Peony Against Inflammation & More
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Yes, this is about the flower, especially white peony (Paeonia lactiflora), and especially the root thereof (Paeoniae radix alba). Yes, the root gets a different botanical name but we promise it is the same plant. You will also read about its active glycoside paeoniflorin, and less commonly, albiflorin (a neuroprotective glycoside present in the root).
It’s one of those herbs that has made its way out of Traditional Chinese Medicine and into labs around the world.
It can be ingested directly as food, or as a powder/capsule, or made into tea.
Anti-inflammatory
Peony suppresses inflammatory pathways, which thus reduces overall inflammation. In particular, this research review found:
❝Pharmacologically, paeoniflorin exhibits powerful anti-inflammatory and immune regulatory effects in some animal models of autoimmune diseases including Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE)❞
The reviewers also (albeit working from animal models) suggest it may be beneficial in cases of kidney disease and liver disease, along with other conditions.
Here’s a larger review, which also has studies involving humans (and in vivo studies), that found it to effectively help treat autoimmune conditions including rheumatoid arthritis and psoriasis, amongst others:
❝Modern pharmacological research on TGP is based on the traditional usage of PRA, and its folk medicinal value in the treatment of autoimmune diseases has now been verified. In particular, TGP has been developed into a formulation used clinically for the treatment of autoimmune diseases.
Based on further research on its preparation, quality control, and mechanisms of action, TGP is expected to eventually play a greater role in the treatment of autoimmune diseases. ❞
(TGP = Total Glucosides of Paeony)
Antidepressant / Anxiolytic
It also acts as a natural serotonin reuptake inhibitor (as per many pharmaceutical antidepressants), by reducing the expression of the serotonin transporter protein:
Gut Microbiota-Based Pharmacokinetics and the Antidepressant Mechanism of Paeoniflorin
(remember, most serotonin is produced in the gut)
Here’s how that played out when tested (on rats, though):
Against PMS and/or menopause symptoms
Peony is widely used in Traditional Chinese Medicine to reduce these symptoms in general. However, we couldn’t find a lot of good science for that, although it is very plausible (as the extract contains phytoestrogens and may upregulate estrogen receptors while dialling down testosterone production). Here’s the best we could find for that, and it’s a side-by-side along with licorice root:
❝Paeoniflorin, glycyrrhetic acid and glycyrrhizin decreased significantly the testosterone production but did not change that of delta 4-androstenedione and estradiol. Testosterone/delta 4-androstenedione production ratio was lowered significantly by paeoniflorin, glycyrrhetic acid and glycyrrhizin❞
Effect of paeoniflorin, glycyrrhizin and glycyrrhetic acid on ovarian androgen production
(note: that it didn’t affect estradiol levels is reasonable; it contains phytoestrogens after all, not estradiol—and in fact, if you are taking estradiol, you might want to skip this one, as its phytoestrogens could compete with your estradiol for receptors)
Want to try some?
We don’t sell it, but here for your convenience is an example product on Amazon 😎
Enjoy!
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Pasteurization: What It Does And Doesn’t Do
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Pasteurization’s Effect On Risks & Nutrients
In Wednesday’s newsletter, we asked you for your health-related opinions of raw (cow’s) milk, and got the above-depicted, below-described, set of responses:
- About 47% said “raw milk is dangerous to consume, whereas pasteurization makes it safer”
- About 31% said “raw milk is a good source of vital nutrients which pasteurization would destroy”
- About 14% said “both raw milk and pasteurized milk are equally unhealthy”
- About 9% said “both raw milk and pasteurized milk are equally healthy”
Quite polarizing! So, what does the science say?
“Raw milk is dangerous to consume, whereas pasteurization makes it safer: True or False?”
True! Coincidentally, the 47% who voted for this are mirrored by the 47% of the general US population in a similar poll, deciding between the options of whether raw milk is less safe to drink (47%), just as safe to drink (15%), safer to drink (9%), or not sure (30%):
Public Fails to Appreciate Risk of Consuming Raw Milk, Survey Finds
As for what those risks are, by the way, unpasteurized dairy products are estimated to cause 840x more illness and 45x more hospitalizations than pasteurized products.
This is because unpasteurized milk can (and often does) contain E. coli, Listeria, Salmonella, Cryptosporidium, and other such unpleasantries, which pasteurization kills.
Source for both of the above claims:
(we know the title sounds vague, but all this information is easily visible in the abstract, specifically, the first two paragraphs)
Raw milk is a good source of vital nutrients which pasteurization would destroy: True or False?
False! Whether it’s a “good” source can be debated depending on other factors (e.g., if we considered milk’s inflammatory qualities against its positive nutritional content), but it’s undeniably a rich source. However, pasteurization doesn’t destroy or damage those nutrients.
Incidentally, in the same survey we linked up top, 16% of the general US public believed that pasteurization destroys nutrients, while 41% were not sure (and 43% knew that it doesn’t).
Note: for our confidence here, we are skipping over studies published by, for example, dairy farming lobbies and so forth. Those do agree, by the way, but nevertheless we like sources to be as unbiased as possible. The FDA, which is not completely unbiased, has produced a good list of references for this, about half of which we would consider biased, and half unbiased; the clue is generally in the journal names. For example, Food Chemistry and the Journal of Food Science and Journal of Nutrition are probably less biased than the International Dairy Association and the Journal of Dairy Science:
FDA | Raw Milk Misconceptions and the Danger of Raw Milk Consumption
this page covers a lot of other myths too, more than we have room to “bust” here, but it’s very interesting reading and we recommend to check it out!
Notably, we also weren’t able to find any refutation by counterexample on PubMed, with the very slight exception that some studies sometimes found that in the case of milks that were of low quality, pasteurization can reduce the vitamin E content while increasing the vitamin A content. For most milks however, no significant change was found, and in all cases we looked at, B-vitamins were comparable and vitamin D, popularly touted as a benefit of cow’s milk, is actually added later in any case. And, importantly, because this is a common argument, no change in lipid profiles appears to be findable either.
In science, when something has been well-studied and there aren’t clear refutations by counterexample, and the weight of evidence is clearly very much tipped into one camp, that usually means that camp has it right.
Milk generally is good/bad for the health: True or False?
True or False, depending on what we want to look at. It’s definitely not good for inflammation, but the whole it seems to be cancer-neutral and only increases heart disease risk very slightly:
- Keep Inflammation At Bay ← short version is milk is bad, fermented milk products are fine in moderation
- Is Dairy Scary? ← short version is that milk is neither good nor terrible; fermented dairy products however are health-positive in numerous ways when consumed in moderation
You may be wondering…
…how this goes for the safety of dairy products when it comes to the bird flu currently affecting dairy cows, so:
Take care!
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What Mattress Is Best, By Science?
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The Foundations of Good Sleep
You probably know the importance of good sleep for good health. If not, here’s a quick refresher:
- Why You Probably Need More Sleep
- How Sleep-Deprived Are You, Really?
- The 6 Dimensions Of Sleep (And Why They Matter)
You should also definitely check out this quite famous book on the topic:
Why We Sleep – by Dr Matthew Walker
What helps, to get that good sleep
We’ve covered this a little before too, for example:
- Safe Effective Sleep Aids For Seniors
- Sleep Better With Better Air
- How To Nap Like A Pro (No More “Sleep Hangovers”!)
How to level-up from there
One of the biggest barriers to good sleep for many people is obstructive sleep apea:
Healthier, Natural Sleep Without Obstruction!
We covered (in the above article) a whole lot of ways of mitigating/managing obstructive sleep apnea. One of the things we mentioned as beneficial was avoiding sleeping on one’s back, and this is something Mayo Clinic’s Dr. Somers agreed with:
Back Sleeping, And Sleeping Differently After 50
“But side-sleeping is uncomfortable”
If this is you, then chances are you have the wrong mattress.
If your mattress is too firm, you can get around it by using this “five pillow” method:
Click Here If The Embedded Video Doesn’t Load Automatically
If your mattress is too soft, then sorry, you really just have to throw that thing out and start again.
The Goldilocks mattress
While different people will have different subjective preferences, the science is quite clear on what is actually best for people’s spines. As this review of 39 qualified scholarly articles concluded:
❝Results of this systematic review show that a medium-firm mattress promotes comfort, sleep quality and rachis alignment❞
~ Dr. Gianfilippo Caggiari et al.
Read in full: What type of mattress should be chosen to avoid back pain and improve sleep quality? Review of the literature
Note: to achieve “medium-firm” that remains “medium firm” has generally been assumed to require a memory-foam mattress.
How memory-foam works: memory-foam is a moderately thermosoftening material, designed to slightly soften at the touch of human body temperature, and be firmer at room temperature. This will result in it molding itself to the form of a human body, providing what amounts to personalized support for your personal shape and size, meaning your spine can stay exactly as it’s supposed to when you’re sleeping on your side, instead of (for example) your hips being wider meaning that your lumbar vertebrae are raised higher than your thoracic vertebrae, giving you the equivalent of a special nocturnal scoliosis.
It will, therefore, stop working if
- the ambient temperature is comparable to human body temperature (as happens in some places sometimes, and increasingly often these days)
- you die, and thus lose your body temperature (but in that case, your spinal alignment will be the least of your concerns)
Here’s a good explanation of the mechanics of memory foam from the Sleep Foundation:
Sleep Foundation | What is Memory Foam?
An alternative to memory foam?
If you don’t like memory foam (one criticism is that it doesn’t allow good ventilation underneath the body), there is an alterative, the grid mattress.
It’s very much “the new kid on the block” and the science is young for this, but for example this recent (April 2024) study that concluded:
❝The grid mattress is a simple, noninvasive, and nonpharmacological intervention that improved adults sleep quality and health. Controlled trials are encouraged to examine the effects of this mattress in a variety of populations and environments.❞
~ Dr. Heather Hausenblas et al.
Read in full: Effectiveness of a grid mattress on adults’ sleep quality and health: A quasi-experimental intervention study
However, that was a small (n=39) uncontrolled (i.e. there was no control group) study, and the conflict of interest statement is, well, interesting:
❝Heather A. Hausenblas, Stephanie L. Hooper, Martin Barragan, and Tarah Lynch declare no conflict of interest. Michael Breus served as a former consultant for Purple, LLC.❞
~ Ibid.
…which is a fabulous way of distracting from the mention in the “Acknowledgements” section to follow, that…
❝Purple, LLC, provided financial support for the study❞
~ Ibid.
Purple is the company that invented the mattress being tested. So while this doesn’t mean the study is necessarily dishonest and/or corrupt, it does at the very least raise a red flag for a potential instance of publication bias (because Purple may have funded multiple studies and then pulled funding of the ones that weren’t going their way).
If you are interested in Purple’s mattress and how it works, you can check it out here ← this is a link for your interest and information; not an advertisement or an endorsement. We look forward to seeing more science for this though, and echo their own call for randomized controlled trials!
Summary
Sleep is important, and while it’s a popular myth that we need less as we get older, the truth is that we merely get less on average, while still needing the same amount.
A medium-firm memory-foam mattress is a very good, well-evidenced way to support that (both figuratively and literally!).
A grid mattress is an interesting innovation, and/but we’d like to see more science for it.
Take care!
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Intermittent Fasting, Intermittently?
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve 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 too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝Have you come across any research on alternate-day intermittent fasting—specifically switching between one day of 16:8 fasting and the next day of regular eating patterns? I’m curious if there are any benefits or drawbacks to this alternating approach, or if the benefits mainly come from consistent intermittent fasting?❞
Short and unhelpful answer: no
Longer and hopefully more helpful answer:
As you probably know, usually people going for approaches based on the above terms either
- practise 16:8 fasting (fast for 16 hours each day, eat during an 8-hour window) or
- practise alternate-day fasting (fast for 24 hours, eat whenever for 24 hours, repeat)
…which latter scored the best results in this large meta-analysis of studies:
There is also the (popular) less extreme version of alternate-day fasting, sometimes called “eat stop eat”, which is not a very helpful description because that describes almost any kind of eating/fasting, but it usually refers to “once per week, take a day off from eating”.
You can read more about each of these (and some other variants), here:
Intermittent Fasting: What’s The Truth?
What you are describing (doing 16:8 fasting on alternate days, eating whenever on the other days) is essentially: intermittent fasting, just with one 16-hour fast per 48 hours instead of per the usual 24 hours.
See also: International consensus on fasting terminology ← the section on the terms “STF & PF” covers why this gets nudged back under the regular IF umbrella
Good news: this means there is a lot of literature into the acute (i.e., occurring the same day, not long-term)* benefits of 16:8 IF, and that means that you will be getting those benefits, every second day.
You remember that meta-analysis we posted above? While it isn’t mentioned in the conclusion (which only praised complete alternate-day fasting producing the best outcomes overall), sifting through the results data discovers that time-restricted eating (which is what you are doing, by these classifications) was the only fasting method to significantly reduce fasting blood glucose levels.
(However, no significant differences were observed between any IF form and the reference (continuous energy restriction, CER, i.e. calorie-controlled) diets in fasting insulin and HbA1c levels)
*This is still good news in the long-term though, because getting those benefits every second day is better than getting those benefits on no days, and this will have a long-term impact on your healthy longevity, just like how it is better to exercise every second day than it is to exercise no days, or better to abstain from alcohol every second day than it is to abstain on no days, etc.
In short, by doing IF every second day, you are still giving your organs a break sometimes, and that’s good.
All the same, if it would be convenient and practical for you, we would encourage you to consider either the complete alternate-day fasting (which, according to a lot of data, gives the best results overall),or time-restricted eating (TRE) every day (which, according to a lot of data, gives the best fasting blood sugar levels).
You could also improve the TRE days by shifting to 20:4 (i.e., 20 hours fasting and 4 hours eating), this giving your organs a longer break on those days.
Want to learn more?
For a much more comprehensive discussion of the strengths and weaknesses of different approaches to intermitted fasting, check out:
Enjoy!
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How To Stay Alive (When You Really Don’t Want To)
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How To Stay Alive (When You Really Don’t Want To)
A subscriber recently requested:
❝Request: more people need to be aware of suicidal tendencies and what they can do to ward them off❞
…and we said we’d do that one of these Psychology Sundays, so here we are, doing it!
First of all, we’ll mention that we did previously do a main feature on managing depression (in oneself or a loved one); here it is:
The Mental Health First Aid That You’ll Hopefully Never Need
Now, not all depression leads to suicidality, and not all suicide is pre-empted by depression, but there’s a large enough crossover that it seems sensible to put that article here, for anyone who might find it of use, or even just of interest.
Now, onwards, to the specific, and very important, topic of suicide.
This should go without saying, but some of today’s content may be a little heavy.
We invite you to read it anyway if you’re able, because it’s important stuff that we all should know, and not talking about it is part of what allows it to kill people.
So, let’s take a deep breath, and read on…
The risk factors
Top risk factors for suicide include:
- Not talking about it
- Having access to a firearm
- Having a plan of specifically how to commit suicide
- A lack of social support
- Being male
- Being over 40
Now, some of these are interesting sociologically, but aren’t very useful practically; what a convenient world it’d be if we could all simply choose to be under 40, for instance.
Some serve as alarm bells, such as “having a plan of specifically how to commit suicide”.
If someone has a plan, that plan’s never going to disappear entirely, even if it’s set aside!
(this writer is deeply aware of the specifics of how she has wanted to end things before, and has used the advice she gives in this article herself numerous times. So far so good, still alive to write about it!)
Specific advices, therefore, include:
Talk about it / Listen
Depending on whether it’s you or someone else at risk:
- Talk about it, if it’s you
- Listen attentively, if it’s someone else
There are two main objections that you might have at this point, so let’s look at those:
“I have nobody to talk to”—it can certainly feel that way, sometimes, but you may be surprised who would listen if you gave them the chance. If you really can’t trust anyone around you, there are of course suicide hotlines (usually per area, so we’ll not try to list them here; a quick Internet search will get you what you need).
If you’re worried it’ll result in bad legal/social consequences, check their confidentiality policy first:
- Some hotlines can and will call the police, for instance.
- Others deliberately have a set-up whereby they couldn’t even trace the call if they wanted to.
- On the one hand, that means they can’t intervene
- On the other hand, that means they’re a resource for anyone who will only trust a listener who can’t intervene.
“But it is just a cry for help”—then that person deserves help. What some may call “attention-seeking” is, in effect, care-seeking. Listen, without judgement.
Remove access to firearms, if applicable and possible
Ideally, get rid of them (safely and responsibly, please).
If you can’t bring yourself to do that, make them as inconvenient to get at as possible. Stored securely at your local gun club is better than at home, for example.
If your/their plan isn’t firearm-related, but the thing in question can be similarly removed, remove it. You/they do not need that stockpile of pills, for instance.
And of course you/they could get more, but the point is to make it less frictionless. The more necessary stopping points between thinking “I should just kill myself” and being able to actually do it, the better.
Have/give social support
What do the following people have in common?
- A bullied teenager
- A divorced 40-something who just lost a job
- A lonely 70-something with no surviving family, and friends that are hard to visit
Often, at least, the answer is: the absence of a good social support network
So, it’s good to get one, and be part of some sort of community that’s meaningful to us. That could look different to a lot of people, for example:
- A church, or other religious community, if we be religious
- The LGBT+ community, or even just a part of it, if that fits for us
- Any mutual-support oriented, we-have-this-shared-experience community, could be anything from AA to the VA.
Some bonus ideas…
If you can’t live for love, living for spite might suffice. Outlive your enemies; don’t give them the satisfaction.
If you’re going to do it anyway, you might as well take the time to do some “bucket list” items first. After all, what do you have to lose? Feel free to add further bucket list items as they occur to you, of course. Because, why not? Before you know it, you’ve postponed your way into a rich and fulfilling life.
Finally, some gems from Matt Haig’s “The Comfort Book”:
- “The hardest question I have been asked is: “How do I stay alive for other people if I have no one?” The answer is that you stay alive for other versions of you. For the people you will meet, yes, but also the people you will be.”
- “Stay for the person you will become”
- “You are more than a bad day, or week, or month, or year, or even decade”
- “It is better to let people down than to blow yourself up”
- “Nothing is stronger than a small hope that doesn’t give up”
- “You are here. And that is enough.”
You can find Matt Haig’s excellent “The Comfort Book” on Amazon, as well as his more well-known book more specifically on the topic we’ve covered today, “Reasons To Stay Alive“.
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Sleeping on Your Back after 50; Yay or Nay?
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Sleeping Differently After 50
Sleeping is one of those things that, at any age, can be hard to master. Some of our most popular articles have been on getting better sleep, and effective sleep aids, and we’ve had a range of specific sleep-related questions, like whether air purifiers actually improve your sleep.
But perhaps there’s an underlying truth hidden in our opening sentence…is sleeping consistently difficult because the way we sleep should change according to our age?
Inspired by Brad and Mike’s video below (which was published to their 5 million+ subscribers!), there are 4 main elements to consider when sleeping on your back after you’ve hit the 50-year mark:
- Degenerative Disk Disease: As you age, your spine may start to show signs of wear and tear, which directly affects comfort while lying on your back.
- Sleep Apnea and Snoring: Sleep Apnea and snoring become more of an issue with age, and sleeping on your back can exacerbate these problems; when you sleep on your back, the soft tissues in your throat, as well as your tongue, “fall back” and partly obstruct your the airway.
- Spinal Stenosis: Spinal Stenosis–the often-age-related narrowing of your spinal canal–can put pressure on the nerves that travel through the spine, which equally makes back-sleeping harder.
- GERD: The all-too-familiar gastroesophageal reflux disease can be more problematic when lying flat on your back, as doing so can allow easy access for stomach acid to move upwards.
Alternatives to Back Sleeping
Referencing the Mayo Clinic’s Sleep Facility’s director, Dr. Virend Somers, today’s video suggests a simple solution: sleeping on your side. The video goes into a bit more detail but, as you know, here at 10almonds we like to cut to the chase.
Modifications for Back Sleeping
If you’re a lifelong back-sleeping and cannot bear the idea of changing to your side, or your stomach, then there are a few modifications that you can make to ease any pain and discomfort.
Most solutions revolve around either leg wedges or pillow adjustments. For instance, if you’re suffering from back pain, try propping your knees up. Or if GERD is your worst enemy, a wedge pillow could help keep that acid down.
As can be expected, the video dives into more detail:
How was the video? If you’ve discovered any great videos yourself that you’d like to share with fellow 10almonds readers, then please do email them to us!
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The Toe-Tapping Tip For Better Balance
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Balance is critical for health especially in older age, since it’s amazing how much else can go dramatically and suddenly wrong after a fall. So, here’s an exercise to give great balance and stability:
How to do it
You will need:
- Something to hold onto, such as a countertop
- A target on the floor, such as a mark or a coin
The steps:
- Lift one leg up, bring your foot forward, and tap the object in front of you.
- Then, bring that foot back to where it started.
- Next, switch to the other leg and tap.
- Alternate between your right and left legs, shifting back and forth.
- Your goal is to do this for 10 repetitions on each leg without holding on.
How it works:
Whenever you tap, you have to lift one leg up and reach it out in front of you. Doing this requires you to stand on one leg while moving a weight (namely: your other leg), which is something many people, especially upon getting older, are hesitant to do. If you’re unable to stand on one leg, let alone move your center of gravity (per the counterbalance of the other leg) while doing so, you may end up shuffling and walking with your feet sliding across the ground—something you really want to avoid.
For more on all of this plus a visual demonstration, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Fall Special ← this is about not falling, or, failing that, minimizing injury if you do
Take care!
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