. The 2021 Nobel Prize in Physiology or Medicine went to scientists who discovered the mechanisms that allow us to feel the most basic sensations: cold and hot. In comparison, pain is a hydra. A simple number might feel definitive. But it’s not helping anyone make the pain go away.

    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.

    Subscribe to KFF Health News’ free Morning Briefing.

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  • Tomato vs Cucumber – Which is Healthier?

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    Our Verdict

    When comparing tomato to cucumber, we picked the tomato.

    Why?

    Both are certainly great, but there are some nutritional factors between them:

    In terms of macros, everything is approximately equal except that tomato has more than 2x the fiber, so that’s a win for tomato.

    When it comes to vitamins, tomatoes have more of vitamins A, B1, B3, B6, B9, C, E, and choline, while cucumber has more of vitamins B2, B5, and K. In short, an 8:3 victory for tomatoes.

    In the category of minerals, tomatoes have more copper, potassium, and manganese, while cucumber has more calcium, iron, magnesium, selenium, and zinc. So, a win for cucumber this time.

    Both have useful phytochemical properties, too; tomatoes are rich in lycopene which has many benefits, and cucumbers have powerful anti-inflammatory powers whose mechanism of action is not yet fully understood—see the links below for more details!

    All in all, enjoy either or both (they make a great salad chopped roughly together with some olives, a little garlic, and a drizzle of olive oil and balsamic vinegar with a twist or three of black pepper), but if you have to pick just one (what a cruel world), we say the tomato has the most benefits, on balance.

    Want to learn more?

    You might like to read:

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  • Eggplant vs Zucchini – Which is Healthier?

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    Our Verdict

    When comparing eggplant to zucchini, we picked the zucchini.

    Why?

    In terms of macros, eggplant has more carbs and fiber while zucchini has more protein; we’ll generally prioritize fiber, so call this a subjective win for eggplant in this category, though an argument could be made for a tie.

    In the category of vitamins, eggplant has more of vitamins B3, B5, and E, while zucchini has more of vitamins A, B1, B2, B6, B9, C, K, and choline, scoring a win for zucchini here.

    Looking at minerals, eggplant has more copper, manganese, and selenium, while zucchini has more calcium, iron, magnesium, phosphorus, potassium and zinc, meaning another win for zucchini in this round.

    In terms of polyphenols, eggplant has a greater variety of polyphenols, while zucchini has greater total mass of polyphenols, so we’re calling this one a tie.

    Adding up the sections makes for an overall win for zucchini, but by all means enjoy either or both (perhaps together!); diversity is good!

    Want to learn more?

    You might like:

    What’s Your Plant Diversity Score?

    Enjoy!

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