What Mattress Is Best, By Science?

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The Foundations of Good Sleep

You probably know the importance of good sleep for good health. If not, here’s a quick refresher:

You should also definitely check out this quite famous book on the topic:

Why We Sleep – by Dr Matthew Walker

What helps, to get that good sleep

We’ve covered this a little before too, for example:

How to level-up from there

One of the biggest barriers to good sleep for many people is obstructive sleep apea:

Healthier, Natural Sleep Without Obstruction!

We covered (in the above article) a whole lot of ways of mitigating/managing obstructive sleep apnea. One of the things we mentioned as beneficial was avoiding sleeping on one’s back, and this is something Mayo Clinic’s Dr. Somers agreed with:

Back Sleeping, And Sleeping Differently After 50

“But side-sleeping is uncomfortable”

If this is you, then chances are you have the wrong mattress.

If your mattress is too firm, you can get around it by using this “five pillow” method:

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If your mattress is too soft, then sorry, you really just have to throw that thing out and start again.

The Goldilocks mattress

While different people will have different subjective preferences, the science is quite clear on what is actually best for people’s spines. As this review of 39 qualified scholarly articles concluded:

❝Results of this systematic review show that a medium-firm mattress promotes comfort, sleep quality and rachis alignment❞

~ Dr. Gianfilippo Caggiari et al.

Read in full: What type of mattress should be chosen to avoid back pain and improve sleep quality? Review of the literature

Note: to achieve “medium-firm” that remains “medium firm” has generally been assumed to require a memory-foam mattress.

How memory-foam works: memory-foam is a moderately thermosoftening material, designed to slightly soften at the touch of human body temperature, and be firmer at room temperature. This will result in it molding itself to the form of a human body, providing what amounts to personalized support for your personal shape and size, meaning your spine can stay exactly as it’s supposed to when you’re sleeping on your side, instead of (for example) your hips being wider meaning that your lumbar vertebrae are raised higher than your thoracic vertebrae, giving you the equivalent of a special nocturnal scoliosis.

It will, therefore, stop working if

  • the ambient temperature is comparable to human body temperature (as happens in some places sometimes, and increasingly often these days)
  • you die, and thus lose your body temperature (but in that case, your spinal alignment will be the least of your concerns)

Here’s a good explanation of the mechanics of memory foam from the Sleep Foundation:

Sleep Foundation | What is Memory Foam?

An alternative to memory foam?

If you don’t like memory foam (one criticism is that it doesn’t allow good ventilation underneath the body), there is an alterative, the grid mattress.

It’s very much “the new kid on the block” and the science is young for this, but for example this recent (April 2024) study that concluded:

❝The grid mattress is a simple, noninvasive, and nonpharmacological intervention that improved adults sleep quality and health. Controlled trials are encouraged to examine the effects of this mattress in a variety of populations and environments.❞

~ Dr. Heather Hausenblas et al.

Read in full: Effectiveness of a grid mattress on adults’ sleep quality and health: A quasi-experimental intervention study

However, that was a small (n=39) uncontrolled (i.e. there was no control group) study, and the conflict of interest statement is, well, interesting:

❝Heather A. Hausenblas, Stephanie L. Hooper, Martin Barragan, and Tarah Lynch declare no conflict of interest. Michael Breus served as a former consultant for Purple, LLC.❞

~ Ibid.

…which is a fabulous way of distracting from the mention in the “Acknowledgements” section to follow, that…

❝Purple, LLC, provided financial support for the study❞

~ Ibid.

Purple is the company that invented the mattress being tested. So while this doesn’t mean the study is necessarily dishonest and/or corrupt, it does at the very least raise a red flag for a potential instance of publication bias (because Purple may have funded multiple studies and then pulled funding of the ones that weren’t going their way).

If you are interested in Purple’s mattress and how it works, you can check it out herethis is a link for your interest and information; not an advertisement or an endorsement. We look forward to seeing more science for this though, and echo their own call for randomized controlled trials!

Summary

Sleep is important, and while it’s a popular myth that we need less as we get older, the truth is that we merely get less on average, while still needing the same amount.

A medium-firm memory-foam mattress is a very good, well-evidenced way to support that (both figuratively and literally!).

A grid mattress is an interesting innovation, and/but we’d like to see more science for it.

Take care!

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  • 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 Plan For The Unplannable

    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 Always Follow Through

    ❝Two roads diverged in a wood, and I—
    I took the one less traveled by,
    And that has made all the difference:
    Now my socks are wet.❞

    ~ with apologies to Robert Frost

    The thing is, much like a different Robert wrote, “The best-laid schemes o’ mice an’ men gang aft agley”, and when we have a plan and the unexpected occurs, we often find ourselves in a position of “well then, now what?”

    This goes for New Year’s Resolutions that lasted until around January the 4th, and it goes for “xyz in a month” plans of diet, exercise, or so forth.

    We’ve written before on bolstering flagging motivation when all is as expected but we just need an extra boost:

    How To Keep On Keeping On… Long Term!

    …but what about when the unexpected happens?

    First rule: wear a belt and suspenders

    Not literally, unless that’s your thing. But you might have heard this phrase from the business world, and it applies to healthful practices too:

    If your primary plan fails, you need a second one already in place.

    In business, we see this as “business continuity management”. For example, your writer here, I have backups for every important piece of tech I own, Internet connections from two different companies in case one goes down, and if there’s a power cut, I have everything accessible and sync’d on a fully-charged tablet so I can complete my work there if necessary. And yes, I have low-tech coffee-brewing equipment too.

    In health, we should be as serious. We all learned back in 2020 that grocery stores and supply chains can fail; how do we eat healthily when all that is on sale is an assortment of random odds and ends? The answer, as we now know because hindsight really is 2020 in this case, is to keep a well-stocked pantry of healthy things with a long shelf life. Also a good stock of whatever supplements we take, and medicines, and water. And maintain them and rotate the stock!

    And what of exercise? We must not rely on gyms, we can use and enjoy them sure, but we should have at least one good go-to routine for which we need nothing more than a bit of floorspace at home.

    If you’re unsure where to start with that one, we strongly recommend this book that we reviewed recently:

    Science of Pilates: Understand the Anatomy and Physiology to Perfect Your Practice – by Tracy Ward

    Second rule: troubleshoot up front

    With any given intended diet or exercise regime or other endeavor, we must ask ourselves: what could prevent me from doing this? Set a timer for at least 10 minutes, and write down as many things as possible. Then plan for those.

    You can read a bit more about some of this here, the below article was written about facing depression and anxiety, but if you can enact your plans when unmotivated and fearful, then you will surely be able to enact them when not, so this information is good anyway:

    When You Know What You “Should” Do (But Knowing Isn’t The Problem)

    Third rule: don’t err the same way twice

    We all screw up sometimes. To err is, indeed, human. So to errantly eat the wrong food, or do so at the wrong time, or miss a day’s exercise session etc, these things happen.

    Just, don’t let it happen twice.

    Once is an outlier; twice is starting to look like a pattern.

    How To Break Out Of Cycles Of Self-Sabotage, And Stop Making The Same Mistakes

    Enjoy!

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  • The Biological Mind – by Dr. Alan Jasanoff

    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 special is our brain? According to Dr. Alan Jasanoff, it’s not nearly as special as we think it is.

    In this work, he outlines the case for how we have collectively overstated the brain’s importance. That it’s just another organ like a heart or a kidney, and that who we are is as much a matter of other factors, as what goes on in our brain.

    In this reviewer’s opinion, he overcorrects a bit. The heart and kidneys are very simple organs, as organs go. The brain is not. And while everything from our gut microbiota to our environment to our hormones may indeed contribute to what is us, our brain is one thing that can’t just be swapped out.

    Nevertheless, this very well-written book can teach us a lot about everything else that makes us us, including many biological factors that many people don’t know about or consider.

    Towards the end of the book, he switches into futurist speculation, and his speculation can be summed up as “we cannot achieve anything worthwhile in the future”.

    Bottom line: if you’ve an interest in such things as how transplanting glial cells can give a 30% cognitive enhancement, and how a brain transplant wouldn’t result in the same us in a different body, this is the book for you.

    Click here to check out The Biological Mind, and learn about yours!

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  • 6 Signs Of Stroke (One Month In Advance)

    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.

    Most people can recognise the signs of a stroke when it’s just happened, but knowing the signs that appear a month beforehand would be very useful. That’s what this video’s about!

    The Warning Signs

    • Persistently elevated blood pressure: one more reason to have an at-home testing kit and use it regularly! Or a smartwatch or similar that’ll do it for you. The reason this is relevant is because high blood pressure can lead to damaging blood vessels, causing a stroke.
    • Excessive fatigue: of course, this one can have many possible causes, but one of them is a “transient ischemic attack” (TIA), which is essentially a micro-stroke, and can be a precursor to a more severe stroke. So, we’re not doing the Google MD thing here of saying “if this, then that”, but we are saying: paying attention to the overall patterns can be very useful. Rather than fretting unduly about a symptom in isolation, see how it fits into the big picture.
    • Vision problems: especially if sudden-onset with no obvious alternative cause can be a sign of neural damage, and may indicate a stroke on the way.
    • Speech problems: if there’s not an obvious alternative explanation (e.g. you’ve just finished your third martini, or was this the fourth?), then speech problems (e.g. slurred speech, trouble forming sentences, etc) are a very worrying indicator and should be treated as a medical emergency.
    • Neurological problems: a bit of a catch-all category, but memory issues, loss of balance, nausea without an obvious alternative cause, are all things that should get checked out immediately just in case.
    • Numbness or weakness in the extremities: especially if on one side of the body only, is often caused by the TIA we mentioned earlier. If it’s both sides, then peripheral neuropathy may be the culprit, but having a neurologist take a look at it is a good idea either way.

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Two Things You Can Do To Improve Stroke Survival Chances

    Take care!

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  • What Different Kinds of Hair Loss/Thinning Say About Your Health

    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.

    Dr. Siobhan Deshauer shows us different kinds of hair loss, what causes them, and what can be done about them:

    Many different causes

    Here’s how to tell them apart:

    • Alopecia areata is an autoimmune condition where the immune system mistakenly attacks hair follicles, causing hair loss that can occur at any age and affects about 1 in 50 people. It often presents as smooth patches of hair loss and can be treated with steroid injections. Severe cases may require high-dose prednisone, which can restore hair growth over time.
    • Discoid lupus is an autoimmune disease that affects the skin, leading to inflammation, scarring, and permanent hair loss. Unlike alopecia areata, it causes visible damage to the scalp and hair follicles. This type of lupus typically does not involve internal organs, unlike systemic lupus. 
    • Telogen effluvium occurs when a major systemic shock, such as an infection, surgery, or significant stress, triggers many hair follicles to enter the resting phase simultaneously, resulting in delayed hair shedding. The condition is diagnosed with a “hair pull test” and is typically temporary, as the resting phase is followed by normal hair growth phases.
    • Allergic reactions to products, such as hair dye containing PPD, can cause hair loss due to scalp irritation and inflammation. An allergic response may trigger hair follicles to enter a resting phase, leading to hair loss by the same mechanism as telogen effluvium. Treatment with steroids can calm the reaction, and hair usually regrows after recovery.
    • Syphilis, a sexually transmitted infection, can present with varied symptoms, including hair loss in a distinct moth-eaten pattern. Hair loss due to syphilis is reversible and curable with penicillin treatment, with hair regrowth typically occurring a few months after treatment.
    • Biotin deficiency is rare due to its production by gut bacteria and presence in foods such as nuts, seeds, and beans such as soybeans. Deficiency can result from excessive consumption of raw egg whites, which block absorption. Severe deficiency causes hair loss and skin issues but can be treated effectively with biotin supplements.
    • Iron deficiency anemia can cause hair thinning along with symptoms like fatigue and breathlessness. It often results from inadequate dietary intake, but can also occur after heavy menstrual bleeding. Treatment with iron supplements, or blood transfusions in severe cases, can restore both hair and energy levels, leading to significant improvements.
    • Trichotillomania is a psychological condition marked by an uncontrollable urge to pull out one’s hair, often associated with anxiety or depression. Hair patches may show different stages of regrowth. While it can be challenging to manage, the condition can be treated with appropriate psychological and medical support.
    • Traction alopecia results from hairstyles that exert prolonged tension on the hair, causing it to thin or fall out. This type of hair loss can be prevented by reducing the strain on the hair. Loosening hairstyles and giving the scalp a break can help hair regrow over time.
    • Hypothyroidism causes symptoms like fatigue, dry skin, and hair thinning due to insufficient thyroid hormone production—however, it can be managed with diet, and if necessary, thyroid medications.
    • Zinc deficiency may also cause hair loss and a characteristic rash. Treatment with zinc supplements can significantly improve hair growth and other symptoms.
    • Medications, such as chemotherapy drugs, Accutane, and anti-seizure medications like valproic acid, are known to cause hair loss as a side effect. This type of hair loss is often reversible once the medication is stopped.
    • Male pattern hair loss, or androgenic alopecia, is influenced by testosterone and genetic risk factors—which, contrary to popular belief, can come from either or both sides of the family. Early onset, especially before age 40, is linked to an increased risk of heart disease. However, effective treatments are available, and early intervention is beneficial.
    • Female pattern hair loss is basically the same thing as male pattern hair loss (indeed, it is literally still androgenic alopecia), just a) almost always much less severe and b) with a gender-appropriate name. It affects up to 40% of women by age 50 and is characterized by thinning hair at the top of the head. It’s related to hormonal imbalances involving testosterone, such as those seen in PCOS and menopause, amongst other less common causes. Early treatment can be effective, and research is ongoing to develop more targeted therapies.

    Dr. Siobhan Deshauer advises, if you’re experiencing hair loss, to monitor other symptoms too if applicable, take photos for tracking, and consult a doctor early for diagnosis and potential treatment.

    For more on all of this plus visual illustrations, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

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  • Unlock Your Air-Fryer’s Potential!

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    Unlock Your Air-Fryer’s Potential!

    You know what they say:

    “you get out of it what you put in”

    …and in the case of an air-fryer, that’s very true!

    More seriously:

    A lot of people buy an air fryer for its health benefits and convenience, make fries a couple of times, and then mostly let it gather dust. But for those who want to unlock its potential, there’s plenty more it can do!

    Let’s go over the basics first…

    Isn’t it just a tiny convection oven?

    Mechanically, yes. But the reason that it can be used to “air-fry” food rather than merely bake or roast the food is because of its tiny size allowing for much more rapid cooking at high temperatures.

    On which note… If you’re shopping for an air-fryer:

    • First of all, congratulations! You’re going to love it.
    • Secondly: bigger is not better. If you go over more than about 4 liters capacity, then you don’t have an air-fryer; you have a convection oven. Which is great and all, but probably not what you wanted.

    Are there health benefits beyond using less oil?

    It also creates much less acrylamide than deep-frying starchy foods does. The jury is out on the health risks of acrylamide, but we can say with confidence: it’s not exactly a health food.

    I tried it, but the food doesn’t cook or just burns!

    The usual reason for this is either over-packing the fryer compartment (air needs to be able to circulate!), or not coating the contents in oil. The oil only needs to be a super-thin layer, but it does need to be there, or else again, you’re just baking things.

    Two ways to get a super thin layer of oil on your food:

    • (works for anything you can air-fry) spray the food with oil. You can buy spray-on oils at the grocery store (Fry-light and similar brands are great), or put oil in little spray bottle (of the kind that you might buy for haircare) yourself.
    • (works with anything that can be shaken vigorously without harming it, e.g. root vegetables) chop the food, and put it in a tub (or a pan with a lid) with about a tablespoon of olive oil. Don’t worry if that looks like it’s not nearly enough—it will be! Now’s a great time to add your seasonings* too, by the way. Put the lid on, and holding the lid firmly in place, shake the tub/pan/whatever vigorously. Open it, and you’ll find the oil has now distributed itself into a very thin layer all over the food.

    *About those seasonings…

    Obviously not everything will go with everything, but some very healthful seasonings to consider adding are:

    Garlic and black pepper can go with almost anything (and in this writer’s house, they usually do!)

    Turmeric has a sweet nutty taste, and will add its color anything it touches. So if you want beautiful golden fries, perfect! If you don’t want yellow eggplant, maybe skip it.

    Cinnamon is, of course, great as part of breakfast and dessert dishes

    On which note, things most people don’t think of air-frying:

    • Breakfast frittata—the healthy way!
    • Omelets—no more accidental scrambled egg and you don’t have to babysit it! Just take out the tray that things normally sit on, and build it directly onto the (spray-oiled) bottom of the air-fryer pan. If you’re worried it’ll burn: a) it won’t, because the heat is coming from above, not below b) you can always use greaseproof paper or even a small heatproof plate
    • French toast—again with no cooking skills required
    • Fish cakes—make the patties as normal, spray-oil and lightly bread them
    • Cauliflower bites—spray oil or do the pan-jiggle we described; for seasonings, we recommend adding smoked paprika and, if you like heat, your preferred kind of hot pepper! These are delicious, and an amazing healthy snack that feels like junk food.
    • Falafel—make the balls as usual, spray-oil (do not jiggle violently; they won’t have the structural integrity for that) and air-fry!
    • Calamari (vegan option: onion rings!)—cut the squid (or onions) into rings, and lightly coat in batter and refrigerate for about an hour before air-frying at the highest heat your fryer does. This is critical, because air-fryers don’t like wet things, and if you don’t refrigerate it and then use a high heat, the batter will just drip, and you don’t want that. But with those two tips, it’ll work just great.

    Want more ideas?

    Check out EatingWell’s 65+ Healthy Air-Fryer Recipes ← the recipes are right there, no need to fight one’s way to them in any fashion!

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    Learn to Age Gracefully

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