Rethinking Exercise: The Workout Paradox

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The notion of running a caloric deficit (i.e., expending more calories than we consume) to reduce bodyfat is appealing in its simplicity, but… we’d say “it doesn’t actually work outside of a lab”, but honestly, it doesn’t actually work outside of a calculator.

Why?

For a start, exercise calorie costs are quite small numbers compared to metabolic base rate. Our brain alone uses a huge portion of our daily calories, and the rest of our body literally never stops doing stuff. Even if we’re lounging in bed and ostensibly not moving, on a cellular level we stay incredibly busy, and all that costs (and the currency is: calories).

Since that cost is reflected in the body’s budget per kg of bodyweight, a larger body (regardless of its composition) will require more calories than a smaller one. We say “regardless of its composition” because this is true regardless—but for what it’s worth, muscle is more “costly” to maintain than fat, which is one of several reasons why the average man requires more daily calories than the average woman, since on average men will tend to have more muscle.

And if you do exercise because you want to run out the budget so the body has to “spend” from fat stores?

Good luck, because while it may work in the very short term, the body will quickly adapt, like an accountant seeing your reckless spending and cutting back somewhere else. That’s why in all kinds of exercise except high-intensity interval training, a period of exercise will be followed by a metabolic slump, the body’s “austerity measures”, to balance the books.

You may be wondering: why is it different for HIIT? It’s because it changes things up frequently enough that the body doesn’t get a chance to adapt. To labor the financial metaphor, it involves lying to your accountant, so that the compensation is not made. Congratulations: you’re committing calorie fraud (but it’s good for the body, so hey).

That doesn’t mean other kinds of exercise are useless (or worse, necessarily counterproductive), though! Just, that we must acknowledge that other forms of exercise are great for various aspects of physical health (strengthening the body, mobilizing blood and lymph, preventing disease, enjoying mental health benefits, etc) that don’t really affect fat levels much (which are decided more in the kitchen than the gym—and even in the category of diet, it’s more about what and how and when you eat, rather than how much).

For more information on metabolic balance in the context of exercise, enjoy:

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  • Blind Spots – by Dr. Marty Makary

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    From the time the US recommended not giving peanuts to infants for the first three years of life “in order to avoid peanut allergies” (whereupon non-exposure to peanuts early in life led to, instead, an increase in peanut allergies and anaphylactic incidents), to the time the US recommended not taking HRT on the strength of the claim that “HRT causes breast cancer” (whereupon the reduced popularity of HRT led to, instead, an increase in breast cancer incidence and mortality), to many other such incidents of very bad public advice being given on the strength of a single badly-misrepresented study (for each respective thing), Dr. Makary puts the spotlight on what went wrong.

    This is important, because this is not just a book of outrage, exclaiming “how could this happen?!”, but rather instead, is a book of inquisition, asking “how did this happen?”, in such a way that we the reader can spot similar patterns going forwards.

    Oftentimes, this is a simple matter of having a basic understanding of statistics, and checking sources to see if the dataset really supports what the headlines are claiming—and indeed, whether sometimes it suggests rather the opposite.

    The style is a little on the sensationalist side, but it’s well-supported with sound arguments, good science, and clear mathematics.

    Bottom line: if you’d like to improve your scientific literacy, this book is an excellent illustrative guide.

    Click here to check out Blind Spots, and eliminate yours!

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  • Boundary-Setting Beyond “No”

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    More Than A “No”

    A lot of people struggle with boundary-setting, and it’s not always the way you might think.

    The person who “can’t say no” to people probably comes to mind, but the problem is more far-reaching than that, and it’s rooted in not being clear over what a boundary actually is.

    For example: “Don’t bring him here again!”

    Pretty clear, right?

    And while it is indeed clear, it’s not a boundary; it’s a command. Which may or may not be obeyed, and at the end of the day, what right have we to command people in general?

    Same goes for less dramatic things like “Don’t talk to me about xyz”, which can still be important or trivial, depending on whether the topic of xyz is deeply traumatizing for you, or mildly annoying, or something else entirely.

    Why this becomes a problem

    It becomes a problem not because of any lack of clarity about your wishes, but rather, because it opens the floor for a debate. The listener may be given to wonder whether your right to not experience xyz is greater or lesser than their right to do/say/etc xyz.

    “My right to swing my fist ends where someone else’s nose begins”

    …does not help here, firstly because both sides will believe themself (or nobody) to be the injured party; for the fist-swinger, the other person’s nose made a vicious assault on their freedom. Or secondly, maybe there was some higher principle at stake; a reason why violence was justified. And then ten levels of philosophical debate. We see this a lot when it comes to freedom of expression, and vigorous debate over whether this entails freedom from social consequences of one’s words/actions.

    How a good boundary-setting works (if this, then that)

    Consider two signs:

    • No trespassing!
    • Trespassers will be shot!

    Superficially, the second just seems like a more violent rendition of the first. But in fact, the second is more informationally useful: it explains what will happen if the boundary is not respected, and allows the reader to make their own informed decision with regard to what to do with that information.

    We can employ this method (and can even do so gently, if we so wish and hopefully we mostly do wish to be gentle) when it comes to social and interpersonal boundary-setting:

    • If you bring him here again, I will refuse you entrance
    • If you bring up that topic again, I will ask you to leave
    • If you do that, I will never speak to you again
    • If you don’t stop drinking, I will divorce you

    This “if-this-then-that” model does the very first thing that any good boundary does: make itself clear.

    It doesn’t rely on moral arguments; it doesn’t invite debate. For example in that last case, it doesn’t argue that the partner doesn’t have the right to drink—it simply expresses what the speaker will exercise their own right to do, in that eventuality.

    (as an aside, the situation that occurs when one is enmeshed with someone who is dependent on a substance is a complex topic, and if you’re interested in that, check out: Codependency Isn’t What Most People Think)

    Back on track: boundary-setting is not about what’s right or good—it’s about nothing more nor less than a clear delineation between what we will and won’t accept, and how we’ll enforce that.

    We can also, in particularly personal boundary-setting (such as with sexual boundaries’ oft-claimed “gray areas”), fix an improperly-set boundary that forgot to do the above, e.g:

    “How about [proposition]?”
    “No thank you” ← casually worded answer; contextually reasonable, and yet not a clear boundary per what we discussed above
    “Come on, I think you’d like it”
    “I said no. No means no. Ask me again and I will [consequences that are appropriate and actionable]”

    What’s “appropriate and actionable” may vary a lot from one situation to another, but it’s important that it’s something you can do and are prepared to do and will do if the condition for doing it is met.

    Anything less than that is not a boundary—it’s just a request.

    Note: this does not require that we have power, by the way. If we have zero power in a situation, well, that definitely sucks, but even then we can still express what is actionable, e.g. “I will never trust you again”.

    “Price of entry”

    You may have wondered, upon reading “boundary-setting is not about what’s right or good—it’s about nothing more nor less than a clear delineation between what we will and won’t accept, and how we’ll enforce that”, can’t that be used to control and manipulate people, essentially coercing them to do or not do things with the threat of consequences (specifically: bad ones)?

    And the answer is: yes, yes it can.

    But that’s where the flipside comes into play—the other person gets to set their boundaries, too.

    For all of us, if we have any boundaries at all, there is a “price of entry” and all who want to be in our lives, or be close to us, have to decide for themselves whether that price of entry is worth it.

    • If a person says “do not talk about topic xyz to me or I will leave”, that is a price of entry for being close to them.
    • If you are passionate about talking about topic xyz to the point that you are unwilling to shelve it when in their presence, then that is the price of entry for being close to you.
    • If one or more of you is not willing to pay the price of entry, then guess what, you’re just not going to be close.

    In cases of forced proximity (e.g. workplaces or families) this is likely to get resolved by the workplace’s own rules (i.e. the price of entry that you agreed to when signing a contract to work there), and if something like that doesn’t exist (such as in families), well, that forced proximity is going to reach a breaking point, and somebody may discover it wasn’t enforceable after all.

    See also: Family Estrangement: More Common Than Most People Think

    …which also details how to fix it, where possible.

    Take care!

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  • Who Screens The Sunscreens?

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    We Screen The Sunscreens!

    Yesterday, we asked you what your sunscreen policy was, and got a spread of answers. Apparently this one was quite polarizing!

    One subscriber who voted for “Sunscreen is essential to protect us against skin aging and cancer” wrote:

    ❝My mom died of complications from melanoma, so we are vigilant about sun and sunscreen. We are a family of campers and hikers and gardeners—outdoors in all seasons—and we never burn❞

    Our condolences with regard to your mom! Life is so precious, and when something like that happens, it tends to stick with us. We’re glad you and your family are taking care of yourselves.

    Of the subscribers who voted for “I put some on if I think I might otherwise get sunburned”, about half wrote to express uncertainties:

    • uncertainty about how safe it is, and
    • uncertainty about how helpful it is

    …so we’re going to tackle those questions in a moment. But what of those who voted for “Sunscreen is full of harmful chemicals that can cause cancer”?

    Of those, only one wrote a message, which was to say one has to be very careful of what is in the formula.

    Let’s take a look, then…

    Sunscreen is full of harmful chemicals that can cause cancer: True or False?

    False—according to current best science. Research is ongoing!

    There are four main chemicals (found in most sunscreens) that people tend to worry about:

    • Abobenzone
    • Oxybenzone
    • Octocrylene
    • Ecamsule

    Now, these two sound like four brands of rocket fuel, but then, dihydrogen monoxide (DHMO), which is also found in most sunscreens, sounds like a deadly toxin too. That’s water, by the way.

    But what of these four chemicals? Well, as we say, research is ongoing, but we found a study that measured all four, to see how much got into the blood, and what adverse effects, if any, this caused.

    We’ll skip to their conclusion:

    ❝In this preliminary study involving healthy volunteers, application of 4 commercially available sunscreens under maximal use conditions resulted in plasma concentrations that exceeded the threshold established by the FDA for potentially waiving some nonclinical toxicology studies for sunscreens. The systemic absorption of sunscreen ingredients supports the need for further studies to determine the clinical significance of these findings. These results do not indicate that individuals should refrain from the use of sunscreen.❞

    Now, “exceeded the threshold established by the FDA for potentially waiving some nonclinical toxicology studies for sunscreens” sounds alarming, so why did they close with the words “These results do not indicate that individuals should refrain from the use of sunscreen”?

    Let’s skip back up to a line from the results:

    ❝The most common adverse event was rash, which developed in 1 participant with each sunscreen.❞

    This was most probably due to the oxybenzone, which can cause allergic skin reactions in some people.

    Let us take a moment to remember the most common adverse event that occurs from not wearing sunscreen: sunburn!

    You can read the full study here:

    Effect of Sunscreen Application Under Maximal Use Conditions on Plasma Concentration of Sunscreen Active Ingredients—A Randomized Clinical Trial

    None of those ingredients have been found to be carcinogenic, even at the maximal blood plasma concentrations studied, from applications 4x/day to 75% of the body.

    UVA rays, on the other hand, are absolutely very much known to cause cancer, and the effect is cumulative.

    Sunscreen is essential to protect us against skin aging and cancer: True or False?

    True, unequivocally, unless we live indoors and/or otherwise never go about under sunlight.

    “But our ancestors—” lived under the same sun we do, and either used sunscreen or got advanced skin aging and cancer.

    Sunscreen of times past ranged from mud to mineral lotions, but it’s pretty much always existed. Even non-human animals that have skin and don’t have fur or feathers, tend to take mud-baths in sunny parts of the world.

    If you’d like to avoid oxybenzone and other chemicals, though, you might have your reasons. Maybe you’re allergic, or maybe you read that it’s a potential endocrine disruptor with estrogen-like and anti-androgenic properties that you don’t want.

    There are other options, to include physical blockers containing zinc and titanium dioxide, which are generally recognized as safe and effective ingredients.

    If you’re interested, you can even make your own sunscreen that blocks both UVA and UVB rays (UVA is what causes skin cancer; UVB is “milder” and is what causes sunburn):

    How to Make a Safe and Effective Sunscreen from Scratch – medically reviewed by Dr. Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT

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  • Ridged Nails: What Are They Telling You?
  • Can you die from long COVID? The answer is not so simple

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    Nearly five years into the pandemic, COVID is feeling less central to our daily lives.

    But the virus, SARS-CoV-2, is still around, and for many people the effects of an infection can be long-lasting. When symptoms persist for more than three months after the initial COVID infection, this is generally referred to as long COVID.

    In September, Grammy-winning Brazilian musician Sérgio Mendes died aged 83 after reportedly having long COVID.

    Australian data show 196 deaths were due to the long-term effects of COVID from the beginning of the pandemic up to the end of July 2023.

    In the United States, the Centers for Disease Control and Prevention reported 3,544 long-COVID-related deaths from the start of the pandemic up to the end of June 2022.

    The symptoms of long COVID – such as fatigue, shortness of breath and “brain fog” – can be debilitating. But can you die from long COVID? The answer is not so simple.

    Jan Krava/Shutterstock

    How could long COVID lead to death?

    There’s still a lot we don’t understand about what causes long COVID. A popular theory is that “zombie” virus fragments may linger in the body and cause inflammation even after the virus has gone, resulting in long-term health problems. Recent research suggests a reservoir of SARS-CoV-2 proteins in the blood might explain why some people experience ongoing symptoms.

    We know a serious COVID infection can damage multiple organs. For example, severe COVID can lead to permanent lung dysfunction, persistent heart inflammation, neurological damage and long-term kidney disease.

    These issues can in some cases lead to death, either immediately or months or years down the track. But is death beyond the acute phase of infection from one of these causes the direct result of COVID, long COVID, or something else? Whether long COVID can directly cause death continues to be a topic of debate.

    Of the 3,544 deaths related to long COVID in the US up to June 2022, the most commonly recorded underlying cause was COVID itself (67.5%). This could mean they died as a result of one of the long-term effects of a COVID infection, such as those mentioned above.

    COVID infection was followed by heart disease (8.6%), cancer (2.9%), Alzheimer’s disease (2.7%), lung disease (2.5%), diabetes (2%) and stroke (1.8%). Adults aged 75–84 had the highest rate of death related to long COVID (28.8%).

    These findings suggest many of these people died “with” long COVID, rather than from the condition. In other words, long COVID may not be a direct driver of death, but rather a contributor, likely exacerbating existing conditions.

    A woman lying in bed in the dark.
    The symptoms of long COVID can be debilitating. Lysenko Andrii/Shutterstock

    ‘Cause of death’ is difficult to define

    Long COVID is a relatively recent phenomenon, so mortality data for people with this condition are limited.

    However, we can draw some insights from the experiences of people with post-viral conditions that have been studied for longer, such as myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS).

    Like long COVID, ME/CFS is a complex condition which can have significant and varied effects on a person’s physical fitness, nutritional status, social engagement, mental health and quality of life.

    Some research indicates people with ME/CFS are at increased risk of dying from causes including heart conditions, infections and suicide, that may be triggered or compounded by the debilitating nature of the syndrome.

    So what is the emerging data on long COVID telling us about the potential increased risk of death?

    Research from 2023 has suggested adults in the US with long COVID were at greater risk of developing heart disease, stroke, lung disease and asthma.

    Research has also found long COVID is associated with a higher risk of suicidal ideation (thinking about or planning suicide). This may reflect common symptoms and consequences of long COVID such as sleep problems, fatigue, chronic pain and emotional distress.

    But long COVID is more likely to occur in people who have existing health conditions. This makes it challenging to accurately determine how much long COVID contributes to a person’s death.

    Research has long revealed reliability issues in cause-of-death reporting, particularly for people with chronic illness.

    Flowers in a cemetery.
    Determining the exact cause of someone’s death is not always easy. Pixabay/Pexels

    So what can we conclude?

    Ultimately, long COVID is a chronic condition that can significantly affect quality of life, mental wellbeing and overall health.

    While long COVID is not usually immediately or directly life-threatening, it’s possible it could exacerbate existing conditions, and play a role in a person’s death in this way.

    Importantly, many people with long COVID around the world lack access to appropriate support. We need to develop models of care for the optimal management of people with long COVID with a focus on multidisciplinary care.

    Dr Natalie Jovanovski, Vice Chancellor’s Senior Research Fellow in the School of Health and Biomedical Sciences at RMIT University, contributed to this article.

    Rose (Shiqi) Luo, Postdoctoral Research Fellow, School of Health and Biomedical Sciences, RMIT University; Catherine Itsiopoulos, Professor and Dean, School of Health and Biomedical Sciences, RMIT University; Kate Anderson, Vice Chancellor’s Senior Research Fellow, RMIT University; Magdalena Plebanski, Professor of Immunology, RMIT University, and Zhen Zheng, Associate Professor, STEM | Health and Biomedical Sciences, RMIT University

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

    Don’t Forget…

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  • “Why Does It Hurt When I Have Sex?” (And What To Do About It)

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    This is one that affects mostly women, with 43% of American women reporting such issues at some point. There’s a distribution curve to this, with higher incidence in younger and older women; younger while first figuring things out, and older with menopause-related body changes. But, it can happen at any time (and often not for obvious reasons!), so here’s what OB/GYN Dr. Jennifer Lincoln advises:

    Many possibilities, but easily narrowed down

    Common causes include:

    • vaginal dryness, which itself can have many causes (half of which are “low estrogen levels” for various different reasons)
    • muscular issues, which can be in response to anxiety, pain, and occur as a result of pelvic floor muscle tightening
    • vulvar issues, ranging from skin disorders (e.g. lichen sclerosis or lichen planus) to nerve disorders (e.g. vestibulitis or vestibulodynia)
    • uterine issues, including endometriosis, fibroids, or scar tissue if you had a surgery
    • infections, of the STI variety, but bear in mind that some STIs such as herpes do not necessarily require direct sexual contact per se, and yeast infections definitely don’t. Some STIs are more serious than others, so getting things checked out is a good idea (don’t worry, clinics are discreet about this sort of thing)
    • bowel issues, notwithstanding that we have been talking about vaginal sex here, it can’t be happy if its anatomical neighbors aren’t happy—so things like IBS, Crohn’s, or even just constipation, aren’t irrelevant
    • trauma, of various kinds, affecting sexual experiences

    That’s a lot of possibilities, so if there’s not something standing out as “yes, now that you mention it, it’s obviously that”, Dr. Lincoln recommends a full health evaluation and examination of medical history, as well as a targeted physical exam. That may not be fun, but at least, once it’s done, it’s done.

    Treatments vary depending on the cause, of course, and there are many kinds of physical and psychological therapies, as well as surgeries for the uterine issues we mentioned.

    Happily, many of the above things can be addressed with simpler and less invasive methods, including learning more about the relevant anatomy and physiology and how to use it (be not ashamed; most people never got meaningful education about this!)*, vulvar skin care (“gentle” is the watchword here), the difference a good lube can make, and estrogen supplementation—which if you’re not up for general HRT, can be a topical estrogen cream that alleviates sexual function issues without raising blood serum estradiol levels.

    *10almonds tip: check out the recommended book “Come As You Are” in our links below; it has 400 pages of stuff most people never knew about anatomy and physiology down there; you can thank us later!

    Meanwhile, for more on each of these, enjoy:

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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:

    Is Dairy Scary?

    Take care!

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