Psychoactive Drugs Are Having a Moment. The FDA Will Soon Weigh In.

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Lori Tipton is among the growing number of people who say that MDMA, also known as ecstasy, saved their lives.

Raised in New Orleans by a mother with untreated bipolar disorder who later killed herself and two others, Tipton said she endured layers of trauma that eventually forced her to seek treatment for crippling anxiety and hypervigilance. For 10 years nothing helped, and she began to wonder if she was “unfixable.”

Then she answered an ad for a clinical trial for MDMA-assisted therapy to treat post-traumatic stress disorder. Tipton said the results were immediate, and she is convinced the drug could help a lot of people. But even as regulators weigh approval of the first MDMA-based treatment, she’s worried that it won’t reach those who need it most.

“The main thing that I’m always concerned about is just accessibility,” the 43-year-old nonprofit project manager said. “I don’t want to see this become just another expensive add-on therapy for people who can afford it when people are dying every day by their own hand because of PTSD.”

MDMA is part of a new wave of psychoactive drugs that show great potential for treating conditions such as severe depression and PTSD. Investors are piling into the nascent field, and a host of medications based on MDMA, LSD, psychedelic mushrooms, ketamine, the South American plant mixture ayahuasca, and the African plant ibogaine are now under development, and in some cases vying for approval by the Food and Drug Administration.

Proponents hope the efforts could yield the first major new therapies for mental illness since the introduction of modern antidepressants in the 1980s. But not all researchers are convinced that their benefits have been validated, or properly weighed against the risks. And they can be difficult to assess using traditional clinical trials.

The first MDMA-assisted assisted therapy appeared to be on track for FDA approval this August, but a recent report from an independent review committee challenged the integrity of the trial data from the drug’s maker, Lykos Therapeutics, a startup founded by a psychedelic research and advocacy group. The FDA will convene a panel of independent investigators on June 4 to determine whether to recommend the drug’s approval.

Proponents of the new therapies also worry that the FDA will impose treatment protocols, such as requiring multiple trained clinicians to monitor a patient for extended periods, that will render them far too expensive for most people.

Tipton’s MDMA-assisted therapy included three eight-hour medication sessions overseen by two therapists, each followed by an overnight stay at the facility and an integration session the following day.

“It does seem that some of these molecules can be administered safely,” said David Olson, director of the University of California-Davis Institute for Psychedelics and Neurotherapeutics. “I think the question is can they be administered safely at the scale needed to really make major improvements in mental health care.”

Breakthrough Therapies?

Psychedelics and other psychoactive substances, among the medicines with the oldest recorded use, have long been recognized for their potential therapeutic benefits. Modern research on them started in the mid-20th century, but clinical trial results didn’t live up to the claims of advocates, and they eventually got a bad name both from their use as party drugs and from rogue CIA experiments that involved dosing unsuspecting individuals.

The 1970 Controlled Substances Act made most psychoactive drugs illegal before any treatments were brought to market, and MDMA was classified as a Schedule 1 substance in 1985, which effectively ended any research. It wasn’t until 2000 that scientists at Johns Hopkins University were granted regulatory approval to study psilocybin anew.

Ketamine was in a different category, having been approved as an anesthetic in 1970. In the early 2000s, researchers discovered its antidepressant effects, and a ketamine-based therapy, Spravato, received FDA approval in 2019. Doctors can also prescribe generic ketamine off-label, and hundreds of clinics have sprung up across the nation. A clinical trial is underway to evaluate ketamine’s effectiveness in treating suicidal depression when used with other psychiatric medications.

Ketamine’s apparent effectiveness sparked renewed interest in the therapeutic potential of other psychoactive substances.

They fall into distinct categories: MDMA is an entactogen, also known as an empathogen, which induces a sense of connectedness and emotional communion, while LSD, psylocibin, and ibogaine are psychedelics, which create altered perceptual states. Ketamine is a dissociative anesthetic, though it can produce hallucinations at the right dose.

Despite the drugs’ differences, Olson said they all create neuroplasticity and allow the brain to heal damaged neural circuits, which imaging shows can be shriveled up in patients with addiction, depression, and PTSD.

“All of these brain conditions are really disorders of neural circuits,” Olson said. “We’re basically looking for medicines that can regrow these neurons.”

Psychedelics are particularly good at doing this, he said, and hold promise for treating diseases including Alzheimer’s.

A number of psychoactive drugs have now received the FDA’s “breakthrough therapy” designation, which expedites development and review of drugs with the potential to treat serious conditions.

But standard clinical trials, in which one group of patients is given the drug and a control group is given a placebo, have proven problematic, for the simple reason that people have no trouble determining whether they’ve gotten the real thing.

The final clinical trial for Lykos’ MDMA treatment showed that 71% of participants no longer met the criteria for PTSD after 18 weeks of taking the drug versus 48% in the control group.

A March report by the Institute for Clinical and Economic Review, an independent research group, questioned the company’s clinical trial results and challenged the objectivity of MDMA advocates who participated in the study as both patients and therapists. The institute also questioned the drug’s cost-effectiveness, which insurers factor into coverage decisions.

Lykos, a public benefit company, was formed in 2014 as an offshoot of the Multidisciplinary Association for Psychedelic Studies, a nonprofit that has invested more than $150 million into psychedelic research and advocacy.

The company said its researchers developed their studies in partnership with the FDA and used independent raters to ensure the reliability and validity of the results.

“We stand behind the design and results of our clinical trials,” a Lykos spokesperson said in an email.

There are other hazards too. Psychoactive substances can put patients in vulnerable states, making them potential victims for financial exploitation or other types of abuse. In Lykos’ second clinical trial, two therapists were found to have spooned, cuddled, blindfolded, and pinned down a female patient who was in distress.

The substances can also cause shallow breathing, heart issues, and hyperthermia.

To mitigate risks, the FDA can put restrictions on how drugs are administered.

“These are incredibly potent molecules and having them available in vending machines is probably a bad idea,” said Hayim Raclaw of Negev Capital, a venture capital fund focused on psychedelic drug development.

But if the protocols are too stringent, access is likely to be limited.

Rachel del Dosso, a trauma therapist in the greater Los Angeles area who offers ketamine-assisted therapy, said she’s been following the research on drugs like MDMA and psilocybin and is excited for their therapeutic potential but has reservations about the practicalities of treatment.

“As a therapist in clinical practice, I’ve been thinking through how could I make that accessible,” she said. “Because it would cost a lot for [patients] to have me with them for the whole thing.”

Del Dosso said a group therapy model, which is sometimes used in ketamine therapy, could help scale the adoption of other psychoactive treatments, too.

Artificial Intelligence and Analogs

Researchers expect plenty of new discoveries in the field. One of the companies Negev has invested in, Mindstate Design Labs, uses artificial intelligence to analyze “trip reports,” or self-reported drug experiences, to identify potentially therapeutic molecules. Mindstate has asked the FDA to green-light a clinical trial of the first molecule identified through this method, 5-MeO-MiPT, also known as moxy.

AlphaFold, an AI program developed by Google’s DeepMind, has identified thousands of potential psychedelic molecules.

There’s also a lot of work going into so-called analog compounds, which have the therapeutic effects of hallucinogens but without the hallucinations. The maker of a psilocybin analog announced in March that the FDA had granted it breakthrough therapy status.

“If you can harness the neuroplasticity-promoting properties of LSD while also creating an antipsychotic version of it, then that can be pretty powerful,” Olson said.

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.

Subscribe to KFF Health News’ free Morning Briefing.

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  • ‘Noisy’ autistic brains seem better at certain tasks. Here’s why neuroaffirmative research matters

    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.

    Pratik Raul, University of Canberra; Jeroen van Boxtel, University of Canberra, and Jovana Acevska, University of Canberra

    Autism is a neurodevelopmental difference associated with specific experiences and characteristics.

    For decades, autism research has focused on behavioural, cognitive, social and communication difficulties. These studies highlighted how autistic people face issues with everyday tasks that allistic (meaning non-autistic) people do not. Some difficulties may include recognising emotions or social cues.

    But some research, including our own study, has explored specific advantages in autism. Studies have shown that in some cognitive tasks, autistic people perform better than allistic people. Autistic people may have greater success in identifying a simple shape embedded within a more complex design, arranging blocks of different shapes and colours, or spotting an object within a cluttered visual environment (similar to Where’s Wally?). Such enhanced performance has been recorded in babies as young as nine months who show emerging signs of autism.

    How and why do autistic individuals do so well on these tasks? The answer may be surprising: more “neural noise”.

    What is neural noise?

    Generally, when you think of noise, you probably think of auditory noise, the ups and downs in the amplitude of sound frequencies we hear.

    A similar thing happens in the brain with random fluctuations in neural activity. This is called neural noise.

    This noise is always present, and comes on top of any brain activity caused by things we see, hear, smell and touch. This means that in the brain, an identical stimulus that is presented multiple times won’t cause exactly the same activity. Sometimes the brain is more active, sometimes less. In fact, even the response to a single stimulus or event will fluctuate continuously.

    Neural noise in autism

    There are many sources of neural noise in the brain. These include how the neurons become excited and calm again, changes in attention and arousal levels, and biochemical processes at the cellular level, among others. An allistic brain has mechanisms to manage and use this noise. For instance, cells in the hippocampus (the brain’s memory system) can make use of neural noise to enhance memory encoding and recall.

    Evidence for high neural noise in autism can be seen in electroencephalography (EEG) recordings, where increased levels of neural fluctuations were observed in autistic children. This means their neural activity is less predictable, showing a wider range of activity (higher ups and downs) in response to the same stimulus.

    In simple terms, if we imagine the EEG responses like a sound wave, we would expect to see small ups and downs (amplitude) in allistic brains each time they encounter a stimulus. But autistic brains seem to show bigger ups and downs, demonstrating greater amplitude of neural noise.

    Many studies have linked this noisy autistic brain with cognitive, social and behavioural difficulties.

    But could noise be a bonus?

    The diagnosis of autism has a long clinical history. A shift from the medical to a more social model has also seen advocacy for it to be reframed as a difference, rather than a disorder or deficit. This change has also entered autism research. Neuroaffirming research can examine the uniqueness and strengths of neurodivergence.

    Psychology and perception researcher David Simmons and colleagues at the University of Glasgow were the first to suggest that while high neural noise is generally a disadvantage in autism, it can sometimes provide benefits due to a phenomenon called stochastic resonance. This is where optimal amounts of noise can enhance performance. In line with this theory, high neural noise in the autistic brain might enhance performance for some cognitive tasks.

    Our 2023 research explores this idea. We recruited participants from the general population and investigated their performance on letter-detection tasks. At the same time, we measured their level of autistic traits.

    We performed two letter-detection experiments (one in a lab and one online) where participants had to identify a letter when displayed among background visual static of various intensities.

    By using the static, we added additional visual noise to the neural noise already present in our participants’ brains. We hypothesised the visual noise would push participants with low internal brain noise (or low autistic traits) to perform better (as suggested by previous research on stochastic resonance). The more interesting prediction was that noise would not help individuals who already had a lot of brain noise (that is, those with high autistic traits), because their own neural noise already ensured optimal performance.

    Indeed, one of our experiments showed people with high neural noise (high autistic traits) did not benefit from additional noise. Moreover, they showed superior performance (greater accuracy) relative to people with low neural noise when the added visual static was low. This suggests their own neural noise already caused a natural stochastic resonance effect, resulting in better performance.

    It is important to note we did not include clinically diagnosed autistic participants, but overall, we showed the theory of enhanced performance due to stochastic resonance in autism has merits.

    Why this is important?

    Autistic people face ignorance, prejudice and discrimination that can harm wellbeing. Poor mental and physical health, reduced social connections and increased “camouflaging” of autistic traits are some of the negative impacts that autistic people face.

    So, research underlining and investigating the strengths inherent in autism can help reduce stigma, allow autistic people to be themselves and acknowledge autistic people do not require “fixing”.

    The autistic brain is different. It comes with limitations, but it also has its strengths.

    Pratik Raul, PhD candidiate, University of Canberra; Jeroen van Boxtel, Associate professor, University of Canberra, and Jovana Acevska, Honours Graduate Student, University of Canberra

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

    The Conversation

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  • How & Why Non-Sleep Deep Rest Works (And What Activities Trigger The Same State)

    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.

    Stress is a natural response that evolved over thousands of years to help humans meet challenges by priming the body and mind for action. However, chronic stress is harmful, as it diverts energy away from essential processes like cell maintenance and repair, leading to deterioration of health (physical and mental).

    Counteracting this requires intentional periods of deep rest… But how?

    Parasympathetic Response

    Practices as diverse as mindfulness meditation, yoga, prayer, tai chi, qigong, knitting, painting, gardening, and sound baths can help induce states of deep rest—these days often called “Non-Sleep Deep Rest” (NSDR), to differentiate it from deep sleep.

    How it works: these activities send signals to the brain that the body is safe, initiating biological changes that…

    • protect chromosomes from DNA damage
    • promote cellular repair, and
    • enhance mitochondrial function.

    If we then (reasonably!) conclude from this: “so, we must embrace moments of stillness and mindfulness, and allow ourselves to experience the ease and safety of the present”, that may sound a little wishy-washy, but the neurology of it is clear, the consequences of that neurological response on every living cell in the body are also clear, so by doing NSDR (whether by yoga nidra or knitting or something else) we can significantly improve our overall well-being.

    Note: the list of activities above is far from exhaustive, but do be aware that this doesn‘t mean any activity you enjoy and do to unwind will trigger NSDR. On the contrary, many activities you enjoy and do to unwind may trigger the opposite, a sympathetic nervous system response—watching television is a common example of this “wrong choice for NSDR”. Sure, it can be absorbing and a distraction from your daily stressors, but it also can be exciting (both cognitively and neurologically and thus also physiologically), which is the opposite of what we want.

    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:

    Non-Sleep Deep Rest: A Neurobiologist’s Take

    Take care!

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  • Why Everyone You Don’t Like Is A Narcissist

    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.

    We’ve written before about how psychiatry tends to name disorders after how they affect other people, rather than how they affect the bearer, and this is most exemplified when it comes to personality disorders. For example:

    “You have a deep insecurity about never being good enough, and you constantly mess up in your attempt to overcompensate? You may have Evil Bastard Disorder!”

    “You have a crippling fear of abandonment and that you are fundamentally unloveable, so you do all you can to try to keep people close? You must have Manipulative Bitch Disorder!”

    See also: Miss Diagnosis: Anxiety, ADHD, & Women

    Antisocial Diagnoses

    These days, it is easy to find on YouTube countless videos of how to spot a narcissist, with a list of key traits that all mysteriously describe exactly the exes of everyone in the comments.

    And these days it is mostly “narcissist”, because “psychopath” and “sociopath” have fallen out of popular favor a bit:

    • perhaps for coming across as overly sensationalized, and thus lacking credibility
    • perhaps because “Narcissistic Personality Disorder (NPD)” exists in the DSM-5 (the US’s latest “Diagnostic and Statistical Manual of Mental Disorders”), while psychopathy and sociopathy are not mentioned as existing.

    You may be wondering: what do “psychopathy” and “sociopathy” mean?

    And the answer is: they mean whatever the speaker wants them to mean. Their definitions and differences/similarities have been vigorously debated by clinicians and lay enthusiasts alike for long enough that the scientific world has pretty much given up on them and moved on.

    Stigma vs pathology

    Because of the popular media (and social media) representation of NPD, it is easy to armchair diagnose one’s relative/ex/neighbor/in-law/boss/etc as being a narcissist, because the focus is on “narcissists do these bad things that are mean to people”.

    If the focus were instead on “narcissists have cripplingly low self-esteem, and are desperate to not show weakness in a world they have learned is harsh and predatory”, then there may not be so many armchair diagnoses—or at the very least, the labels may be attached with a little more compassion, the same way we might with other mental health issues such as depression.

    Not that those with depression get an easy time of it socially either—society’s response is generally some manner of “aren’t you better yet, stop being lazy”—but at the very least, depressed people are not typically viewed with hatred.

    A quick aside: if you or someone you know is struggling with depression, here are some things that actually help:

    The Mental Health First-Aid You’ll Hopefully Never Need

    The disorder is not the problem

    Maybe your relative, ex, neighbor, etc really is clinically diagnosable as a narcissist. There are still two important things to bear in mind:

    • After centuries of diagnosing people with mental health maladies that we now know don’t exist per se (madness, hysteria, etc), and in recent decades countless revisions to the DSM and similar tomes, thank goodness we now have the final and perfect set of definitions that surely won’t be re-written in the next few years or so ← this is irony; it will absolutely be re-written numerous times yet because of course it’s still not a magically perfect descriptor of the broad spectrum of human nature
    • The disorder is not the problem; the way they treat (or have treated) you is the problem.

    For example, let’s take a key thing generally attributed to narcissists: a lack of empathy

    Now, empathy can be divided into:

    • affective empathy: the ability to feel what other people are feeling
    • cognitive empathy: the ability to intellectually understand what other people are feeling (akin to sympathy, which is the same but with the requisite of having experienced the thing in question oneself)

    A narcissist (as well as various other people without NPD) will typically have negligible affective empathy, and their cognitive empathy may be a little sluggish too.

    Sluggish = it may take them a beat longer than most people, to realize what an external signifier of emotions means, or correctly guess how something will be felt by others. This can result in gravely misspeaking (or inappropriately emoting), after failing to adequately quickly “read the room” in terms of what would be a socially appropriate response. To save face, they may then either deny/minimize the thing they just said/did, or double-down on it and go on [what for them feels like] the counterattack.

    As to why this shutting off of empathy happens: they have learned that the world is painful, and that people are sources of pain, and so—to avoid further pain—have closed themselves off to that, often at a very early age. This will also apply to themselves; narcissists typically have negligible self-empathy too, which is why they will commonly make self-destructive decisions, even while trying to put themselves first.

    Important note on how this impacts other people: the “Golden Rule” of “treat others as you would wish to be treated” becomes intangible, as they have no more knowledge of their own emotional needs than they do of anyone else’s, so cannot make that comparison.

    Consider: if instead of being blind to empathy, they were colorblind… You would probably not berate them for buying green apples when you asked for red. They were simply incapable of seeing that, and consequently made a mistake. So it is when it’s a part of the brain that’s not working normally.

    So… Since the behavior does adversely affect other people, what can be done about it? Even if “hate them for it and call for their eradication from the face of the Earth” is not a reasonable (or compassionate) option, what is?

    Take the bull by the horns

    Above all, and despite all appearances, a narcissist’s deepest desire is simply to be accepted as good enough. If you throw them a life-ring in that regard, they will generally take it.

    So, communicate (gently, because a perceived attack will trigger defensiveness instead, and possibly a counterattack, neither of which are useful to anyone) what behavior is causing a problem and why, and ask them to do an alternative thing instead.

    And, this is important, the alternative thing has to be something they are capable of doing. Not merely something that you feel they should be capable of doing, but that they are actually capable of doing.

    • So not: “be a bit more sensitive!” because that is like asking the colorblind person to “be a bit more observant about colors”; they are simply not capable of it and it is folly to expect it of them, because no matter how hard they try, they can’t.
    • But rather: “it upsets me when you joke about xyz; I know that probably doesn’t make sense to you and that’s ok, it doesn’t have to. I am asking, however, if you will please simply refrain from joking about xyz. Would you do that for me?”

    Presented with such, it’s much more likely that the narcissist will drop their previous attempt to be good enough (by joking, because everyone loves someone with a sense of humor, right?) for a new, different attempt to be good enough (by showing “behold, look, I am a good person and doing the thing you asked, of which I am capable”).

    That’s just one example, but the same methodology can be applied to most things.

    For tricks pertaining to how to communicate such things without causing undue resistance, see:

    Seriously Useful Communication Skills

    Take care!

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  • How To Reduce The Harm Of Festive Drinking (Without Abstaining)

    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.

    How To Reduce The Harm Of Festive Drinking

    Not drinking alcohol is—of course—the best way to avoid the harmful effects of alcohol. However, not everyone wants to abstain, especially at this time of year, so today we’re going to be focusing on harm reduction without abstinence.

    If you do want to quit (or even reduce) drinking, you might like our previous article about that:

    How To Reduce Or Quit Alcohol

    For everyone else, let’s press on with harm reduction:

    Before You Drink

    A common (reasonable, but often unhelpful) advice is “set yourself a limit”. The problem with this is that when we’re sober, “I will drink no more than n drinks” is easy. After the first drink, we start to feel differently about it.

    So: delay your first drink of the day for as long as possible

    That’s it, that’s the tip. The later you start drinking, not only will you likely drink less, but also, your liver will have had longer to finish processing whatever you drank last night, so it’s coming at the new drink(s) fresh.

    On that note…

    Watch your meds! Often, especially if we are taking medications that also tax our liver (acetaminophen / paracetamol / Tylenol is a fine example of this), we are at risk of having a bit of a build-up, like an office printer that still chewing on the last job while you’re trying to print the next.

    Additionally: do indeed eat before you drink.

    While You Drink

    Do your best to drink slowly. While this can hit the same kind of problem as the “set yourself a limit” idea, in that once you start drinking you forget to drink slowly, it’s something to try for.

    If your main reason for drinking is the social aspect, then merely having a drink in your hand is generally sufficient. You don’t need to be keeping pace with anyone.

    It is further good to alternate your drinks with water. As in, between each alcoholic drink, have a glass of water. This helps in several ways:

    • Hydrates you, which is good for your body’s recovery abilities
    • Halves the amount of time you spend drinking
    • Makes you less thirsty; it’s easy to think “I’m thirsty” and reach for an alcoholic drink that won’t actually help. So, it may slow down your drinking for that reason, too.

    At the dinner table especially, it’s very reasonable to have two glasses, one filled with water. Nobody will be paying attention to which glass you drink from more often.

    After You Drink

    Even if you are not drunk, assume that you are.

    Anything you wouldn’t let a drunk person in your care do, don’t do. Now is not the time to drive, have a shower, or do anything you wouldn’t let a child do in the kitchen.

    Hospital Emergency Rooms, every year around this time, get filled up with people who thought they were fine and then had some accident.

    The biggest risks from alcohol are:

    1. Accidents
    2. Heart attacks
    3. Things actually popularly associated with alcohol, e.g. alcohol poisoning etc

    So, avoiding accidents is as important as, if not more important than, avoiding damage to your liver.

    Drink some water, and eat something.

    Fruit is great, as it restocks you on vitamins, minerals, and water, while being very easy to digest.

    Go to bed.

    There is a limit to how much trouble you can get into there. Sleep it off.

    In the morning, do not do “hair of the dog”; drinking alcohol will temporarily alleviate a hangover, but only because it kicks your liver back into an earlier stage of processing the alcohol—it just prolongs the inevitable.

    Have a good breakfast, instead. Remember, fruit is your friend (as explained above).

    Want to know more?

    Here’s a great service with a lot of further links to a lot more resources:

    With You | How to safely detox from alcohol at home

    Take care!

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  • Savory Protein Crêpe

    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.

    Pancakes have a bad reputation healthwise, but they don’t have to be so. Here’s a very healthy crêpe recipe, with around 20g of protein per serving (which is about how much protein most people’s body’s can use at one sitting) and a healthy dose of fiber too:

    You will need

    Per crêpe:

    • ½ cup milk (your preference what kind; we recommend oat milk for this)
    • 2 oz chickpea flour (also called garbanzo bean flour, or gram flour)
    • 1 tsp nutritional yeast
    • 1 tsp ras el-hanout (optional but tasty and contains an array of beneficial phytochemicals)
    • 1 tsp dried mixed herbs
    • ⅛ tsp MSG or ¼ tsp low-sodium salt

    For the filling (also per crêpe):

    • 6 cherry tomatoes, halved
    • Small handful baby spinach
    • Extra virgin olive oil

    Method

    (we suggest you read everything at least once before doing anything)

    1) Mix the dry crêpe ingredients in a bowl, and then stir in the milk, whisking to mix thoroughly. Leave to stand for at least 5 minutes.

    2) Meanwhile, heat a little olive oil in a skillet, add the tomatoes and fry for 1 minute, before adding the spinach, stirring, and turning off the heat. As soon as the spinach begins to wilt, set it aside.

    3) Heat a little olive oil either in the same skillet (having been carefully wiped clean) or a crêpe pan if you have one, and pour in a little of the batter you made, tipping the pan so that it coats the pan evenly and thinly. Once the top is set, jiggle the pan to see that it’s not stuck, and then flip your crêpe to finish on the other side.

    If you’re not confident of your pancake-tossing skills, or your pan isn’t good enough quality to permit this, you can slide it out onto a heatproof chopping board, and use that to carefully turn it back into the pan to finish the other side.

    4) Add the filling to one half of the crêpe, and fold it over, pushing down at the edges with a spatula to make a seal, cooking for another 30 seconds or so. Alternatively, you can just serve a stack of crêpes and add the filling at the table, folding or rolling per personal preference:

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • How much weight do you actually need to lose? It might be a lot less than you think

    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.

    If you’re one of the one in three Australians whose New Year’s resolution involved losing weight, it’s likely you’re now contemplating what weight-loss goal you should actually be working towards.

    But type “setting a weight loss goal” into any online search engine and you’ll likely be left with more questions than answers.

    Sure, the many weight-loss apps and calculators available will make setting this goal seem easy. They’ll typically use a body mass index (BMI) calculator to confirm a “healthy” weight and provide a goal weight based on this range.

    Your screen will fill with trim-looking influencers touting diets that will help you drop ten kilos in a month, or ads for diets, pills and exercise regimens promising to help you effortlessly and rapidly lose weight.

    Most sales pitches will suggest you need to lose substantial amounts of weight to be healthy – making weight loss seem an impossible task. But the research shows you don’t need to lose a lot of weight to achieve health benefits.

    Using BMI to define our target weight is flawed

    We’re a society fixated on numbers. So it’s no surprise we use measurements and equations to score our weight. The most popular is BMI, a measure of our body weight-to-height ratio.

    BMI classifies bodies as underweight, normal (healthy) weight, overweight or obese and can be a useful tool for weight and health screening.

    But it shouldn’t be used as the single measure of what it means to be a healthy weight when we set our weight-loss goals. This is because it:

    • fails to consider two critical factors related to body weight and health – body fat percentage and distribution
    • does not account for significant differences in body composition based on gender, ethnicity and age.

    How does losing weight benefit our health?

    Losing just 5–10% of our body weight – between 6 and 12kg for someone weighing 120kg – can significantly improve our health in four key ways.

    1. Reducing cholesterol

    Obesity increases the chances of having too much low-density lipoprotein (LDL) cholesterol – also known as bad cholesterol – because carrying excess weight changes how our bodies produce and manage lipoproteins and triglycerides, another fat molecule we use for energy.

    Having too much bad cholesterol and high triglyceride levels is not good, narrowing our arteries and limiting blood flow, which increases the risk of heart disease, heart attack and stroke.

    But research shows improvements in total cholesterol, LDL cholesterol and triglyceride levels are evident with just 5% weight loss.

    2. Lowering blood pressure

    Our blood pressure is considered high if it reads more than 140/90 on at least two occasions.

    Excess weight is linked to high blood pressure in several ways, including changing how our sympathetic nervous system, blood vessels and hormones regulate our blood pressure.

    Essentially, high blood pressure makes our heart and blood vessels work harder and less efficiently, damaging our arteries over time and increasing our risk of heart disease, heart attack and stroke.

    Older man takes his blood pressure at home
    Losing weight can lower your blood pressure.
    Prostock-studio/Shutterstock

    Like the improvements in cholesterol, a 5% weight loss improves both systolic blood pressure (the first number in the reading) and diastolic blood pressure (the second number).

    A meta-analysis of 25 trials on the influence of weight reduction on blood pressure also found every kilo of weight loss improved blood pressure by one point.

    3. Reducing risk for type 2 diabetes

    Excess body weight is the primary manageable risk factor for type 2 diabetes, particularly for people carrying a lot of visceral fat around the abdomen (belly fat).

    Carrying this excess weight can cause fat cells to release pro-inflammatory chemicals that disrupt how our bodies regulate and use the insulin produced by our pancreas, leading to high blood sugar levels.

    Type 2 diabetes can lead to serious medical conditions if it’s not carefully managed, including damaging our heart, blood vessels, major organs, eyes and nervous system.

    Research shows just 7% weight loss reduces risk of developing type 2 diabetes by 58%.

    4. Reducing joint pain and the risk of osteoarthritis

    Carrying excess weight can cause our joints to become inflamed and damaged, making us more prone to osteoarthritis.

    Observational studies show being overweight doubles a person’s risk of developing osteoarthritis, while obesity increases the risk fourfold.

    Small amounts of weight loss alleviate this stress on our joints. In one study each kilogram of weight loss resulted in a fourfold decrease in the load exerted on the knee in each step taken during daily activities.

    Man on bathroom scales
    Losing weight eases stress on joints.
    Shutterstock/Rostislav_Sedlacek

    Focus on long-term habits

    If you’ve ever tried to lose weight but found the kilos return almost as quickly as they left, you’re not alone.

    An analysis of 29 long-term weight-loss studies found participants regained more than half of the weight lost within two years. Within five years, they regained more than 80%.

    When we lose weight, we take our body out of its comfort zone and trigger its survival response. It then counteracts weight loss, triggering several physiological responses to defend our body weight and “survive” starvation.

    Just as the problem is evolutionary, the solution is evolutionary too. Successfully losing weight long-term comes down to:

    • losing weight in small manageable chunks you can sustain, specifically periods of weight loss, followed by periods of weight maintenance, and so on, until you achieve your goal weight

    • making gradual changes to your lifestyle to ensure you form habits that last a lifetime.

    Setting a goal to reach a healthy weight can feel daunting. But it doesn’t have to be a pre-defined weight according to a “healthy” BMI range. Losing 5–10% of our body weight will result in immediate health benefits.

    At the Boden Group, Charles Perkins Centre, we are studying the science of obesity and running clinical trials for weight loss. You can register here to express your interest.The Conversation

    Nick Fuller, Charles Perkins Centre Research Program Leader, University of Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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