SMOL Bowl With Sautéed Greens
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Whole grains are good, and gluten is bad for some people. Today’s dish has four whole grains, and no gluten (assuming no cross-contamination, so look for the gluten-free label if that’s important to you). Breafast? Brunch? Lunch? Supper, even? This is good at any time of day, packed with nutrients and full of flavor!
You will need (per person)
- 1 cup mixed cooked grains of equal parts sorghum, millet, oats, lentils (SMOL)—these can be cooked in bulk in advance and frozen in portions, as it’s often good to used mixed grains, and these four are a great combination for many purposes.
- ½ cup low sodium vegetable stock (ideally you made this yourself from vegetable offcuts you kept in the freezer until you had enough for this purpose, but failing that, low-sodium stock cubes can be bought at most large supermarkets).
- ½ cup finely chopped red onion
- 6 oz cavolo nero, finely chopped
- 1 small carrot, finely chopped
- 3 cloves garlic, finely chopped
- 1 tbsp nutritional yeast
- 1 tsp black pepper, coarse ground
- 1 tsp white miso paste
- To serve: 1 lemon wedge
Method
(we suggest you read everything at least once before doing anything)
1) Add the stock to a sauté pan over a medium heat, and add the onion, garlic, and carrot. Stir frequently for about 7 minutes.
2) Add the cavolo nero and miso paste, stirring for another 4 minutes. If there is any liquid remaining, drain it off now.
3) Warm the SMOL mixture (microwave is fine) and spoon it into a bowl, topping with the nutritional yeast and black pepper. Finally, add the hot cavolo nero mixture.
4) Serve with the lemon wedge on the side, to add a dash of lemon at will.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
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Metabolic Health Roadmap – by Brenda Wollenberg
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The term “roadmap” is often used in informative books, but in this case, Wollenberg (a nutritionist with decades of experience) really does deliver what can very reasonably be described as a roadmap:
She provides chapters in the form of legs of a journey [to better metabolic health], and those legs are broadly divided into an “information center” to deliver new information, a “rest stop” for reflection, “roadwork” to guide the reader through implementing the information we just learned, in a practical fashion, and finally “traveller assistance” to give additional support / resources, as well as any potential troubleshooting, etc.
The information and guidance within are all based on very good science; a lot is what you will have read already about blood sugar management (generally the lynchpin of metabolic health in general), but there’s also a lot about leveraging epigenetics for our benefit, rather than being sabotaged by such.
There’s a little guidance that falls outside of nutrition (sleep, exercise, etc), but for the most part, Wollenberg stays within her own field of expertise, nutrition.
The style is idiosyncratic; it’s very clear that her goal is providing the promised roadmap, and not living up to any editor’s wish or publisher’s hope of living up to industry standard norms of book formatting. However, this pays off, because her delivery is clear and helpful while remaining personable and yet still bringing just as much actual science, and this makes for a very pleasant and informative read.
Bottom line: if you’d like to improve your metabolic health, as well as get held-by-the-hand through your health-improvement journey by a charming guide, this is very much the book for you!
Click here to check out the Metabolic Health Roadmap, and start taking steps!
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Are You Taking PIMs?
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Getting Off The Overmedication Train
The older we get, the more likely we are to be on more medications. It’s easy to assume that this is because, much like the ailments they treat, we accumulate them over time. And superficially at least, that’s what happens.
And yet, almost half of people over 65 in Canada are taking “potentially inappropriate medications”, or PIMs—in other words, medications that are not needed and perhaps harmful. This categorization includes medications where the iatrogenic harms (side effects, risks) outweigh the benefits, and/or there’s a safer more effective medication available to do the job.
You may be wondering: what does this mean for the US?
Well, we don’t have the figures for the US because we’re working from Canadian research today, but given the differences between the two country’s healthcare systems (mostly socialized in Canada and mostly private in the US), it seems a fair hypothesis that if it’s almost half in Canada, it’s probably more than half in the US. Socialized healthcare systems are generally quite thrifty and seek to spend less on healthcare, while private healthcare systems are generally keen to upsell to new products/services.
The three top categories of PIMs according to the above study:
- Gabapentinoids (anticonvulsants also used to treat neuropathic pain)
- Proton pump inhibitors (PPIs)
- Antipsychotics (especially, to people without psychosis)
…but those are just the top of the list; there are many many more.
The list continues: opioids, anticholinergics, sulfonlyurea, NSAIDs, benzodiazepines and related rugs, and cholinesterase inhibitors. That’s where the Canadian study cuts off (although it also includes “others” just before NSAIDs), but still, you guessed it, there are more (we’re willing to bet statins weigh heavily in the “others” section, for a start).
There are two likely main causes of overmedication:
The side effect train
This is where a patient has a condition and is prescribed drug A, which has some undesired side effects, so the patient is prescribed drug B to treat those. However, that drug also has some unwanted side effects of its own, so the patient is prescribed drug C to treat those. And so on.
For a real-life rundown of how this can play out, check out the case study in:
The Hidden Complexities of Statins and Cardiovascular Disease (CVD)
The convenience factor
No, not convenient for you. Convenient for others. Convenient for the doctor if it gets you out of their office (socialized healthcare) or because it was easy to sell (private healthcare). Convenient for the staff in a hospital or other care facility.
This latter is what happens when, for example, a patient is being too much trouble, so the staff give them promazine “to help them settle down”, notwithstanding that promazine is, besides being a sedative, also an antipsychotic whose common side effects include amenorrhea, arrhythmias, constipation, drowsiness and dizziness, dry mouth, impotence, tiredness, galactorrhoea, gynecomastia, hyperglycemia, insomnia, hypotension, seizures, tremor, vomiting and weight gain.
This kind of thing (and worse) happens more often towards the end of a patient’s life; indeed, sometimes precipitating that end, whether you want it or not:
Mortality, Palliative Care, & Euthanasia
How to avoid it
Good practice is to be “open-mindedly skeptical” about any medication. By this we mean, don’t reject it out of hand, but do ask questions about it.
Ask your prescriber not only what it’s for and what it’ll do, but also what the side effects and risks are, and an important question that many people don’t think to ask, and for which doctors thus don’t often have a well-prepared smooth-selling reply, “what will happen if I don’t take this?”
And look up unbiased neutral information about it, from reliable sources (Drugs.com and The BNF are good reference guides for this—and if it’s important to you, check both, in case of any disagreement, as they function under completely different regulatory bodies, the former being American and the latter being British. So if they both agree, it’s surely accurate, according to best current science).
Also: when you are on a medication, keep a journal of your symptoms, as well as a log of your vitals (heart rate, blood pressure, weight, sleep etc) so you know what the medication seems to be helping or harming, and be sure to have a regular meds review with your doctor to check everything’s still right for you. And don’t be afraid to seek a second opinion if you still have doubts.
Want to know more?
For a more in-depth exploration than we have room for here, check out this book that we reviewed not long back:
To Medicate or Not? That is the Question! – by Dr. Asha Bohannon
Take care!
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High Histamine Foods To Avoid (And Low Histamine Foods To Eat Instead)
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Nour Zibdeh is an Integrative and Functional Dietician, and she helps people overcome food intolerances. Today, it’s about getting rid of the underdiagnosed condition that is histamine intolerance, by first eliminating the triggers, and then not getting stuck on the low-histamine diet
The recommendations
High histamine foods to avoid include:
- Alcohol (all types)
- Fermented foods—normally great for the gut, but bad in this case
- That includes most cheeses and yogurts
- Aged, cured, or otherwise preserved meat
- Some plants, e.g. tomato, spinach, eggplant, banana, avocado. Again, normally all great, but not in this case.
Low histamine foods to eat include:
- Fruits and vegetables not mentioned above
- Minimally processed meat and fish, either fresh from the butcher/fishmonger, or frozen (not from the chilled food section of the supermarket), and eaten the same day they were purchased or defrosted, because otherwise histamine builds up over time (and quite quickly)
- Grains, but she recommends skipping gluten, given the high likelihood of a comorbid gluten intolerance. So instead she recommends for example quinoa, oats, rice, buckwheat, millet, etc.
For more about these (and more examples), as well as how to then phase safely off the low histamine diet, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Further reading
Food intolerances often gang up on a person (i.e., comorbidity is high), so you might also like to read about:
- Gluten: What’s The Truth?
- Fiber For FODMAP-Avoiders
- Foods For Managing Hypothyroidism (incl. Hashimoto’s)
- Crohn’s, Food Intolerances, & More
Take care!
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Cure – by Dr. Jo Marchant
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The subtitle here, “a journey into the science of mind over body”, prompts an immediate question: is this book actually about science?
And yes, yes it is. It’s not about “positive energy” or “tapping into your divine essence” or anysuch. It’s about science, and scientific studies.
The author’s PhD is in genetics and medical microbiology, not metaphysics or something.
For those of us who read a lot of clinical studies about a lot of things (hi, regular researcher/writer here), we’re very used to placebo being used as a control in medical science.
“This drug performed no better than placebo” is generally considered a disappointing statement… But what if the placebo was already having a profound effect? Shouldn’t that be worthy of note too?
Dr. Marchant looks at more than just drugs, though, and also looks into the science (complete with EEGs and such) of hypnosis and virtual reality.
The writing style here is very accessible without skimping on science. This is to be expected; Dr. Marchant also has an MSc in science communication, and spent a time as senior editor of New Scientist magazine.
This isn’t a how-to book, but there are some practical takeaways too, specific things we can do to augment (or avoid sabotaging) any medications we take, for example.
Bottom line: placebo effect (and its evil twin, the nocebo effect) has a profound impact on all of us whether we want it or not, so we might as well learn about how it works and how to leverage it. This book gives a very good, hard science grounding.
Click here to check out “Cure” and get the most out of whatever you take (or do) for your health!
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Jamaican Coconut Rice
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This is a great dish that can be enjoyed hot or cold, as a main or as a side. It has carbs, proteins, healthy fats, fiber, as well as an array of healthy phytochemicals. Not to mention, a great taste!
You will need
- 1 cup wholegrain basmati rice (it may also be called “brown basmati rice“; this is the same) (traditional recipe calls for pudding rice, but we’re going with the healthier option here)
- 2 cans (each 12 z / 400g) coconut milk
- 2 cups (or 2 cans, of which the drained weight is comparable to a cup each) cooked black beans. If you cook them yourself, this is better, as you will be able to cook them more al dente than you can get from a can, and this firmness is desirable. But canned is fine if that’s what’s available.
- 1 large red onion, finely chopped
- ½ cup low-sodium vegetable stock (ideally you made this yourself from vegetable offcuts you saved in the freezer for this purpose, but failing that, low-sodium stock cubes can be bought at any large supermarket)
- 2 serrano chilis, finely chopped
- 1 Scotch bonnet chili, without doing anything to it
- 1 tbsp black pepper, coarse ground
- 1 tbsp chia seeds
- 1 tbsp coconut oil
- Garnish: parsley, chopped
Note: we have erred on the side of low-heat when it comes to the chilis. If you know that you and (if applicable) everyone else eating would enjoy more heat, add more heat. If not, let extra heat be added at the table via your hot sauce of choice. Sounds heretical, but it ensures everyone gets the right amount! It’s easy to add heat than to take it out, after all.
However: if you do end up with too much heat in this or any other dish, adding acid will usually help to neutralize that. In the case of this dish, we’d recommend lime juice as a complementary flavor.
Method
(we suggest you read everything at least once before doing anything)
1) In a big sauté pan, add the coconut oil, melt it if not already melted, and add the chopped onion and the chopped chilis, at a temperature sufficient to sizzle. Keep them all moving. Once the coconut oil is absorbed into the onion (this will happen before the onion is fully cooked), add the vegetable stock, followed by the coconut milk; mix it all gently to create a smooth consistency.
2) Add the rice, chia seeds, and black pepper; mix it all gently but thoroughly; turn the temperature to a simmer, and add the Scotch bonnet chili, without cutting it at all.
3) Cover and keep on low for about 20–30 minutes until the rice is looking done. Check on it periodically to make sure it’s not running out of liquid, but resist the urge to stir it; it shouldn’t be burning but paradoxically, once you start stirring you can’t stop or it will definitely burn.
4) Take out the Scotch bonnet chili, and discard*. Add the black beans.
*its job was to add flavor without adding the high-level heat of that particular chili. If you’re a regular heat-fiend, feel free to experiment with using sliced Scotch bonnet chilis instead of serrano chilis; just be aware that there’s a big difference in heat. Only do this if you really like heat. Using it the way we described in the main recipe is what’s traditional in the Caribbean, by the way.
5) Now you can (and in fact must) stir, to mix in the black beans and bring them back to temperature within the dish. Be aware that once you start stirring, you need to keep stirring until you’re ready to take it off the heat.
6) Serve, adding the parsley garnish.
(this example went light on the beans; our recipe includes more for a heartier dish)
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Should You Go Light Or Heavy On Carbs?
- Our Top 5 Spices: How Much Is Enough For Benefits?
- Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
- Burn! How To Boost Your Metabolism
- Capsaicin For Weight Loss And Against Inflammation
Take care!
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What you need to know about endometriosis
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Endometriosis affects one in 10 people with a uterus who are of reproductive age. This condition occurs when tissue similar to the endometrium—the inner lining of the uterus—grows on organs outside of the uterus, causing severe pain that impacts patients’ quality of life.
Read on to learn more about endometriosis: What it is, how it’s diagnosed and treated, where patients can find support, and more.
What is endometriosis, and what areas of the body can it affect?
The endometrium is the tissue that lines the inside of the uterus and sheds during each menstrual cycle. Endometriosis occurs when endometrial-like tissue grows outside of the uterus.
This tissue can typically grow in the pelvic region and may affect the outside of the uterus, fallopian tubes, ovaries, vagina, bladder, intestines, and rectum. It has also been observed outside of the pelvis on the lungs, spleen, liver, and brain.
What are the symptoms?
Symptoms may include pelvic pain and cramping before or during menstrual periods, heavy menstrual bleeding, bleeding or spotting between periods, pain with bowel movements or urination, pain during or after sex or orgasm, fatigue, nausea, bloating, and infertility.
The pain associated with this condition has been linked to depression, anxiety, and eating disorders. A meta-analysis published in 2019 found that more than two-thirds of patients with endometriosis report psychological stress due to their symptoms.
Who is at risk?
Endometriosis most commonly occurs in people with a uterus between the ages of 25 and 40, but it can also affect pre-pubescent and post-menopausal people. In rare cases, it has been documented in cisgender men.
Scientists still don’t know what causes the endometrial-like tissue to grow, but research shows that people with a family history of endometriosis are at a higher risk of developing the condition. Other risk factors include early menstruation, short menstrual cycles, high estrogen, low body mass, and starting menopause at an older age.
There is no known way to prevent endometriosis.
How does endometriosis affect fertility?
Up to 50 percent of people with endometriosis may struggle to get pregnant. Adhesions and scarring on the fallopian tubes and ovaries as well as changes in hormones and egg quality can contribute to infertility.
Additionally, when patients with this condition are able to conceive, they may face an increased risk of pregnancy complications and adverse pregnancy outcomes.
Treating endometriosis, taking fertility medications, and using assistive reproductive technology like in vitro fertilization can improve fertility outcomes.
How is endometriosis diagnosed, and what challenges do patients face when seeking a diagnosis?
A doctor may perform a pelvic exam and request an ultrasound or MRI. These exams and tests help identify cysts or other unusual tissue that may indicate endometriosis.
Endometriosis can only be confirmed through a surgical laparoscopy (although less-invasive diagnostic tests are currently in development). During the procedure, a surgeon makes a small cut in the patient’s abdomen and inserts a thin scope to check for endometrial-like tissue outside of the uterus. The surgeon may take a biopsy, or a small sample, and send it to a lab.
It takes an average of 10 years for patients to be properly diagnosed with endometriosis. A 2023 U.K. study found that stigma around menstrual health, the normalization of menstrual pain, and a lack of medical training about the condition contribute to delayed diagnoses. Patients also report that health care providers dismiss their pain and attribute their symptoms to psychological factors.
Additionally, endometriosis has typically been studied among white, cisgender populations. Data on the prevalence of endometriosis among people of color and transgender people is limited, so patients in those communities face additional barriers to care.
What treatment options are available?
Treatment for endometriosis depends on its severity. Management options include:
- Over-the-counter pain medication to alleviate pelvic pain
- Hormonal birth control to facilitate lighter, less painful periods
- Hormonal medications such as gonadotropin-releasing hormone (GnRH) or danazol, which stop the production of hormones that cause menstruation
- Progestin therapy, which may stop the growth of endometriosis tissue
- Aromatase inhibitors, which reduce estrogen
In some cases, a doctor may perform a laparoscopic surgery to remove endometrial-like tissue.
Depending on the severity of the patient’s symptoms and scar tissue, some doctors may also recommend a hysterectomy, or the removal of the uterus, to alleviate symptoms. Doctors may also recommend removing the patient’s ovaries, inducing early menopause to potentially improve pain.
Where can people living with endometriosis find support?
Given the documented mental health impacts of endometriosis, patients with this condition may benefit from therapy, as well as support from others living with the same symptoms. Some peer support organizations include:
- Endometriosis Coalition Patient Support Group (virtual)
- MyEndometriosisTeam (virtual)
- Endo Black, Inc. (Washington, D.C.)
- endoQueer (virtual)
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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