Rebalancing Dopamine (Without “Dopamine Fasting”)
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Rebalancing Dopamine (Without “Dopamine Fasting”)
This is Dr. Anna Lembke. She’s a professor of psychiatry at Stanford, and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic—as well as running her own clinical practice, and serving on the board of an array of state and national addiction-focused organizations.
Today we’re going to look at her work on dopamine management…
Getting off the hedonic treadmill
For any unfamiliar with the term, the “hedonic treadmill” is what happens when we seek pleasure, enjoy the pleasure, the pleasure becomes normalized, and now we need to seek a stronger pleasure to get above our new baseline.
In other words, much like running on a reciprocal treadmill that just gets faster the faster we run.
What Dr. Lembke wants us to know here: pleasure invariably leads to pain
This is not because of some sort of extrinsic moral mandate, nor even in the Buddhist sense. Rather, it is biology.
Pleasure and pain are processed by the same part of the brain, and if we up one, the other will be upped accordingly, to try to keep a balance.
Consequently, if we recklessly seek “highs”, we’re going to hit “lows” soon enough. Whether that’s by drugs, sex, or just dopaminergic habits like social media overuse.
Dr. Lembke’s own poison of choice was trashy romance novels, by the way. But she soon found she needed more, and more, and the same level wasn’t “doing it” for her anymore.
So, should we just give up our pleasures, and do a “dopamine fast”?
Not so fast!
It depends on what they are. Dopamine fasting, per se, does not work. We wrote about this previously:
Short On Dopamine? Science Has The Answer
However, when it comes to our dopaminergic habits, a short period (say, a couple of weeks) of absence of that particular thing can help us re-find our balance, and also, find insight.
Lest that latter sound wishy-washy: this is about realizing how bad an overuse of some dopaminergic activity had become, the better to appreciate it responsibly, going forwards.
So in other words, if your poison is, as in Dr. Lembke’s case, trashy romance novels, you would abstain from them for a couple of weeks, while continuing to enjoy the other pleasures in life uninterrupted.
Substances that create a dependency are a special case
There’s often a popular differentiation between physical addictions (e.g. alcohol) and behavioral addictions (e.g. video games). And that’s fair; physiologically speaking, those may both involve dopamine responses, but are otherwise quite different.
However, there are some substances that are physical addictions that do not create a physical dependence (e.g. sugar), and there are substances that create a physical dependence without being addictive (e.g. many antidepressants)
See also: Addiction and physical dependence are not the same thing
In the case of anything that has created a physical dependence, Dr. Lembke does not recommend trying to go “cold turkey” on that without medical advice and supervision.
Going on the counterattack
Remember what we said about pleasure and pain being processed in the same part of the brain, and each rising to meet the other?
While this mean that seeking pleasure will bring us pain, the inverse is also true.
Don’t worry, she’s not advising us to take up masochism (unless that’s your thing!). But there are very safe healthy ways that we can tip the scales towards pain, ultimately leading to greater happiness.
Cold showers are an example she cites as particularly meritorious.
As a quick aside, we wrote about the other health benefits of these, too:
A Cold Shower A Day Keeps The Doctor Away?
Further reading
Want to know more? You might like her book:
Dopamine Nation: Finding Balance in the Age of Indulgence
Enjoy!
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What’s the difference between miscarriage and stillbirth?
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What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.
Former US First Lady Michelle Obama revealed in her memoir she had a miscarriage. UK singer-songwriter and actor Lily Allen has gone on the record about her stillbirth.
Both miscarriage and stillbirth are sadly familiar terms for pregnancy loss. They can be traumatic life events for the prospective parents and family, and their impacts can be long-lasting. But the terms can be confused.
Here are some similarities and differences between miscarriage and stillbirth, and why they matter.
christinarosepix/Shutterstock Let’s start with some definitions
In broad terms, a miscarriage is when a pregnancy ends while the fetus is not yet viable (before it could survive outside the womb).
This is the loss of an “intra-uterine” pregnancy, when an embryo is implanted in the womb to then develop into a fetus. The term miscarriage excludes ectopic pregnancies, where the embryo is implanted outside the womb.
However, stillbirth refers to the end of a pregnancy when the fetus is normally viable. There may have been sufficient time into the pregnancy. Alternatively, the fetus may have grown large enough to be normally expected to survive, but it dies in the womb or during delivery.
The Australian Institute of Health and Welfare defines stillbirth as a fetal death of at least 20 completed weeks of gestation or with a birthweight of at least 400 grams.
Internationally, definitions of stillbirth vary depending on the jurisdiction.
How common are they?
It is difficult to know how common miscarriages are as they can happen when a woman doesn’t know she is pregnant. There may be no obvious symptoms or something that looks like a heavier-than-normal period. So miscarriages are likely to be more common than reported.
Studies from Europe and North America suggest a miscarriage occurs in about one in seven pregnancies (15%). More than one in eight women (13%) will have a miscarriage at some time in her life.
Around 1–2% of women have recurrent miscarriages. In Australia this is when someone has three or more miscarriages with no pregnancy in between.
Australia has one of the lowest rates of stillbirth in the world. The rate has been relatively steady over the past 20 years at 0.7% or around seven per 1,000 pregnancies.
Who’s at risk?
Someone who has already had a miscarriage or stillbirth has an increased risk of that outcome again in a subsequent pregnancy.
Compared with women who have had a live birth, those who have had a stillbirth have double the risk of another. For those who have had recurrent miscarriages, the risk of another miscarriage is four-fold higher.
Some factors have a u-shaped relationship, with the risk of miscarriage and stillbirth lowest in the middle.
For instance, maternal age is a risk factor for both miscarriage and stillbirth, especially if under 20 years old or older than 35. Increasing age of the male is only a risk factor for stillbirth, especially for fathers over 40.
An older dad can be a risk factor for stillbirth, but not miscarriage. Elizaveta Galitckaia/Shutterstock Similarly for maternal bodyweight, women with a body mass index or BMI in the normal range have the lowest risk of miscarriage and stillbirth compared with those in the obese or underweight categories.
Lifestyle factors such as smoking and heavy alcohol drinking while pregnant are also risk factors for both miscarriage and stillbirth.
So it’s important to not only avoid smoking and alcohol while pregnant, but before getting pregnant. This is because early in the pregnancy, women may not know they have conceived and could unwittingly expose the developing fetus.
Why do they happen?
Miscarriage often results from chromosomal problems in the developing fetus. However, genetic conditions or birth defects account for only 7-14% of stillbirths.
Instead, stillbirths often relate directly to pregnancy complications, such as a prolonged pregnancy or problems with the umbilical cord.
Maternal health at the time of pregnancy is another contributing factor in the risk of both miscarriage and stillbirths.
Chronic diseases, such as high blood pressure, diabetes, hypothyroidism (underactive thyroid), polycystic ovary syndrome, problems with the immune system (such as an autoimmune disorder), and some bacterial and viral infections are among factors that can increase the risk of miscarriage.
Similarly mothers with diabetes, high blood pressure, and untreated infections, such as malaria or syphilis, face an increased risk of stillbirth.
In many cases, however, the specific cause of pregnancy loss is not known.
How about the long-term health risks?
Miscarriage and stillbirth can be early indicators of health issues later in life.
For instance, women who have had recurrent miscarriages or recurrent stillbirths are at higher risk of cardiovascular disease (such as heart disease or stroke).
Our research has also looked at the increased risk of stroke. Compared with women who had never miscarried, we found women with a history of three or more miscarriages had a 35% higher risk of non-fatal stroke and 82% higher risk of fatal stroke.
Women who had a stillbirth had a 31% higher risk of a non-fatal stroke, and those who had had two or more stillbirths were at a 26% higher risk of a fatal stroke.
We saw similar patterns in chronic obstructive pulmonary disease or COPD, a progressive lung disease with respiratory symptoms such as breathlessness and coughing.
Our data showed women with a history of recurrent miscarriages or stillbirths were at a 36% or 67% higher risk of COPD, respectively, even after accounting for a history of asthma.
Long-term health risks of recurrent miscarriages or stillbirths include developing lung disease later in life. PRPicturesProduction/Shutterstock Why is all this important?
Being well-informed about the similarities and differences between these two traumatic life events may help explain what has happened to you or a loved one.
Where risk factors can be modified, such as smoking and obesity, this information can be empowering for individuals who wish to reduce their risk of miscarriage and stillbirth and make lifestyle changes before they become pregnant.
More information and support about miscarriage and stillbirth is available from SANDS and Pink Elephants.
Gita Mishra, Professor of Life Course Epidemiology, Faculty of Medicine, The University of Queensland; Chen Liang, PhD student, reproductive history and non-communicable diseases in women, The University of Queensland, and Jenny Doust, Clinical Professorial Research Fellow, School of Public Health, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Kidney Beans vs Fava Beans – Which is Healthier?
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Our Verdict
When comparing kidney beans to fava beans, we picked the kidney beans.
Why?
It’s a simple and straightforward one today!
The macronutrient profiles are mostly comparable, but kidney beans do have a little more protein and a little more fiber.
In the category of vitamins, kidney beans have more of vitamins B1, B5, B6, B9, C, E, & K, while fava beans boast only more of vitamins B2 and B3. They are both equally good sources of choline, but the general weight of vitamins is very much in kidney beans’ favor, with a 7:2 lead, most of which have generous margins.
When it comes to minerals, kidney beans have more iron, phosphorus, and potassium, while fava beans have more copper and selenium. They’re both equally good sources of other minerals they both contain. Still, a 3:2 victory for kidney beans on the mineral front.
Adding up the moderate victory on macros, the strong victory on vitamins, and the slight victory on minerals, all in all makes for a clear win for kidney beans.
Still, enjoy both! Diversity is healthy.
Want to learn more?
You might like to read:
Chickpeas vs Black Beans – Which is Healthier?
Take care!
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Codependent No More – by Melody Beattie
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This is a book review, not a book summary, but first let’s quickly cover a common misconception, because the word “codependent” gets misused a lot in popular parlance:
- What codependence isn’t: “we depend on each other and must do everything together”
- What codependence is:“person 1 has a dependency on a substance (or perhaps a behavior, such as gambling); person 2 is trying to look after person 1, and so has developed a secondary relationship with the substance/behavior. Person 2 is now said to be codependent, because it becomes all-consuming for them too, even if they’re not using the substance/behavior directly”
Funny how often it happens that the reality is more complex than the perception, isn’t it?
Melody Beattie unravels all this for us. We get a compassionate and insightful look at how we can look after ourselves, while looking after another. Perhaps most importantly: how and where to draw a line of what we can and cannot do/change for them.
Because when we love someone, of course we want to fight their battles with them, if not for them. But if we want to be their rock of strength, we can’t get lost in it too, and of course that hurts.
Beatty takes us through these ideas and more, for example:
- How to examine our own feelings even when it’s scary
- How to practice self-love and regain self-worth, while still caring for them
- How to stop being reactionary, step back, and act with purpose
If the book has any weak point, it’s that it repeatedly recommends 12-step programs, when in reality that’s just one option. But for those who wish to take another approach, this book does not require involvement in a 12-step program, so it’s not a barrier to usefulness.
Click here to check out Codependent No More and take care of yourself, too
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Three Critical Kitchen Prescriptions
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Three Critical Kitchen Prescriptions
This is Dr. Saliha Mahmood-Ahmed. She’s a medical doctor—specifically, a gastroenterologist. She’s also a chef, and winner of the BBC’s MasterChef competition. So, from her gastroenterology day-job and her culinary calling, she has some expert insights to share on eating well!
❝Food and medicine are inextricably linked to one another, and it is an honour to be a doctor who specialises in digestive health and can both cook, and teach others to cook❞
~ Dr. Saliha Mahmood-Ahmed, after winning MasterChef and being asked if she’d quit medicine to be a full-time chef
Dr. Mahmood-Ahmed’s 3 “Kitchen Prescriptions”
They are:
- Cook, cook, cook
- Feed your gut bugs
- Do not diet
Let’s take a look at each of those…
Cook, cook, cook
We’re the only species on Earth that cooks food. An easy knee-jerk response might be to think maybe we shouldn’t, then, but… We’ve been doing it for at least 30,000 years, which is about 1,500 generations, while a mere 100 generations is generally sufficient for small evolutionary changes. So, we’ve evolved this way now.
More importantly in this context: we, ourselves, should cook our own food, at least per household.
Not ready meals; we haven’t evolved for those (yet! Give it another few hundred generations maybe)
Feed your gut bugs
The friendly ones. Enjoy prebiotics, probiotics, and plenty of fiber—and then be mindful of what else you do or don’t eat. Feeding the friendly bacteria while starving the unfriendly ones may seem like a tricky task, but it actually can be quite easily understood and implemented. We did a main feature about this a few weeks ago:
Making Friends With Your Gut (You Can Thank Us Later)
Do not diet
Dr. Mahmood-Ahmed is a strong critic of calorie-counting as a weight-loss strategy:
Rather than focusing on the number of calories consumed, try focusing on introducing enough variety of food into your daily diet, and on fostering good microbial diversity within your gut.
It’s a conceptual shift from restrictive weight loss, to prescriptive adding of things to one’s diet, with fostering diversity of microbiota as a top priority.
This, too, she recommends be undertaken gently, though—making small, piecemeal, but sustainable improvements. Nobody can reasonably incorporate, say, 30 new fruits and vegetables into one’s diet in a week; it’s unrealistic, and more importantly, it’s unsustainable.
Instead, consider just adding one new fruit or vegetable per shopping trip!
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Let’s Get Letting Go (Of These Three Things)
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Let It Go…
This is Dr. Mitika Kanabar. She’s triple board-certified in addiction medicine, lifestyle medicine, and family medicine.
What does she want us to know?
Let go of what’s not good for you
Take a moment to release any tension you were holding, perhaps in your shoulders or jaw.
Now release the breath you might have been holding while doing that.
Dr. Kanabar is a keen yoga practitioner, and recommends it for alleviating stress, as well as its more general somatic benefits. And yes, stress is in large part somatic too!
One method she recommends for de-stressing quickly is to imagine holding a pin-wheel (the kind that whirls around when blown), and imagine slowly blowing it. The slowness of the exhalation here not only means we exhale more (shallow breathing starts with the out-breath!), but also gives us time to focus on the present moment.
Having done that, she recommends to ask yourself:
- What can you change right now?
- What about next time?
- How can you do better?
And then the much more relaxing questions:
- What can you not change?
- What can you let go?
- Whom can you ask for help?
Why did we ask the first questions first? It’s a lot like a psychological version of the physical process of progressive relaxation, involving first a deliberate tensing up, and then a greater relaxation:
How To Deal With The Body’s “Wrong” Stress Response
The diet that’s not good for you
Dr. Kanabar also recommends letting go of the diet that’s not good for you, too. In particular, she recommends dropping alcohol, sugar, and animal products.
Note: from a purely health perspective, general scientific consensus is that fermented dairy products are healthy in small amounts, as are well-sourced fish and poultry in moderation, assuming they’re not ultraprocessed or fried. However, we’re reporting Dr. Kanabar’s advice as it is.
Dr. Kanabar recommends either doing a 21-day challenge of abstention (and likely finding after 21 days that, in fact, you’re fine without), or taking a slow-and-gentle approach.
Some things will be easier one way or the other, and in particular if you drink heavily or use some other substance that gives withdrawal symptoms if withdrawn, the slow-and-gentle approach will be best:
Which Addiction-Quitting Methods Work Best?
If it’s sugar you’re quitting, you might like to check out:
Food Addictions: When It’s More Than “Just” Cravings
If it’s meat, though (in particular, quitting red meat is a big win for your health), the following can help:
The Whys and Hows of Cutting Meats Out Of Your Diet
Want more from Dr. Kanabar?
There’s one more thing she advises to let go of, and that’s excessive use of technology (the kind with screens) in the evening, and not just because of the blue light thing.
With full appreciation of the irony of a one-hour video about too much screentime:
Click Here If The Embedded Video Doesn’t Load Automatically
Enjoy!
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Can you drink your fruit and vegetables? How does juice compare to the whole food?
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Do you struggle to eat your fruits and vegetables? You are not alone. Less than 5% of Australians eat the recommended serves of fresh produce each day (with 44% eating enough fruit but only 6% eating the recommended vegetables).
Adults should aim to eat at least five serves of vegetables (or roughly 375 grams) and two serves of fruit (about 300 grams) each day. Fruits and vegetables help keep us healthy because they have lots of nutrients (vitamins, minerals and fibre) and health-promoting bioactive compounds (substances not technically essential but which have health benefits) without having many calories.
So, if you are having trouble eating the rainbow, you might be wondering – is it OK to drink your fruits and vegetables instead in a juice or smoothie? Like everything in nutrition, the answer is all about context.
Darina Belonogova/Pexels It might help overcome barriers
Common reasons for not eating enough fruits and vegetables are preferences, habits, perishability, cost, availability, time and poor cooking skills. Drinking your fruits and vegetables in juices or smoothies can help overcome some of these barriers.
Juicing or blending can help disguise tastes you don’t like, like bitterness in vegetables. And it can blitz imperfections such as bruises or soft spots. Preparation doesn’t take much skill or time, particularly if you just have to pour store-bought juice from the bottle. Treating for food safety and shipping time does change the make up of juices slightly, but unsweetened juices still remain significant sources of nutrients and beneficial bioactives.
Juicing can extend shelf life and reduce the cost of nutrients. In fact, when researchers looked at the density of nutrients relative to the costs of common foods, fruit juice was the top performer.
So, drinking my fruits and veggies counts as a serve, right?
How juice is positioned in healthy eating recommendations is a bit confusing. The Australian Dietary Guidelines include 100% fruit juice with fruit but vegetable juice isn’t mentioned. This is likely because vegetable juices weren’t as common in 2013 when the guidelines were last revised.
The guidelines also warn against having juice too often or in too high amounts. This appears to be based on the logic that juice is similar, but not quite as good as, whole fruit. Juice has lower levels of fibre compared to fruits, with fibre important for gut health, heart health and promoting feelings of fullness. Juice and smoothies also release the sugar from the fruit’s other structures, making them “free”. The World Health Organization recommends we limit free sugars for good health.
But fruit and vegetables are more than just the sum of their parts. When we take a “reductionist” approach to nutrition, foods and drinks are judged based on assumptions made about limited features such as sugar content or specific vitamins.
But these features might not have the impact we logically assume because of the complexity of foods and people. When humans eat varied and complex diets, we don’t necessarily need to be concerned that some foods are lower in fibre than others. Juice can retain the nutrients and bioactive compounds of fruit and vegetables and even add more because parts of the fruit we don’t normally eat, like the skin, can be included.
Juicing or blending might mean you eat different parts of the fruit or vegetable. flyingv3/Shutterstock So, it is healthy then?
A recent umbrella review of meta-analyses (a type of research that combines data from multiple studies of multiple outcomes into one paper looked at the relationship between 100% juice and a range of health outcomes.
Most of the evidence showed juice had a neutral impact on health (meaning no impact) or a positive one. Pure 100% juice was linked to improved heart health and inflammatory markers and wasn’t clearly linked to weight gain, multiple cancer types or metabolic markers (such as blood sugar levels).
Some health risks linked to drinking juice were reported: death from heart disease, prostate cancer and diabetes risk. But the risks were all reported in observational studies, where researchers look at data from groups of people collected over time. These are not controlled and do not record consumption in the moment. So other drinks people think of as 100% fruit juice (such as sugar-sweetened juices or cordials) might accidentally be counted as 100% fruit juice. These types of studies are not good at showing the direct causes of illness or death.
What about my teeth?
The common belief juice damages teeth might not stack up. Studies that show juice damages teeth often lump 100% juice in with sweetened drinks. Or they use model systems like fake mouths that don’t match how people drinks juice in real life. Some use extreme scenarios like sipping on large volumes of drink frequently over long periods of time.
Juice is acidic and does contain sugars, but it is possible proper oral hygiene, including rinsing, cleaning and using straws can mitigate these risks.
Again, reducing juice to its acid level misses the rest of the story, including the nutrients and bioactives contained in juice that are beneficial to oral health.
Juice might be more convenient and could replace less healthy drinks. PintoArt/Shutterstock So, what should I do?
Comparing whole fruit (a food) to juice (a drink) can be problematic. They serve different culinary purposes, so aren’t really interchangeable.
The Australian Guide to Healthy Eating recommends water as the preferred beverage but this assumes you are getting all your essential nutrients from eating.
Where juice fits in your diet depends on what you are eating and what other drinks it is replacing. Juice might replace water in the context of a “perfect” diet. Or juice might replace alcohol or sugary soft drinks and make the relative benefits look very different.
On balance
Whether you want to eat your fruits and vegetables or drink them comes down to what works for you, how it fits into the context of your diet and your life.
Smoothies and juices aren’t a silver bullet, and there is no evidence they work as a “cleanse” or detox. But, with society’s low levels of fruit and vegetable eating, having the option to access nutrients and bioactives in a cheap, easy and tasty way shouldn’t be discouraged either.
Emma Beckett, Adjunct Senior Lecturer, Nutrition, Dietetics & Food Innovation – School of Health Sciences, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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