How To Leverage Placebo Effect For Yourself
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Placebo Effect: Making Things Work Since… Well, A Very Long Time Ago
The placebo effect is a well-known, well-evidenced factor that is very relevant when it comes to the testing and implementation of medical treatments:
NIH | National Center for Biotechnology Information | Placebo Effect
Some things that make placebo effect stronger include:
- Larger pills instead of small ones: because there’s got to be more going on in there, right?
- Thematically-colored pills: e.g. red for stimulant effects, blue for relaxing effects
- Things that seem expensive: e.g. a well-made large heavy machine, over a cheap-looking flimsy plastic device. Similarly, medication from a small glass jar with a childproof lock, rather than popped out from a cheap blister-pack.
- Things that seem rational: if there’s an explanation for how it works that you understand and find rational, or at least you believe you understand and find rational ← this works in advertising, too; if there’s a “because”, it lands better almost regardless of what follows the word “because”
- Things delivered confidently by a professional: this is similar to the “argument from authority” fallacy (whereby a proposed authority will be more likely trusted, even if this is not their area of expertise at all, e.g. celebrity endorsements), but in the case of placebo trials, this often looks like a well-dressed middle-aged or older man with an expensive haircut calling for a young confident-looking aide in a lab coat to administer the medicine, and is received better than a slightly frazzled academic saying “and, uh, this one’s yours” while handing you a pill.
- Things with ritual attached: this can be related to the above (the more pomp and circumstance is given to the administration of the treatment, the better), but it can also be as simple as an instruction on an at-home-trial medication saying “take 20 minutes before bed”. Because, if it weren’t important, they wouldn’t bother to specify that, right? So it must be important!
And now for a quick personality test
Did you see the above as a list of dastardly tricks to watch out for, or did you see the above as a list of things that can make your actual medication more effective?
It’s arguably both, of course, but the latter more optimistic view is a lot more useful than the former more pessimistic one.
Since placebo effect works at least somewhat even when you know about it, there is nothing to stop you from leveraging it for your own benefit when taking medication or doing health-related things.
Next time you take your meds or supplements or similar, pause for a moment for each one to remember what it is and what it will be doing for you. This is a lot like the principles (which are physiological as well as psychological) of mindful eating, by the way:
How To Get More Nutrition From The Same Food
Placebo makes some surprising things evidence-based
We’ve addressed placebo effect sometimes as part of an assessment of a given alternative therapy, often in our “Mythbusting Friday” edition of 10almonds.
- In some cases, placebo is adjuvant to the therapy, i.e. it is one of multiple mechanisms of action (example: chiropractic or acupuncture)
- In some cases, placebo is the only known mechanism of action (example: homeopathy)
- In some cases, even placebo can’t help (example: ear candling)
One other fascinating and far-reaching (in a potentially good way) thing that placebo makes evidence-based is: prayer
…which is particularly interesting for something that is fundamentally faith-based, i.e. the opposite of evidence-based.
Now, we’re a health science publication, not a theological publication, so we’ll consider actual divine intervention to be beyond the scope of mechanisms of action we can examine, but there’s been a lot of research done into the extent to which prayer is beneficial as a therapy, what things it may be beneficial for, and what factors affect whether it helps:
Prayer and healing: A medical and scientific perspective on randomized controlled trials
👆 full paper here, and it is very worthwhile reading if you have time, whether or not you are religious personally
Placebo works best when there’s a clear possibility for psychosomatic effect
We’ve mentioned before, and we’ll mention again:
- psychosomatic effect does not mean: “imagining it”
- psychosomatic effect means: “your brain regulates almost everything else in your body, directly or indirectly, including your autonomic functions, and especially notably when it comes to illness, your immune responses”
So, a placebo might well heal your rash or even shrink a tumor, but it probably won’t regrow a missing limb, for instance.
And, this is important: it’s not about how credible/miraculous the outcome will be!
Rather, it is because we have existing pre-programmed internal bodily processes for healing rashes and shrinking tumors, that just need to be activated—whereas we don’t have existing pre-programmed internal bodily processes for regrowing a missing limb, so that’s not something our brain can just tell our body to do.
So for this reason, in terms of what placebo can and can’t do:
- Get rid of cancer? Yes, sometimes—because the body has a process for doing that; enjoy your remission
- Fix a broken nail? No—because the body has no process for doing that; you’ll just have to cut it and wait for it to grow again
With that in mind, what will you use the not-so-mystical powers of placebo for? What ever you go for… Enjoy, and take care!
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The Brain-Skin Doctor
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Of Brains And Breakouts
Today’s spotlight is on Dr. Claudia Aguirre. She’s a molecular neuroscientist, and today she’s going to be educating us about skin.
What? Why?
When we say “neuroscience”, we generally think of the brain. And indeed, that’s a very important part of it.
We might think about eyes, which are basically an extension of the brain.
We don’t usually think about skin, which (just like our eyes) is constantly feeding us a lot of information about our surroundings, via a little under three million nerve endings. Guess where the other ends of those nerves lead!
There’s a constant two-way communication going on between our brain and our skin.
What does she want us to know?
Psychodermatology
The brain and the skin talk to each other, and maladies of one can impact the other:
- Directly, e.g. stress prompting skin breakouts (actually this is a several-step process physiologically, but for the sake of brevity we’ll call this direct)
- Indirectly, e.g. nervous disorders that result in people scratching or picking at their skin, which prompts a whole vicious cycle of one thing making the other worse
Read more: Psychodermatology: The Brain-Skin Connection
To address both kinds of problems, clearly something beyond moisturizer is needed!
Mindfulness (meditation and beyond)
Mindfulness is a well-evidenced healthful practice for many reasons, and Dr. Aguirra argues the case for it being good for our skin too.
As she points out,
❝Cultural stress and anxiety can trigger or aggravate many skin conditions—from acne to eczema to herpes, psoriasis, and rosacea.
Conversely, a disfiguring skin condition can trigger stress, anxiety, depression, and even suicide.
Chronic, generalized anxiety can create chronic inflammation and exacerbate inflammatory skin conditions, such as those I mentioned previously.
Chronic stress can result in chronic anxiety, hypervigilance, poor sleep, and a whole cascade of effects resulting in a constant breakdown of tissues and organs, including the skin.❞
So, she recommends mindfulness-based stress reduction (MBSR), for the above reasons, along with others!
Read more: Mind Matters
How to do it: No-Frills, Evidence-Based Mindfulness
And as for “and beyond?”
Do you remember in the beginning of the pandemic, when people were briefly much more consciously trying to avoid touching their faces so much? That, too, is mindfulness. It may have been a stressed and anxious mindfulness for many*, but mindfulness nonetheless.
*which is why “mindfulness-based stress reduction” is not a redundant tautology repeated more than once unnecessarily, one time after another 😉
So: do try to keep aware of what you are doing to your skin, and so far as is reasonably practicable, only do the things that are good for it!
The skin as an endocrine organ
Nerves are not the only messengers in the body; hormones do a lot of our body’s internal communication too. And not just the ones everyone remembers are hormones (e.g. estrogen, testosterone, although yes, they do both have a big impact on skin too), but also many more, including some made in the skin itself!
Dr. Aguirra gives us a rundown of common conditions, the hormones behind them, and what we can do if we don’t want them:
Read more: Rethinking The Skin As An Endocrine Organ
Take-away advice:
For healthy skin, we need to do more than just hydrate, get good sleep, have good nutrition, and get a little sun (but not too much).
- We should also practice mindfulness-based stress reduction, and seek help for more serious mental health issues.
- We should also remember the part our hormones play in our skin, and not just the obvious ones.
Did you know that vitamin D is also a hormone, by the way? It’s not the only hormone at play in your skin by a long way, but it is an important one:
Society for Endocrinology | Vitamin D
Want to know more?
You might like this interview with Dr. Aguirre:
The Brain in Our Skin: An Interview with Dr. Claudia Aguirre
Take care!
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How to Eat to Change How You Drink – by Dr. Brooke Scheller
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Whether you want to stop drinking or just cut down, this book can help. But what makes it different from the other reduce/stop drinking books we’ve reviewed?
Mostly, it’s about nutrition. This book focuses on the way that alcohol changes our relationship to food, our gut, our blood sugars, and more. The author also explains how reducing/stopping drinking, without bearing these things in mind, can be unnecessarily extra hard.
The remedy? To bear them in mind, of course, but that requires knowing them. So what she does is explain the physiology of what’s going on in terms of each of the above things (and more), and how to adjust your diet to make up for what alcohol has been doing to you, so that you can reduce/quit without feeling constantly terrible.
The style is very pop-science, light in tone, readable. She makes reference to a lot of hard science, but doesn’t discuss it in more depth than is necessary to convey the useful information. So, this is a practical book, aimed at all people who want to reduce/quit drinking.
Bottom line: if you feel like it’s hard to drink less because it feels like something is missing, it’s probably because indeed something is missing, and this book can help you bridge that gap!
Click here to check out How To Eat To Change How You Drink, and do just that!
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To tackle gendered violence, we also need to look at drugs, trauma and mental health
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After several highly publicised alleged murders of women in Australia, the Albanese government this week pledged more than A$925 million over five years to address men’s violence towards women. This includes up to $5,000 to support those escaping violent relationships.
However, to reduce and prevent gender-based and intimate partner violence we also need to address the root causes and contributors. These include alcohol and other drugs, trauma and mental health issues.
Why is this crucial?
The World Health Organization estimates 30% of women globally have experienced intimate partner violence, gender-based violence or both. In Australia, 27% of women have experienced intimate partner violence by a co-habiting partner; almost 40% of Australian children are exposed to domestic violence.
By gender-based violence we mean violence or intentionally harmful behaviour directed at someone due to their gender. But intimate partner violence specifically refers to violence and abuse occurring between current (or former) romantic partners. Domestic violence can extend beyond intimate partners, to include other family members.
These statistics highlight the urgent need to address not just the aftermath of such violence, but also its roots, including the experiences and behaviours of perpetrators.
What’s the link with mental health, trauma and drugs?
The relationships between mental illness, drug use, traumatic experiences and violence are complex.
When we look specifically at the link between mental illness and violence, most people with mental illness will not become violent. But there is evidence people with serious mental illness can be more likely to become violent.
The use of alcohol and other drugs also increases the risk of domestic violence, including intimate partner violence.
About one in three intimate partner violence incidents involve alcohol. These are more likely to result in physical injury and hospitalisation. The risk of perpetrating violence is even higher for people with mental ill health who are also using alcohol or other drugs.
It’s also important to consider traumatic experiences. Most people who experience trauma do not commit violent acts, but there are high rates of trauma among people who become violent.
For example, experiences of childhood trauma (such as witnessing physical abuse) can increase the risk of perpetrating domestic violence as an adult.
Childhood trauma can leave its mark on adults years later. Roman Yanushevsky/Shutterstock Early traumatic experiences can affect the brain and body’s stress response, leading to heightened fear and perception of threat, and difficulty regulating emotions. This can result in aggressive responses when faced with conflict or stress.
This response to stress increases the risk of alcohol and drug problems, developing PTSD (post-traumatic stress disorder), and increases the risk of perpetrating intimate partner violence.
How can we address these overlapping issues?
We can reduce intimate partner violence by addressing these overlapping issues and tackling the root causes and contributors.
The early intervention and treatment of mental illness, trauma (including PTSD), and alcohol and other drug use, could help reduce violence. So extra investment for these are needed. We also need more investment to prevent mental health issues, and preventing alcohol and drug use disorders from developing in the first place.
Early intervention and treatment of mental illness, trauma and drug use is important. Okrasiuk/Shutterstock Preventing trauma from occuring and supporting those exposed is crucial to end what can often become a vicious cycle of intergenerational trauma and violence. Safe and supportive environments and relationships can protect children against mental health problems or further violence as they grow up and engage in their own intimate relationships.
We also need to acknowledge the widespread impact of trauma and its effects on mental health, drug use and violence. This needs to be integrated into policies and practices to reduce re-traumatising individuals.
How about programs for perpetrators?
Most existing standard intervention programs for perpetrators do not consider the links between trauma, mental health and perpetrating intimate partner violence. Such programs tend to have little or mixed effects on the behaviour of perpetrators.
But we could improve these programs with a coordinated approach including treating mental illness, drug use and trauma at the same time.
Such “multicomponent” programs show promise in meaningfully reducing violent behaviour. However, we need more rigorous and large-scale evaluations of how well they work.
What needs to happen next?
Supporting victim-survivors and improving interventions for perpetrators are both needed. However, intervening once violence has occurred is arguably too late.
We need to direct our efforts towards broader, holistic approaches to prevent and reduce intimate partner violence, including addressing the underlying contributors to violence we’ve outlined.
We also need to look more widely at preventing intimate partner violence and gendered violence.
We need developmentally appropriate education and skills-based programs for adolescents to prevent the emergence of unhealthy relationship patterns before they become established.
We also need to address the social determinants of health that contribute to violence. This includes improving access to affordable housing, employment opportunities and accessible health-care support and treatment options.
All these will be critical if we are to break the cycle of intimate partner violence and improve outcomes for victim-survivors.
The National Sexual Assault, Family and Domestic Violence Counselling Line – 1800 RESPECT (1800 737 732) – is available 24 hours a day, seven days a week for any Australian who has experienced, or is at risk of, family and domestic violence and/or sexual assault.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14. In an emergency, call 000.
Siobhan O’Dean, Postdoctoral Research Associate, The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney; Lucinda Grummitt, Postdoctoral Research Fellow, The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, and Steph Kershaw, Research Fellow, The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Cottage Cheese vs Ricotta – Which is Healthier?
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Our Verdict
When comparing cottage cheese to ricotta, we picked the ricotta.
Why?
Cottage cheese is a famous health food, mostly for being a low-fat, low-carb, source of protein. And yet, ricotta beats it in most respects.
Looking at the macros first, cottage cheese has more carbs, while ricotta has more protein and fat. The fat profile is pretty much the same, and in both cases it’s two thirds saturated fat, which isn’t good in either case, but cottage cheese has less overall fat which means less saturated fat in total even if the percentage is the same. Because the difference in carbs and protein is not large, while ricotta has considerably more fat, we’ll call this category a win for cottage cheese.
In terms of vitamins, cottage cheese has more of vitamins B1, B5, and B12, while ricotta has more of vitamins A, B2, B3, B9, D, E, and K, so this one’s a win for ricotta.
In the category of minerals, cottage cheese has slightly more copper, while ricotta has much more calcium, iron, magnesium, manganese, potassium, selenium, and zinc. In particular, 2.5x more calcium, and 5x more iron! An easy and clear win for ricotta here.
Taking everything into account: yes, cottage cheese has less fat (and thus, in total, less saturated fat, although the percentage is the same), but that doesn’t make up for ricotta winning in pretty much every other respect. Still, enjoy either or both (in moderation!) if you be so inclined.
Want to learn more?
You might like to read:
Take care!
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The Neuroscience of You – by Dr. Chantel Prat
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The insides of people are rarely so standardized as one finds in a medical textbook, and that’s just as true of the brain as it is of any other organ—and often more so.
Our brains all look quite different from each other’s. Of course there are similarities; a wobbly mass of white and grey matter with tiny blood vessels running through. The constituent parts are (usually!) all present and correct. But… what is “correct”?
Dr. Chantel Prat takes us on a tour of the anatomical features that we may have grown or shrunken over the course of our life, according to how we’ve used them, or not. She also looks at what’s going on when it comes to the smaller scale—from the neuronal to the neurochemical.
We learn the truth (and myth) when it comes to left- and right-brainedness, and we learn how whether we saw that dress as black and blue or white and gold, depends on our circadian rhythm (and thus whether we have wired ourselves for perceiving colors more or less often under daylight or artificial light). And lots more.
The style throughout is very accessible, for a book that goes beyond most “how the brain works” books.
Bottom line: if you’re interested in the workings of your brain (as opposed to: a standardized Platonic ideal of what a brain might be), then this book will set you on the right track.
Click here to check out The Neuroscience of You, and learn more about what makes you you!
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Here’s To Getting Assuredly Good Health
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An unusual amount of excitement in the health news world this week, with health insurance in the spotlight:
Deny, Delay, Depose?
Insurance company UnitedHealthcare, which used AI with a 90% error rate to deny insurance claims (of which, disproportionately denying insurance claims of the elderly), has come under extra public scrutiny this week for its recent-years business practices:
❝Nearly 1 in 5 insured adults experienced claim denials during a 12-month period.
Those with job-based insurance or Affordable Care Act policies ran into this problem about twice as often as those covered by Medicare or Medicaid❞
…although, the company has dramatically increased its care denials for Medicare Advantage enrollees, doubling the rate of denials as it implemented its new, automated denials process.
Anesthesiologist Dr. Brain Schmutzler noted:
❝We have a bigger issue with the insurance companies in general, who, essentially, it’s their job to make money, not to actually pay for health care❞
And in those cases where healthcare is not denied, it is often dangerously delayed, as insurance companies can stall for time to decide whether they’re going to pay or not.
One useful take-away from all of this is that if your insurance claim is denied, consider fighting it, as often they can be overturned.
Specifically, it can be good to insist on knowing who (named persons) was involved in the denial process, and their qualifications. Once upon a time, this was mostly unqualified interns, which prompted insurance companies to reverse the denial rather than admit that; nowadays it’s mostly AI, which many companies can hope will shield them from culpability—either way, fighting for one’s rights can often be successful.
Read in full: Killing of UnitedHealthcare CEO prompts flurry of stories on social media over denied insurance claims
Related: With Medical Debt Burdening Millions, a Financial Regulator Steps In to Help
Rest Easy
Health insurer Elevance Health (formerly Anthem Blue Cross Blue Shield), had last month announced plans to limit its coverage for anesthesia used in operations, whereby they would pay for only a certain amount of anesthetic, and if the procedure was still ongoing when that amount had been used, then well, you were on your own.
However, on Thursday afternoon and allegedly completely coincidentally in the wake of the Wednesday assassination of the CEO who oversaw the denial of so many health insurance claims, this decision to limit paying for anesthesia was reversed, retracted, and they are now doing their best to downplay what the proposal would have meant for anesthesiologists and patients:
Read in full: Insurance company halts plan to put time limits on coverage for anesthesia during surgery
Related: The Insider’s Guide To Making Hospital As Comfortable As Possible ← an anesthesiologist’s tips
Getting a good grip of your health
What’s the best indicator of good health when it comes to age-related health issues? It’s not BMI! Could it be blood pressure? It could, but the news presently is about grip strength.
While training to have an amazing grip (and neglecting all else) will not necessarily increase your general healthspan, having a weak or strong grip is strongly associated with, respectively, having weak or strong general health in later years.
This is because unless someone has been training very unnaturally, grip strength is a good general measure of overall muscle strength, which in turn is a good indicator of metabolic health, as well as bodily robustness.
Read in full: Handgrip strength is a reliable predictor for age-related disease and disability, finds study
Related: Resistance Is Useful! (Especially As We Get Older)
Take care!
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